Engagement, acceptability, usability and satisfaction with Active for Life, a computer-tailored web-based physical activity intervention using Fitbits in older adults.

BACKGROUND: Preliminary evidence suggests that web-based physical activity interventions with tailored advice and Fitbit integration are effective and may be well suited to older adults. Therefore, this study aimed to examine the engagement, acceptability, usability, and satisfaction with 'Active for Life,' a web-based physical activity intervention providing computer-tailored physical activity advice to older adults. METHODS: Inactive older adults (n = 243) were randomly assigned into 3 groups: 1) tailoring + Fitbit, 2) tailoring only, or 3) a wait-list control. The tailoring + Fitbit group and the tailoring-only group received 6 modules of computer-tailored physical activity advice over 12 weeks. The advice was informed by objective Fitbit data in the tailoring + Fitbit group and self-reported physical activity in the tailoring-only group. This study examined the engagement, acceptability, usability, and satisfaction of Active for Life in intervention participants (tailoring + Fitbit n = 78, tailoring only n = 96). Wait-list participants were not included. Engagement (Module completion, time on site) were objectively recorded through the intervention website. Acceptability (7-point Likert scale), usability (System Usability Scale), and satisfaction (open-ended questions) were assessed using an online survey at post intervention. ANOVA and Chi square analyses were conducted to compare outcomes between intervention groups and content analysis was used to analyse program satisfaction. RESULTS: At post-intervention (week 12), study attrition was 28% (22/78) in the Fitbit + tailoring group and 39% (37/96) in the tailoring-only group. Engagement and acceptability were good in both groups, however there were no group differences (module completions: tailoring + Fitbit: 4.72 ± 2.04, Tailoring-only: 4.23 ± 2.25 out of 6 modules, p = .14, time on site: tailoring + Fitbit: 103.46 ± 70.63, Tailoring-only: 96.90 ± 76.37 min in total, p = .56, and acceptability of the advice: tailoring + Fitbit: 5.62 ± 0.89, Tailoring-only: 5.75 ± 0.75 out of 7, p = .41). Intervention usability was modest but significantly higher in the tailoring + Fitbit group (tailoring + Fitbit: 64.55 ± 13.59, Tailoring-only: 57.04 ± 2.58 out of 100, p = .003). Participants reported that Active for Life helped motivate them, held them accountable, improved their awareness of how active they were and helped them to become more active. Conversely, many participants felt as though they would prefer personal contact, more detailed tailoring and more survey response options. CONCLUSIONS: This study supports web-based physical activity interventions with computer-tailored advice and Fitbit integration as engaging and acceptable in older adults. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry: ACTRN12618000646246. Registered April 23 2018, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374901.

The Effectiveness of a Computer-Tailored Web-Based Physical Activity Intervention Using Fitbit Activity Trackers in Older Adults (Active for Life): Randomized Controlled Trial.

BACKGROUND: Physical activity is an integral part of healthy aging; yet, most adults aged ≥65 years are not sufficiently active. Preliminary evidence suggests that web-based interventions with computer-tailored advice and Fitbit activity trackers may be well suited for older adults. OBJECTIVE: The aim of this study was to examine the effectiveness of Active for Life, a 12-week web-based physical activity intervention with 6 web-based modules of computer-tailored advice to increase physical activity in older Australians. METHODS: Participants were recruited both through the web and offline and were randomly assigned to 1 of 3 trial arms: tailoring+Fitbit, tailoring only, or a wait-list control. The computer-tailored advice was based on either participants' Fitbit data (tailoring+Fitbit participants) or self-reported physical activity (tailoring-only participants). The main outcome was change in wrist-worn accelerometer (ActiGraph GT9X)-measured moderate to vigorous physical activity (MVPA) from baseline to after the intervention (week 12). The secondary outcomes were change in self-reported physical activity measured by means of the Active Australia Survey at the midintervention point (6 weeks), after the intervention (week 12), and at follow-up (week 24). Participants had a face-to-face meeting at baseline for a demonstration of the intervention and at baseline and week 12 to return the accelerometers. Generalized linear mixed model analyses were conducted with a γ distribution and log link to compare MVPA and self-reported physical activity changes over time within each trial arm and between each of the trial arms. RESULTS: A total of 243 participants were randomly assigned to tailoring+Fitbit (n=78, 32.1%), tailoring only (n=96, 39.5%), and wait-list control (n=69, 28.4%). Attrition was 28.8% (70/243) at 6 weeks, 31.7% (77/243) at 12 weeks, and 35.4% (86/243) at 24 weeks. No significant overall time by group interaction was observed for MVPA (P=.05). There were no significant within-group changes for MVPA over time in the tailoring+Fitbit group (+3%, 95% CI -24% to 40%) or the tailoring-only group (-4%, 95% CI -24% to 30%); however, a significant decline was seen in the control group (-35%, 95% CI -52% to -11%). The tailoring+Fitbit group participants increased their MVPA 59% (95% CI 6%-138%) more than those in the control group. A significant time by group interaction was observed for self-reported physical activity (P=.02). All groups increased their self-reported physical activity from baseline to week 6, week 12, and week 24, and this increase was greater in the tailoring+Fitbit group than in the control group at 6 weeks (+61%, 95% CI 11%-133%). CONCLUSIONS: A computer-tailored physical activity intervention with Fitbit integration resulted in improved MVPA outcomes in comparison with a control group in older adults. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12618000646246; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618000646246.

Using social return on investment analysis to calculate the social impact of modified vehicles for people with disability.

INTRODUCTION: Returning to driving is often a goal for people with acquired disabilities. Vehicle modifications make it possible for people with both acquired and lifelong disabilities to drive yet can be costly. There has been no financial evaluation of vehicle modifications in Australia or internationally. METHODS: A social return on investment analysis of vehicle modifications was undertaken. Primary data were collected via qualitative interviews with consumers and other stakeholders (e.g. driver-trained occupational therapists, rehabilitation physicians, driving instructors, vehicle modifiers) (n = 23). Secondary data were collected from literature searches and used to identify suitable financial proxies and make estimations of the proportion of drivers with vehicle modifications experiencing each outcome. A co-investment model was adopted to estimate social return on investment and payback period for funder and consumer. Five scenarios were developed to illustrate social return for low-cost modifications (Scenario 1) through to high-cost modifications (Scenario 5). RESULTS: Social return on investment ratios was positive for funder and consumer investment in all five scenarios. Social return on investment calculations based on co-investment ranged from $17.32 for every $1 invested (Scenario 1) to $2.78 for every $1 invested (Scenario 5). Consumers' payback periods were between 5.4 and 7.1 months, and funders between 3.5 weeks and 2 years 8.4 months. CONCLUSION: Vehicle modifications represent sound investments for both funders and consumers. Given the short payback periods, funders should reconsider age restrictions on vehicles considered suitable for modifications, especially for low- to medium-cost modifications.

Implementation of Dialectical Behavior Therapy in Residential Treatment Programs: A Process Evaluation Model for a Community-Based Agency.

Dialectical behavior therapy (DBT) can be challenging to implement in community-based settings. Little guidance is available on models to evaluate the effectiveness or sustainability of training and implementation efforts. Residential programs have much to gain from introduction of evidence-based practices, but present their own challenges in implementation. This paper presents a low-cost process evaluation model to assess DBT training piloted in residential programs. The model targets staff and organizational factors associated with successful implementation of evidence-based practices and matches data collection to the four stages of the DBT training model. The strengths and limitations of the evaluation model are discussed.

Mapping an Australian Occupational Therapy curriculum: Linking intended learning outcomes with entry-level competency standards.

BACKGROUND: Curriculum mapping involves systematic charting of programme content against professional competencies. This process can reveal strengths, gaps and redundancies within educational programmes. METHODS: Curriculum mapping occurred using intended learning (ILOs) as documented in individual courses and linking them to units and elements within the occupational therapy minimum competency standards (ACSOT) and Miller's Framework of competency. Five occupational therapy academics and two impartial research assistants identified links between ILOs and units and elements of the ACSOT. Analysis of each course in the curriculum was completed by two reviewers. A systematic protocol was developed that enabled a transparent process and resolution of discrepancies between reviewers. RESULTS: There were many links (47% of total) between the documented curriculum and ACSOT Unit 1 Professional attitudes and behaviours. The other six units of the ACSOT had between 5% (Unit 7) and 16% links (Unit 3). No links were made between ILOs and the elements of evaluation (4.4), cessation (3.7) and quality assurance of services (7.3). Difficulties mapping ILOs to units and elements revealed inconsistencies in specificity and language in the ILOs and also ambiguities and gaps within the standards themselves. Mapping against Miller's framework showed a steady increase in performance expectations of students across the four years levels. CONCLUSION: Curriculum mapping is recommended for critical reflection about content of occupational therapy programmes and to review pedagogical approaches. This process revealed strengths and weaknesses of the occupational therapy curriculum being mapped but also revealed insight into the current ACSOT that may inform future iterations.

Simulated versus traditional occupational therapy placements: A randomised controlled trial.

BACKGROUND/AIM: Professional practise placements in occupational therapy education are critical to ensuring graduate competence. Australian occupational therapy accreditation standards allow up to 200 of a mandated 1000 placement hours to include simulation-based learning. There is, however, minimal evidence about the effectiveness of simulation-based placements compared to traditional placements in occupational therapy. We evaluated whether occupational therapy students completing a 40 hour (one week block) Simulated Clinical Placement (SCP) attained non-inferior learning outcomes to students attending a 40 hour Traditional Clinical Placement (TCP). METHODS: A pragmatic, non-inferiority, assessor-blinded, multicentre, randomised controlled trial involving students from six Australian universities was conducted. Statistical power analysis estimated a required sample of 425. Concealed random allocation was undertaken with a 1:1 ratio within each university. Students were assigned to SCP or TCP in one of three settings: vocational rehabilitation, mental health or physical rehabilitation. SCP materials were developed, manualised and staff training provided. TCPs were in equivalent practice areas. Outcomes were assessed using a standardised examination, unit grades, the Student Practice Evaluation Form-Revised and student confidence survey. A generalised estimating equation approach was used to assess non-inferiority of the SCP to the TCP. RESULTS: Of 570 randomised students (84% female), 275 attended the SCP and 265 the TCP (n = 540, 94.7% retention). There were no significant differences between the TCP and SCP on (i) examination results (marginal mean difference 1.85, 95% CI: 0.46-3.24; P = 0.087); (ii) unit score (mean (SD) SCP: 71.9 (8.8), TCP: 70.34 (9.1); P = 0.066); or (iii) placement fail rate, assessed using the Student Practice Evaluation Form-Revised (100% passed both groups). CONCLUSION: Students can achieve equivalent learning outcomes in a 40 hour simulated placement to those achieved in a 40 hour traditional placement. These findings provide assurance to students, educators and professional accreditation bodies that simulation can be embedded in occupational therapy education with good effect.

Effectiveness of distance learning strategies for continuing professional development (CPD) for rural allied health practitioners: a systematic review.

BACKGROUND: Allied health professionals working in rural areas face unique challenges, often with limited access to resources. Accessing continuing professional development is one of those challenges and is related to retention of workforce. Effectiveness of distance learning strategies for continuing professional development in rural allied healthcare workers has not been evaluated. METHODS: We searched 17 databases and the grey literature up to September 2016 following the PRISMA guidelines. Any primary studies were included that focussed on allied health and distance delivery regardless of education topic or study design. Two independent reviewers extracted data and critically appraised the selected studies. RESULTS: The search returned 5257 results. With removal of duplicate references, we reviewed 3964 article titles and abstracts; n = 206 appeared potentially eligible and were scrutinised via full text screening; n = 14 were included. Studies were published between 1997 and 2016, were of varied methodological quality and were predominantly from Australia, USA and Canada with a focus on satisfaction of learners with the delivery method or on measures of educational outcomes. Technologies used to deliver distance education included video conference, teleconference, web based platforms and virtual reality. Early papers tended to focus more on the technology characteristics than educational outcomes. Some studies compared technology based delivery to face to face modes and found satisfaction and learning outcomes to be on par. Only three studies reported on practice change following the educational intervention and, despite a suggestion there is a link between the constructs, none measured the relationship between access to continuing professional development and workforce retention. CONCLUSION: Technology based options of delivery have a high utility, however the complex inter-relatedness of time, use, travel, location, costs, interactivity, learning outcomes and educational design suggest a need for more sophisticated consideration by educational providers. TRIAL REGISTRATION: Registration with PROSPERO 30 June 2016: CRD42016041588 .

Partnership, inclusion and innovation in occupational therapy: Essential or optional ingredients to flourish in a changing environment?

BACKGROUND/AIM: Historically occupational therapy has evidenced a tenacity to adjust and adapt to societal changes. Currently in Australia we are in the midst of significant change in health, disability and aged care service delivery alongside increasing numbers of new graduates seeking employment. Both of these changes create challenges and opportunities for the profession. How the profession adjusts to new service delivery models and supports new graduates in this changing work environment will influence our future. METHODS: Using examples from practice the paper explores ways in which partnership, inclusion and innovation can be effective in a changing environment. RESULTS: Doing effective partnership takes time, energy and a shared commitment of all involved and often requires negotiations and compromise. Inclusion can be tricky and requires vigilance and ongoing reflection on actions to determine if the outcomes are what was intended. Innovation can play two roles; it can be used to conserve current practice in new ways or it can offer agency to disrupt and redefine practice. CONCLUSION: The way in which the profession chooses to enact partnerships and inclusion will play a vital role in shaping the future. Similarly the space and support made for conservative or disruptive innovation will determine how we choose to define ourselves going forward. Moreover, these choices and actions will govern how effective we are in navigating the changing environment and supporting new graduates transitioning into the profession.

Previously inactive rural adults' experiences of commencing and maintaining a walking routine following participation in a walking intervention.

OBJECTIVE: This study aimed to richly describe previously inactive Riverland adults' experiences of commencing and maintaining a walking routine following participation in a walking intervention. DESIGN: Qualitative description using semi-structured in-depth interviews and thematic analysis. SETTING: Riverland, South Australia. PARTICIPANTS: Nine adults (four men and five women) aged between 40 and 65 years. INTERVENTION: Six-week walking intervention included issuing of pedometers, setting goals, completing logs and weekly emails to remind participants to wear their pedometers, recording of steps and provision of strategies for increasing daily steps. MAIN OUTCOME MEASURES: Rich description of participants' experiences represented by four themes and a number of subthemes, supported by direct quotes. RESULTS: Four themes: taking care of me through my walk, pedometers and accountability as motivators, fitting walking in and commencing and maintaining a walking routine. CONCLUSIONS: The participants' experience of commencing a walking routine differed from maintaining a walking routine. Future attempts to support maintenance of a walking routine may be strengthened through identifying and including ways to provide accountability for walking to others beyond the intervention as well as strategies that support the integration of walking into every activity. Furthermore, future walking interventions should enable participants to tailor their walks to their own preferences and mental health benefits of walking should be promoted at least as much as the physical benefits.

Twelve tips for teaching evidence-based physical examination.

BACKGROUND: Practicing evidence-based physical examination (EBPE) requires clinicians to apply the diagnostic accuracy of PE findings in relation to a suspected disease. Though it is important to effectively teach EBPE, clinicians often find the topic challenging. AIMS: There are few resources available to guide clinicians on strategies to teach EBPE. We seek to fill that need by presenting tips for effectively teaching EBPE in the clinical context. METHODS: This report is based primarily on the authors' experience and is supported by the available literature. RESULTS: We present 12 practical tips targeting the clinician educator. The first six tips condense key preparatory steps for the teacher, including basic statistics underpinning EBPE. The final six tips provide specific guidance on how to teach EBPE in the clinical environment. CONCLUSIONS: By practicing the 12 tips provided, clinicians will develop the confidence needed to effectively teach EBPE in inpatient or outpatient settings.

Effect of a pharmacist intervention on clinically important medication errors after hospital discharge: a randomized trial.

BACKGROUND: Clinically important medication errors are common after hospital discharge. They include preventable or ameliorable adverse drug events (ADEs), as well as medication discrepancies or nonadherence with high potential for future harm (potential ADEs). OBJECTIVE: To determine the effect of a tailored intervention on the occurrence of clinically important medication errors after hospital discharge. DESIGN: Randomized, controlled trial with concealed allocation and blinded outcome assessors. (ClinicalTrials.gov registration number: NCT00632021) SETTING: Two tertiary care academic hospitals. PATIENTS: Adults hospitalized with acute coronary syndromes or acute decompensated heart failure. INTERVENTION: Pharmacist-assisted medication reconciliation, inpatient pharmacist counseling, low-literacy adherence aids, and individualized telephone follow-up after discharge. MEASUREMENTS: The primary outcome was the number of clinically important medication errors per patient during the first 30 days after hospital discharge. Secondary outcomes included preventable or ameliorable ADEs, as well as potential ADEs. RESULTS: Among 851 participants, 432 (50.8%) had 1 or more clinically important medication errors; 22.9% of such errors were judged to be serious and 1.8% life-threatening. Adverse drug events occurred in 258 patients (30.3%) and potential ADEs in 253 patients (29.7%). The intervention did not significantly alter the per-patient number of clinically important medication errors (unadjusted incidence rate ratio, 0.92 [95% CI, 0.77 to 1.10]) or ADEs (unadjusted incidence rate ratio, 1.09 [CI, 0.86 to 1.39]). Patients in the intervention group tended to have fewer potential ADEs (unadjusted incidence rate ratio, 0.80 [CI, 0.61 to 1.04]). LIMITATION: The characteristics of the study hospitals and participants may limit generalizability. CONCLUSION: Clinically important medication errors were present among one half of patients after hospital discharge and were not significantly reduced by a health-literacy-sensitive, pharmacist-delivered intervention. PRIMARY FUNDING SOURCE: National Heart, Lung, and Blood Institute.

Outcomes from the implementation of a facility-specific evidence-based falls prevention intervention program in residential aged care.

For residents in long-term care facilities, falling is a major concern requiring preventive intervention. A prospective cohort study measured the impact of falls reduction following the implementation of evidence-based fall prevention interventions in 9 Australian residential care facilities. An external project team provided a comprehensive audit of current practice. Facilitated by an action research approach, interventions were individualized to be facility- and patient-specific and included the following: environmental modifications such as low beds and height-adjustable chairs, movement alarms, hazard removal, and hip protectors. Participants included 670 residents and 650 staff from 9 facilities across 3 states. A significant reduction of falls were observed per site in the proportion of fallers (P = .044) and single fallers (P = .04). However, overall the number of falls was confounded by multiple falls in residents. Reduction in fallers was sustained in the 6-month follow-up phase. Positive outcomes from interventions varied between facilities. Further research is necessary to target frequent fallers.

New graduate occupational therapists experience of showering assessments: a phenomological study.

BACKGROUND: Shower assessments are complex and challenging tasks undertaken by many occupational therapists with little known about how they are conducted and how new graduates learn to carry these out. There are no published guidelines and limited opportunity for students to practise shower assessments during their training bringing into question how new graduates learn to do this assessment and judge their effectiveness. AIM: To investigate the experience of new graduate occupational therapists undertaking their first shower assessments in South Australia. METHOD: Six graduate occupational therapists participated in a phenomenological study. Data were gathered through semi-structured interviews and analysed according to Giorgi's descriptive phenomenological method. FINDINGS: New graduates found the shower assessment process cognitively and emotionally demanding. Without prior experience, new graduates lacked confidence to perform the practical aspects of conducting a shower assessment. The sense of responsibility for getting it right and ensuring client safety was at times overwhelming. Social norms around nudity, age and gender impacted on the graduate's interaction with clients in the shower environment. However, graduates with previous care attendant work were better able to manage the social and practical challenges inherent in shower assessments. CONCLUSION: The findings of this study suggest that additional experiential, 'hands on', learning is needed in university curriculum for new graduates to develop practical clinical skills, particularly as practice placements have become more diverse. Similarly there is a need for organisations to provide orientation activities and mentoring for new graduates as they transition from student to therapist.

Evaluation of Alzheimer's Australia Vic Memory Lane Cafés.

BACKGROUND: This paper describes the evaluation of the Memory Lane Café service in Victoria, Australia. The Alzheimer's Australia Vic Memory Lane Café model aims to provide a social and educational service to people living with dementia and their carers, family members or friends. Dementia is a serious health issue in Australia, with prevalence estimated at 6.5% of people over 65 years of age. Living with dementia has significant social and psychological ramifications, often negatively affecting quality of life. Social support groups can improve quality of life for people living with dementia. METHODS: The evaluation included focus groups and surveys of people with dementia and their carers, staff consultation, service provider interviews, and researcher observation. The Melbourne Health Mental Health Human Research Ethics Committee approved the project. Participants included people with dementia (aged 60 to 93 years, previously enrolled in the Alzheimer's Australia Vic's six-week Living With Memory Loss Program), their carers, friends and/or family members, staff working in the Cafés, and service providers with links to the Cafés. RESULTS: This evaluation found that Memory Lane Cafés promote social inclusion, prevent isolation, and improve the social and emotional well-being of attendees. However, Cafés did not meet the needs of all potential attendees. CONCLUSIONS: The evaluation recommended that existing Café services be continued and possibilities for extending the Cafés be explored. Based on evaluation outcomes, the Department of Health Victoria is funding four additional pilot programs in café style support services.

International allied health student placements: A meta-synthesis.

BACKGROUND: Increasingly universities are offering international student placements as part of the global internationalisation movement. This review sought to synthesize the findings of studies to further understand the learning outcomes described by allied health students. AIMS/OBJECTIVES: To contribute to the understanding of the learning outcomes described by allied health students who have undertaken an international placement. METHODS: A qualitative meta-synthesis was conducted. From six databases, twenty-one studies were identified and critically appraised. Data were meta-aggregated, integrated and interpreted to develop new themes, with the experiences of over 259 allied health students synthesized. RESULTS: Themes include: the intertwined personal and professional development experienced by the students; confidence and independence, relationship building, insight into culture, service provision and differences in socio-economic and political contexts. CONCLUSION: Universities offering students international placements provide their students with opportunities to achieve unique learning outcomes with significant personal and professional transformational development that cannot be replicated by local placements.

Feasibility and outcomes of a home-based exercise program on improving balance and gait stability in women with lower-limb osteoarthritis or rheumatoid arthritis: a pilot study.

UNLABELLED: Williams SB, Brand CA, Hill KD, Hunt SB, Moran H. Feasibility and outcomes of a home-based exercise program on improving balance and gait stability in women with lower-limb osteoarthritis or rheumatoid arthritis: a pilot study. OBJECTIVE: To evaluate the feasibility and gait stability and balance outcomes of a 4-month individualized home exercise program for women with arthritis. DESIGN: Pre-post interventional study. SETTING: General community. PARTICIPANTS: Women (N=49) (volunteers) with lower-limb osteoarthritis or lower-limb rheumatoid arthritis were enrolled. Only 39 subjects were eligible and completed the study. INTERVENTION: After completion of the initial assessment, all participants received home balance exercises from an experienced physiotherapist based on assessment findings and exercises available from commercially available kits. All measures were repeated 4 months later. MAIN OUTCOME MEASURES: Falls risk (Falls Risk of Older People-Community Setting) and balance measures. RESULTS: Thirty-nine women (mean age, 69.3y; 95% confidence interval, 65.7-72.9) completed the 4-month program. At baseline, 64% of participants reported falling in the preceding 12 months, and the average falls risk (Falls Risk of Older People-Community Setting) score was 14.5, with 42% rated as moderate risk (16-23). Participants achieved improved performance on most balance and related measures after the exercise program, including falls risk (P=.01), activity levels (P=.015), fear of falling (P=.022), functional reach test (P=.001), rising index for sit to stand (P=.001), step width in walking (P=.001), and body mass index (P=.006). CONCLUSIONS: An individualized balance training home exercise program is feasible for older women with osteoarthritis or rheumatoid arthritis and may improve stability during walking and other functional activities.

A description and evaluation of an innovative rural rehabilitation programme in South Eastern Australia.

PURPOSE: To describe and evaluate the effectiveness of an innovative model of rehabilitation designed to meet the needs of a sparsely populated rural area in South Eastern Australia. METHOD: Five rural health services collaborated to establish a rehabilitation programme. Evaluation included comparing length of stay (LOS) and improvement in the Modified Barthel Index (BI) with the Victorian State average for Level 2 (non-specialist) rehabilitation. Surveys were conducted with staff, clients and carers in the programme. RESULTS: An inpatient rehabilitation programme was successfully established through cooperation between five health services. Clients admitted to the programme improved functionally at least as well as the Victorian State average for similar client groups (BI change 26.5 compared with 22.3 points, p < 0.001), with a shorter LOS (13.8 compared with 22.3 days) but more were discharged to residential aged care (16.1% compared with 6%). CONCLUSIONS: The programme was successful in meeting its stated aims. The model described could be adopted in rural areas sharing similar characteristics. Key enablers to the success of the programme included: collaboration between hospitals; a skilled and enthusiastic leader; recruitment of allied health staff; consistent medical leadership; access to training and support from a major regional rehabilitation centre; and access to funding to enable the programme to establish itself and demonstrate outcomes for clients.

Occupational therapy entry-level education in Australia: which path(s) to take?

BACKGROUND/AIM: There has been an increase in the number of occupational therapy educational programmes offered in Australia over recent years. Although universities offer bachelor, masters and graduate-entry masters programmes, there is a push to consider phasing out occupational therapy bachelor degrees. The aim of this study was to identify advantages and disadvantages associated with current and future credentials needed for entry into the profession. METHODS: This article reviews current literature and other issues concerning entry-level occupational therapy education. RESULTS: The underlying issues are complex and require great consideration as a profession. CONCLUSION: As a profession we need to take charge of our destiny before governments, universities and other stakeholders/professions determine the basic level of entry for our profession.