title: Perspectives of occupational therapists working in primary health promotion.
abstract: OBJECTIVE
  Given a global reorientation of health services towards upstream, or primary health promotion, there is a need to explore the role of occupational therapy in this area of practice. This study aimed to explore and describe the primary health promotion practice of community health workers with an occupational therapy background. The study highlights their practice working at a community or population (macro) level, rather than at the client service (micro) level, and explores related enablers and barriers to this practice.
  
  
  METHODS
  The study utilised the qualitative methodology of narrative enquiry. Five workers with an occupational therapy background were recruited from community health services within Victoria. Data were gathered via in-depth interviews. Individual participant interview data were ordered to form a narrative detailing each participant's experience. These narratives were then analysed to generate themes representing important aspects of participant's experiences.
  
  
  RESULTS
  Although some practitioners with an occupational therapy background perform primary health promotion, the findings indicate that a number of barriers deter occupational therapists from engaging in this type of practice, including lack of funding, preparation and limited understanding of the role of occupational therapy in health promotion. Enablers to engagement included undertaking further education, gaining clinical experience and establishing a professional identity.
  
  
  CONCLUSIONS
  This study provides insights into the experiences of occupational therapists who work at a macro rather than micro-level of practice, and emphasises some of the barriers and enablers to embracing the sorts of roles that are emerging as part of a changing health system.
authors.affiliation: Department of Occupational Therapy, School of Allied Health, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria, Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Wood
authors.forename: Tracy
authors.initials: T
authors.lastname: Fortune
authors.forename: Carol
authors.initials: C
authors.lastname: McKinstry
mesh_terms: D001291:Attitude of Health Personnel; D001315:Australia; D003153:Community Health Services; D005260:Female; D006293:Health Promotion; D006801:Humans; D007407:Interviews as Topic; D033262:Narration; D011320:Primary Health Care