Changes in self-perceived performance and satisfaction with performance of daily activities following interdisciplinary rehabilitation in people with late effects of polio.

BACKGROUND: People with late effects of polio (LEoP) may need rehabilitation to manage everyday life but knowledge of the benefits of interdisciplinary rehabilitation is limited. OBJECTIVE: To evaluate changes in performance and satisfaction with performance of activities among people with LEoP following interdisciplinary rehabilitation. METHODS: A pre-post retrospective study based on data on 102 participants with LEoP from a rehabilitation clinic. Changes in performance and satisfaction with performance of daily activities before and after interdisciplinary rehabilitation were assessed with the Canadian Occupational Performance Measure (COPM). RESULTS: There were statistically significant increases in the mean performance and mean satisfaction with performance COPM scores from admission to discharge. Twenty-three percent and 19% of the participants, respectively, had improved their performance and satisfaction with performance, 25% and 26% of the participants had no changes, and 19% and 22% of the participants, respectively, rated their performance and satisfaction lower at discharge compared to admission. CONCLUSION: Interdisciplinary rehabilitation can enhance self-rated performance and satisfaction with performance of daily activities among people with LEoP. Future studies of rehabilitation for people with LEoP should use a prospective design and capture the participants' process of change related to their rehabilitation period.

Electronic medication administration record (eMAR) in Swedish home healthcare-Implications for Nurses' and nurse Assistants' Work environment: A qualitative study.

BACKGROUND: The electronic medication administration record (eMAR) is an eHealth system that has replaced the traditional paper-based medication administration used in many healthcare settings. Research has highlighted that eHealth technologies can change working methods and professional roles in both expected and unexpected ways. To date, there is sparse research that has explored how nurses and nurse assistants (NA) in home healthcare experience eMAR in relation to their work environment. AIM: The aim was to explore how nurses and nurse assistants experienced their work environment, in terms of job-demand, control, and support in a Swedish home healthcare setting where an electronic medication administration record had been implemented to facilitate delegation of medical administration. METHOD: We took a qualitative approach, where focus groups were used as data collection method. The focus groups included 16 nurses and nine NAs employed in a Swedish municipality where an eMAR had been implemented 6 months before the first focus groups were performed. The analysis adapted the job-demand-control-support model, by condensing the professionals' experiences into the three categories of demand, control, and support, in alignment with the model. RESULTS: NAs experienced high levels of job demand and low levels of job control. The use of the eMAR limited NAs' ability to control their work, in terms of priorities, content, and timing. In contrast, the nurses described demands as high but manageable, and described having a high level of control. Both professions found the eMar supportive. CONCLUSION: Nurses and NAs in home healthcare experienced changes in their work environment regarding demand, control, and support when an eMAR was implemented to facilitate delegation of medical administration. In general, nurses were satisfied with the eMAR. However, NAs felt that the eMAR did not cover all aspects of their daily work. Healthcare organisations should be aware of the changes that digitalisation processes entail in the work environment of nurses and NAs in home healthcare.

Taking control of one's everyday life - a qualitative study of experiences described by participants in an occupational intervention.

BACKGROUND: Sick leave due to stress-related ill-health is increasing and is often caused by occupational imbalance. These types of issues tend to affect both the ability to work and cope with everyday life, as well as the overall experience of health, negatively. There is still little knowledge on how to prepare people and workplaces for the return-to-work process after participation in a work rehabilitation program due to stress and occupational ill-health. Therefore, this study aimed to describe what is needed to achieve a balanced everyday life that includes paid work as experienced by individuals who had participated in a ReDO® intervention due to occupational imbalance and ill-health. METHODS: The concluding notes from 54 informants' medical records were used for qualitative content analysis. The informants had participated in an occupational therapy group intervention to promote occupational health and regain full work capacity. RESULTS: The analysis resulted in one major theme and four categories describing how the informants perceive that they must take control of their everyday life as a whole. By doing so, they need to work with structurization and prioritization, social interaction, boundary setting, and occupational meaningfulness. CONCLUSION: The study indicates a highly relational process, where it is impossible to divide life into private and work, and presupposes balance in everyday life in multiple dimensions. Its contribution includes the formulation of perceived needs in the transition between intervention and return to work and could, through further research, be used to generate a more effective and sustainable return- and rehabilitation models.

How does ReDO®-10 work? Understanding the mechanisms of action of an intervention focused on daily activities and health from the perspective of participants.

Evaluation of a complex healthcare intervention should include careful exploration of the mechanisms through which it brings about change. This paper describes a qualitative evaluation of the Redesigning Daily Occupations (ReDO®-10) programme as it was implemented for the first time with women with stress-related issues in a primary care setting in Ireland. The ReDO®-10 is a 10-week group intervention designed to support participants make changes to their daily activity patterns to have a more satisfying and balanced daily life. Fourteen women were interviewed after completing the programme. The aim was to explore changes that participants perceived they experienced and to understand how the content of ReDO®-10 was thought to bring about this change (if it did). Directed content analysis was used to analyse the qualitative data using the Behaviour Change Wheel and Theoretical Domains Framework as a coding framework. Overall, four BCW functions of ReDO® -10 were identified: Education, Persuasion, Modelling and Enablement. Participants described improved belief in their own capabilities, knowledge and goals around life changes. Many behaviour changes were also described, particularly in relation to doing more restorative activities in daily life. Behaviour change techniques that were identified as important for change were practicing new, restorative occupations in group sessions and as homework and the use of self-analysis activities to understand the relationship between activities and health for these participants. Modelling, support and other effects of group dynamics were also vital in changes that occurred.

Nurses' Perspectives on an Electronic Medication Administration Record in Home Health Care: Qualitative Interview Study.

BACKGROUND: eHealth is considered by policy makers as a prerequisite for meeting the demands of health care from the growing proportion of older people worldwide. The expectation about what the efficiency of eHealth can bring is particularly high in the municipal home health care sector, which is facing pressure regarding resources because of, for example, earlier discharges from hospitals and a growing number of patients receiving medications and treatments at home. Common eHealth services in home health care are electronic medication administration records (eMARs) that aim to communicate delegated tasks between professionals. However, there is an extensive gap in the research on how technology affects and is experienced by home health care professionals. OBJECTIVE: The objective of this paper is to shed light on how home care nurses experience eMARs in a Swedish municipality. METHODS: This qualitative interview study was conducted among home health care nurses using eMARs to facilitate communication and signing of delegated nursing tasks. The analysis of the interviews was performed using constructivist grounded theory, according to Charmaz. RESULTS: Of the 19 day-employed nurses in the municipality where an eMAR was used, 16 (84%) nurses participated in the study. The following two categories were identified from the focus group interviews: nurses become monitors and slip away from the point of care. The nurses experienced that they became monitors of health care through the increased transparency provided by the eMAR and the measurands they also applied, focusing on the quantitative aspects of the delegated nursing tasks rather than the qualitative aspects. The nurses experienced that their monitoring changed the power relations between the professions, reinforcing the nurses' superior position. The experience of the eMAR was regarded as transitioning the nurses' professional role-away from the point of care and toward more administration-and further strengthened the way of managing work through delegation to health care assistants. CONCLUSIONS: Previous analyses of eHealth services in health care showed that implementation is a complex process that changes health care organizations and the work of health care professionals in both intended and unintended ways. This study adds to the literature by examining how users of a specific eHealth service experience its impacts on their daily work. The results indicate that the inscribed functions in an eHealth service may affect the values and priorities where the service is in use. This presents an opportunity for future research and for health care organizations to assess the impacts of specific eHealth services on health care professionals' work and to further examine the effects of inscribed functions in relation to how they may affect actions and priorities at individual and organizational levels.

Assessing the use of a portable time-geographic diary for detecting patterns of daily occupations.

BACKGROUND: A time-geographic diary approach is of interest in occupational therapy due to the inclusion of the diarist's subjective experiences. There are several methods for detecting doing in time, but details needed for analysis are still lacking. The smartphone application POrtable Diary Data collector (PODD), a 24-hr diary based on the time-geographic diary has recently been introduced. AIM: To test the usability of PODD as a tool for diary data collection to detect and visualize sequences of daily activities. MATERIAL AND METHODS: An exploratory sequential design was used, where diary data was first collected and then followed by a questionnaire assessing usefulness. Thirty-one occupational therapy students participated. Usability testing was applied, exploring how participants experienced the use of the device. Data was analysed qualitatively and quantitatively. RESULTS: The PODD visually presents activity sequences and thus assists in detecting patterns of daily occupations (PDO). The students agreed on the supportive statements concerning learnability, efficiency and memorability. Regarding errors and satisfaction, participants agreed that the device was easy to use. CONCLUSIONS: Using a mobile application to collect data about students' daily activities was effective. However, the PODD needs to be further evaluated among other groups and contexts as well as for its usefulness for PDO analyses.

A feasibility study of the Redesigning Daily Occupations (ReDOTM-10) programme in an Irish context.

BACKGROUND: Despite high demand, mental health services in primary care in Ireland are underdeveloped. People with mild/moderate anxiety, depression and unspecified psychological distress are frequently seen in primary care settings, mostly by general practitioners (GPs). Occupational therapists have the potential to contribute to service-provision with interventions specially designed for the targeted group e.g. the Redesigning Daily Occupations programme (ReDO-10). AIMS/OBJECTIVES: This study aimed to explore the feasibility of a future RCT of the ReDO-10 programme in Ireland and the contextual factors that would influence future implementation. MATERIAL AND METHODS: Using a multi-phase, mixed-method design, qualitative and quantitative data were gathered from key stakeholders: ReDO-10 participants (n = 10), GPs (n = 9) and occupational therapists (n = 2). Acceptability, satisfaction, cultural fit and demand were explored, as well as methodological issues such as appropriateness of recruitment methods, outcome measures and randomization. RESULTS: ReDO-10 was acceptable to participants who reported improvements in their occupational patterns and valued the group-based format. GPs and occupational therapists welcomed the intervention, but acknowledged the limitations of time and resources in the Irish primary care context. CONCLUSIONS: ReDO-10 is feasible to explore in a future RCT in Ireland and this study provides important context for future implementation and/or research.

Exploring risk factors for developing occupational ill health - departing from an occupational perspective.

BACKGROUND: Sick leave due to stress-related mental ill health increases in society. In occupational therapy, occupational balance is considered important for experiencing health and well-being. Thus, knowledge regarding occupational balance and occupational value constitute essential parts of occupational therapists' work with people suffering from occupational ill health. OBJECTIVE: The aim of this study is to analyse the relationships between sociodemographic factors, occupational value, occupational balance and perceived health in people suffering from occupational ill health. METHODS: In a quantitative cross-sectional study data from a total of 218 individuals were included, 192 women, 22 men and 4 individuals who did not specify their gender. Data were collected by means of surveys prior to an occupational therapy intervention. The instruments used included OVal-pd, OBQ, EQ5D and a sociodemographic questionnaire. Data were analysed using regression and decision tree analysis. RESULTS: The results show that individuals who experience an imbalance in their everyday life and who have few or no experiences of daily occupations imprinted by socio-symbolic occupational value experienced lower perceived health. CONCLUSIONS: Low level of experiences of balance in daily life and occupational value seems to be the main risk factors for the development of occupational ill health, rather than sociodemographic factors.

The BELE program: The development of a holistic interdisciplinary health-promoting program enhancing work-life balance among female employees working in human service organizations in Sweden.

BACKGROUND: Despite an increase in work-life balance literature, the development of successful support to help employees manage their work -life balance is slow. Moreover, there are few interventions with a comprehensive approach to workplace health promotion focusing on work-life balance. OBJECTIVE: This paper aims to present the development and building blocks of a holistic interdisciplinary health-promoting program, the BELE program, to enhance female employees working in human service organizations health and well-being with a focus on work-life balance. METHODS: The planning and development of the program was done through an intervention mapping and research circles methodology. RESULTS: The planning- and development process of the program resulted in a theoretical framework, and a program structure with a program content. The intervention program was named "The Balance in Everyday Life Empowerment program" (BELE program). CONCLUSIONS: The BELE program adds to the existing body of work-life balance knowledge, so far often based on a conflict approach. Interventions focusing on a comprehensive approach to health and work-life balance with a salutogenic approach are rare. Furthermore, the integration with occupational therapy and health promotion in a workplace health promotion framework is innovative. In a previous study, the BELE program has shown that it enhances women's well-being and balance in their everyday life.

A concept analysis of creative activities as intervention in occupational therapy.

Background: This article is based on a common understanding of the concept of creative activities as intervention, as described in occupational therapy literature. Historically, creative activities have been used as intervention in occupational therapy. There is, however, a lack of clarity in descriptions of the concept.Aims/Objectives: To investigate and clarify the concept of creative activities as intervention (CaI) and to validate the findings in occupational therapy practice.Material and methods: A selection of articles according to PRISMA resulted in 15 articles, analysed with concept analysis. The results were validated by a reference panel of seven occupational therapists using a questionnaire and data was analysed by descriptive statistics.Results: Five attributes defined CaI: (1) Often consisting of elements of art and craft using mind and body, (2) Being experienced as meaningful, (3) Creating creative processes, (4) Developing skills, enhancing occupational performance and managing everyday life, and (5) Being easy to modify individually or in groups with different approaches. Three cases were generated from the attributes to illustrate the integrity of the analysis.Conclusions and significance: The results led to a description of CaI that could facilitate future research communication and common definition in occupational therapy practice.

Occupational Health among Swedish Occupational Therapists: A Cross-Sectional Study.

The Swedish public sector is facing great challenges in recruiting and retaining healthcare professionals, due to increasing sick leave numbers. The aim of this study was to describe Swedish occupational therapists' occupational health in terms of risk factors in the social and organizational work environment, occupational balance, and work-related mental health problems. A web survey was emailed to all working members of the Swedish Association of Occupational Therapists (n = 7600) and 3658 answered the survey. The web survey included questions on sociodemographic characteristics, social and organizational environment, occupational balance, and work-related health. The occupational therapists in general rated their workload as high, which was described as leading to increased stress, difficulties doing a good job, and increased job turnover. They also reported having difficulties maintaining occupational balance. Almost a fifth reported having symptoms related to mild incipient exhaustion or a pronounced exhaustion disorder. Almost 60 percent reported having, during the last year, seriously considered seeking new employment as an occupational therapist and 35 percent had seriously intended to leave their profession. In conclusion, there is an urgent need to improve the work situation of occupational therapists. If not, increases in mental health problems, sick leave and job turnover rates may seriously jeopardize the welfare system by eroding healthcare.

The occupation-based intervention REDO™-10: Long-term impact on work ability for women at risk for or on sick leave.

Background: Stress-related disorders are increasing in western societies and are the main reason for sick-leave in Sweden. Previous research justifies occupation-based interventions to increase health and work ability.Aim: To investigate if the occupation-based intervention ReDO™-10 predicts work ability for women at risk for or on sick-leave.Material and Methods: A longitudinal cohort study design including the REDOTM-10. The participants answered a questionnaire about their perceptions of health, work ability, occupational balance, occupational values and mastery at baseline, after intervention and at 12 months follow-up. Differences before and after the intervention as well as at 12 months follow-up and possible predictors of work ability were analyzed.Results: Eighty-six women (response rate 70%) answered the questionnaire at follow-up. Perceived health, occupational balance, occupational value, mastery and work ability were improved after intervention. Perceived health, mastery and socio-symbolic value predicted work ability.Conclusion: The intervention increased perceived health and perceived health predicted work ability. However, the occupational aspects in the intervention did not predict work ability. For the intervention to predict work ability, the work placement might be necessary.Significance: The results of the present study add to earlier evidence that a work focus is of importance both in prevention of sick leave and in return to work interventions.

The linkage between patterns of daily occupations and occupational balance: Applications within occupational science and occupational therapy practice.

Patterns of daily occupations (PDO) and occupational balance (OB) are recurring phenomena in the literature. Both are related with health and well-being, which makes them central in occupational therapy practice and occupational science. The aim was to review how PDO and OB are described in the literature, to propose a view of how the two constructs may be linked, and elaborate on how such a view may benefit occupational science and occupational therapy. The literature was analysed by latent and manifest content analysis and comparative analysis. The findings were summarized in a model, framing PDO as the more objective and OB as the more subjective result from an interaction between personal preferences and environmental influences. The proposed model does not assume a cause-effect relationship between the targeted constructs, rather a mutual influence and a joint reaction to influencing factors. Indicators of PDO and OB were identified, as well as tools for assessing PDO and OB. The authors propose that discerning PDO and OB as separate but interacting phenomena may be useful in developing a theoretical discourse in occupational science and enhancing occupational therapy practice. Although the scope of this study was limited, the proposed view may hopefully inspire further scrutiny of constructs.

Methodological challenges when doing research that includes ethnic minorities: a scoping review.

BACKGROUND: There are challenging methodological issues in obtaining valid and reliable results on which to base occupational therapy interventions for ethnic minorities. The aim of this scoping review is to describe the methodological problems within occupational therapy research, when ethnic minorities are included. METHOD: A thorough literature search yielded 21 articles obtained from the scientific databases PubMed, Cinahl, Web of Science and PsychInfo. Analysis followed Arksey and O'Malley's framework for scoping reviews, applying content analysis. RESULTS: The results showed methodological issues concerning the entire research process from defining and recruiting samples, the conceptual understanding, lack of appropriate instruments, data collection using interpreters to analyzing data. CONCLUSION: In order to avoid excluding the ethnic minorities from adequate occupational therapy research and interventions, development of methods for the entire research process is needed. It is a costly and time-consuming process, but the results will be valid and reliable, and therefore more applicable in clinical practice.

Health transition after lung transplantation - a grounded theory study.

AIMS AND OBJECTIVES: To investigate lung recipients' process of transition from prior the transplantation to one year afterwards, as well as what their main concerns are and how they deal with these concerns. BACKGROUND: During the last three decades, lung transplantation has been established as an effective treatment for patients with end-stage pulmonary disease. Towards the end of the 20th century, the concept of survival expanded to also include improving health-related quality of life (HRQoL). Although many studies have been published regarding lung recipients' HRQoL, aspects of health and everyday life remain understudied. Lung transplantation demands some kind of transition. However, very little is known about this transitional process. DESIGN: A qualitative inductive approach using Grounded Theory (GT) was used. METHODS: A total of ten adult males and five adult females (n = 15) with a mean age of 55 years were included in the study and interviewed one year after transplantation. The open-ended interviews were digitally recorded and transcribed verbatim after each interview. The analysis of the material was performed consistent with Charmaz contructivistic approach of GT. RESULTS: The core category Reconstructing daily occupations summarises a process wherein the generated GT is present through four main categories: Restricting, Regaining, Reorganising and Enriching. The process of reconstructing daily occupations is necessary to regain health. CONCLUSIONS: A trajectory of health transition is evident, starting pretransplant with the lung disease and severe illness and proceeding at least up to one year after the transplantation with experienced health. RELEVANCE TO CLINICAL PRACTICE: The result enables a unique possibility to enhance the lung recipients' striving for everyday life and thereby promote health. There is a need for change in the existing multidisciplinary transplant team to also include an occupational therapist to support and guide the lung recipients in changing their occupational patterns.

Women's perceived work environment after stress-related rehabilitation: experiences from the ReDO project.

PURPOSE: The study aimed to investigate (a) if women's perceptions of their work environment changed during a 16-week rehabilitation period and at a 12-month follow-up; (b) whether such changes were related to outcomes in terms of return to work, well-being and valued occupations. METHODS: Eighty-four gainfully employed women on sick-leave due to stress-related disorders responded to instruments assessing perceptions of the work environment, well-being (self-esteem, self-mastery, quality of life, perceived stress, self-rated health) and perceived occupational value. Data about return to work were collected from registers. Non-parametric statistics were used. RESULTS: The increase in the women's ratings of their work environment was non-significant between baseline and completed rehabilitation but was statistically significant between baseline and the 12-month follow-up. No relationships were found between changes in perceptions of the work environment and outcomes after the rehabilitation. At the follow-up, however, there were associations between perceived work environment changes in a positive direction and return to work; improved self-esteem, self-mastery, quality of life, perceived occupational value and self-rated health; and reduced stress. CONCLUSION: It seems important to consider the work environment in rehabilitation for stress-related problems, and a follow-up appears warranted to detect changes and associations not visible immediately after rehabilitation. IMPLICATIONS FOR REHABILITATION: Work environment Perceptions of the work environment seem important for return to work, although other factors are likely to contribute as well. Perceptions of the work environment are associated with several aspects of well-being. When developing rehabilitation interventions a focus on the clients' perceptions of their work environment seems vital.

A longitudinal study of the working relationship and return to work: perceptions by clients and occupational therapists in primary health care.

BACKGROUND: The working relationship between client and therapist can be important to enhance outcomes from vocational rehabilitation for women with stress-related disorders in primary health care. The aim was to investigate the working relationship, as perceived by clients and therapists in the Redesigning Daily Occupations (ReDO™) program, and its relationships to return to work and satisfaction with the rehabilitation. Another aim was to compare the ReDO™ group and a "care-as-usual" (CAU) group regarding perceptions of the working relationship with the social insurance officer. METHOD: Forty-two ReDO™ clients and 42 matched controls receiving CAU participated. The study included four measurements (baseline, after 16 weeks rehabilitation and follow-ups after 6 and 12 months). 37 + 37 clients completed. Return to work data was obtained from the Social Insurance Offices (SIO), and the working relationship and client satisfaction were assessed by self-report questionnaires. RESULTS: The clients rated the working relationship higher than the therapists (mean rating 101.1 vs. 93.9; p < 0.001). The therapists' rating showed a statistically significant association with return to work at the 12-month follow-up, and the clients' perceptions were statistically significantly related to how they rated satisfaction with the rehabilitation received. The ReDO™ and the CAU groups did not differ regarding how they rated the relationship with the SIO officer (mean ratings 83.9 vs. 77; p = 0.189). The working relationship with the SIO officer was not related to return to work, but an association (rs = 0.70, p < 0.001) to client satisfaction at 16 weeks appeared in the CAU group alone. CONCLUSION: The working relationship as perceived by clients and therapists seemed to be partly separate phenomena, the client perceptions being linked with satisfaction with the rehabilitation and the therapist perceptions with the clients' return to work. The relationship to the SIO officers was of no importance to return to work but was of some significance for satisfaction with the rehabilitation among the CAU clients. Therapists should strive to improve the relationship with clients to whom they feel the relationship is fragile since that might enhance the chances for those clients to return to work. TRIAL REGISTRATION: Registered at ClinicalTrials.gov (identifier NCT01234961) 2 November 2010.

Satisfaction with daily occupations amongst asylum seekers in Denmark.

AIM: The aim of this study was to describe asylum seekers' satisfaction with daily occupations and activity level while in a Danish asylum centre, and whether this changed over time. Another aim was to describe whether exposure to torture, self-rated health measures, and ADL ability were related to their satisfaction with daily occupations and activity level. METHODS: A total of 43 asylum seekers at baseline and 17 at follow-up were included. The questionnaires Satisfaction with Daily Occupations, Major Depression Inventory, WHO-5 Wellbeing, Pain Detect, a questionnaire covering torture, and basic social information were used as well as Assessment of Motor and Process Skills. RESULTS: The results showed a low level of satisfaction with daily occupations at both baseline and follow-up. There was no statistically significant change in satisfaction or activity level between baseline and the follow-up. Associations between AMPS process skills--education, worst pain and activity level--were present at baseline, as was a relationship between AMPS process skills and satisfaction. At follow-up, associations between WHO-5 and satisfaction and activity level and between MDI scores and activity level were found. CONCLUSION: Asylum seekers experience a low level of satisfaction with daily occupations, both at arrival and after 10 months in an asylum centre. There is a need for further research and development of occupation-focused rehabilitation methods for the asylum seeker population.

A longitudinal study of changes in asylum seekers ability regarding activities of daily living during their stay in the asylum center.

The aim was to assess change in activities of daily living (ADL) ability amongst asylum seekers and if there were any difference between tortured and non-torture following a 10 months post-arrival period, and if self-reported health and exposure to torture were factors related to change in ADL-ability. The study was a combined baseline, follow-up correlational study amongst individuals from Afghanistan, Iran and Syria, living in Danish asylum centers. Forty-three persons aged 20-50, were invited and participated in the baseline study. Twenty-two were still in asylum center at the follow-up and 17 of them participated. ADL-ability was measured using Assessment of Motor and Process Skills and questionnaires about exposure to torture, self-reported mental health and pain. ADL motor and process measures, well-being and self-rated health declined from baseline to follow-up. Measures of pain and depression increased. Exposure to physical torture and change in ADL motor (r = 0.525) measures were associated, as well as change in current pain and change in ADL process (r = 0.525) measures. Due to preponderance of torture survivors analysis of group difference was not applicable. Health care workers should be aware of ADL concerns and exposure to torture in this population to best address their needs within rehabilitation settings.

Effect of an occupation-focused family intervention on change in parents' time use and children's body mass index.

OBJECTIVE. This study explored factors related to changes in the time parents spent with their children with obesity and associated decreases in children's body mass index (BMI) z-scores after an occupation-focused intervention. METHOD. Parents participated in a 1-yr occupation-focused intervention to promote healthy family lifestyles. Data on 40 parents of 22 children with obesity ages 4-6 yr were collected before and after intervention and analyzed using linear and multiple regression methods. RESULTS. Parents increased time spent with their children by an average of 91 min/day. Parents' finances, perceived satisfaction in daily occupations, low BMI, and mastery at inclusion were associated with increased time spent with their children. Mothers' subjective health and high mastery and fathers' perceived occupational value and education explained 67% of the variance in children's BMI z-scores. CONCLUSION. The results indicate important factors to consider in developing interventions that facilitate occupational engagement and health among children with obesity and their families.