Medicine and Health Sciences Commons^™

The Benefits And Barriers To Expanding Crna Programs In Michigan, Grace Van Zweden

Honors Theses

The demand for Certified Registered Nurse Anesthetists (CRNAs) and their delivery of safe, high-quality anesthesia care has increased significantly due to nationwide anesthesia provider shortages and the growing reliance on CRNAs to meet healthcare system needs. This demand underscores the importance of expanding nurse anesthesia programs in Michigan and across the United States to support nurses pursuing advanced education and to improve patient access to essential care within their communities. The CRNA profession has evolved over time to meet the changing needs of the healthcare system, and current CRNA programs require applicants to satisfy rigorous and highly specific admission criteria. …

Cultivating The Growing Self, Kelly Allen

The Open Journal of Occupational Therapy

Khanna Blithe O. Cortes-Amores, MAOT, OTRP, clinician, assistant professor at Cebu Doctors’ University, and co-founder of The Growing Self, a mental health occupational therapy clinic in Cebu, Philippines, provided the cover art for the fall issue of The Open Journal of Occupational Therapy (OJOT). The watercolor painting, titled Peace (2017), features a dreamlike image of a serene female figure with hair that merges into the limbs and branches of a tree. A leafy green vine winds upward around her torso, becomes transparent as it partly overlays her face, and defines the crown of her head. Colorful abstract petal and earthen …

The Importance Of The New Caregiver Codes In Occupational Therapy, Jayna Niblock, Elizabeth G. Hunter, Carli Dimeo, Jackson Miller, Manali George, Allison M. Martin, Samantha M. Barefoot

The Open Journal of Occupational Therapy

Occupational therapists play a critical role in supporting caregivers, a role that continues to grow with the rising number of unpaid family caregivers. Evidence shows that occupational therapists-led caregiver interventions, ranging from skills training to problem-solving and environmental modifications, significantly improve both caregiver and client outcomes. In 2024 and 2025, new Caregiver Training Services (CTS) and Current Procedural Terminology (CPT) codes were introduced, enabling occupational therapists to bill and allowing for reimbursement of caregiver education directly tied to client goals. While these codes offer a transformative opportunity to formalize and fund caregiver support, their adoption has been limited because of …

An Occupational Revolution: Reclaiming What Matters, Carol Lambdin-Pattavina, Wendy B. Stav, Nicole Quint, Sandee M. Dunbar

The Open Journal of Occupational Therapy

Intentional use of the word occupation to describe why, what, and how we do as occupational therapists and occupational therapy assistants is central to maintaining our professional identity and to centering occupation in everyday practice. Throughout occupational therapy's history, using occupation, as opposed to words such as task or activity, has fallen both in and out of favor in practice and education in the United States. Some argue that task and activity, while not reflective of the nuances of the word occupation, including meaning and purpose, are more accessible to external audiences than occupation, which is often confused with …

Policy Solutions For Traumatic Brain Injury: Advancing New York State's First Tbi Special Needs Assisted Living Program, Dianne Schwarz, Natalie F. Douglas

The Open Journal of Occupational Therapy

Traumatic Brain Injury (TBI) presents long-term challenges that are poorly addressed by traditional assisted living and nursing home models. In New York State, individuals with moderate to severe TBI are often placed in settings unequipped to provide cognitive, behavioral, and neurorehabilitative care. This policy and advocacy paper proposes the establishment of a Special Needs Assisted Living Program (SNALP) specifically for individuals with TBI. Drawing from clinical expertise, stakeholder engagement, and a discontinued but promising pilot program, this manuscript outlines the systemic barriers to TBI-specific care, including regulatory gaps, lack of Medicaid reimbursement, and limited public awareness. The proposed model integrates …

Occupational Therapy Student Perceptions Of Sexuality And Intimacy Education: A Cross-Sectional Study, Jennifer H. Barnett, Amanda K. Giles

The Open Journal of Occupational Therapy

Sexuality and intimacy are meaningful activities within the scope of occupational therapy (OT), encompassing valued roles and occupations that contribute significantly to a person’s health, well-being, and identity. Despite acknowledgement of their importance, many occupational therapists overlook these areas during routine assessment and intervention because of feelings of insufficient knowledge, comfort, and confidence. This study used a cross-sectional design to electronically survey 149 occupational therapy doctoral (OTD) students across their first, second, or third year of education to determine their perceptions of sexuality and intimacy education. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed via codebook …

Integrating Behavioral Health Practice Approaches And Occupational Therapy: Curricular Considerations, Kaylynn M. Garrison, Susan C. Burwash

The Open Journal of Occupational Therapy

Occupational Therapy programs preparing occupational therapists to work in the field need to enhance students' education surrounding mental/behavioral health (MH/BH) needs. Thus, a curricular approach is needed that not only includes OT conceptual practice models but also those practice approaches used in MH/BH care. Creating educational experiences that include knowledge from inside and outside OT establishes theoretical foundations that better equip students entering practice to address mental health needs of their clients. Further, educators can assist students to appraise the fit between specific practice approaches and OT practice. A review of current MH/BH literature found three common practice approaches used …

Exploring Career Pathways Of The Occupational Therapy Afwc Role: A Review Of Push, Pull, And Stay Factors, Kimberley Persons, Patricia Laverdure, Elizabeth Lequieu, Elizabeth D. Deiuliis

The Open Journal of Occupational Therapy

Academic Fieldwork Coordinators (AFWCs) are essential to occupational therapy (OT) education, yet little is known about the career pathways, retention, and attrition associated with this role. With increasing faculty turnover, understanding the factors that influence AFWC career decisions is critical. This mixed-methods study surveyed 187 OT educators across the US, including current, former, and never-serving AFWCs. A researcher-designed Qualtrics survey gathered demographic, quantitative, and open-ended qualitative data. Quantitative data were analyzed using chi-square tests; qualitative responses underwent thematic analysis. Respondents reported psychological (e.g., burnout, satisfaction), job (e.g., mentoring, administrative burden), organizational (e.g., support, workload), and leadership/team (e.g., recognition, collaboration) factors …

Optimizing Academic Success For Otd Students: A Lassi-Based Pre/Posttest Study On Intervention Effectiveness, Mica Rutschke, Dailen Castillo, Lauren Peyton

The Open Journal of Occupational Therapy

Graduate students frequently experience heightened anxiety that can interfere with academic performance, well-being, and persistence in graduate programs. This pilot study explored the effectiveness of a targeted academic intervention for Occupational Therapy Doctorate (OTD) students using the Learning and Study Strategies Inventory (LASSI) as a pre/post assessment tool. Ten first-year OTD students completed the LASSI at program entry and again after participating in a faculty-led intervention focused on growth mindset and anxiety management strategies. The intervention included a lunch-hour educational session on evidence-based techniques, such as mindfulness, test-taking skills, cognitive reframing, and stress regulation. Faculty advisors also used individualized LASSI …

Deliberate Practice In Occupational Therapy Education: A Conceptual Model For Professional Growth, Suzanne Marasco, Matthew A. Witenstein

The Open Journal of Occupational Therapy

In response to national calls for a more representative health care workforce, this conceptual paper proposes the Model of Deliberate Occupational Therapy Practice (MDOTP), which aims to enhance pedagogical strategies related to supporting, engaging, and leveraging students’ unique cultural and experiential assets. Grounded in the scholarship of integration, authors draw from three theoretical frameworks, Funds of Knowledge, Therapeutic Use of Self, and Street-Level Bureaucracy, to provide a robust foundation for refining psychosociocultural approaches in occupational therapy education. After describing the MDOTP, a subsequent set of Guiding Principles (encourage reflective practice, development of the professional self, incorporate community-based learning, and promote …

School-Based Executive Function Guideline (Sb-Efg): A Practice Guideline For Executive Function Assessment And Intervention In School-Based Practice, Ida Koraitem, Amanda Sarafian, Lenin Grajo

The Open Journal of Occupational Therapy

Executive functioning (EF) is comprised of various cognitive skills, such as working memory, inhibitory control, and cognitive flexibility, which monitor and guide goal-directed behavior and set a foundation on which healthy development may occur. Although the impact of EF skills on school participation has increasingly been recognized over the years, there are limited occupational therapy models that help occupational therapists integrate EF intervention into school-based practice. Children with limitations in EF have unique needs and challenges that impact school participation; therefore, it is imperative that occupational therapists address EF in school-based practice. This author- developed practice guideline discusses essential elements …

The Empower Model: A Framework For Fostering Neurodivergent Occupational Participation And Supporting Neurodiversity-Affirming Occupational Therapy Practice, Bryden Carlson-Giving

The Open Journal of Occupational Therapy

Neurodivergent occupations are ways of embodying life and experiencing the world that speak true to their neurotype; they are vivid, complex, and need to be fostered by the occupational therapy profession. Though the neurodiversity movement is garnering increased attention in the profession, the medical model of disability remains the dominating lens influencing occupational therapy services. Neuronormativity remains the ideal form of participation, which can lead to occupational therapists manifesting occupational marginalization with their neurodivergent clients. To date, there is a lack of practical frameworks supporting occupational therapists in integrating neurodiversity-affirming and anti-ableist principles into everyday occupational therapy practice. This paper …

Occupational Therapy For Ostomy Patients In Acute Care: A Case Series, Carolina Orozco, John V. Rider, Pamela Morales

The Open Journal of Occupational Therapy

Background: Ostomy surgery, which diverts stool or urine through an abdominal stoma, significantly impacts individuals’ physical and psychosocial functioning. Skilled education and training are required to promote independence in ostomy self-care. Occupational therapists are uniquely equipped to address these needs through holistic, person-centered approaches.

Method: This retrospective descriptive case series examines the integration of occupational therapy services, including ostomy-specific evaluation and intervention, for three patients in an acute care hospital.

Results: Three cases, varying in age, diagnosis, and functional status, demonstrate individualized occupational therapy interventions targeting activities of daily living, instrumental activities of daily living, and health management, emphasizing ostomy …

Interventions For Lgbtq+ Youth: A Scoping Review To Support Occupational Therapy Practice In The United States, Ricardo D. Ramirez, Iris Nosek, Alexandrea Guiritan, Annalise Valente, Francinne Fotopoulos, Jennifer Westrick

The Open Journal of Occupational Therapy

Background: Youth in the lesbian, gay, bisexual, transgender, queer/questioning, and other dissident genders and sexualities (LGBTQ+) community face extensive health disparities and dynamic political landscapes. Occupational therapy (OT) has potential to support LGBTQ+ youth; however, there is limited guidance for occupational therapists and occupational therapy assistants seeking to implement evidence-based interventions with this population. Therefore, the purpose of this scoping review was to examine interventions within the scope of OT to support LGBTQ+ youth.

Method: We used Arksey and O'Malley’s framework to guide this scoping review and searched five databases: PubMed, Scopus, PsycINFO, CINAHL, and Google Scholar. Using …

Autism And Air Travel, Joceline Rodriguez, Riley Rynders, Mckenzie Guth, Divya Sood

The Open Journal of Occupational Therapy

Background: Autistic children frequently encounter several difficulties during travel, especially in airport environments. This research study aimed to investigate the perceptions of parents of autistic children, as well as airport and airline staff, regarding the support available and barriers these children encounter during air travel.

Method: A qualitative descriptive design was used, involving data collection through interviews with two distinct groups of participants: airport and airline staff (n = 4) and caregivers of autistic children (n = 5).

Results: Caregiver participants shared that having access to quiet spaces, sensory rooms, and more readily available information on accommodation …

Group Occupational Therapy Sessions Using Hippotherapy: Growth Of Resilience And Leadership In Youth Facing Adversity, Marra I. Robert, Julie Jacob, Gerry Conti, Laura Alegre

The Open Journal of Occupational Therapy

Background: Youth experiencing adversity face significant challenges and are more likely to experience mental health concerns, low self-confidence, and difficulty with leadership skills, impacting their future occupational potential. This study examined the impact of using hippotherapy in a group occupational therapy intervention on the resilience, mental health, and leadership of youth facing adversity.

Method: Twenty-one youth experiencing adversity participated in a 10-week group occupational therapy intervention. Using a single-group pretest/posttest mixed-methods design, the Resilience Scale for Children and Adolescents (RSCA) was administered pr and postintervention alongside structured interviews.

Results: Quantitative results indicated statistically significant improvements in emotional …

Experiences Of Parents Of Children Diagnosed With Eating Disorders, Elizabeth C. Larson Traver, Crystal C. Barchacky

The Open Journal of Occupational Therapy

Background: Eating disorders are diagnoses found throughout the world regardless of race, gender, and age. Recovery for these diagnoses are typically demanding and on-going, leading parents and caregivers of those diagnosed to face substantial stress throughout the process. While many treatments use caregivers as agents of change, these are established with the client in mind and do little to aid the families through their own stress and decline in well-being.

Method: This qualitative phenomenological study explored the lived experiences of 10 caregivers during their children's recovery through in-depth interviews regarding that time of their lives. Participants were recruited via …

Promoting The Well-Being Of Refugee Students Through A Kawa-Guided Occupational Therapy Intervention: A Mixed-Methods Study, Suzanne Brederson, Heidi Baist, Jennifer E. Lape

The Open Journal of Occupational Therapy

Background: Refugee students newly enrolled in U.S. schools encounter academic, socialization, and mental health challenges because of trauma, language barriers, and cultural differences. Many have had limited or interrupted access to formal education in their home country. This study aimed to gain the perspectives of refugee students on their lived experiences and explore the impact of an occupational therapy intervention guided by the Kawa model on the well-being of this student population.

Methods: The researchers employed a convergent mixed-methods design. Refugee students (n = 8) created Kawa models, which provided rich, qualitative data. Participants completed pre and posttest surveys. Quantitative …

Effects Of The Lsvt Big® On Occupational Performance And Functional Skills In Parkinson’S Disease: A Case Study, Sandra J. Allen, Madison Gumm, Donald Stapleton, Lexee Trainer, Lydia Workman

The Open Journal of Occupational Therapy

Background: Parkinson’s disease (PD) leads to motor decline and reduced occupational performance. Limited evidence addresses if gains from the LSVT BIG® are sustained, particularly in occupation-focused outcomes.

Objective: This single-subject study evaluated the effects of the LSVT BIG® on occupational performance and functional skill outcomes in a 69-year-old woman with PD, and whether improvements were sustained 8 weeks postintervention.

Methods: The participant completed 16 1-hr LSVT BIG® sessions over 4 weeks. Outcomes included the Canadian Occupational Performance Measure (COPM), the Performance Assessment of Self-Care Skills (PASS), the Five Times Sit to Stand (FTSTS), and the Functional Reach Test (FRT). …

Solving The Problem Of Non-Linear Data In The Health Care Professions Using Spline Regression, Heather Staal, Rob Lyerla, Diane Powers Dirette

The Open Journal of Occupational Therapy

No abstract provided.

Bridging The Gap: Critical Resources For Grandparent Caregivers And Their Grandchildren, Kathy Dial, Cara Tonn, Omotomilola Jegede, Cindy Kekeh, Loriena Yancura, Michele Kekeh

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

US population estimates indicate that approximately 2.5 million children live apart from both parents. Family relatives, often called kinship caregivers, care for 70% to 90% of these children, with grandparents making up the largest category (Radel et al., 2016). This study aimed to identify the most helpful resources and sources for grandparent caregivers to support the overall well-being of their families. Phone or Zoom interviews were conducted among a purposive sample of 24 grandparent caregivers from February to March 2022 to examine their initial experiences as caregivers, the current support services and resources they received, and other resources and services …

Montana Kinship Navigator Program: A Statewide Frontier Initiative Promoting Kinship Family Health And Wellness, Daniel J. Koltz Dr., Peyton Vining, Yu Jiang

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

This practice brief report describes the development, implementation, and new updates of the Montana Kinship Navigator Program (MTKNP), a statewide initiative designed to support kinship caregivers in a large, rural frontier context. Montana’s geographic isolation, limited infrastructure, and sparse population create significant barriers for kinship families, including restricted access to healthcare, transportation, childcare, and social services. These challenges are compounded when caregivers unexpectedly assume responsibility for children, often with limited resources and support. MTKNP addresses these gaps through a comprehensive, evidence-informed model that integrates information and referral services with individualized case management. The program serves both formal and informal kinship …

The Health And Well-Being Of Grandparents Who Report Major Responsibilities For Grandchildren: Perceived Physical Health, Depressive Affect, And Life Satisfaction, Tze-Li Hsu Phd, Patricia Drentea Phd

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

This study examines how grandparents who report major responsibilities for their grandchildren experience perceived physical health, depressive affect, and life satisfaction compared to grandparents who do not report these responsibilities. Using data from the third wave of MIDUS (2013–2014), a nationally representative dataset focused on mid to later life (n = 1,819), we analyzed a sample of grandparents. Ordered logistic regression was used for perceived physical health, and ordinary least squares (OLS) regression was used for depressive symptoms and life satisfaction. Results indicate that grandparents with caregiving responsibilities are more likely to be women, non-White, and have lower incomes and …

The Effects Of Anti-Gdnf On The Sensory And Autonomic Nervous System In The Heart, Tryphosa Konadu

Honors Theses

Heart disease is the number one leading cause of death; about 1 in every five deaths is due to heart disease. “Heart disease” is a catch-all phrase that encompasses a variety of conditions that affect the heart’s structure and function. Many of these symptoms can be attributed to dysfunction within the parasympathetic, sympathetic, and sensory nervous systems. Neurotrophic factors like GDNF (Glial cell line-derived neurotrophic factor), BDNF (Brain-derived neurotrophic factor), and NGF (Nerve growth factor) promotes neuronal survival, and regeneration of the nerve fibers of the heart, especially sensory and autonomic nerve fibers. Studies have suggested that increased expression of …

Setting The Stage For Surviving Cancer, Kelly Allen

The Open Journal of Occupational Therapy

Margaret Petersen, theater artist and assistant stage manager of the Grand Rapids Ballet, is featured in the cover art for the Summer 2026 issue of the Open Journal of Occupational Therapy (OJOT). The self-portrait photograph depicts Petersen standing cheerfully on a terrace, dressed as an orange “safety cone” holding onto an IV pole. She takes in some fresh air as she receives her chemotherapy medication at the Lemmen-Holton Cancer Pavillion. Donned in orange coveralls and a modified hat topped with a small traffic cone and the word SAFETY emblazoned across the front, it is the costume she created to wear …

Occupational Therapy's Role In Optimizing Health Using 4ms Framework: Primary Care And Beyond, Nicole Karabas, Lydia Royeen, Bridget Hahn

The Open Journal of Occupational Therapy

As the older adult population in the United States continues to grow rapidly, the health care system faces increasing challenges in meeting their complex needs. A proactive, rather than reactive, approach to health care is necessary to support older adults in maintaining function and well-being. The Age-Friendly Health Systems 4Ms Framework; What Matters, Medication, Mentation, and Mobility, provides an evidence-based model for optimizing care across settings. Occupational therapists are uniquely positioned to implement the 4Ms framework because of their holistic and client-centered approach to evaluation and intervention.

By addressing "What Matters," occupational therapists  align care with individual goals and daily …

Occupational Therapists’ Emerging Role In Running Bereavement Support Groups, Diana Daus, Rondalyn V. Whitney, Susan Taddonio

The Open Journal of Occupational Therapy

Grief is well recognized as a stress response and, as such, significantly impacts engagement in meaningful occupational performance and engagement in meaningful occupations. Prolonged grief disorder (PGD), a newly recognized diagnosis, reflects the public health risk for the bereaved. Multiple client factors and performance patterns of those experiencing grief disrupt multiple areas of occupation. This opinion paper evaluates occupational therapy’s role in bereavement groups in the occupational therapy scope of practice.

Incivility And Toxicity In Occupational Therapy Academic Environments, Sharon Gutman, Sandra Rogers, Rondalyn V. Whitney

The Open Journal of Occupational Therapy

Toxicity in the academic environment is defined as an insidious form of behavior that is characterized by overt negativity with the intent to cause harm and includes bullying, manipulation, gas lighting, discrimination, preferential treatment, and ostracization. Reasons accounting for the existence of toxicity in academia include long-standing cultural norms of competition for scarce resources, devaluing of collaboration, unrealistic workload expectations and benchmarks for success, a milieu of excessive and negative critique, low salaries and professional rewards, and a hierarchical ranking system that encourages abuse of power without consequences. The impact of toxicity in academia on occupational therapy faculty include high …

Primary Care Reimbursement: Current Processes And Future Advocacy, Brenda Koverman, Monika I. Robinson, Lydia Royeen

The Open Journal of Occupational Therapy

Occupational therapy’s (OT) role in primary care is emerging as a viable practice area. Yet, operational efforts that include reimbursement continue to lag and have been identified as a barrier to entry. Current literature reveals confusing and overlapping reimbursement descriptions. Payment for services is critical for the sustainability of this practice area. This paper proposes a taxonomy to assist frontline clinicians, leaders, and provider practice managers to determine the best reimbursement strategy for their specific clinic. Differentiating and defining payment models, reimbursement determinants, and reimbursements methods allows OT leaders a shared language. Implementing the best reimbursement tactic will ensure the …

Practical Insights For Implementing An Intensive Therapeutic Day-Camp For Children With Hemiplegia: Guidelines For Practice, Rachel M. Vaughn, Holly Holland, Kerry Blazek, Jessica Margaret Cassidy

The Open Journal of Occupational Therapy

This guideline for practice provides practical recommendations for successfully executing a therapeutic day-camp for children with hemiplegia. By drawing from the literature and providing an in-depth explanation of our camp model, we address the challenges clinicians encounter when initiating therapeutic camp programming. A panel of physical and occupational therapists provides a comprehensive program description entailing a detailed explanation of camp programming, the combined therapeutic approach of intensive uni and bimanual training, and sample documents and activities. The program description, including camp attributes in relation to the ICF framework, provides an overview of our day-camp model, which has served children and …