Novel Practice Areas and Approaches to Service Delivery

Occupational therapy has an important and expanding role in non-traditional settings and emerging practice areas outside of the healthcare system. This has impacted types of service delivery models and expanded a focus on community-based practice and outcomes. Additionally, OT’s role in traditional medical care has evolved into new settings and functions. In response, there is a need to determine the effectiveness of both models of service delivery and the interventions.  

• Initiatives that emphasize health for all people are focusing on the social determinants of health or the “conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” ^{1 2} 

• OTs provide novel services in traditional medical settings (i.e., primary care; dental offices), although there is limited research identifying best models of practice.³ 

• In recent years, there is an increase in OT implemented through community health models where services are provided in non-medical and health settings. This includes cross-disciplinary work in areas such as trauma informed care, transportation, immigration, foster care, sensory-friendly environments, and the arts to identify only a few.^{4 5 6} 

• Population health programs, an emerging area of practice in OT, are often implemented through novel service delivery models and in non-traditional settings.⁷ 

• Telehealth and health information communications technologies are providing new avenues of service delivery to improve health care access and quality to meet the needs of medically underserved areas and populations. ^{8 9} 

Need and Relevance to Occupational Therapy 

Novel practice and service delivery methods has been identified as 

• a critical area to target to promote health and participation for all people 

• an area in which evidence-based measures and interventions are needed 

• an area where application of the unique expertise of occupational therapy would be highly beneficial 

The occupational therapy lens provides a comprehensive understanding of the person-environment fit to support performance of everyday activities and participation in home and community settings. This lens also bridges biomedical and sociocultural perspectives on the factors that support health and well-being at both person and population levels.¹⁰ 

Current knowledge, research training, measures and interventions in the emerging and novel practice areas are inadequate for addressing participation and health issues across the broad range of contexts.  AOTF is committed to the development of a scientific network and body of evidence to achieve effective and efficient advances in occupational therapy science in school, home, clinical, and community settings. 

Novel practice areas and approaches to service delivery have a dearth of research due to their recent emergence or expansion in occupational therapy. This provides a unique opportunity for occupational therapy scientists to establish and build the knowledge-base for the profession. There is also a need to develop a coordinated network for research in this area and train more occupational therapy researchers.  We believe a significant investment is needed to improve research in a range of emerging practice areas and novel service delivery methods in order to identify best practice and achieve better outcomes for a diverse group of consumers across a spectrum of conditions and settings. 

1. Office of Disease Prevention and Health Promotion. (2016). Social determinants of health. Retrieved from[Text Wrapping Break]http://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health 

2. Centers for Medicare and Medicaid Services. (2021). CMS issues new roadmap for states to address the social determinants of health to improve outcomes, lower costs, support state valued-based care strategies. Retrieved from https://www.cms.gov/newsroom/press-releases/cms-issues-new-roadmap-states-address-social-determinants-health-improve-outcomes-lower-costs 

3. American Occupational Therapy Association. (2020). Role of occupational therapy in primary care. American Journal of Occupational Therapy, 74(Suppl. 3), 7413410040. https://doi.org/10.5014/ajot.2020.74S3001  

4. Jaegers, L.A., Skinner,E., Conners,B. ,Hayes,C. ,West-Bruce,S. ,Vaughn,M.G.,...Barney,K.F. (2020).Evaluation of the jail-based Occupational Therapy Transition and Integration Services program for community reentry. American Journal of Occupational Therapy,74, 7403205030.https://doi.org/10.5014/ajot.2020.035287 

5. Paul-Ward, A., & Lambdin-Pattavina, C. A. (2016). The Issue Is—New roles for occupational therapy to promote independence among youth aging out of foster care. American Journal of Occupational Therapy, 70, 7003360010.http:// dx.doi.org/10.5014/ajot.2016.017426 

6. Silverman, F., & Tyszka, A. C. (2017). Centennial Topics—Supporting participation for children with sensory processing needs and their families: Community-based action research. American Journal of Occupational Therapy, 71, 7104100010. https://doi.org/10.5014/ajot.2017.025544 

7. Braveman, B. (2016). Health Policy Perspectives—Population health and occupational therapy. American Journal of Occupational Therapy, 70, 7001090010. http://dx.doi.org/10.5014/ajot.2016.701002 

8. American Occupational Therapy Association. (2018). Telehealth in occupational therapy. American Journal of Occupational Therapy, 72(Suppl. 2), 7212410059. https://doi.org/10.5014/ajot.2018.72S219 

9. U.S. Department of Health and Human Services. (2016). Health information technologies. Retrieved from[Text Wrapping Break]http://www.hhs.gov/ocr/privacy/hipaa/understanding/special/healthit/ 

10. American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010. https://doi. org/10.5014/ajot.2020.74S2001