Occupational Therapy’s Role in

Health Promotion
The path to health and well-being is intricately linked to the daily occupations in which we choose to participate. The World Health Organization (WHO) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO, 1948). In the International Classification of Functioning, Disability and Health (ICF) model, the WHO further quantifies and measures health based on the ability of a person to participate in life (WHO). Occupational therapy is a profession that focuses on enabling clients to maximize their capacity to participate in life activities that are important and meaningful to them. With escalating health care costs and changing demographics in the United States, the U.S. Department of Health and Human Services (HHS), has emphasized health promotion and disease prevention to improve the life expectancy, health and quality of life of all Americans (HHS, 1998). Health promotion is a prevention strategy that allows people to manage and improve their overall health status. Occupational therapy practitioners play an important role in promoting health and preventing disease and disability (AOTA, 2008). Their unique perspective helps clients adapt and organize their daily occupations or activities related to self-care, home management, community participation, education, work and/or leisure into daily routines to prevent and minimize dysfunction, promote and develop a healthy lifestyle, and facilitate adaptation and recovery from injury, disease, or developmental challenges.

Occupational Therapy and Health Promotion
Occupational therapy practitioners believe that “health is strongly influenced by [individuals] having choice and control in everyday occupations” (CAOT, 2002, p.31), and as such, occupation is a determinant of health. “Occupations are purposeful and meaningful daily activities that fill a person’s time” (AOTA, 2008). These can be activities that individuals need or want to do that relate to self-care, play or leisure, their work and/or home, and community-based tasks. Through participation in their daily occupations, individuals can positively influence their health (Wilcock, 2006). Occupational therapy practitioners are trained to view a person holistically in the context of their daily lives, across the lifespan. For example, they can create health-promoting play activities for children to enhance physical well being, develop injury prevention programs for adult workers, or educate seniors on home and activity modifications to prevent falls or identify and provide adaptations to cars so that seniors can drive more safely.
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Role of Occupational Therapy
Behavior patterns which can be influenced by the environment, education, poverty, genetic disposition, and access to health care are the leading cause for poor health, disease, disability, and early death (McGinnis, Williams-Russo, & Knickman, 2002). Occupational therapy practitioners understand the complex and dynamic interactions between the person, their environment and activities they need to accomplish in their daily lives. They also recognize the importance of habits and routines that promote the adoption and maintenance of healthy behaviors. This enables the occupational therapy practitioner to facilitate success by matching the person’s skills to the demands of the activity, by utilizing environmental supports, by minimizing environmental barriers, and by offering solutions to challenges associated with changing habits and routines. For example, a person who enjoyed gardening but gave up this meaningful activity due to back pain may experience improved well being if they can continue through adaptations such as raised gardens or long handled tools to minimize strain on the back. Teaching someone to change positions frequently and to limit their time per day in the garden might be an alternate approach to improved health. Occupational therapy practitioners can identify and address barriers between the client’s abilities and the demands of their daily lives at home and at work, thereby promoting a healthier lifestyle. For example, an occupational therapy practitioner working with a client with diabetes may teach techniques to monitor skin integrity and avoid skin breakdown, assist in establishing a daily meal intake schedule for proper nutrition, and assist the client in locating an accessible community exercise program.

Who Can Benefit From Occupational Therapy to Promote Health?
Occupational therapy practitioners work with individuals across the life span, with populations and with organizations. They work with individuals and groups who have disabilities as well as healthy individuals. Health promotion services occur in various settings including, but not limited to, hospitals, skilled nursing facilities, continuing care retirement centers, community organizations, schools, and workplaces. Occupational therapy services related to health promotion are broad ranging from general prevention strategies for a healthy population such as backpack awareness day and car safety recommendation programs for adult drivers to specific health enhancing activities for individuals with chronic medical conditions. A study done in Southern California on older residents of low income housing found that occupational therapy was more effective in maintaining and promoting a healthy and more independent lifestyle than control groups that received either no services or social activity services only (Clark et al., 1997).

Occupational therapy enables people of all ages live life to its fullest by helping them to promote health, make lifestyle or environmental changes, and prevent—or live better with—injury, illness or disability. By looking at the whole picture—a client’s psychological, physical, emotional, and social make-up—occupational therapy assists people to achieve their goals, function at the highest possible level, maintain or rebuild their independence and participate in the everyday activities of life.

How do Occupational Therapy Practitioners Promote Health and Well-Being?
Occupational therapy practitioners: • Perform assessments for health risks related to potential for falls, safety in independent living, and cognitive/memory screens in older adults • Evaluate children for gross and fine motor deficits, sensory processing or adaptive behavior differences which may result in developmental delays • Teach strategies to incorporate healthy habits and routines into daily activities for clients of all ages and abilities • Identify solutions to personal and environmental barriers limiting clients from engaging in healthy activities • Educate about the importance of relaxation and rest to achieve balance between work and leisure; teach relaxation techniques • Provide skills training in areas such as socialization, care giving, parenting, time management, stress management, etc. Some examples of occupation-based health promotion programs: • Community-based fall prevention programs for seniors • Workplace injury prevention and wellness programs • Ergonomic principles applied to computer workstations in schools and workplaces to decrease repetitive motion and musculoskeletal disorders • Stress and anger management programs for children in juvenile detention programs. • Parenting classes for teenage mothers, mothers in homeless shelters, or those recovering from drug dependency • Backpack safety to prevent injury from heavily loaded backpacks in school-age children • Self-management programs to enable those with chronic diseases like diabetes, rheumatoid arthritis and cardiac conditions to optimize health through appropriate routines (modifications when necessary) and participation in meaningful occupations • CarFit programs for drivers to match the needs of the driver with minor adaptations to the car • Caregiver education to prevent injury and/or burnout Occupational therapy promotes health and wellbeing through active involvement in meaningful occupations. By helping clients eliminate barriers, enhance their self-management skills, improve their performance of daily activities and adopt healthy habits and routines, occupational therapy unlocks the door to participation across the lifespan.

Occupational therapy enables people of all ages live life to its fullest by helping them to promote health, make lifestyle or environmental changes, and prevent—or live better with—injury, illness or disability. By looking at the whole picture—a client’s psychological, physical, emotional, and social make-up—occupational therapy assists people to achieve their goals, function at the highest possible level, maintain or rebuild their independence and participate in the everyday activities of life.

References and Resources
American Occupational Therapy Association (2008). Occupational therapy practice framework: Domain and Process, 2nd Ed., American Journal of Occupational Therapy, 62(6), 625–683. Canadian Association of Occupational Therapists (2002). Enabling occupation: an occupational theray perspective. Author, Ottawa: ON Clark, F., Azen, S. P., Zemke, R., Jackson, J., Carlson, M., Mandel, D. et al. (1997). Occupational Therapy for independent living older adults: A randomized controlled tiral. Journal of the American Medical Association, 278, 1321–1326. McGinnis, J. M., Williams-Russo, P., & Knickman, J. R. (2002). The case for more active policy attention to health promotion. Health Affairs, 21, 78–03. U.S. Department of Health and Human Services (1998). Healthy People 2010. Retrieved November 17, 2008, from www.healthypeople.gov. Wilcock, A. A. (2006). An occupational perspective of health (2nd ed.). Thorofare, NJ: SLACK incorporated. World Health Organization. (1948). Preamble to the constitution of the World Health Organization. Official Records of the World Health Organization. Retrieved February 17, 2010 form http://whqlibdoc.who.int/hist/official_records/2e.pdf

This fact sheet was developed for AOTA by Jyothi Gupta, PhD, OTR/L, OT(C), Barbara E. Chandler, PhD, OTR/L, FAOTA, and Pam Toto, MS, OTR/L, BCG, FAOTA. Copyright © 2010 American Occupational Therapy Association. All rights reserved. This material may be printed and distributed without prior written consent.

Occupational therapy enables people of all ages live life to its fullest by helping them to promote health, make lifestyle or environmental changes, and prevent—or live better with—injury, illness or disability. By looking at the whole picture—a client’s psychological, physical, emotional, and social make-up—occupational therapy assists people to achieve their goals, function at the highest possible level, maintain or rebuild their independence and participate in the everyday activities of life.

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