Community means different things to different people - no single definition that captures the full meaning of the term
a specific group of people, often living in the same geographical area, who share a common culture, values, and norms are arranged in a social structure according to relationships that the community has developed over a period of time.
Often comes together to accomplish things that cannot easily be done alone
community includes more than a "geographic location for practice, but includes an orientation to collective health, social priorities, and different modes of service provision"
services are provided across the lifespan
includes a range of health-related services
prevention & health promotion
acute & chronic medical care
habilitation & rehabilitation
direct service provision
indirect service provision
George Barton & Eleanor Slagle developed CB programs in early 1900s
Barton - focused on utilizing occupations to enable convalescents to return to productive living
Slagle: created a program to provide persons with mental and/or physical disabilities as opportunity to work and become self-sufficient
OTs early work focused on prevention
expand OT practice
enhances understanding of OT
increases recognition of OT
influences health & social policy
provides opportunity for new leadership roles
groups in the AOTA vision 2030
maximizes health, well-being, and quality of life for all people, populations, and communities through effective solutions that facilitate participation in everyday living
any combination of educational and social supports for people taking greater control of and improving their own or the health of a geographic location
educational programs at sites include:
schools
employers/work sites
organizations
mass media
e.g. backpack program, ergonomics education
social approaches focus on
organizing individual
advocacy and support groups for individuals with certain conditions, diseases, risk factors
legal/political supports
economic factors
efforts to modify the socio-cultural, political, economic, and environmental contexts of the community of accomplish health-related goals
population-based approaches
typically initiated by health-care and govt agencies & involve community organization strategies
focus on community-wide change instead of individual change
seek to have an impact on systems that affect health in communities
generated by leaders & members of the community; existing community resources are utilized
principles of client-centered practice are followed -- the client is the entire community
goal: to promote community population, obtain new information, and enhance community autonomy
OTPs can identify occupational risk factors, engage in problem solving, develop and implement potential solutions to meet and optimize the community's occupational needs
advocate: identifies needs and speaks up for those needs
case manager: coordinate services
consultant: provide expert advice in program development
program manager: responsible for design, development, function, evaluation, budgeting, hiring, & supervision
private practice owner/entrepreneur: organizes a business venture, assessing and responding to the needs of the community
sense of positive hopefulness
understanding of individuals in their specific personal circumstances
creativity to envision a variety of possibilities
ability to set aside one's cultural, personal, and professional biases and respect individual choices rather than passing judgment
Knowledge competencies
Performance skill competencies
Critical reasoning competencies
Ethical reasoning competencies
Interpersonal abilities
Traits, qualities, & characteristics
conceptual framework that allows explanation & investigation of a phenomenon
client-centered
occupation-based
supported with evidence
based on dynamic systems theory
ecologically sound
strengths-based
attention to & consideration of:
context/environment
occupational risks factors
physical, social, cultural, temporal factors
habits, roles, routines, rituals (e.g. performance patterns)
health is based on personal, social, economic & ecological (environmental) factors
engagement serves to improve self-efficacy, identity, and participation that provides purpose & meaning
theory provides a foundation for thinking and is science driven & evidence-based
"systematic way of understanding events or situations" that describes the relationships between the constructs, concepts, and principles on which it is built
occupation-based
MOHO
Transactional Perspective of Occupation
Wilcock Doing, Being, Belonging, Becoming
Occupational Justice Approach
Occupation-focused health promotion approach
Non-occupation-based:
social cognitive theory
health belief model
transtheoretical model of health behavior change (stages of change)
precede-proceed planning model
1.9% of OTs work in a community setting
adult day care program, area agency on aging, community residential care facility, low vision programs, group hopes, prevention/wellness programs, retirement/assisted living, senior centers
opportunities for utilizing OT expertise and scope in community or population health practice are limitless but typically not designated as OT positions
to expand community-based OT, practitioners must seek out positions that although not labeled OT could benefit from unique contributions of OT