Received: 16 January 2022 Accepted: 26 July 2022

DOI: 10.1111/1440-1630.12835

REVIEW ARTICLE

Profile of occupational therapy services in non-urban

settings: A global scoping review

Karen Hayes1 | Vagner Dos Santos1 | Moses Costigan2,3 | Danielle Morante4

1
School of Allied Health, Exercise and
Sports Sciences, Charles Sturt University,
Port Macquarie, New South Wales,
Australia
2
Manning Mental Health Unit, NSW
Health, Taree, New South Wales,
Australia
3
Providence Wellbeing, Port Macquarie,
New South Wales, Australia
4
Port Macquarie Base Hospital, NSW
Health, Port Macquarie, New South
Wales, Australia
Correspondence
Karen Hayes, School of Allied Health,
Exercise and Sports Sciences, Charles
Sturt University, 7 Major Innes Road, Port
Macquarie, NSW, Australia, 2444.
Email: khayes@csu.edu.au
Funding information
This research received no specific grant
from any funding agency in the public,
commercial, or not-for-profit sectors
Abstract
Introduction: Regional, rural, and remote people represent nearly half the
world’s population yet experience disproportionally higher disease, mortality,
and disability rates, coupled with limited healthcare access. Occupational ther-
apy has committed to occupational justice, yet no descriptive framework of
services provided by occupational therapists in non-urban locations exists.
Understanding current non-urban service practices will provide a basis for
non-urban service development and research to reduce this inequity.
Methods: Four databases were systematically searched for publications
describing non-urban occupational therapy services, from any country, written
in English, French, Portuguese, or Spanish, from 2010 to 2020. Publications
were screened against criteria for inclusion, and data were identified using an
extraction tool and presented in a frequency table, on a map, and in a search-
able supporting information Table S1.
Results: Only 117 publications were included discussing services provided to
populations across 19 countries. They were mostly published in English (98%)
and about populations from English-speaking countries (70%). Included publi-
cations discussed individualist services (65%), for defined age groups (74%),
and for people with specific medical diagnoses (58%). Services were commonly
provided in the client’s community (56%), originating from urban locations
(45%) where the provider travelled (26%) or contacted clients using telehealth
(19%). Individual 1:1 enabling strategies were most described (59%), including
remediation (34%), compensation (9%), or education (7%). Community enable-
ment strategies were infrequently described (14%), focused primarily on trans-
formation to improve existing service delivery (9%), with some redistributive
justice (3%), and one community development strategy (1%). Exploratory
research services accounted for the remaining studies (27%). Differences were
noted between Global North and South approaches.
Conclusion: Globally, occupational therapy has limited focus on non-urban
services and favours individualist rehabilitative strategies provided by

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© 2022 The Authors. Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.

Aust Occup Ther J. 2023;70:119–141. wileyonlinelibrary.com/journal/aot 119

120
therapists remote from the client’s context. Further research is required on the
effectiveness and appropriateness of occupational therapy strategies to
improve rural/urban inequity and health outcomes.
1 | INTRODUCTION
Globally, regional, rural, and remote (henceforth referred
to as non-urban) people experience higher mortality,
morbidity, and disability rates, while having less access to
health care, professionals, and funding (Scheil-
Adlung, 2015; World Health Organisation, 2021). This
non-urban inequity extends across countries, regardless
of development level, and amplifies existing inequities
such as race, gender, and social class, rather than being
explained by it (Taylor, 2019). For example, within the
same country, non-urban women are generally poorer
and sicker than urban women; non-urban people of col-
our are generally poorer and sicker than urban-based
people of colour (Taylor, 2019). The global occupational
therapy community stated its commitment to promoting
occupational justice and human rights (World Federation
of Occupational Therapists, 2019), including the right to
an adequate standard of living and health care services
for all people (United Nations, 1948). The inequity
between urban/non-urban populations within and
between countries is therefore of interest to occupational
therapists.
Increasing service access by enticing urban therapists
to non-urban spaces has been an area of research
for many years (e.g. Bell, 2011; Humphreys
et al., 2018; Lannin & Longland, 2003; Matichuk
et al., 2016; McAuliffe & Barnett, 2010; McKinstry &
Cusick, 2015; Playford et al., 2020; Roots et al., 2014; van
Rensburg & Du Toit, 2016; Wolfgang et al., 2014). While
strategies such as undergraduate workplace learning
placements in rural areas have been trialled to increase
the student preparation for, and understanding of non-
urban practice contexts (e.g. Humphreys et al., 2018; Mu
et al., 2004; van Rensburg & Du Toit, 2016), for many, the
contextual adjustment from urban to non-urban practice
is reported to be difficult and something for which many
feel unprepared (Cosgrave et al., 2018; Roots et al., 2014).
While providing opportunities to experience non-
urban life and practice during non-urban placements
allows some level of contextual preparation, it has been
suggested that urban focused practice models, research,
and education, tacitly suggest that urban practice is the
norm and non-urban is abnormal (Malatzky &
Bourke, 2016). Further, it has been suggested that until
the competencies required in non-urban occupational
therapy practice are understood, valued, and integrated
HAYES ET AL.
Key Points for Occupational Therapy
• Despite community level urban/rural inequity,
the most common non-urban services
described used an individualist rehabilitative
approach
• Non-urban services are frequently provided by
urban-based occupational therapists via out-
reach which may limit contextual
understanding
• Further research is required on how occupa-
tional therapy can address rural/urban
inequity
into, undergraduate education, attraction to, and engage-
ment in non-urban practice will continue to be limited
(Lannin & Longland, 2003; Roots & Li, 2013). However,
the scope and form of occupational therapy services pro-
vided in non-urban spaces remains poorly described.
This paper presents a profile of occupational therapy
services provided to non-urban people from a global
scoping review of over a decade of publications. In this
article, we will present the geographical and temporal
distribution of the publications and highlight global foci,
including the types of services discussed, to whom they
are provided, and how and where they occur. Better
understanding what, how, and where services are pro-
vided will help identify the current position of occupa-
tional therapy in meeting the pressing global need for
health service access in non-urban spaces, opportunities
for further research, and how the profession may better
prepare therapists for non-urban practice.
A secondary thematic analysis of the data, examining
the underpinning values expressed in publications about
non-urban services approaches, will be presented in a
subsequent article (Hayes et al., 2022).
2 | METHOD
This global scoping review followed the Joanna Briggs
Institute (JBI) methodology for scoping reviews (Peters
et al., 2020). A scoping review protocol was peer-reviewed
and published in the JBI Evidence Synthesis (Hayes
HAYES ET AL.
et al., 2021). A preliminary search of PROSPERO, MED-
LINE, the Cochrane Database of Systematic Reviews, and
JBI Evidence Synthesis was conducted, and no current or
in-progress scoping reviews on the topic were identified.
2.1 | Literature search and screening
Four electronic databases, MEDLINE (Ovid), CINAHL
(EBSCOhost), Emcare, and ProQuest Nursing & Allied
Health databases, were searched in September 2020. The
databased were searched for any and all publications
which discussed any type of occupational therapy service
provided to any persons living in non-urban locations
across the globe. A full search strategy for each database
is presented in Appendix A.
MEDLINE (Ovid, 2020b) and CINAHL
(EBSCOhost, 2020) databases were selected due to exten-
sive MESH aligned health catalogues (5600 and 4000
journals, respectively), whereas Emcare was selected for
its alternative catalogue of 1800 journals unavailable on
other databases (Ovid, 2020a). ProQuest was selected for
a strong catalogue of health literature and extensive grey
literature, including 12,300 dissertations
(ProQuest, 2020). All information sources, including
research and grey literature published from January 2010
to September 2020, in English, Spanish, French, and Por-
tuguese, were included to capture a contemporary range
and global scope. The second author, proficient in all
these languages, analysed the articles in these languages
in their original, untranslated format.
Publications were included if they reported services
provided by occupational therapists to any persons living
in non-urban environments. Occupational therapy ser-
vices included those provided to individual people,
groups of people, and or at a community level, whether
by the occupational therapist alone or as part of a multi-
disciplinary team. No exclusion criteria related to age,
ethnicity, gender, and health statuses were applied. The
review intended to define rurality using the Australian
Statistical Geography Standard of rural (non-urban) as
inner regional, outer regional, remote, or very remote
(Australian Bureau of Statistics, 2018; Hayes et al., 2021);
however, due to the lack of consistent definition of rural-
ity and remoteness across the globe (Carson et al., 2011)
and the inconsistent reporting of location in the exam-
ined publications, the reviewers relied on the study text
to report rurality. Publications reporting student issues or
placements, recruitment issues, professional development
access, or perspectives of being a rural occupational ther-
apist were excluded.
All retrieved citations were uploaded into Endnote
V9.2 (Clarivate Analytics, PA, USA) and duplicates
121
removed. The JBI System for the Unified Management,
Assessment and Review of Information (SUMARI) (Munn
et al., 2019) was used to complete the title and abstract
screen. However, after this initial screen, author access to
the JBI electronic SUMARI tool was restricted following
staff movements. The data were therefore transferred to a
Google Sheet™ to complete the full text screen and allow
access by all team members, while still maintaining the
overall JBI scoping review principles and process.
All titles and abstracts were screened against inclu-
sion criteria by two reviewers to progress to full text
review, and full text publications were again assessed by
two independent reviewers. The primary reason for
exclusion was recorded, and any disagreements between
the reviewers were resolved through discussion. Refer-
ence lists of all studies selected for inclusion in the review
were screened to identify additional studies.
2.2 | Data extraction
Each article was interrogated using a custom data extrac-
tion tool (See Appendix B: Data extraction tool), and the
resultant data were entered in a Microsoft Excel™
spreadsheet. Geographical spread was examined by deter-
mining the country, and where stated, the regions in
which the service was provided. The country was identi-
fied as either being in the Global North or South relative
to the Brandt line (Brandt, 1980). The Brandt line delin-
eates countries between the theoretical Global North and
South, based on level of development and political/
economic power, rather than pure North/South direc-
tionality (Brandt, 1980). For example, Australia, while in
the Southern hemisphere, is North of the Brandt line due
to its wealth, power, and economic development,
whereas India in the Northern hemisphere is part of the
Global South (Brandt, 1980). The Brandt line has been
found to remain relevant and reflective of relative levels
of development, wealth, and power in the present day
(Lees, 2021). The Global North and South have been
noted to differ between occupational therapy practice
approach (Dos Santos, 2017; Gerlach et al., 2018;
Laliberte Rudman, 2013) and conception of disability
(Dos Santos & Leon Spesny, 2016; Grech, 2016). Further,
a research bias has been noted that privileges Global
North research, limiting publication and citation of litera-
ture from these spaces (Reidpath & Allotey, 2019). Strati-
fying the publications between Global North and South
countries then allows examination of trends between the
different regions without limiting the impact of Global
South approaches.
The client served in each publication was classified as
either individual (including family where appropriate),
122
groups where clients with similar needs received service
collectively, or communities. Client age group was classi-
fied based on the publication text as children and fami-
lies, adults, elders, or all ages. The main diagnostic or
intervention group was recorded as free text and later
themed into like groups.
Service setting was extracted and classified as inpa-
tient, clinic, community, or virtual. Service origin was
classified as a local service already existing in the com-
munity, an outreach service where the provider either
travels or uses telehealth technology, a distant service
that the client travels to or an occupational therapist
trained/supervised worker who provides intervention
under supervision of a distantly based occupational
therapist.
Occupational therapy services were categorised into
six different enabling strategies used with individuals,
groups, and communities (Curtin, 2017). Enabling strate-
gies describe strategies occupational therapists use to
empower people to engage in meaningful occupations
(Curtin, 2017). Enabling strategies described in the publi-
cations describing interventions for individuals and
groups were classified as (1) remediation strategies to
improve personal physical, cognitive or emotional perfor-
mance; (2) compensation strategies which changed the
environment or task; or (3) education strategies to support
the client’s understanding of how they could improve per-
formance, whereas community level strategies were clas-
sified as (4) community development where the therapist
engaged in participatory capacity building with a commu-
nity, (5) transformation where the therapist partnered
with marginalised groups to build services to meet their
needs, or (6) redistributive justice where the therapist par-
ticipated in action or advocacy to improve the occupa-
tional rights of a community or population (Watson,
2006; Moyers, 2005, cited in Curtin, 2017). As many of the
papers used a research approach and did not use occupa-
tional therapy enablement strategies, an additional cate-
gory of ‘research only’ was added and research papers
were categorised as inductive exploratory or deductive.
Inductive research included non-participatory observa-
tions, focus groups, and interviews, whereas deductive
approach were mainly based on cross-sectional design.
2.3 | Data presentation
The data frequency of the publications is summarised in
a table and represented geographically on a world map.
The approximate position of the Brandt Line
(Brandt, 1980) has been represented on the map to visu-
ally demonstrate the division between Global North and
South countries. The frequency summary table overviews
HAYES ET AL.
of the scope of occupational therapy services provided
non-urban spaces and the relative number of publica-
tions from the Global North/South. Detailed extraction
data for each article are available in the searchable
Microsoft Excel™ spreadsheet supporting information
Table S1: Data Extraction Tool.
3 | RESULTS
Despite the broad criteria across more than a decade of
global publications, 117 articles were included (See
Figure 1: Flow diagram for the scoping review process
[Adapted from the PRISMA statement by Moher and col-
leagues cited Peters et al., 2020].). The supporting infor-
mation Table S2: Exclusions lists excluded publications
and primary reason for exclusion.
3.1 | Publication characteristics
Most publications were journal articles (99), conference
abstracts (10), and poster abstracts (5). Two (2) doctoral
theses, one defended in Australia and another in
United States of America (USA) (Dender, 2014;
Maxwell, 2010) and one (1) report (Jones, 2013), were
also examined. Nearly all conference abstracts and post-
ers were presented at occupational therapy conferences,
including the Australian Occupational Therapy National
Conference and Exhibition (6) (Fishpool et al., 2011;
Gauld et al., 2011a; Hickey et al., 2011; Hyett et al., 2011;
Kingston & Gray, 2011), the American Occupational
Therapy Association Annual Conference and Expo
(5) (Cronin, 2018; Hunter & Kitzman, 2018; Kahanov
et al., 2018; McGuire et al., 2015; Mroz, 2018), Royal Col-
lege of Occupational Therapists Annual Conference
(Britain) (2) (Carter et al., 2017; Smith & Cooke, 2017),
and the All India Occupational Therapists’ Association
Conference (OTICON’2019) (1) (Slaich, 2019). One poster
was presented at the Annual & Scientific Meeting of the
Irish Gerontological Society (McLoughlin et al., 2019).
Qualitative studies made up 35%, quantitative 29%,
and 9% were mixed methods. Theoretical descriptive
papers, including commentaries, reviews, and service
descriptions, made up 27% of included publications.
Nearly all the publications (115; 98%) were written in
English, one Brazilian study was written in Portuguese
(Costa, 2012), and one Columbian study in Spanish
(Gomez-Galindo et al., 2017). Three publications were
written in both French and English (Keightley
et al., 2011, 2018; Kiepek et al., 2015) and two in both
Portuguese and English (Macedo et al., 2016; Santos &
Aiache Menta, 2016).
HAYES ET AL. 123

F I G U R E 1 Flow diagram for the

scoping review process (adapted from
the PRISMA statement by Moher and
colleagues cited Peters et al., 2020)

F I G U R E 2 Significantly more studies (69%) were conducted with populations North of the Brandt Line in wealthier, more powerful
Global North countries, whereas South African populations were the most studied (16%) in the Global South

3.2 | Geographical distribution studies crossed multiple countries, 123 groups are repre-
sented. About 70% of the publications were from English-
The services described were provided to people in non- speaking countries (Australia, Canada, United Kingdom
urban spaces across 19 countries (See Figure 2). As some [UK], Ireland, and USA). Brandt Line stratification
124
(Brandt, 1980) identified significantly more publications
from the Global North (69%) compared with the Global
South (26%). Most Global North populations were
clustered in the United Stated of America (28%),
Australia (24%), and Canada (11%). South African popu-
lations were the most frequently studied in the Global
South (13%), with all remaining Global South countries
having between one and three studies each. Four of the
studies (3%) did not state in which country the popula-
tion lived.
3.3 | Temporal distribution
The 10 years from 2010 to 2020 demonstrated a mean of
10.9 (
4.1) publications annually with a frequency range
between 2 and 16 (See Figure 3).
3.4 | Occupational therapy services
provided
Table 1 summarises client groups served, and services
provided by occupational therapists
3.5 | Clients receiving services
Most publications described services provided to persons/
families on a one-to-one basis (65%), followed by commu-
nities (26%), and group interventions (10%). There was a
clear split across the Brandt line with community level
interventions described more commonly in global South
countries (57%) compared with Global North (13%).
South Africa accounted for 26% of all publications dis-
cussing community level interventions, followed by
Australia (23%), Canada (13%), and Brazil (10%).
HAYES ET AL.
3.6 | Client age groups
Most services discussed were limited by age groups (74%)
with 12% catering for all ages. South African populations
represented 50% of the all-age services. Conversely,
Global North countries of USA, Australia, and Canada,
while having the highest publication frequency rates
(64%), focused 91% on a single age group.
3.7 | Intervention/diagnostic groups
served
Most (58%) described services provided for specific
medical-diagnostic groups. The clinical population most
served were people who experienced an injury (21%), par-
ticularly people who experienced a neurological insult
(stroke, traumatic brain injury, and spinal cord injury)
(13%). Developmental diagnoses were the next most dis-
cussed group (20%), followed by clinical populations with
illnesses such as cancer or dementia (17%). Non-
diagnosis specific intervention groups such as First
Nations Communities, farmers, or people recovering
from natural disasters were discussed in 19%, whereas a
general focus on people with disability was described in
17%, and pure generalist services were discussed in 17%.
Global South publications more commonly discussed
generalist groups, including non-diagnostic intervention
groups (33%) and people with disabilities (30%) totalling
63% of Global South publications and representing popu-
lations from South Africa (11) and Brazil (2), Tanzania
(2), Kenya (2), Bangladesh (1), Columbia (1), Honduras
(1), Morocco (1), Burkina Faso (1), Ecuador (1). Indian
(3), Jordanian (1), and Arminian (1) studies all focused
on a single diagnostic group.
Conversely, 80% of Global North publications were
mostly diagnosis specific, particularly the USA (23),
F I G U R E 3 Publications per year 2010–
2020. *Publications included until 18 Sept 2020
HAYES ET AL. 125

TABLE 1 Summary of services provided to non‐urban populations described in the publications Global North/South location and
global total

Global north Global south Unstated Total

Service provided to:
Individuals (1:1) 63 (77%) 11 (37%) 2 76 (65%)
Groups 8 (10%) 2 (7%) 0 10 (9%)
Communities 12 (13%) 17 (57%) 2 31 (26%)
Age groups:
Children and families 27 (33%) 12 (40%) 1 40 (34%)
Adults 33 (40%) 4 (13%) 37 (32%)
Elders 8 (10%) 2 (7%) 10 (9%)
All ages 4 (5%) 10 (33%) 14 (12%)
Not stated 11 (13%) 2 (7%) 3 16 (14%)
Diagnosis/intervention groups:
Injury
Neurological insult 11 (13%) 1 (3%) 2 14 (12%)
Hand injury 6 (7%) 0 (0%) 1 7 (6%)
Orthopaedic injury 2 (2%) 0 (0%) 2 (2%)
Falls 1 (1%) 0 (0%) 1 (1%)
Drivers 1 (1%) 0 (0%) 1 (1%)
21 (25%) 1 (3%) 3 25 (21%)
Developmental
School aged children 4 (5%) 3 (10%) 7 (6%)
Autism 5 (6%) 0 (0%) 5 (4%)
Foetal alcohol syndrome 3 (4%) 1 (3%) 4 (3%)
Pre-school aged children 2 (2%) 2 (7%) 4 (3%)
Developmental delay 3 (4%) 0 (0%) 3 (3%)
17 (20%) 6 (20%) 23 (20%)
Non-diagnostic intervention groups
First nations peoples 4 (5%) 2 (7%) 6 (5%)
Population health 2 (2%) 3 (10%) 5 (4%)
Carers 2 (2%) 1 (3%) 3 (3%)
Farmers 3 (4%) 0 (0%) 3 (3%)
Community/village 0 (0%) 2 (7%) 2 (2%)
Disaster recovery 1 (1%) 0 (0%) 1 (1%)
Primary health care 0 (0%) 1 (3%) 1 (1%)
12 (14%) 10 (33%) 22 (19%)
Illness
Age related illness 3 (4%) 1 (3%) 4 (3%)
Mental illness 2 (2%) 1 (3%) 1 4 (3%)
Cancer 3 (4%) 0 (0%) 3 (3%)
Cardiopulmonary 3 (4%) 0 (0%) 3 (3%)
Drug/alcohol abuse/addiction 2 (2%) 1 (3%) 3 (3%)
Dementia 1 (1%) 0 (0%) 1 (1%)
(Continues)
126 HAYES ET AL.

TABLE 1 (Continued)

Global north Global south Unstated Total

HIV (0%) 1 (3%) 1 (1%)
Melioidosis 1 (1%) 0 (0%) 1 (1%)
15 (18%) 4 (13%) 1 20 (17%)
Disability 11 (13%) 9 (30%) 20 (17%)
Generalist 3 (4%) 0 (0%) 3 (3%)
Not stated 4 (5%) 0 (0%) 4 (3%)
Service origin:
Local service 27 (33%) 7 (23%) 1 35 (30%)
Outreach
Telehealth 20 (24%) 1 (3%) 1 22 (19%)
Provider travels 13 (16%) 16 (53%) 1 30 (26%)
33 (40%) 17 (56%) 2 42 (45%)
Distant (client travels) 9 (11%) 3 (10%) 12 (10%)
OT trained worker 5 (6%) 1 (3%) 6 (5%)
Not stated 9 (11%) 2 (7%) 1 12 (8%)
Service received in:
Community 39 (47%) 25 (83%) 2 66 (56%)
Virtual 20 (24%) 1 (3%) 1 22 (19%)
Clinic 11 (13%) 2 (7%) 13 (11%)
Inpatient 6 (7%) 0 (0%) 6 (5%)
Not stated 7 (8%) 2 (7%) 1 10 (9%)
Occupational therapy emblement services provided:
Remediation
Rehabilitation 13 (16%) 0 (0%) 14 (12%)
School readiness/support 6 (7%) 3 (10%) 9 (8%)
Hand therapy 6 (7%) 0 (0%) 1 7 (6%)
Occupational intervention 2 (4%) 0 (0%) 3 (3%)
Early intervention 3 (4%) 0 (0%) 2 (2%)
Aged care 0 (0%) 1 (3%) 1 (1%)
Mental health intervention 1 (1%) 0 (0%) 1 (1%)
Mirror therapy 0 (0%) 0 (0%) 1 1 (1%)
Opioid withdrawal 1 (1%) 0 (0%) 1 (1%)
Speech and language therapy 0 (0%) 1 (3%) 1 (1%)
Task specific practice 1 (1%) 0 (0%) 1 (1%)
33 (39%) 6 (20%) 2 40 (34%)
Compensation
Assistive equipment/mods 6 (7%) 2 (2%) 8 (7%)
Falls prevention 1 (1%) 0 (0%) 1 (1%)
Palliative care 1 (1%) 0 (0%) 1 (1%)
8 (10%) 3 (10%) 11 (9%)
(Continues)
HAYES ET AL. 127

TABLE 1 (Continued)

Global north Global south Unstated Total

Education
Coaching 4 (5%) 0 (0%) 4 (3%)
Health education 4 (4%) 0 (0%) 4 (3%)
8 (10%) 0 (0%) 8 (7%)
Multiple (individual enabling strategy)
Remediation and education 2 (2%) 0 (0%) 2 (2%)
Remediation, compensation, and education 7 (8%) 1 (3%) 8 (7%)
9 (11%) 1 (3%) 10 (9%)
Total (individual enabling strategies) 58 (71%) 10 (33%) 69 (59%)
Community development
Age friendly community 1 (1%) 0 (0%) 1 (1%)
1 (0%) 0 (3%) 1 (1%)
Transformation
Social occupational therapy 0 (0%) 1 (3%) 1 (1%)
Service development 8 (10%) 0 (0%) 2 10 (7%)
8 (10%) 1 (3%) 2 11 (9%)
Redistributive justice
Occupational rights discussion 0 (0%) 1 (3%) 1 (1%)
Water and sanitation rights 0 (0%) 1 (3%) 1 (0%)
Policy analysis 0 (0%) 1 (3%) 1 (1%)
Curriculum advocacy 0 (0%) 1 (3%) 1 (1%)
0 (1%) 4 (10%) 4 (3%)
Total (community enabling strategies) 10 (11%) 5 (17%) 16 (14%)
Research only
Inductive exploratory research 10 (12%) 15 (50%) 25 (21%)
Deductive research 6 (8%) 1 (3%) 7 (6%)
16 (19%) 16 (53%) 2 32 (27%)

Note: Numbers in bold were to emphasise percentages rather than numbers given the difference in numbers between North/South. Numbers in italics were to
collate numbers under headings.

Australia (20), Canada (4), UK (4), and Ireland (1). The
single Japanese study focused on a non-diagnostic com-
munity (Kim et al., 2018).
3.8 | Service origin
Globally, urban outreach services were the most com-
monly described (45%) where the provider travelled to
the client (26%) or contacted via telehealth services
(19%). Services located in the client’s non-urban commu-
nity were discussed in 30% of publications. Clients
accessed services in distant urban locations in 12%,
including in Australia (6), USA (3), Bangladesh (1), India
(1), and South Africa (1). Local non-health professionals
were trained to provide interventions under supervision
from a distant therapist in Australia (2), USA (2), Canada
(1), and South Africa (1). Twelve papers did not outline
service location and how clients accessed.
Differences were observed between Global North/
South services. Global South publications commonly
described services where the therapist travelled to the cli-
ent (53%) with providers travelling to populations in
South African (11), Tanzanian (2), and Brazilian (1),
Jordanian (1), Honduran (1), Moroccan, Burkinabè (1),
and Ecuadorian (1). Global North services described trav-
elling less frequently (16%), and this approach was only
discussed in Australia (8), Canada (4), and the USA (2).
Global North publications discussed outreach more com-
monly via telehealth (24%), predominantly in the USA
128
(13) and also Australia, (4), Canada (2), and the UK (1).
Local services which already existed in the non-urban
community were discussed in 23% of Global South publi-
cations, including Brazil (2), Kenya (2), India (1), and
South Africa (1) compared with 33% in the Global North
from the USA (10), Australia (6), Canada (5), UK (4),
Ireland (1), and Japan (1).
3.9 | Location where service was
received
Most publications discussed services in a community set-
ting (56%) followed by virtual services (19%), clinic-based
(11%), inpatient care (5%), and 10 publications did not
state a location where the service was received.
Nearly all Global South publications described ser-
vices provided in a community setting (83%), with only
one South African service located in a clinic and one
Indian service using telehealth. All remaining publica-
tions from Armenia, Bangladesh, Brazil, Colombia,
Honduras, Morocco, Burkina Faso, Tanzania, Ecuador,
Jordan, and Kenya discussed services located in the
community.
Publications from Global North services were com-
monly community based (47%); however, inpatient ser-
vices were discussed in 7% of Global North publications
about Australia (4), Canada (1), and the UK (1). Clinics
were discussed in 13% of Global North services in
Australia (6), the UK (2), and the USA (3). Most publica-
tions about virtual services were from the USA (13) fol-
lowed by Australia (4), Canada (2), and the UK (1). The
Irish and Japanese services were both community-based.
3.10 | Enabling services provided
Globally, the publications discussed services providing
individualised enablement strategies, including remedia-
tion (34%), compensation (9%), and education (7%). Indi-
vidual enabling strategies accounted for 71% of the
strategies described by Global North publications, includ-
ing 100% of UK (5), 76% of USA (26), 57% of Australian
(17), 57% of Canadian (8), and both Irish (1) and
Japanese (1) studies. One third of Global South publica-
tions (10) discussed individual enabling services, includ-
ing South Africa (5), India (2), Armenia (1), Kenya (1),
and Tanzania (1).
Community level enablement strategies were least
commonly discussed, representing 14% publications (16).
Transformation, particularly engaging with communities
to develop or realign existing services with community
needs, was the most common community strategy (9%)
HAYES ET AL.
and included in publications from Canada (4), Australia
(3), South Africa (1), and the USA (1). Redistributive jus-
tice strategies aimed at indirectly influencing policy, cur-
riculum, or justice, featured in 3% of publications, from
South Africa (2), Brazil (1), and Canada (1). One Cana-
dian publication discussed a community development
enabling strategy.
In addition to papers which reported the enablement
strategies used by occupational therapists in non-urban
spaces, 32 articles (27%) discussed occupational therapy
research services, which did not directly provide enable-
ment strategies, but explored experiences or the state of
non-urban populations to inform future services. Most of
the papers classified as research only were inductive
exploratory research considering the experience or needs
of the community (21%), followed by deductive research
(primarily cross sectional) comparing non-urban popula-
tions with existing urban data (7%). Research only studies
were the most common strategy used in Global South
publications at 53%, but only represented 19% of Global
North publications.
4 | DISCUSSION
In the first scoping review, to our knowledge, of non-
urban occupational therapy services, we found a small
number of publications given the breadth of the search
criteria, across a small number of countries, typically
English-speaking, focused mainly on urban-outreach,
individualistic rehabilitative services, for people with a
medical diagnosis, in pre-defined age groups. Occupa-
tional therapy is now present in 98 countries (World
Federation of Occupational Therapists, 2021), but fewer
than 20% of these countries have published anything
about non-urban occupational therapy services over the
decade studied in the databases searched. This limited
engagement with non-urban research is consistent with
existing literature that non-urban health research receives
both less attention and funding than in urban spaces
(Barclay et al., 2018); however, by not focusing on non-
urban practice, occupational therapy risks neglecting the
health and wellbeing of nearly half the world’s population,
who in nearly all cases, have greater need than those in
urban populations. Non-urban research scarcity not only
limits health access now but may also decrease the visibil-
ity and thereby perceived value of and interest in rural
practice for future therapists (Malatzky & Bourke, 2016).
Limited non-urban research contributes to the construc-
tion of non-urban practice as less visible, legitimate, and
valued and may tacitly reinforce and reproduce limits on
non-urban research/practice interest, further heightening
non-urban inequity (Malatzky & Bourke, 2016). This
HAYES ET AL.
project aligns with the profession’s growing commitment
to social and occupational justice (Dos Santos et al., 2022;
Hammell, 2020a; Lopes & Malfitano, 2021) and aims to
prompt further research in this space.
Further research is required regarding how occupa-
tional therapy can best serve non-urban people. Most
occupational therapy publications about occupational
therapy services appear stratified by age groups and diag-
nostic presentations, for example, children with autism
(Johnsson et al., 2019; Little et al., 2018; Little &
Wallisch, 2019; McClure et al., 2010; Monz et al., 2019) or
adults with stroke (Danzl et al., 2013, 2016; Hermann
et al., 2010; Marsden et al., 2010; Merchant et al., 2016).
However, stratifying by diagnostic and age groups under-
estimates contextual and environmental impacts
(Taylor, 2019) and may limit access for people who do
not fit neatly into these classifications, possibly funda-
mentally misunderstanding non-urban contexts. Non-
urban contexts, while non-homogenous and unique
(Moran et al., 2021), are typified by small populations,
separated by geographic distances, with limited access to
infrastructure (Carson et al., 2011; Farias &
Faleiro, 2021), thus, identifying sufficient population to
provide a stratified service that may be fraught and con-
trasts with consistent non-urban therapist reports citing
the requirement of both generalist knowledge and prac-
tice approach (e.g. Barker et al., 2021; Orda et al., 2017;
Roots et al., 2014; Woolley et al., 2019). Some of this con-
textual misunderstanding may result from the significant
number of publications found reporting on services pro-
vided by occupational therapists not living in the non-
urban community they served, with many originating
from urban spaces. It remains unclear if the non-urban
context can be effectively understood if the therapist is
unfamiliar with it.
Contextual understanding is essential to effective
practice as it allows therapist to be cognisant of and tailor
interventions to contextual limits and opportunities
(Hammell, 2020b). The inequity in healthcare access, for-
mal education access, and income are population level
issues impacting on health outcomes and the context of
practice (Taylor, 2019). Misunderstanding the context in
which clients are working may result in poor occupa-
tional therapy theory application and potentially reduce
client trust, rapport, and belief in the usefulness of ther-
apy (Dew et al., 2013). While some studies considered
contextual factors and engaged local support for contex-
tualisation and implementation of distant occupational
therapy services (Bellefontaine et al., 2015; Dew
et al., 2014), many did not address context. Given that
much of the non-urban health workforce literature high-
lights culture shock and needs to adjust to non-urban
contexts experienced by clinicians who relocate to non-
129
urban spaces (Cosgrave et al., 2019; Roots et al., 2014), it
may be assumed that the knowledge that urban people
have about non-urban contexts is limited. As McAdam
et al. (2019) demonstrated in a review of occupational
participation in a rural South African community, the
traditional occupational classifications in the literature
exclude occupations in which rural people participate,
such as water and fuel fetching. More research is there-
fore required to identify both the common contextual dif-
ferences between urban and non-urban spaces and how
effectively therapists located geographically distant to the
client can assess and integrate contextual factors into
their practice.
Most publications in this review discussed services
provided in community settings, yet the focus is mainly
on individual rehabilitative practice (e.g. Babikian
et al., 2018; Coetzee, 2011; de Villiers et al., 2019;
Maxwell, 2010). Individualist rehabilitative approach in
occupational therapy practice has been criticised as plac-
ing responsibility for social level inequity on individual
clients and limiting the human capacity to create, adapt,
and produce (Barlott & Turpin, 2021; Dos Santos & Leon
Spesny, 2016; Turcotte & Holmes, 2021). While the indi-
vidual interventions provided were no doubt personally
valuable to the clients concerned, given the overall nega-
tive effect of non-urban location on the health and well-
being, community level interventions may be more
impactful for non-urban people. We identified very few
publications using community level enablement strate-
gies. Only four publications addressed redistributive jus-
tice, and all but one of these were from the Global South
(Costa, 2012; Lauckner & Stadnyk, 2014; McAdam &
Rose, 2020; Watson & Duncan, 2010). Most of the Global
North community level strategies were related to trans-
formation, service development regarding non-urban ser-
vice uptake/relevance to increase participation in
individualised therapy (e.g. Churchill, 2016; Curtis, 2012;
Gauld et al., 2011a, 2011b; Keightley et al., 2011;
Kitzman & Hunter, 2011; Morgan et al., 2019). Given the
inequity experienced by non-urban communities
(Taylor, 2019), redistributive justice, focusing on
increased access to resources and opportunities, may be
more impactful in rural communities than any individu-
alist strategy (Watson, 2013). Further research should
consider how occupational therapists can engage with
and implement community level enablement strategies
in non-urban spaces.
The commonly cited difference between Global North
and Global South occupational therapy approaches
(Gerlach et al., 2018; Grech, 2016; Laliberte
Rudman, 2013) was also demonstrated in this review.
While Global South publications reported some diagnosis
related, individualist interventions, there were
130
proportionally more community level, generalist services
discussed (e.g. Costa, 2012; McAdam & Rose, 2020;
Watson & Duncan, 2010). Considering context beyond
the individual is aligned with Southern epistemologies
and represents a long tradition among occupational ther-
apists of regions such as Latin America (Correia
et al., 2021; Díaz-Leiva & Malfitano, 2021; Núñez, 2019;
Santos et al., 2020). However, an overall publication bias
has been found favouring Global North science research
(Reidpath & Allotey, 2019), which may be influencing
the number of Global South publications available for
this review. It would be worth considering if occupational
therapy journals privilege Global North publications and
if so, whether effective practices from Global South coun-
tries being overlooked, for both non-urban populations
and occupational therapy at large.
The limitations in this review include the following:
(i) potential oversight of some publications due to search
and inclusion strategies. While a rigorous identification
and inclusion process was implemented, there remains a
risk that some data which may have provided further
insights were inadvertently omitted (Peters et al., 2020)
(ii) We did not search RedeSciELO, which may include
more publications form countries with strong occupa-
tional therapy presence and production in the Global
South, including South Africa (SciELO, 2022a), Brazil
(SciELO, 2022b), Colombia (SciELO, 2022c). (iii) The
data were limited to a decade of research, and examina-
tion over a longer period may have demonstrated a trend
in research frequency. (iv) Finally, analysis was limited
to publication data, whereas data regarding authors and
institutions in which non-urban occupational therapy
knowledge was produced have not been examined. Anal-
ysis of this data may highlight key knowledge makers in
this space and provide opportunity to develop a global
network of non-urban occupational therapy researchers
to lead enhancements in non-urban occupational therapy
research and practice.
5 | C ON C L U S I ON S
Despite demonstrable global need in non-urban spaces,
this review demonstrates that occupational therapy has
engaged in proportionally little research regarding non-
urban practice. Further research is required to identify
effective approaches to non-urban service delivery, the
level of contextual analysis and understanding which can
be provided by urban-based occupational therapists to
non-urban contexts, and how occupational therapists can
implement community level enabling strategies to help
reduce inequity between urban and non-urban
populations.
HAYES ET AL.
ACKNOWLEDGEMENT
The authors would like to acknowledge Gail Whiteford
for her comments on the late version of the manuscript.
Open access publishing facilitated by Charles Sturt Uni-
versity, as part of the Wiley - Charles Sturt University
agreement via the Council of Australian University
Librarians.
CONFLICT OF INTEREST
The authors declare no conflict of interest.
AUTHOR CONTRIBUTIONS
All listed authors have significantly contributed to the
design, data collection, data analysis, and writing of this
research paper and approved the final version.
DA TA AVAI LA BI LI TY S T ATE ME NT
The data that supports the findings of this study are avail-
able in the supporting information of this article.
ORCID
Karen Hayes https://orcid.org/0000-0002-3421-7406
Vagner Dos Santos https://orcid.org/0000-0002-6104-
4168
RE FER EN CES
Australian Bureau of Statistics. (2018). Australian Statistical Geogra-
phy Standard (ASGS) - Volume 5 - Remoteness Structure. Com-
monwealth of Australia. https://www.abs.gov.au/ausstats/
abs@.nsf/mf/1270.0.55.005
Babikian, V., Sarafian, A., & Grajo, L. (2018). Developing a pilot
occupational therapy program in rural Armenia. OT Practice,
23(17), 20–23. PMID: https://www.aota.org/Publications-
News/otp/Archive/2018/rural-armenia.aspx
Barclay, L., Phillips, A., & Lyle, D. (2018). Rural and remote health
research: Does the investment match the need? Australian
Journal of Rural Health, 26(2), 74–79. https://doi.org/10.1111/
ajr.12429
Barker, R., Chamberlain-Salaun, J., Harrison, H., Nash, R.,
Nielsen, I., Harvey, D., Sim, J., Ciccone, N., Carr, J., Bird, K.,
Palermo, C., & Devine, S. (2021). Evaluation of the allied
health rural generalist program 2017-2019. Australian Journal
of Rural Health, 29(2), 158–171. https://doi.org/10.1111/ajr.
12745
Barlott, T., & Turpin, M. (2021). Desiring occupation: Theorising
the passion, creativity, and social production of everyday life.
Journal of Occupational Science, 1-11, 130–140. https://doi.org/
10.1080/14427591.2020.1867226
Bell, E. (2011). Creating ’the rural pathway’: Australia’s university
departments of rural health and rural clinical schools. Interna-
tional Journal of Child Health & Human Development, 4(1),
135–144.
Bellefontaine, K., Hurley, M., & Irngaut, S. (2015). Community
therapy assistant: Supporting rehabilitation services in the
remote arctic community of Igloolik, Nunavut. Occupational
Therapy Now, 17(2), 21–22.
HAYES ET AL.
Brandt, W. (1980). North-South: A Programme for Survival: Report
of the Independent Commission on International Development
Issues. Pan World Affairs.
Carson, D., Ensign, P. C., Rasmussen, O. R., & Taylor, A. (2011).
Perspectives on ’Demography at the edge’. In D. B. Carson,
R. O. Rasmussen, E. Prescott, L. Huskey, & A. Taylor (Eds.),
Demography at the Edge Remote Human Populations in Devel-
oped Nations. Ashgate. https://doi.org/10.4324/9781315576480
Carter, M., Flisher, R., Smith, A., Warburton, B., & Wesson, S.
(2017). The value of mental health occupational therapy deliv-
ered across rural Lincolnshire acute hospitals. British Journal
of Occupational Therapy, 80, 82–83. PMID: https://journals.
sagepub.com/toc/bjod/80/8_suppl
Churchill, K. (2016). Addressing the needs of rural drivers in
Alberta: Occupational therapy innovation in action. Occupa-
tional Therapy Now, 18(6), 24–24.
Coetzee, Z. (2011). Every dance has its own story - how participa-
tion in dance empowered youth living in a rural community to
buffer an intergenerational cycle of poverty. South African
Journal of Occupational Therapy, 41(3), 50–55. PMID: https://
www.sajot.co.za/index.php/sajot/article/view/89
Correia, R. L., Wertheime, L. G., Morrison, R., & Silva, C. R. (2021).
Contemporary perspectives of occupational therapy in Latin
America: Contributions to the glocal dialogue. South African
Journal of Occupational Therapy, 51(4), 41–50. https://doi.org/
10.17159/2310-3833/2021/vol51n4a6
Cosgrave, C., Malatzky, C., & Gillespie, J. (2019). Social determi-
nants of rural health workforce retention: A scoping review.
International Journal of Environmental Research and Public
Health, 16(3), 314. https://doi.org/10.3390/ijerph16030314
Cosgrave, C., Maple, M., & Hussain, R. (2018). An explanation of
turnover intention among early-career nursing and allied
health professionals working in rural and remote Australia-
findings from a grounded theory study. Rural and Remote
Health, 18(3), 4511. https://doi.org/10.22605/RRH4511
Costa, S. L. (2012). Social occupational therapy: Matters and action
possibilities with traditional peoples and communities. Cader-
nos de Terapia Ocupacional da UFSCar, 20(1), 43–54. https://
doi.org/10.4322/cto.2012.005
Cronin, A. F. (2018). Addressing the special care needs of rural chil-
dren. American Journal of Occupational Therapy, 72, 1–1.
https://doi.org/10.5014/ajot.2018.72S1-PO2017
Curtin, M. (2017). Overview of enabling skills and strategies. In M.
Curtin, M. Egan, & J. Adams (Eds.), Occupational Therapy for
People Experiencing Illness, Injury, or Impairment: Promoting
Occupation and Participation (7th ed.) (pp. 322–333). Elsevier.
Curtis, K. (2012). Including infants: An inter-agency model for
parent-infant mental health and well-being in rural regions.
Children Australia, 37(3), 90–93. https://doi.org/10.1017/cha.
2012.26
Danzl, M. M., Harrison, A., Hunter, E. G., Kuperstein, J., Sylvia, V.,
Maddy, K., & Campbell, S. (2016). ’A lot of things passed me
by’: Rural stroke survivors’ and caregivers’ experience of
receiving education from health care providers. The Journal of
Rural Health, 32(1), 13–24. https://doi.org/10.1111/jrh.12124
Danzl, M. M., Hunter, E. G., Campbell, S., Sylvia, V., Kuperstein, J.,
Maddy, K., & Harrison, A. (2013). “Living with a ball and
chain”: The experience of stroke for individuals and their
131
caregivers in rural Appalachian Kentucky. The Journal of
Rural Health, 29(4), 368–382. https://doi.org/10.1111/jrh.12023
de Villiers, D., Homan, A., & van Rooyen, C. (2019). Early child-
hood development and the crosstrainer programme in rural
Mahikeng. South African Journal of Occupational Therapy,
49(2), 18–23. https://doi.org/10.17159/23103833/2019/
vol49n2a4
Dender, A. (2014). An Investigation of Play and Literacy of Western
Australian Indigenous Children. Deakin University. http://hdl.
handle.net/10536/DRO/DU:30067394
Dew, A., Bulkeley, K., Veitch, C., Bundy, A., Gallego, G.,
Lincoln, M., Brentnall, J., & Griffiths, S. (2013). Addressing
the barriers to accessing therapy services in rural and remote
areas. Disability and Rehabilitation, 35(18), 1564–1570. https://
doi.org/10.3109/09638288.2012.720346
Dew, A., Bulkeley, K., Veitch, C., Bundy, A., Lincoln, M.,
Glenn, H., Gallego, G., & Brentnall, J. (2014). Local therapy
facilitators working with children with developmental delay in
rural and remote areas of western New South Wales,
Australia: The ’Outback’ service delivery model. Australian
Journal of Social Issues, 49(3), 309–328. https://doi.org/10.
1002/j.1839-4655.2014.tb00315.x
Díaz-Leiva, M. M., & Malfitano, A. P. S. (2021). Reflexiones sobre la
idea de América Latina y sus contribuciones a las terapias ocu-
pacionales del sur. Cadernos Brasileiros de Terapia Ocupacio-
nal, 29, 1–14. https://doi.org/10.1590/2526-8910.ctoen1961
Dos Santos, V. (2017). Occupational therapy across South America:
An overview of its backgrounds, current situation and some
contemporary issues. In D. Sakellariou & N. Pollard (Eds.),
Occupational Therapies Without Borders: Integrating Justice
With Practice (2nd ed, pp. 203–210). Elsevier.
Dos Santos, V., & Leon Spesny, S. (2016). Questioning the concept
of culture in mainstream occupational therapy. Cadernos de
Terapia Ocupacional da UFSCar, 24(1), 185–190. https://doi.
org/10.4322/0104-4931.ctoRE0675
Dos Santos, V., Munoz, I., & Nunes, M. (2022). Questões Contempor-
âneas da Terapia Ocupacional na América do Sul (2nd ed.).
EDitoria CRV.
EBSCOhost. (2020). CINAHL. EBSCO. https://www.ebscohost.com/
nursing/products/cinahl-databases
Farias, M. N., & Faleiro, W. (2021). O cotidiano uma família rural
atingida por barragem. Revista Chilena de Terapia Ocupacio-
nal, 21(1), 91–100. https://doi.org/10.5354/0719-5346.2021.
53626
Fishpool, J., Towns, A., & Bridge, C. (2011). Efficacy of follow up
practices by occupational therapists in rural and remote
health. Australian Occupational Therapy Journal, 58, 25–25,
50. https://doi.org/10.1111/j.1440-1630.2011.00937.x
Gauld, S., Smith, S., & Kendall, M. (2011a). From research to prac-
tice: Developing a community-based rehabilitation approach
with indigenous people with acquired brain injury living in
rural and remote Queensland. Australian Occupational Ther-
apy Journal, 58, 12–12, 50. https://doi.org/10.1111/j.1440-1630.
2011.00937.x
Gauld, S., Smith, S., & Kendall, M. B. (2011b). Using participatory
action research in community-based rehabilitation for people
with acquired brain injury: From service provision to partner-
ship with aboriginal communities. Disability and
132
Rehabilitation, 33(19–20), 1901–1911. https://doi.org/10.3109/
09638288.2010.550382
Gerlach, A. J., Teachman, G., Laliberte-Rudman, D.,
Aldrich, R. M., & Huot, S. (2018). Expanding beyond individu-
alism: Engaging critical perspectives on occupation. Scandina-
vian Journal of Occupational Therapy, 25(1), 35–43. https://
doi.org/10.1080/11038128.2017.1327616
Gomez-Galindo, A. M., Penas-Felizzola, O. L., & Parra-
Esquivel, E. I. (2017). Peace experiences in occupational ther-
apy: Contributions from Colombian regions. Revista de Salud
Publica, 19(5), 664–670. https://doi.org/10.15446/rsap.V19n5.
6248
Grech, S. (2016). Disability and Development: Critical Connections,
Gaps and Contradictions. In S. Grech & K. Soldatic (Eds.), Dis-
ability in the Global South: The Critical Handbook (pp. 3–19).
Springer International Publishing AG. https://doi.org/10.1007/
978-3-319-42488-0_1
Hammell, K. W. (2020a). Engagement in living during the COVID-
19 pandemic and ensuing occupational disruption. Occupa-
tional Therapy Now, 22(4), 7–8.
Hammell, K. W. (2020b). Making choices from the choices we have:
The contextual-embeddedness of occupational choice. Cana-
dian Journal of Occupational Therapy, 87(5), 400–411. https://
doi.org/10.1177/0008417420965741
Hayes, K., Dos Santos, V., Costigan, M., & Morante, D. (2022).
Extension, Austerity, and Emergence: Themes Identified From a
Global Scoping Review Of Non-urban Occupational Therapy
Services. Manuscript submitted for publication.
Hayes, K., Morante, D., Costigan, M., & Dos Santos, V. (2021).
Occupational therapy services provided to populations in non-
urban areas: A scoping review protocol. JBI Evidence Synthesis,
19(8), 1964–1970. https://doi.org/10.11124/JBIES-20-00242
Hermann, V. H., Herzog, M., Jordan, R., Hofherr, M., Levine, P., &
Page, S. J. (2010). Telerehabilitation and electrical stimulation:
An occupation-based, client-centered stroke intervention
[evaluation study]. American Journal of Occupational Therapy,
64(1), 73–81. https://doi.org/10.5014/ajot.64.1.73
Hickey, K., Robertson, R., Springall, M., & Christley, J. (2011). Pilot
project trialling home based mirror therapy to improve the
functional outcomes of geographically isolated patients with a
hemiplegic upper limb post stroke. Australian Occupational
Therapy Journal, 58, 82–82, 104. https://doi.org/10.1111/j.
1440-1630.2011.00938.x
Humphreys, J., Lyle, D., & Barlow, V. (2018). University depart-
ments of rural health: Is a national network of multidisciplin-
ary academic departments in Australia making a difference?
Rural and Remote Health, 18(1), 1–11. https://doi.org/10.
22605/RRH4315
Hunter, E. G., & Kitzman, P. (2018). Patient-centered outcomes:
Partnering with people with neurological disability from rural
communities to understand priorities. The American Journal
of Occupational Therapy, 72(4_Supplement_1), 7211510159.
https://doi.org/10.5014/ajot.2018.72S1-RP101C
Hyett, N., Dickson-Swift, V., & McKinstry, C. (2011). Accessing
alcohol and other drug services in a rural community: Client
experiences of changing factors that impact on their health
and wellbeing. Australian Occupational Therapy Journal, 58,
25–26. https://doi.org/10.1111/j.1440-1630.2011.00937.x
HAYES ET AL.
Johnsson, G., Kerslake, R., & Crook, S. (2019). Delivering allied
health services to regional and remote participants on the
autism spectrum via video-conferencing technology: Lessons
learned. Rural and Remote Health, 19(3), 1–6. https://doi.org/
10.22605/RRH5358
Jones, H. (2013). Mainstreaming Disability and Ageing in Water,
Sanitation and Hygiene Programmes: A Mapping Study Carried
out for Water Aid. WaterAid. https://www.issuelab.org/
resources/23045/23045.pdf
Kahanov, L., Fuss, S., Hunt, M., Kreusel, L., McMahon, R., &
Fisher, G. (2018). Identifying the needs of adolescents with
visual impairments in a nonurban setting. American Journal of
Occupational Therapy, 72, 1–1. https://doi.org/10.5014/ajot.
2018.72S1-PO5045
Keightley, M., Agnihotri, S., Subramaniapillai, S., Gray, J.,
Keresztesi, J., Colantonio, A., Polatajko, H. J., Cameron, D., &
Wiseman-Hakes, C. (2018). Investigating a theatre-based inter-
vention for indigenous youth with fetal alcohol spectrum dis-
order. Canadian Journal of Occupational Therapy. Revue
Canadienne D’Ergothérapie, 85(2), 128–136. https://doi.org/10.
1177/0008417417719722
Keightley, M. L., King, G. E., Jang, S. H., White, R. J.,
Colantonio, A., Minore, J. B., Katt, M. V., Cameron, D. A.,
Bellavance, A. M., & Longboat-White, C. H. (2011). Brain
injury from a first Nations’ perspective: Teachings from elders
and traditional healers. Canadian Journal of Occupational
Therapy, 78(4), 237–245. https://doi.org/10.2182/cjot.2011.78.
4.5
Kiepek, N., Groom, B., Toppozini, D., Kakekagumick, K.,
Muileboom, J., & Kelly, L. (2015). Evaluation of an inpatient
medical withdrawal program in rural Ontario: A 1-year pro-
spective study. Canadian Journal of Rural Medicine, 20(3), 92–
97. PMID: https://srpc.ca/resources/Documents/CJRM/
vol20n3/pg92.pdf
Kim, M. S., Park, S. Y., Jeong, W. M., Park, S. H., & Park, K. Y.
(2018). A case study of an occupational activity program fol-
lowing the great East Japan earthquake and tsunami and the
restoration of roles. Medico-Legal Update, 18(1), 272–277.
https://doi.org/10.5958/0974-1283.2018.00057.9
Kingston, G. A., & Gray, M. (2011). Occupational therapy services
for people in rural and remote locations who have sustained a
traumatic hand injury. Australian Occupational Therapy Jour-
nal, 58, 138–138, 140. https://doi.org/10.1111/j.1440-1630.
2011.00939.x
Kitzman, P. H., & Hunter, E. G. (2011). Developing a community
based rehabilitation network for people with spinal cord
injury: A case study in Appalachian Kentucky. Journal of
Rural and Community Development, 6(1), 95–104. PMID:
https://journals.brandonu.ca/jrcd/article/view/410
Laliberte Rudman, D. (2013). Enacting the critical potential of occu-
pational science: Problematizing the ’Individualizing of Occu-
pation’. Journal of Occupational Science, 20(4), 298–313.
https://doi.org/10.1080/14427591.2013.803434
Lannin, N., & Longland, S. (2003). Critical shortage of occupational
therapists in rural Australia: Changing our long-held beliefs
provides a solution. Australian Occupational Therapy Journal,
50(3), 184–187. https://doi.org/10.1046/j.1440-1630.2003.
00394.x
HAYES ET AL.
Lauckner, H. M., & Stadnyk, R. L. (2014). Examining an occupa-
tional perspective in a rural Canadian age-friendly consulta-
tion process. Australian Occupational Therapy Journal, 61(6),
376–383. https://doi.org/10.1111/1440-1630.12147
Lees, N. (2021). The Brandt line after forty years: The more north-
south relations change, the more they stay the same? Review of
International Studies, 47(1), 85–106. https://doi.org/10.1017/
S026021052000039X
Little, L. M., & Wallisch, A. (2019). Telehealth in early intervention:
A case example in the measurement of outcomes. SIS Quar-
terly Practice Connections, 4(2), 2–4. PMID: https://www.aota.
org/-/media/Corporate/Files/Secure/Publications/SIS-
Quarterly-Newsletters/2019/May/May-2019-SISQPC.pdf
Little, L. M., Pope, E., Wallisch, A., & Dunn, W. (2018). Occupa-
tion-based coaching by means of telehealth for families of
young children with autism spectrum disorder. American Jour-
nal of Occupational Therapy, 72(2), 1–7. https://doi.org/10.
5014/ajot.2018.024786
Lopes, R. E., & Malfitano, A. P. S. (2021). Social Occupational Ther-
apy: Theoretical and Practical Designs. Elsevier Health
Sciences.
Macedo, M. D. C., Neves, A. T. d. L., Bardi, G., Monzeli, G. A., &
Mota, V. V. (2016). Forming insights: Assessment of the occu-
pational therapy practice in a cultural context from experience
with indigenous people. Cadernos de Terapia Ocupacional da
UFSCar, 24(1), 77–89. PMID: https://doi.org/10.4322/0104-
4931.ctoA00665
Malatzky, C., & Bourke, L. (2016). Re-producing rural health: Chal-
lenging dominant discourses and the manifestation of power.
Journal of Rural Studies, 45, 157–164. https://doi.org/10.1016/
j.jrurstud.2016.03.005
Marsden, D., Quinn, R., Pond, N., Golledge, R., Neilson, C.,
White, J., McElduff, P., & Pollack, M. (2010). A
multidisciplinary group programme in rural settings for
community-dwelling chronic stroke survivors and their
carers: A pilot randomized controlled trial. Clinical
Rehabilitation, 24(4), 328–341. https://doi.org/10.1177/
0269215509344268
Matichuk, N., Boniface, G., & Smith, L. (2016). CAOT professional
issue forum: "you work where? Why?" the realities of
rural/remote occupational therapy practice. Occupational
Therapy Now, 18(4), 12–13. PMID: (forum de l’ACE sur Une
question professionnelle: << Vous travaillez ou? Pourquoi?
Les realites de la pratique de l’ergotherapie en region rurale ou
eloignee).
Maxwell, M. (2010). Effects of the Pre-K Handwriting Without Tears
Program on Handwriting Readiness Skills of Preschoolers With
Pre-writing Deficits in a Rural Eastern North Carolina Head
Start program. M.S., East Carolina University. https://
thescholarship.ecu.edu/handle/10342/3155
McAdam, J. C., Franzsen, D., & Casteleijn, D. (2019). Identification
of occupations in a south African rural less-resourced commu-
nity. Journal of Occupational Science, 26(3), 379–393. https://
doi.org/10.1080/14427591.2019.1614476
McAdam, J. C., & Rose, C. M. (2020). Opinion piece: People need
nature to thrive – A case for inclusion of environmental sus-
tainability in occupational therapy practice in rural
South Africa. WFOT Bulletin, 76(1), 25–31. https://doi.org/10.
1080/14473828.2020.1734307
133
McAuliffe, T., & Barnett, F. (2010). Perceptions towards rural and
remote practice: A study of final year occupational therapy
students studying in a regional university in Australia.
Australian Occupational Therapy Journal, 57(5), 293–300.
https://doi.org/10.1111/j.1440-1630.2009.00838.x
McClure, I., Mackay, T., Mamdani, H., & McCaughey, R. (2010). A
comparison of a specialist autism spectrum disorder assess-
ment team with local assessment teams. Autism: The Interna-
tional Journal of Research & Practice, 14(6), 589–603.
https://doi.org/10.1177/1362361310373369
McGuire, B., Cahill, S. M., Krumdick, N., & Lee, M. M. (2015).
Rural school occupational therapists in response to interven-
tion (rti): Doing more with less? American Journal of Occupa-
tional Therapy, 69(s1), 1122–1125. https://doi.org/10.5014/ajot.
2015.69S1-PO3088
McKinstry, C., & Cusick, A. (2015). Australia needs more occupa-
tional therapists in rural mental health services. Australian
Occupational Therapy Journal, 62(5), 275–276. https://doi.org/
10.1111/1440-1630.12229
McLoughlin, P., Murphy, E., O’Sullivan, F., & Connellan, C. (2019).
Implementation of community based comprehensive geriatric
assessment and intervention in a rural Irish setting. Age and
Ageing, 48(s3), iii17–iii65. https://doi.org/10.1093/ageing/
afz103.214
Merchant, J., Kitsos, G., Ashby, S., Kitsos, A., & Hubbard, I. J.
(2016). Occupational therapy and physiotherapy in acute
stroke: Do rural patients receive less therapy? Stroke
Research & Treatment, 2016, 1582706. https://doi.org/10.1155/
2016/1582706
Monz, B. U., Houghton, R., Law, K., & Loss, G. (2019).
Treatment patterns in children with autism in the
United States. Autism Research, 12(3), 517–526. https://doi.
org/10.1002/aur.2070
Moran, M., McKinstry, C., & Curtin, M. (2021). Occupational ther-
apy practice in regional, rural, and remote Australia. In T.
Brown, H. M. Bourke-Taylor, S. Isbel, R. Cordier, & L. Gustafs-
son (Eds.), Occupational Therapy in Australia: Professional
and Practice Issues (pp. 368–382). Routledge. https://doi.org/
10.4324/9781003150732-30
Morgan, D., Kosteniuk, J., Seitz, D., Megan, E. O. C., Kirk, A.,
Stewart, N. J., Holroyd-Leduc, J., Daku, J., Hack, T.,
Hoium, F., Kennett-Russill, D., & Sauter, K. (2019). A five-step
approach for developing and implementing a rural primary
health care model for dementia: A community–academic part-
nership. Primary Health Care Research & Development,
20(e29), 1–11. https://doi.org/10.1017/S1463423618000968
Mroz, T. (2018). Occupational therapy in home health and quality
outcomes for high-risk rural medicare beneficiaries. American
Journal of Occupational Therapy, 72, 1–1. https://doi.org/10.
5014/ajot.2018.72S1-RP101D
Mu, K., Chao, C. C., Jensen, G. M., & Royeen, C. B. (2004).
Effects of interprofessional rural training on students’
perceptions of interprofessional health care services. Journal of
Allied Health, 33(2), 125–131. PMID: http://search.ebscohost.
com/login.aspx?direct=true&db=rzh&AN=106672029&site=
ehost-live
Munn, Z., Aromataris, E., Tufanaru, C., Stern, C., Porritt, K.,
Farrow, J., Lockwood, C., Stephenson, M., Moola, S.,
Lizarondo, L., McArthur, A., Peters, M., Pearson, A., &
134
Jordan, Z. (2019). The development of software to support
multiple systematic review types: The Joanna Briggs institute
system for the unified management, assessment and review of
information (JBI SUMARI). International Journal of Evidence-
Based Healthcare, 17(1), 36–43. https://doi.org/10.1097/XEB.
0000000000000152
Núñez, C. M. V. (2019). Terapias Ocupacionales del Sur: una pro-
puesta para su comprension. Cadernos Brasileiros de Terapia
Ocupacional, 27, 671–680. https://doi.org/10.4322/2526-8910.
ctoARF1859
Orda, U., Orda, S., Sen Gupta, T., & Knight, S. (2017). Building a
sustainable workforce in a rural and remote health service: A
comprehensive and innovative rural generalist training
approach. Australian Journal of Rural Health, 25(2), 116–119.
https://doi.org/10.1111/ajr.12306
Ovid. (2020a). Ovid Emcare. Wolters Kluwer. https://www.ovid.
com/product-details.14007.html
Ovid. (2020b). Ovid MEDLINE. Wolters Kluwer. https://www.ovid.
com/product-details.901.html
Peters, M., Godfrey, C., McInerney, P., Munn, Z., Tricco, A., &
Khalil, H. (2020). Chapter 11: Scoping reviews (2020 version).
In E. Aromataris & Z. Munn (Eds.), Joanna Briggs Institute
Reviewer’s Manual. Joanna Briggs Institute. https://
reviewersmanual.joannabriggs.org/
Playford, D., Moran, M. C., & Thompson, S. (2020). Factors associ-
ated with rural work for nursing and allied health graduates
15-17 years after an undergraduate rural placement through
the University Department of Rural Health program. Rural
and Remote Health, 20(1), 5334. https://doi.org/10.22605/
RRH5334
ProQuest. (2020). Nursing and Allied Health Database. Clarivate.
https://about.proquest.com/products-services/pq_nursingahs_
shtml.html#resources
Reidpath, D. D., & Allotey, P. (2019). The problem of ‘trickle-down
science’ from the global north to the global south. BMJ Global
Health, 4(4), e001719. https://doi.org/10.1136/bmjgh-2019-
001719
Roots, R. K., Brown, H., Bainbridge, L., & Li, L. C. (2014). Rural
rehabilitation practice: Perspectives of occupational therapists
and physical therapists in British Columbia, Canada. Rural &
Remote Health, 14(1), 1–16. https://doi.org/10.22605/RRH2506
Roots, R. K., & Li, L. C. (2013). Recruitment and retention of occu-
pational therapists and physiotherapists in rural regions: A
meta-synthesis. BMC Health Services Research, 13(1), 59–59.
https://doi.org/10.1186/1472-6963-13-59
Roots, R., Smith, L., Brown, H., Bainbridge, L., & Linda, L. (2014).
“All those things you never thought”: Perspectives from occu-
pational therapists practicing in rural British Columbia. Occu-
pational Therapy Now, 16(6), 26–28.
Santos, A. C., & Aiache Menta, S. (2016). Reflecting the interface
between rural work and mental health of citriculture workers.
Cadernos de Terapia Ocupacional da UFSCar, 24(4), 765–775.
https://doi.org/10.4322/0104-4931.ctoAO0718
Santos, V. d., Frank, G., & Mizue, A. (2020). Candangos: Occupa-
tional reconstruction as a tool to understand social problems
and transformative action in the utopian city of Brasília.
Cadernos Brasileiros de Terapia Ocupacional, 28, 765–783.
https://doi.org/10.4322/2526-8910.ctoAO2061
HAYES ET AL.
Scheil-Adlung, X. (2015). Global Evidence on Inequities in Rural
Health Protection: New Data on Rural Deficits In Health Cover-
age for 174 Countries. International Labour Organization.
https://www.social-protection.org/gimi/gess/RessourcePDF.
action;jsessionid=qvObuVzou02uuhj5n530mffgvpU_
7qYh6kJb8xAUZzgiRHE94XJ9!-165389065?id=51297
SciELO. (2022a). SciELO Africa. Scientific Electronic Library Online
South Africa. http://www.scielo.org.za/
SciELO. (2022b). SciELO Brazil. Scientific Electronic Library Online
Brazil. https://www.scielo.br/
SciELO. (2022c). SciELO Columbia. Scientific Electronic Library
Online Columbia. http://www.scielo.org.co/?lng=es
Slaich, V. (2019). Going digital with online occupational therapy.
Indian Journal of Occupational Therapy, 51(2), 67–67.
Smith, S., & Cooke, S. (2017). Custom made rehab: Considering
whether engaging with regional festivals could provide occu-
pational therapy opportunities. Dorset knob throwing - thera-
peutic potential or one hurl too far? British Journal of
Occupational Therapy, 80, 83–84. https://doi.org/10.1177/
0308022619866103
Taylor, M. M. (2019). Rural Health Disparities: Public Health, Policy,
and Planning Approaches. Springer Books. https://doi.org/10.
1007/978-3-030-11467-1
Turcotte, P.-L., & Holmes, D. (2021). From domestication to impe-
rial patronage: Deconstructing the biomedicalisation of occu-
pational therapy. Health (London, England: 1997),
13634593211067891. https://doi.org/10.1177/
13634593211067891
United Nations. (1948). Universal Declaration of Human Rights.
United Nations. https://www.un.org/en/about-us/universal-
declaration-of-human-rights
van Rensburg, E. J., & Du Toit, S. H. J. (2016). The value of a rural
service learning experience for final year undergraduate occu-
pational therapy students. South African Journal of Occupa-
tional Therapy, 46(1), 9–14. https://doi.org/10.17159/2310-
3833/2016/v46n1a4
Watson, R. (2013). A population approach to occupational therapy.
South African Journal of Occupational Therapy, 43(1), 34–39.
PMID: https://www.sajot.co.za/index.php/sajot/article/
view/59
Watson, R., & Duncan, E. M. (2010). The ’right’ to occupational
participation in the presence of chronic poverty. WFOT Bulle-
tin, 62(1), 26–32. https://doi.org/10.1179/otb.2010.62.1.006
Wolfgang, R., Dutton, R., & Wakely, K. (2014). Creating positive
rural experiences for occupational therapy students.
Australian Journal of Rural Health, 22(4), 204–205. https://doi.
org/10.1111/ajr.12104
Woolley, T., Larkins, S., & Gupta, T. S. (2019). Career choicse of the
first seven cohorts of JCU MBBS graduates: Producing general-
ists for regional, rural and remote northern Australia. Rural
and Remote Health, 19(2), 31–40. https://doi.org/10.22605/
RRH4438
World Federation of Occupational Therapists. (2019). Position State-
ment: Occupational Therapy and Human Rights. World Feder-
ation of Occupational Therapists. https://wfot.org/resources/
occupational-therapy-and-human-rights
World Federation of Occupational Therapists. (2021). Member
Organisations Profiles. World Federation of Occupational
HAYES ET AL. 135

Therapists. https://www.wfot.org/membership/member-
organisations/member-organisations-profiles How to cite this article: Hayes, K., Dos Santos,
World Health Organisation. (2021). WHO Guideline on Health
V., Costigan, M., & Morante, D. (2023). Profile of
Workforce Development, Attraction, Recruitment and Retention
occupational therapy services in non-urban
in Rural and Remote Areas. World Health Organisation.
https://www.who.int/publications/i/item/9789240025318 settings: A global scoping review. Australian
Occupational Therapy Journal, 70(1), 119–141.
S UP PO RT ING IN FOR MAT ION https://doi.org/10.1111/1440-1630.12835
Additional supporting information can be found online
in the Supporting Information section at the end of this
article.

A P P END I X A : SEARCH STRATEGY

A.1 | OVID Medline: 18/9/2020

# Search terms Results

1 Agriculture [MeSH] 42,972
2 Remote Consultation [MeSH] 4829
3 Hospitals, Rural [MeSH] 4863
4 Rural Population [MeSH] 59,692
5 Rural Health [MeSH] 23,406
6 Rural Health Services [MeSH] 12,819
7 Farms [MeSH] 2426
8 Farmers [MeSH] 2042
9 Indigenous Peoples [MeSH] 243
10 Health Services, Indigenous [MeSH] 3305
11 TI (Agricultur* OR Remote OR Hospitals, Rural OR Farm* OR Indigenous) 55,093
12 TI (Wilderness OR regional OR provincial OR isolated OR outback OR inland 244,506
OR coast* OR peasant* OR countryside OR frontier OR district)
13 Telemedicine [MeSH] 23,732
14 Videoconferencing [MeSH] 1590
15 Telerehabilitation [MeSH] 394
16 Video recording [MeSH] 25,199
17 Webcast [MeSH] 942
18 TI (Telemedicine OR Videoconferencing OR Telerehabilitation OR Video Recording OR Webcast) 6210
19 TI (Teleconferenc* OR telehealth) 2205
20 Occupational Therapy [MeSH] 13,295
21 Occupational Therapists [MeSH] 321
22 Occupational therap* OR OT 39,991
23 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 466,622
24 20 or 21 or 22 39,991
25 23 and 24 1501
26 Limit 25 to yr = “2010–2021” 369
27 Limit 26 to (English or French or Portuguese or Spanish) 314
136 HAYES ET AL.

A.2 | CINAHL 18/9/2020

# Search terms Results

S1 (MH “Agriculture”) 6905
S2 (MH “Remote Consultation”) 2086
S3 (MH “Hospitals, Rural”) 2893
S4 (MH “Rural Areas”) 22,427
S5 (MH “Rural Health”) 6912
S6 (MH “Rural Health Personnel”) 657
S7 (MH “"Rural Health Centres”) 337
S8 (MH “"Rural Health Services”) 6823
S9 (MH “"Farmworkers”) 3299
S10 (MH “"Telehealth”) 8810
S11 (MH “"Teleconferencing”) 1441
S12 (MH “"Videoconferencing”) 1748
S13 (MH “Telerehabilitation”) 197
S14 (MH “Videorecording”) 28,580
S15 (MH “"Webcasts”) 448
S16 (MH “"Indigenous eoples”) 4645
S17 (MH “"Indigenous Health”) 1266
S18 (MH “"Health Services, Indigenous”) 2483
S19 TI (Agricultur* OR Farm* OR Remote OR Rural OR Telehealth OR Teleconferenc* 46,265
OR Telerehabilitation OR Videoconferenc* OR Videorecording OR Webcast OR Indigenous)
S20 TI (wilderness OR regional OR provincial OR isolated OR outback OR inland OR coast* 40,793
OR peasant* OR countryside OR frontier OR district)
S21 (MH “Occupational therapy”) 23,736
S22 (MH “Occupational therapists”) 9636
S23 Occupational therap* OR OT 60,192
S24 S1 OR S2 OR S3 OR S4 OR S5 OR S6 OR S7 OR S8 OR S9 OR S10 OR S11 OR S12 151,307
OR S13 OR S14 OR S15 OR S16 OR S17 OR S18 OR S19 OR S20
S25 S21 OR S22 OR S23 60,192
S26 S24 AND S25 1689
S27 S25 Limiters - Published Date: 20100101-20201231 953
S28 S26 Limiters - Language: English, French, Portuguese, Spanish 947
HAYES ET AL. 137

A.3 | Emcare 18/9/2020

1 Agriculture/ 6115
2 Teleconsultation/ 4443
3 Rural hospital/ 102
4 Rural population/ 12,620
5 Rural health/ 745
6 Rural health care/ 4312
7 Rural area/ 26,867
8 Agricultural land/ 1319
9 Agricultural worker/ 7058
10 Teleconference/ 926
11 Telehealth/ 6805
12 Telerehabilitation/ 457
13 Videoconferencing/ 2151
14 Videorecording/ 30,684
15 Webcast/ 79
16 Telemedicine/ 10,662
17 Indigenous health care/ 160
18 Indigenous people/ 4975
19 (Agricultur* OR Farm* OR Remote OR Rural OR Telehealth OR Teleconferenc* OR 43,960
Telerehabilitation OR Videoconferenc* OR Videorecording OR Webcast OR Indigenous).m.titl
20 (wilderness OR regional OR provincial OR isolated OR outback OR inland OR coast* 44,669
OR peasant* OR countryside OR frontier OR district).m.titl
21 Occupational therapy/ 13,075
22 Occupational therapist/ 7112
23 (Occupational therap* or OT).mp. 20,895
24 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 or 20 167,290
25 21 or 22 or 23 20,895
26 24 or 25 750
27 Limit 26 to yr = “2010–2020” 487
28 Limit 27 to (English or French or Portuguese or Spanish) 474
138 HAYES ET AL.

A.4 | ProQuest Nursing and Allied Health 18/9/2020

# Search terms Results

S1 mesh. Exact(“Agriculture”) 1431
S2 mesh. Exact(“Remote Consultation”) 318
S3 mesh. Exact(“Hospitals, Rural”) 495
S4 mesh. Exact(“Rural Health”) 1251
S5 mesh. Exact(“Rural Health Services”) 1347
S6 mesh. Exact(“Videoconferencing”) 89
S7 mesh. Exact(“Webcasts as Topic”) 34
S8 mesh. Exact(“Health Services, Indigenous”) 375
S9 ti (rural) AND mesh. Exact(“Health Services, Indigenous”) 9
S10 ti (rural) 16,300
S11 ti (agriculture OR Agricultural) 10,406
S12 ti (teleconference) 160
S13 ti (telehealth) 1634
S14 ti (telerehabilitation) 159
S15 ti (videoconferencing) 153
S16 ti (videoconference) 57
S17 ti (video recording) 141
S18 ti (webcast) 2154
S19 ti (telemedicine) 2732
S20 ti (indigenous) 2390
S21 ti (wilderness) 345
S22 ti (regional) 12,718
S23 ti (provincial) 1275
S24 ti (isolated) 11,535
S25 ti (outback) 71
S26 ti (inland) 215
S27 ti (coast) 1599
S28 ti (peasant) 30
S29 ti (countryside) 58
S30 ti (frontier) 2254
S31 ti (district) 4681
S32 mesh. Exact(“Occupational Therapy” OR “Occupational Therapy Department, Hospital”) 1188
S33 Occupational therapy 95,996
S34 Occupational therapist 45,262
S35 mesh. Exact(“Agriculture”) OR mesh. Exact(“Remote Consultation”) OR mesh. Exact(“Hospitals, Rural”) OR mesh. 72,997
Exact(“Rural Health”) OR mesh. Exact(“Rural Health Services”) OR mesh. Exact(“Videoconferencing”) OR mesh.
Exact(“Webcasts as Topic”) OR mesh. Exact(“Health Services, Indigenous”) OR (ti (rural) AND mesh. Exact
(“Health Services, Indigenous”)) OR ti (rural) OR ti (agriculture OR Agricultural) OR ti (teleconference) OR ti
(telehealth) OR ti (telerehabilitation) OR ti (videoconferencing) OR ti (videoconference) OR ti (video recording)
OR ti (webcast) OR ti (telemedicine) OR ti (indigenous) OR ti (wilderness) OR ti (regional) OR ti (provincial) OR ti
(isolated) OR ti (outback) OR ti (inland) OR ti (coast) OR ti (peasant) OR ti (countryside) OR ti (frontier) OR ti
(district)
(Continues)
HAYES ET AL. 139

# Search terms Results

S36 mesh. Exact(“Occupational Therapy” OR “Occupational Therapy Department, Hospital”) OR (occupational therapy) 103,771
OR (occupational therapist)
S37 (mesh. Exact(“Agriculture”) OR mesh. Exact(“Remote Consultation”) OR mesh. Exact(“Hospitals, Rural”) OR mesh. 1407
Exact(“jRural Health”) OR mesh. Exact(“Rural Health Services”) OR mesh. Exact(“Videoconferencing”) OR mesh.
Exact(“Webcasts as Topic”) OR mesh. Exact(“Health Services, Indigenous”) OR (ti (rural) AND mesh. Exact
(“Health Services, Indigenous”)) OR ti (rural) OR ti (agriculture OR Agricultural) OR ti (teleconference) OR ti
(telehealth) OR ti (telerehabilitation) OR ti (videoconferencing) OR ti (videoconference) OR ti (video recording)
OR ti (webcast) OR ti (telemedicine) OR ti (indigenous) OR ti (wilderness) OR ti (regional) OR ti (provincial) OR ti
(isolated) OR ti (outback) OR ti (inland) OR ti (coast) OR ti (peasant) OR ti (countryside) OR ti (frontier) OR ti
(district)) AND (mesh. Exact(“Occupational Therapy” OR “Occupational Therapy Department, Hospital”) OR
(occupational therapy) OR (occupational therapist))
S38 (mesh. Exact(“Agriculture”) OR mesh. Exact(“Remote Consultation”) OR mesh. Exact(“Hospitals, Rural”) OR mesh. 868
Exact(“Rural Health") OR mesh. Exact("Rural Health Services") OR mesh. Exact("Videoconferencing") OR mesh.
Exact("Webcasts as Topic") OR mesh. Exact("Health Services, Indigenous”) OR (ti (rural) AND mesh. Exact
(“Health Services, Indigenous”)) OR ti (rural) OR ti (agriculture OR Agricultural) OR ti (teleconference) OR ti
(telehealth) OR ti (telerehabilitation) OR ti (videoconferencing) OR ti (videoconference) OR ti (video recording)
OR ti (webcast) OR ti (telemedicine) OR ti (indigenous) OR ti (wilderness) OR ti (regional) OR ti (provincial) OR ti
(isolated) OR ti (outback) OR ti (inland) OR ti (coast) OR ti (peasant) OR ti (countryside) OR ti (frontier) OR ti
(district)) AND (mesh. Exact(“Occupational Therapy” OR “Occupational Therapy Department, Hospital”) OR
(occupational therapy) OR (occupational therapist)) AND yr(2010-2029)
S39 (mesh. Exact(“Agriculture”) OR mesh. Exact(“Remote Consultation”) OR mesh. Exact(“Hospitals, Rural”) OR mesh. 867
Exact(“Rural Health”) OR mesh. Exact(“Rural Health Services”) OR mesh. Exact(“Videoconferencing”) OR mesh.
Exact(“Webcasts as Topic”) OR mesh. Exact(“Health Services, Indigenous”) OR (ti (rural) AND mesh. Exact
(“Health Services, Indigenous”)) OR ti (rural) OR ti (agriculture OR Agricultural) OR ti (teleconference) OR ti
(telehealth) OR ti (telerehabilitation) OR ti (videoconferencing) OR ti (videoconference) OR ti (video recording)
OR ti (webcast) OR ti (telemedicine) OR ti (indigenous) OR ti (wilderness) OR ti (regional) OR ti (provincial) OR ti
(isolated) OR ti (outback) OR ti (inland) OR ti (coast) OR ti (peasant) OR ti (countryside) OR ti (frontier) OR ti
(district)) AND (mesh. Exact(“Occupational Therapy” OR “Occupational Therapy Department, Hospital”) OR
(occupational therapy) OR (occupational therapist)) AND (la.exact((“ENG” OR “POR” OR “SPA”) NOT “TUR”)
AND yr(2010-2029))
140 HAYES ET AL.

A P P END I X B: DATA EXTRACTION TOOL

Article details:
Citation details: Authors:
Year:
Title:
Publication:
DOI/URL:
Language: □ English
□ French
□ Spanish
□ Portuguese
Publication type: □ Journal article
□ Conference abstract
□ Conference poster
□ Thesis
□ Report
□ Other:
Study method: □ Quantitative
□ Qualitative
□ Mixed method
□ Theoretical/descriptive

Client details:
Country (location): □ Global North
(name of country where client received service) □ Global South
Area (location):
(town, state, county etc, where service is received)
Clients served: □ Persons (1:1 individual intervention including families)
□ Groups (clients with the same issue receiving intervention concurrently)
□ Population (community, village, geographically defined group)
Age group: □ Children & families □ Elders
(as defined by the study text) □ Youth □ All ages
□ Adults □ Not stated
Diagnostic or intervention group:

Service details:
Setting: service received □ Inpatient (e.g. hospital, hospice etc)
(where is the service received by client?) □ Clinic (outpatient setting, therapy rooms etc)
□ Community (home, school, library, community centre etc)
□ Virtual (telephone, video conference etc)
□ Not stated
Setting: service origin □ Local service (service already exists in client’s community)
(where does the occupational therapy service come from?) □ Outreach service – provider travels (to client in community)
□ Outreach service - telehealth (telephone, video conference etc)
□ Distant service (client travels to the provider in another community)
□ OT trained worker (OT trains local person to provide intervention)
□ Not stated
(Continues)
HAYES ET AL.
Service details:
Main enablement strategy used:
Details of service provided:
141
□ Remediation (actions to change the person)
□ Compensation (actions to change environment/task)
□ Education (actions to educate client/family)
□ Community development (participatory community capacity building
□ Transformation (partner with marginalised groups to build services)
□ Redistributive justice (action/advocacy to improve community occupational
rights)
□ Research
 Inductive exploratory
 Deductive
 Participatory action research
 Other: