title: Are health promotion and prevention interventions integrated into occupational therapy practice with older adults having disabilities? Insights from six community health settings in Québec, Canada.
abstract: OBJECTIVE
  Increasingly, health-care systems should promote seniors' health and prevent disability. As they enable engagement in meaningful activities within the individuals' living environment, community occupational therapists have great potential to contribute to health promotion and prevention. Despite this potential, little is known about current health promotion and prevention activities in occupational therapy community practice. This study thus aimed to: (1) identify health promotion and prevention interventions used with seniors having disabilities, and (2) explore barriers to integrating such interventions into practice.
  
  
  METHODS
  Secondary data analysis of a qualitative study was carried out using thematic saliency analysis. Eleven community occupational therapists working with seniors having disabilities were recruited in six community health settings in Québec, Canada. Observations of 12 home visits, followed by 12 semi-structured interviews, were conducted with occupational therapists.
  
  
  RESULTS
  Most interventions involved optimising independence in personal care and mobility. Explicit health promotion interventions were limited and included enabling healthy lifestyles by increasing health literacy and empowerment. Meaningful activities (leisure, community participation) were not targeted. Barriers to integrating health promotion into practice were clients' complex health conditions and limited openness to change combined with organisational and professional obstacles, such as a misunderstanding of occupational therapists' role in health promotion.
  
  
  CONCLUSIONS
  Health promotion and prevention interventions are not intentionally integrated into community occupational therapy practice with seniors having disabilities. As a result, seniors' needs to engage in meaningful activities might remain unmet. Overcoming barriers to integrating health promotion and prevention in practice could help improve population health and wellbeing.
authors: Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Québec, Canada; Research Centre on Aging, Health and Social Services Centre, University Institute of Geriatrics of Sherbrooke (CSSS-IUGS), Sherbrooke, Québec, Canada.
authors: Pier-Luc
authors: PL
authors: Turcotte
authors: Annie
authors: A
authors: Carrier
authors: Johanne
authors: J
authors: Desrosiers
authors: Mélanie
authors: M
authors: Levasseur
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D015577:Geriatric Assessment; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000458:organization & administration*; D011315:Preventive Medicine / Q000458:organization & administration*; D036301:Qualitative Research; D011792:Quebec; D018570:Risk Assessment; D016896:Treatment Outcome
keywords: advocacy; ageing; client centred practice; community practice; health promotion; qualitative research