The Human Occupation & Wellbeing Journal
Welcome to The Human Occupation & Wellbeing Journal, a publication dedicated to understanding the multifaceted nature of human occupation and how it shapes and is shaped by wellbeing. We invite submissions that explore the diverse ways in which our occupations (daily activities) interplay with our health and wellbeing. Our journal is not only a forum for rigorous academic debate but also a space where critical perspectives and innovative insights can flourish, driving positive change for humanity (Unhu/Ubuntu). At HOWJ, we recognise that academia thrives on the diverse thoughts and experiences of individuals, leading to meaningful contributions to our communities. We are particularly keen to hear from voices that have historically been marginalised in the peer reviewed publishing arena. Whether you are a student with fresh, innovative insights or a scholar from a minoritised ethnic community or an author from the Global South, your unique perspectives are not only welcome but essential to broadening our collective understanding of how our daily occupations shape and are shaped by wellbeing. The HOWJ is founded as a necessary response to the persistent limitations in current occupational science and occupational therapy research. Today’s practices are often constrained by an unyielding adherence to narrow hegemonic practices, outdated methodologies, and an over-medicalisation of wellbeing that too often overlooks the rich and complex tapestry of social, spiritual, cultural, and subjective dimensions of human occupation. Rather than merely taking incremental steps to try and decolonise existing structures and systems as what traditional journals in this space are constantly grappling with, HOWJ is built from an uncolonised perspective, a system that prioritises humanity and cultural humility. The ethos statement and scope of The HOWJ can be found here.
Editotial Board: The Human Occupation & Wellbeing Journal
© 2025 [Author(s)]. This is an open access article distributed under the **Creative Commons Attribution 4.0 International License (CC BY 4.0)**, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Simulating Intimacy Without Disrobing: Teaching Relational Ethics Through Feeding and Oral Care
Background: At least four and potentially six of the eight basic activities of daily living (ADL) described in the Occupational Therapy Practice Framework involve the patient in a naked or partially-clothed state. Preparing occupational therapy students to assist with intimate ADLs such as bathing, toileting, and dressing poses unique challenges, particularly regarding relational and ethical dimensions of care. While active learning is widely supported in occupational therapy education, little evidence describes high fidelity methods for reproducing these private states. Methodology: This study examined an innovative feeding and oral care lab designed to replicate relational demands of intimate ADL care. The lab required second year students in a Master of Occupational Therapy program to alternate between the roles of therapist and patient while engaging in tasks such as feeding a partner and providing oral hygiene. Following the lab, 106 students across three cohorts submitted reflections which were qualitatively analyzed. Results: Students reported significant emotional complexity in both roles. As student-therapists, they noted discomfort with proximity, bodily functions, and navigating dignity, communication, and consent. As dependent student-patients, they described vulnerability, loss of control, and embarrassment. These reflections underscore core elements of relational ethics in practice, highlighting empathy, professionalism, cultural humility, and therapeutic use of self. This lab successfully simulated the emotional aspects of intimate ADLs in an educationally appropriate, safe environment, supporting self-discovery, emotional processing, and skill development. Conclusion: Findings suggest that high fidelity simulation should emphasize relational authenticity, and this lab experience is recommended for preparing occupational therapy students for the relational and ethical demands of intimate ADLs.
Copyright (c) 2026 Dr. Orli Weisser-Pike, Dr. Stephanie Lancaster (Author) https://creativecommons.org/licenses/by/4.0
The Role of a Non-Immersive Interactive Technology (BITS) in Enhancing Occupational Therapy Outcomes: A Pilot Study
Non-immersive interactive technologies offer cost-effective and engaging tools for rehabilitation, yet limited research has examined occupational therapists’ (OTs) perceptions of their effectiveness and clinical value. This study investigated how OTs view the role of these technologies in enhancing patient outcomes. Licensed OTs (N = 10) from acute care, inpatient, and outpatient settings completed a custom-designed survey assessing perceived benefits, challenges, and satisfaction. Data were analyzed using descriptive statistics and the One-Sample Wilcoxon Signed Rank Test. Results showed significant agreement that non-immersive technologies improve patient motivation (Z = −2.803, p = .005), engagement (Z = −1.990, p = .047), and therapy effectiveness (Z = −2.803, p = .005). However, responses regarding training adequacy (Z = −1.051, p = .293) and promotion of independence (Z = −0.314, p = .753) were more neutral. These findings suggest OTs value non-immersive technologies for supporting therapy but emphasize the need for training and integration strategies. The study highlights therapist perspectives as critical for guiding evidence-based adoption in occupational therapy practice.
Copyright (c) 2026 Jayla Carpenter, Thierry Lienou, Christopher Gaskins (Author) https://creativecommons.org/licenses/by/4.0
Doing, Being, Belonging and Becoming in the Occupation of Dumpster Diving
Background: Dumpster diving refers to the practice of salvaging edible food from commercial or residential waste containers. Although stigmatized and associated with poverty, recent public discourse suggests a shift towards greater visibility and acceptance, particularly in relation to sustainability and food waste reduction. From an occupational science perspective, dumpster diving remains largely unexplored. This scoping review aims to understand how food-related dumpster diving as an occupation can be conceptualized through the dimensions of doing, being, belonging, and becoming. Methodology: Guided by Arksey and O’Malley’s methodological framework, a scoping review was conducted. Data of nine studies representing over 120 individuals engaged in dumpster diving across Europe, North America, and Australia was used and analysed deductively. Findings: Findings portray dumpster diving as a multidimensional occupation. Doing involved planning, executing and activities related to conserving the food. Use of sensory and cognitive skills as well as risk management were highlighted. Being was reflected in identity formation, values, choice, and motivations ranging from food insecurity to activism and enjoyment. Belonging emerged through shared practices, social connections and knowledge exchange, while also shaped by encounters with authority. Becoming incorporated changes in diets, environmental awareness, self-sufficiency, and wellbeing, alongside potential health risks. Conclusion: This review demonstrates that dumpster diving can support meaning, participation, and wellbeing despite its non-normative and sometimes illegal nature. Recognizing dumpster diving as an occupation broadens occupational therapy’s understanding of human engagement and highlights the importance of addressing marginalized and non-sanctioned occupations, discussed here through the lenses of dark side of occupation, occupational justice and ecopation.
Copyright (c) 2026 Tanja Turtiainen MscOT, Anni Pekkanen MScOT, Ella Mutanen OT (Author) https://creativecommons.org/licenses/by/4.0
Perinatal Mental Health Inequalities Affecting Mothers from Ethnic Minority Backgrounds: A Qualitative Study of Occupational Therapy Students' Perspectives from Education to Future Practice
Background: Perinatal mental health inequalities remain a concern in the United Kingdom (UK), particularly for mothers from ethnic minority backgrounds who often face additional social and structural barriers to gaining support. This study aimed to explore how occupational therapy students understand these inequalities and how prepared they feel to work with mothers during the perinatal period. Methodology: A qualitative phenomenological design was used. A purposive sampling strategy was used, and semi-structured interviews were conducted with four occupational therapy students from a UK University. Data were analysed using Braun and Clarke’s six-phase thematic analysis to identify key themes in the participants accounts. Findings: Three themes emerged, pointing to gaps in confidence, understanding, and readiness for culturally responsive work. Students described different levels of awareness of perinatal mental health, with some drawing on placement experience while others relied more on personal or informal knowledge. Students felt that the lack of focused teaching on perinatal mental health and cultural humility sometimes made it harder for them to work out how their academic learning should translate into everyday practice. Conclusion: Overall, the findings suggest that clearer curriculum guidance and more practical learning opportunities may help prepare the future occupational therapy practitioners to deliver safe, fair and more inclusive perinatal mental health care and support.
Copyright (c) 2026 Karlene Ruddock (Author) https://creativecommons.org/licenses/by/4.0
Test-retest reliability and internal consistency of the Occupational Resilience Measure (ORM 1.0)
Background: The Occupational Resilience Measure (ORM 1.0) is a 20-item, multidimensional self-report tool for measuring occupational resilience, a construct defined as an individual’s ability to persist in performing occupations despite barriers. Objective: This study evaluated test-retest reliability and internal consistency and explored the extent to which ORM 1.0 is a reliable measure across a diverse range of activity types. Methods: Ninety-four participants completed the test and retest measurements within a 2- to 3-week period. A total of 202 activities were included in the analysis, grouped into leisure (LE) [94], productivity (PD) [35], and self-care (SC) [73]. Findings: The estimates of test-retest reliability (95% confidence interval [CI] ) for SC, LE, and PD were 0.863 (0.794,0.91), 0.860 (0.793,0.907), and 0.876 (0.771,0.935), respectively, indicating good reliability across the two time points for each of the three categories. The Cronbach’s alphas at time point 1 for SC, LE, and PD were 0.744 (0.666, 0.808), 0.711 (0.63, 0.778), and 0.694 (0.517, 0.818), respectively, suggesting acceptable to good internal consistency. Similarly, the estimates of Cronbach’s alpha at time point 2 for the three occupational categories were: 0.79 (0.725,0.842), 0.766 (0.7,0.82), and 0.775 (0.645,0.866), respectively, indicating good internal consistency at time point 2. Conclusion: The findings suggest that ORM 1.0 has test-retest reliability and internal consistency across leisure, productivity, and self-care activities. Further research is needed to strengthen ORM 1.0 as an evidence-based measure of occupational resilience.
Copyright (c) 2026 Bernard Muriithi, Milan Bimali, Kara Gore (Author) https://creativecommons.org/licenses/by/4.0
Adjustment Disorder, Life Transitions, and Occupational Disruption: Implications for Preventive Occupational Therapy Practice
Background: Adjustment disorder is a prevalent yet frequently underrecognized mental health condition defined as a maladaptive response to an identifiable stressor accompanied by clinically significant distress and functional impairment in social, occupational, or other important domains. Historically regarded as a residual or transient diagnosis, adjustment disorder has often been marginalized in both research and clinical practice. However, emerging evidence suggests that adjustment disorder is associated with sustained functional impairment, disrupted occupational participation, and prolonged difficulties in role performance, particularly during periods of major life transition. Methodology: This paper used a mixed methods approach presenting a narrative evidence synthesis of contemporary interdisciplinary literature through an occupational and wellness lens, supplemented by survey data from adults experiencing recent life transitions to explore perceived impacts on routines, roles, occupational engagement, and awareness of occupational therapy as a potential support. Findings: Findings indicate that adjustment disorder reflects a dynamic and reciprocal process in which occupational disruption and psychological symptoms mutually reinforce one another over time, rather than representing short-lived distress alone. Survey results similarly highlight the extent to which life transitions are experienced as occupationally disruptive, with respondents reporting sustained challenges in maintaining routines, balancing roles, and supporting wellbeing. Despite these challenges, awareness and utilization of occupational therapy were limited, although respondents identified occupation focused support as potentially valuable. Conclusion: By conceptualizing occupational performance and psychological symptoms as mutually reinforcing, this paper positions occupation-centered intervention not only as functional support but as a therapeutic mechanism capable of directly mitigating adjustment-related distress.
Copyright (c) 2026 Dr. Sue Persia (Author) https://creativecommons.org/licenses/by/4.0
Occupations Are Not Neutral: Toward Anti-Caste Occupational Therapy Praxis in India
Occupational therapy is often grounded in theoretical frameworks that conceptualise occupation as an expression of individual choice, motivation, and ability. While such approaches emphasise personal agency and functional performance, they frequently obscure the structural forces that shape occupational possibilities Drawing on occupational science, occupational justice, and anti-caste scholarship, particularly Ambedkarite and Dalit feminist frameworks, this conceptual paper theorises caste as a structural determinant of occupation within the Indian context. It argues that caste produces enduring conditions of occupational marginalisation, alienation, and occupational apartheid by determining access to education, labour, safety, dignity, and social recognition. The paper challenges the dominant assumption of “occupation as choice,” demonstrating how this notion is largely illusory for Caste-oppressed communities whose occupational trajectories are constrained by inherited social location, stigma, and systemic exclusion. In response, the paper offers a theoretical reframing of occupational justice through an anti-caste Ambedkarite lens, advances an epistemic critique of caste neutrality in occupational therapy, and highlights implications for curriculum reform and practice.
Copyright (c) 2026 Preethi Shanmugapriya (Author) https://creativecommons.org/licenses/by/4.0
Our Identity, Promise, and Responsibility: Our Perspective
In this personal reflection, the miscasting of Dian Fossey, the primatologist, conservationist and occupational therapist, in the 1988 movie "Gorillas in the Mist" provides a lens to explore the seemingly enormous challenge of describing one of healthcare’s most important - and most misunderstood - health professions: occupational therapy. This challenge leads directly into longstanding, ongoing debates around defining occupational therapy: who are we, what do we do, and why does that distinction matter, perhaps now more than ever?
Copyright (c) 2025 Professor Gavin Jenkins, Rachel Ashcraft (Author) https://creativecommons.org/licenses/by/4.0
The Lion’s Right to Speak: Historical Erasure, Constitutional Memory, and the Politics of “Progress”
In a world where "progress" is increasingly weaponised as justification for historical erasure, the deliberate suppression of national memory poses a direct threat to democracy, justice, and human rights. This article interrogates how state-led narratives of being "too progressive" or "protecting children" function as strategies of governance that distort constitutional purpose and undermine collective wellbeing. Through comparative analysis of curriculum restrictions and book bans in the United States, the systematic silencing of Gukurahundi in Zimbabwe, and the bureaucratic erasure of the Windrush scandal and Chinese seamen deportations in the United Kingdom, this work argues that the constitutional duty to preserve collective memory is fundamental to safeguarding citizenship, dignity, and rights. Drawing on postcolonial theory, decolonial jurisprudence, feminist epistemology, and queer legal theory, this article argues that historical erasure operates as epistemic violence: a form of structural harm that fractures communities, sustains intergenerational trauma, and undermines the conditions necessary for meaningful democratic participation. The article examines the transformative potential of truth and reconciliation commissions, exploring how societies that confront the past through inclusive, transparent processes more effectively uphold the rights to protest, to speak, and to live with dignity. It proposes a jurisprudence of remembering that recognises memory as a constitutional right essential to both justice and healing. Ultimately, it calls for a re-conceptualisation of constitutional memory as a living archive of dissent and survival, one that guarantees the lion's right to speak, and the state's obligation to listen.
Copyright (c) 2026 Lisa Shoko (Author) https://creativecommons.org/licenses/by/4.0
Exploring Occupational Justice for Black University Students in the United Kingdom: A scoping review
Background: Occupational justice is a core concept within occupational science, concerned with equitable access to meaningful, health-promoting occupations across the life course. Within higher education (HE), occupational injustices may arise through structural racism, discriminatory institutional cultures, exclusionary curricula, and restricted access to academic and social participation. For Black students in the United Kingdom, these injustices shape educational engagement, occupational identity development, mental health, and future life opportunities. This scoping review aimed to systematically map and synthesise existing evidence on occupational injustice experienced by Black university students in the United Kingdom, using an occupational justice lens to illuminate how structural and institutional factors shape participation, wellbeing, and inclusion within higher education. Methods: This scoping review followed Arksey and O’Malley’s methodological framework. A comprehensive search of MEDLINE, APA PsycINFO, and CINAHL Ultimate identified studies published between 2022 and 2025 that explored Black students’ lived experiences within UK HE. Study selection was conducted using explicit inclusion and exclusion criteria. Data were charted systematically and presented in thematic summaries. Results: Five peer-reviewed qualitative studies conducted in England met the inclusion criteria. Three interrelated themes were identified: (1) structural marginalisation and exclusion within higher education; (2) occupational deprivation through restricted access to social, cultural, and institutional capital; and (3) hope, resistance, and possibilities for occupational justice. Conclusions: This scoping review demonstrates that occupational injustices experienced by Black students in UK higher education are deeply embedded within institutional structures and cultures. Applying an occupational justice lens reveals higher education as spaces where inequities are reproduced but also contested. This study necessitates a shift toward decoloniality to address the foundational role of structural racism in shaping the contemporary UK academic landscape.
Copyright (c) 2025 Charmaine Tinarwo, Dr. Blaine Robin (Author) https://creativecommons.org/licenses/by/4.0
Balancing Excellence and Well-being: An Occupational Perspective on Anxiety Among Elite Performers
Background: Elite performers, such as business executives, athletes, and surgeons, face distinctive role demands that contribute to anxiety and psychological stress. Although prior research has explored anxiety within these groups individually, little is known about anxiety among high performers collectively or from an occupational lens. Aims/Objectives: This narrative review synthesizes current evidence on how individuals in high-performance occupations experience anxiety and examines the impact on occupational engagement, role fulfillment, and well-being. Methods: Twenty-eight peer-reviewed articles published between 2015 and 2025 were analyzed from CINAHL, PubMed, and Google Scholar, focusing on executives, elite athletes, and surgeons. Key Findings: Across domains, anxiety emerged as a pervasive and consequential experience shaped by perfectionism, role imbalance, and continual evaluation inherent to high-stakes performance. Effective strategies identified include adaptive coping strategies, such as mindfulness and mastery coping, as well as supportive work environments and engagement in restorative or serious leisure occupations. Conclusions: These findings highlight the potential for occupational therapy to address the contextual and role-based contributors to anxiety, promoting optimal performance and psychological well-being in high-demand professions.
Copyright (c) 2025 Kristen Bowie, Dr. Corey A. Peacock (Author) https://creativecommons.org/licenses/by/4.0
Occupational Resilience (Part 1): Origins and Significance to Health and Well-being
Occupational resilience (OR) is a novel concept emerging in occupational therapy and occupational science, with significant implications for the field. However, its definition is still evolving and needs clarity and consensus. In this article, we offer a definition inspired by the real-life experiences of refugee immigrants who have been resettled in the United States of America (USA). We define OR as the ability to persist in an occupation, where the duration and intensity of engagement are the essential contributors. Therefore, we propose that three elements, occupation, intensity, and duration, constitute the nature of OR and shape how occupation impacts health, either positively or negatively. We argue that OR is both measurable and modifiable, and we draw on the experiences of refugee musicians to gain insights and suggest how to enhance persistence in occupation over extended periods. We believe that OR is relevant to all kinds of human occupations, the various things people do throughout their lives. To support health, measures of OR must be applied judiciously because the link between occupation and health is complex, rarely following simple linear principles. Despite the complexity of the links between OR and health, we argue that the construct is of high significance in clinical practice, experimental research, and epidemiological studies.
Copyright (c) 2025 Dr Bernard Muriithi, Dr. Jyothi Gupta (Author) https://creativecommons.org/licenses/by/4.0
Occupational Resilience (Part 2): Toward a Cross-culturally Relevant Measure of a Novel Construct
Occupational resilience (OR) refers to an individual’s ability to persist in performing an occupation, with the duration and intensity of engagement determining resilience for each occupation. It is a key determinant of both the manner and the extent to which occupations influence health; therefore, it is a promising construct with several potential applications. There are currently no validated OR measures; which problematizes its application. Three considerations were made in designing the Occupational Resilience Measure (ORM 1.0) and evaluating its potential as a cross-culturally relevant measure of OR: 1) the findings of a published study of lived experiences of refugees from non-Western cultures; 2) Western occupational therapy theories, and 3) evaluations of six American occupational therapy scholar-clinicians. The qualitative study identified five factors that produced sustained participation in one occupation [music]. Four of these factors were developed as subscales of ORM 1.0, namely, History, Experience, Benefits, and Adaptation. On evaluating links between these factors and Western theories, we found constructs that closely align with the four factors, which are measurable and/or modifiable variables associated with long-term occupational performance. Lastly, we considered the results of six American scholar-clinicians who evaluated ORM 1.0 via an anonymous survey and supported the tool as valid, clinically relevant, and unique. The high degree of correspondence between the four ORM 1.0 factors and Western constructs suggests strong cross-cultural relevance. We recommend further studies and cross-cultural application and testing of ORM 1.0 in clinical practice and research.
Copyright (c) 2025 Dr Bernard Muriithi, Dr Milan Bimali (Author) https://creativecommons.org/licenses/by/4.0
Occupational Therapy Students’ Confidence in Building Rapport with Clients During Level II Fieldwork
Background: Occupational therapists regard rapport as a critical element to provide quality client-centered care using an intentional and personal therapist-client relationship. This study aimed to describe OT students’ confidence in client rapport-building skills during level II fieldwork. Knowledge of improvement areas with key components to building rapport would inform OT education. Methods: A quantitative, descriptive survey was administered to OT students across the South-eastern United States from winter 2024 to spring 2025. Findings: Results indicate that a variety of factors, including undergraduate background, graduate degree level, and fieldwork experience, influence OT students’ confidence in various areas of rapport building with clients. Of 36 respondents, it was found that, on average, students entering their second level II rotation were 4% more confident in various aspects of client rapport building than students entering their first level II rotation, demonstrating an increase in confidence with continued experience. This 4% difference occurred over a three-month period, on average, indicating early career continued growth in rapport confidence would be substantial. Additionally, rapport building components of empathizing with clients, being on time and prepared, and maintaining professional boundaries with clients were rated highest confidence by respondents. Conclusion: Gaining confidence as an occupational therapy student is important sequentially from didactic learning to experiential learning. Mastering confidence with rapport building, however, is an ongoing learning process throughout an OT career. Continued research on rapport building is needed and foundational to effective, client-centered occupational therapy practice.
Copyright (c) 2025 Taylor Butts, Sydney Hickox, Molly Henkes, Lydia Nobles, Sabrina Rodgers, Anna Stansell, Laurie Vera, MHS, OTR/L, Ryan M. Carrick, PhD, MHS, OTR/L (Author) https://creativecommons.org/licenses/by/4.0
An Occupational Therapy–Led Multifactorial Fall Prevention Program for Community-Dwelling Older Adults: A Pilot Feasibility Study
Background: Falls threaten older adults’ independence and participation in meaningful occupations. From an occupational therapy perspective, fall prevention extends beyond reducing injury risk; it sustains connection, autonomy, and belonging within one’s community. This pilot study examined the feasibility, acceptability, and community impact of an occupational therapy–led, occupation-focused fall prevention program designed to enhance safety, participation, and collective well-being among community-dwelling older adults. Methodology: A quasi-experimental pretest-posttest pilot study was conducted at a community site (seven enrolled; six completed). Six weekly sessions integrated exercise, education, and environmental strategies mapped to the Occupational Therapy Practice Framework, Fourth Edition. Feasibility indicators included recruitment, retention, fidelity, acceptability, and contextual barriers. Secondary outcomes included the Timed Up and Go (TUG), 30-Second Chair Stand, Activities-specific Balance Confidence (ABC) Scale, and Falls Efficacy Scale (FES). Quantitative data were summarized using medians and interquartile ranges and analyzed with Wilcoxon signed-rank tests (α = 0.10); effect sizes (r) estimated the magnitude of change. Results: All feasibility benchmarks were met (86% retention, high attendance, positive feedback). Median TUG improved from 14 to 11 seconds (r = 0.74), indicating a potential signal of improved mobility; other measures showed small, nonsignificant directional changes. Participants described increased confidence, mutual encouragement, and social connection, reflecting a shared commitment to safety and interdependence. Conclusion: An occupation-based, therapist-led fall prevention program was feasible and well received, fostering safe engagement in daily activities and social connectedness. Preliminary directional changes in mobility and confidence suggest potential benefits for future study of effects on participation and wellbeing. Interpreting outcomes through the doing, being, becoming, and belonging lens highlights how mobility practice, confidence, emerging routines, and mutual support can be advanced together in community programs.
Copyright (c) 2025 Dr. Lauren Healy, Dr. Nakia Lynn, Dr. Kristy Meyer (Author) https://creativecommons.org/licenses/by/4.0
“Learning without the fear of failure”: Ungrading as an alternative assessment method in occupational therapy education
Introduction: Mental health concerns among higher education students, especially those in professional graduate programs, have reached a critical level, prompting exploration of alternative pedagogical methods to alleviate stress and enhance learning. This study investigates the potential of ungrading, a system that minimizes or removes traditional grades in favor of frequent, formative feedback, within the context of two first-year entry-level occupational therapy courses. Methods: Through a mixed-methods approach using a survey design followed by a focus group, the authors gathered data from 17 students, examining their perceptions of ungraded assessment versus traditional grading. Findings: Results indicated that if given the option, most students (94%) would choose ungraded classes for learning and retention, citing reduced stress, increased faculty support, and greater comfort in collaborative environments. Qualitative data revealed themes of decreased anxiety, enhanced material comprehension, self-reflection opportunities, and a supportive classroom culture. However, students initially struggled to adjust to the absence of traditional grading, suggesting that structured feedback and consistent check-ins could facilitate the transition. Conclusion: This study contributes to emerging research on ungrading as a viable approach to supporting student mental health and engagement, while aligning with occupational therapy education ideals. Future research should explore the broader applicability of ungrading across health professions and investigate faculty experiences with this assessment model.
Copyright (c) 2025 Dr. Brittany C. Adams, Dr. Alexis M.F. Morin (Author) https://creativecommons.org/licenses/by/4.0
Smartwatches' Influence on Health Behavior Change and Occupational Engagement Among African American Students
Background: African American university students face disproportionate barriers to health and wellness, including elevated stress and limited access to wellness resources. Wearable technologies, such as smartwatches, offer promising tools for promoting health behavior change and occupational engagement in underserved populations. Methods: This cross-sectional study examined the relationship between smartwatch usage and perceived behavior change among 44 African American students. Participants completed a self-administered survey assessing usage frequency, duration, and perceived impact on daily habits. Findings: Pearson correlation analyses revealed a significant positive association between the frequency of smartwatch use and perceived behavior change (r = .302, p = .046), while duration of ownership showed no significant relationship. Conclusion: These findings suggest that consistent smartwatch use may support self-management and meaningful engagement in daily routines, positioning wearable technologies as valuable adjuncts to digital health strategies for minority student populations.
Copyright (c) 2025 Dr Thierry Lienou, Dr Jaleshia Washington, Alain Bagmi (Author) https://creativecommons.org/licenses/by/4.0
COVID-19 and NHS Rationing: Consequences for the Wellbeing and Care of Older Adults
Introduction: This paper critically examines the care of older adults during the early phase of the COVID-19 pandemic (March–June 2020), drawing on social and occupational justice theories. It highlights systemic neglect and advocates for equitable access to meaningful engagement, autonomy, and participation in health-related decision-making for older adults. Methods: A broad review was conducted using peer-reviewed literature, policy documents, UK print media, and international news sources such as CNN, Sky News, Al Jazeera through databases including the Cochrane Library, CINAHL, Medline, and Google Scholar were used. Findings: The analysis offers a contextual critique of NHS and social care resource management in the UK, serving as a benchmark to compare healthcare responses in the United States during the same period. It reveals a moral polarization between rationing and rationalizing elder care and argues that promoting Advance Care Directives risks undermining professional ethical commitments to the sanctity of life. Conclusion & Implications: For occupational therapists, this study provides a framework to examine and address structural determinants affecting older adults’ experiences, especially in crises. It calls for urgent, justice-oriented systemic reform that moves beyond reactive measures toward proactive preparedness. This paper advocates for the adoption of an Occupational Justice Audit Tool to guide equitable system responses, the establishment of mandatory community-based Advance Care Planning hubs and proactive policies to ensure equitable, dignified engagement for aging populations.
Copyright (c) 2025 Dr Regan R. Reid, Dr. Blaine Robin (Author) https://creativecommons.org/licenses/by/4.0
Welcome to The Human Occupation and Wellbeing Journal
Copyright (c) 2025 Dr Tongai F. Chichaya (Author) https://creativecommons.org/licenses/by/4.0
Perceived Outcomes of Intensive Family Therapy or Multi-family Therapy for Adolescents with Anorexia Nervosa and Their Families: A Literature Review
Background: Adolescents aged 15-19 have the highest incident rate for Anorexia Nervosa in the United Kingdom. They lose meaningful occupations which are often replaced with unhelpful occupations, habits and behaviours. Occupational therapists working within a multidisciplinary team can help these individuals navigate the occupational changes. Aims: To identify perceived outcomes of Family Based Therapy for adolescents with a diagnosis of AN and their families and its relevance to Occupational Therapy practice. Methods: A systematic search of EBSCOhost was completed in December 2024. This review included qualitative studies that concerned perceived outcomes of family therapy for adolescents with AN and their families. Six studies met the inclusion criteria and were quality appraised using CASP tool. The themes found were synthesised using the core themes of the Model of Human Occupation (MOHO). Key findings: Four main themes aligning to the MOHO were synthesised that focussed on health and wellbeing of those with eating disorders and their families. Perceived outcomes were mainly self-awareness, motivation and hope. Role changes within families eased guilt and improved relationships. Areas needing further attention were early focus on weight restoration and neglected emotional needs, parents’ preparation for discharge and adolescents’ willingness to work on skills to deal with body image and eating disorder behaviours. Conclusion: Occupational therapists collaborate with individuals and families to identify occupations that serve the eating disorder. They find meaningful alternatives by addressing routines and rituals around food and build skills to deal with emotional distress.
Copyright (c) 2025 Rebecca Scoggie, Preetee Gokhale (Author) https://creativecommons.org/licenses/by/4.0
Reimagining curricula and pedagogy in occupational therapy and occupational science education: Towards epistemic justice, cultural sensitivity and inclusion
Copyright (c) 2025 Dr Dave S.P. Thomas (Author) https://creativecommons.org/licenses/by/4.0
Tamba, dzidza, rarama (play, learn, live): Indigenous Shona games as foundations for life and therapy
Copyright (c) 2025 Moffat Makomo (Author) https://creativecommons.org/licenses/by/4.0
Using Appreciative Inquiry with disability stakeholders to develop a strategic action plan towards UNCRPD implementation in Namibia
Background: This study aimed to develop a strategic action plan for advancing the implementation of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) in Namibia. Methods: Utilising an appreciative inquiry action research methodology, two consultative meetings were conducted involving ten purposively selected disability stakeholders who had previously collaborated but faced organisational challenges leading to group disbandment. The appreciative inquiry 4-D cycle (Discovery, Dream, Design, Destiny) was used to guide the process, enabling stakeholders to leverage strengths and address challenges constructively. The appreciative inquiry approach focused on identifying successful strategies and positive attributes that could be used to effectively promote disability rights in Namibia. Findings: The findings highlight key enablers of action plan implementation, including collaborative work, effective use of human capital, and strong stakeholder commitment. These factors were reinforced by regular meetings, transparent information sharing, and joint awareness-raising programs. Participants harnessed their collective strengths through open communication and mutual respect, leading to the development of a strategic action plan. Conclusion: Appreciative inquiry action research methodology proved effective in developing a strategic action plan to promote the UNCRPD implementation in Namibia. By emphasising positive aspects and leveraging collaborative strengths, stakeholders were able to align efforts towards advancing disability rights within the country.
Copyright (c) 2025 Dr Gwarega Chibaya, Associate Professor Deshini Naidoo, Professor Pragshine Govender (Author) https://creativecommons.org/licenses/by/4.0
A Poo Protest Inspired Contemplation on Three Provocations to Occupational Therapists and Occupational Scientists
Copyright (c) 2025 Dr Frank Kronenberg (Author) https://creativecommons.org/licenses/by/4.0
Occupational transition experiences of international occupational therapy students studying at a university in the United Kingdom
Introduction: The occupational transition of starting university education is typically a time filled with anticipation and enthusiasm. The transitional phase can be anxiety-inducing, more so for individuals relocating to another country to study. The primary aim of this study was to explore the experiences of international occupational therapy students during occupational transitions associated with moving from their home country to study occupational therapy at a university in the United Kingdom (UK). Methods: A qualitative phenomenological study design was used in this study. Semi-structured interviews were conducted with nine participants who were recruited through purposive sampling. NVivo 14 software was used for conducting thematic analysis. Findings: Three themes captured participants’ experiences of occupational transition. “I’ll just say in summary, it was difficult” described challenges with ‘doing’, including academic pressures, cultural differences, homesickness, and increased responsibilities. “I pretty much felt alone” reflected the amorphous nature of support, characterised by limited assistance, delayed communication, and gaps in support systems. “Adaptation is learning the lifestyle” highlighted coping strategies enacted through ‘doing’, such as building new friendships, maintaining regular contact with family and friends, exploring new occupations, and drawing on informal support networks. Conclusion: International occupational therapy students’ transitions to a UK university involve navigating intertwined academic, social, and cultural challenges that impact engagement in meaningful occupations. Embedding an occupational lens when supporting international students through clear signposting, timely responses, peer mentorship, inclusive activities, and opportunities to sustain or adapt familiar occupations can create environments in which international students not only manage the transition but thrive academically, socially, and personally.
Copyright (c) 2025 Vanessa Chitiyo, Msc (Author) https://creativecommons.org/licenses/by/4.0
Beyond Superpowers: Naming and Dismantling Ableism in Occupational Therapy Through the Lens of Lived Experience
This personal narrative explores the presence of ableism within occupational therapy through the lens of lived experience. It draws upon the reflections of a disabled and neurodivergent occupational therapist to highlight the ongoing challenges faced by those with long-term health conditions, disabilities, or neurodivergence in both accessing and delivering occupational therapy. From childhood interventions rooted in normative milestones to discriminatory assumptions during professional training, the piece illustrates how ableist practices remain embedded in the profession. The author recounts a year-long hospital stay following COVID-19 complications, where occupational therapy was fragmented, checklist-driven, and shaped more by service structures than by individual need. Upon discharge, statutory care reduced needs to minimal tasks, with little attention paid to autonomy, participation, or future planning. Returning to work involved navigating inaccessible systems, delayed adjustments, and being labelled “inspirational” merely for persisting. These experiences reveal how unconscious bias and structural barriers impact not only service users but also professionals with lived experience. The piece challenges occupational therapy to move beyond symbolic inclusion and towards meaningful anti-ableist practice. It calls for occupational therapists to confront internalised biases and outdated service models and to centre universal design, co-production, and needs-led assessments. It argues that the profession must shift from celebrating resilience in the face of exclusion to creating systems that genuinely support participation and belonging for all. Occupational therapy cannot promote occupational justice unless it first addresses the injustices within its own culture and practice.
Copyright (c) 2025 Rachel Booth-Gardiner (Author) https://creativecommons.org/licenses/by/4.0
Re-membering through Ubuntu consciousness: A decolonial approach to researching, understanding and healing trauma
Copyright (c) 2025 Maria Takaendisa Bsc, Msc (Author) https://creativecommons.org/licenses/by/4.0
Centering African Voices: An Afrocentric Exploration of the Meaning of Occupation in Occupational Therapy
Background: The concept of occupation is the foundation of occupational therapy practice. However, as a profession historically shaped by Western ideologies, occupational therapy’s foundational constructs may not fully resonate with African worldviews. This study aimed to explore how occupational therapy practitioners practicing in Sub-Saharan Africa define occupation. Methods: This study employed a critical qualitative methodology grounded in the theory of Afrocentricity. Semi-structured interviews were conducted with 20 occupational therapy practitioners across seven Sub-Saharan African countries. Participants were recruited through professional networks, and interviews were conducted via Zoom. Data were thematically analyzed, informed by Afrocentric theory. Findings: Four themes emerged: (1) Occupation as Collective and Contextual Practice, (2) Embedded Emotional and Spiritual Meaning, (3) Language and the Limits of Translation, and (4) Flexibility and Evolution of the Meaning of Occupation. Participants emphasized communal values, spirituality, and dynamic understanding of occupation grounded in local contexts, languages and knowledges, challenging individualistic and static Western definitions. Conclusion: These findings underscore the epistemological divergences between the Global North and the Global South’s understandings of occupation, highlighting the need to reframe occupation through Afrocentric perspectives. By centering African worldviews, the study offers new insights for expanding global occupational therapy theory and practice. Incorporating these understandings into education, policy, and cross-cultural collaboration can foster epistemic justice and ensure more culturally responsive care and support. Global occupational therapy must embrace diverse epistemologies to remain relevant and equitable.
Copyright (c) 2025 Dr Joana Nana Serwaa Akrofi (Author) https://creativecommons.org/licenses/by/4.0