Browsing by Author "Jesus, Tiago S."
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- Barriers and facilitators for the practice of occupational therapy in mental health: findings from a global practitioner survey of the World Federation of Occupational TherapistsPublication . Jesus, Tiago S.; Monteiro, Pedro C.; Ledgerd, Ritchard; Zweck, Claudia von; Costa Monteiro, PedroOccupational therapists are health professionals with knowledge and capacity to address mental health (MH) needs and reduce MH workforce shortages worldwide. However, occupational therapists working in MH are often underrepresented within the MH and occupational therapy workforce. Using the perspective of occupational therapists with MH practice, the study aimed to: identify barriers and facilitators for occupational therapy practice in MH, and analyze differences in respondent or country level characteristics. The study involved secondary ecological analysis of survey responses. The survey was developed and disseminated by the World Federation of Occupational Therapists. Ordinal logistic regressions were used to determine whether individual- and country-level variables (e.g., demographic, socio-economic factors) significantly affected the survey responses. Survey responses (n = 1102) were obtained from 67 countries or territories. Of the nine surveyed factors, six (66%) were rated more often as barriers for practice, including “waiting times”, “services funding”, “intervention costs”, and “therapists availability”. “Screening & referral” and having “education /preparation for MH” were practice facilitators. Responses did not substantially vary by respondent or country-related factors, except for the Socio-Demographic Index which substantially and significantly affected the response pattern for “safety concerns” (estimate: 11.08; 95% CI:7.09-15.07; p<.0001). The results of this large worldwide survey of occupational therapists on the facilitators and barriers for practice in MH can help inform strategies to strengthen practice in this field. While referral and screening mechanisms should be reinforced to facilitate access to occupational therapy, such actions need to be complemented with adequate service funding, career attractiveness, and therapist availability; otherwise, increased service demands may result in unmet needs and service constraints. Further research is needed to investigate why “safety concerns” was a reported barrier particularly for countries with a lower Socio Demographic Index.
- Education of occupational therapists in mental health: A global survey of educators regarding perceived facilitators and barriersPublication . Jesus, Tiago S.; Monteiro, Pedro C.; Ledgerd, Ritchard; Zweck, Claudia von; Costa Monteiro, PedroOccupational therapists can address worldwide mental health (MH) needs and workforce shortages. Ways to advance occupational therapy education to build occupational therapist workforce capacity in MH require further investigation. This study aimed to identify perceived barriers to and facilitators for advancing MH occupational therapy education, as rated by occupational therapy educators from across the world, stratified into groups of high-income countries (HICs) and low- and middle-income countries (LMICs). Global survey, Likert-type, created and distributed by the World Federation of Occupational Therapists. Data were subject to a secondary weighted and subgroup analysis. A total of 155 responses were obtained from occupational therapy educators from 45 countries or territories; 69% of the respondents were from HICs. The weighted analysis showed that educational standards and student interest were large facilitators for both HICs and LMICs. Faculty expertise stood out as a facilitator and the lack thereof as a barrier, both across HICs and LMICs. For HICs, regulation issues, lack of recognition, lack of supervised/fieldwork practice, and lack of workforce demand were frequently reported barriers, whereas lack of teaching resources and practice evidence were often perceived as barriers in LMICs. Capacity building approaches are required to advance MH occupational therapy education, with tailored approaches for HICs and LMICs.
- Rural rehabilitation disparities and strengthening strategies: umbrella reviewPublication . Ayres, Stephanie Nicole; Monteiro, Pedro C.; Doyle, Nancy; Morrow, Corey; Jesus, Tiago S.; Costa Monteiro, Pedro"Rural residents with disabilities often experience healthcare disparities versus urban counterparts. To meta-synthesize the rural rehabilitation disparities, including access barriers, and the strategies for improving rehabilitation access for rural underserved populations. Methods: Umbrella review of the contemporary (2015-2024), English-language reviews focused on rural rehabilitation service-delivery gaps or strategies for adults or children with disabilities, with no country restrictions. Six scientific databases (Medline/PubMed, Scopus, CINAHL, Cochrane Library, PDQ-Evidence, REHABdata) were searched, supplemented by snowballing. Two independent reviewers performed full-text assessments and quality appraisals of the systematic reviews on intervention effects, using the Measurement Tool to Assess Systematic Reviews-2. Of the 530 records identified, 366 were unique references and 16 reviews were finally included, including 8 systematic reviews, two of them with meta-analyses. The 16 reviews included collectively synthesized information from 484 studies. Rural rehabilitation-access disparities were identified. For instance, those derived from supply shortages in low-density markets, workforce recruiting and retention issues, long travel requirements and costs, waiting times or low intervention intensity, and generalist versus specialist skills of the therapist workforce. Rural rehabilitation strengthening strategies were also identified. These include telehealth service options – benefits and challenges; outreach, home and community-centered approaches; navigator programs; and finally, task-sharing with (remote) specialist support. This umbrella review provides a meta-synthesis of the issues affecting equitable access to rehabilitation by rural populations and of the strengthening strategies to address those disparities. Alone or combined, these strategies might be tailored to and with local communities and interested parties for effective co-implementation."