1. Occupational therapy and homelessness: Results of a Canadian survey
Laurence Roy, Ph.D., Alissa Low, M.Sc.A. OT, Bonnie Kirsh, Ph.D., Carrie Anne Marshall, Ph.D., Rebecca Marval, OT Reg (NS), Catherine Vallée, Ph.D.
McGill University, University of Toronto, Queen’s University, Dalhousie University, Université Laval
Canadian Foundation of Occupational Therapy
Project Direction: Development of a Research and Practice Agenda on Homelessness and Occupational Therapy in Canada
Tier 1: Survey (as presented here)
Tier 3: Local Participatory Advisory Committees Tier 4: Participatory Advisory Committees reports
Tier 2: Focus groups
Methods (continued)
The authors of this study are members of the National Interest Group on Occupational Therapy and Homelessness (NIGOTH), which is an emerging group of occupational therapy practitioners, educators, researchers, and students involved in the homeless sector or with individuals experiencing or at risk of homelessness. NIGOTH was formed at the 2014 CAOT conference in Fredericton, after several presenters realized that there was convergence in their interests and abilities in bridging the gap between rehabilitation practices and policies, occupational therapy, and homelessness.
About NIGOTH
Results (continued)
Total n=278
Survey dissemination and data collection: We have partnered with the Canadian Association of Occupational Therapists, as well as the Ordre des ergothérapeutes du Québec to distribute the survey electronically via to all practicing occupational therapists in Canada who have consented to have their names and contact information available to research teams. Inclusion criteria for participating in the survey was simply registered occupational therapists working Canada. Electronic data collection took place between Feb 28, 2017 and May 23, 2017 with final n=278 and the average time of survey completion being 15 min 18 sec. After the initial electronic invitation by , one reminder was sent to potential participants.
Survey analysis & frameworks:
Demographics: Descriptive statistics. Bar & pie graphs created in Excel.
Q1, Q2, Q4, Q5, Q8, Q11, Q12: Descriptive statistics
Q3: Thematic analysis
Q7 and Q9: Systems analysis framework (i.e. micro, meso, macro) by Bronfenbrenner (1994)
Q6, Q13, & part of Q9: Enablement skills of the Canadian Model of Client-Centred Enablement (Townsend & Polatajko, 2013) as a framework  
Q1. In your work as an occupational therapist within the last year, have you come across individual(s) who were experiencing or at risk of homelessness, including persons at high risk of eviction, or in precarious housing?
Q8. What strategies need to be developed to support the practice of occupational therapists working with persons who are experiencing, transitioning from, or at risk of homelessness?
Q2. In what capacity are you working or have you worked with individuals experiencing or at risk of homelessness?
Q11. As a profession, what should our priorities be regarding occupational therapy practice with persons experiencing/at risk of/transitioning from homelessness?
Q4. What tools/strategies do you or have you used in your practice with persons who are experiencing/transitioning from homelessness?
Q12. As a profession, what should our priorities be regarding occupational therapy research with persons experiencing/at risk of/transitioning from homelessness?
Q5. What tools/strategies do you or have you used in your practice with persons who are at risk of homelessness?
Background
This poster presents a survey, which is the first tier of four within a larger study titled, Development of a research and practice agenda on homelessness and occupational therapy in Canada. Taking place in four Canadian cities (Halifax, Montreal, Kingston, Toronto), this project explores the perspective of service users, frontline practitioners, and occupational therapists on local occupational issues of persons experiencing homelessness and aims to build capacity for occupational therapy services to respond to the unmet needs of persons experiencing homelessness in Canada. Foundational to the survey presented here is a recently published scoping review by the authors of this poster, titled Occupation-based practices and homelessness: A scoping review (Roy et al., 2017). Following this survey (tier 1) will be focus groups (tier 2) with persons experiencing homelessness, frontline practitioners, and health and social service providers, including occupational therapists, in order to design and plan a set of locally defined community projects and tools to address gaps in knowledge and improve access to and implementation of OT services for persons experiencing homelessness. The next phases will consist of Participatory Advisory Committees (tier 3) and their resulting reports (tier 4) with the aim of building capacity for the future conduct of large-scale research-action projects on the effects and effectiveness of occupational therapy interventions in local community settings.
Demographics
Acknowledgements
We would like to thank the participants for taking part in this survey and providing such rich responses. The feedback was also much appreciated. We would also like to thank the Canadian Foundation of Occupational Therapy for providing a grant for this project.
Discussion
Diversity of practices in the field. The findings showed a diversity of practices from mental health, physical acute care, private practice, motor vehicle accidents, work accidents, traumatic brain injury, to multiple sclerosis. Emerging practices are occurring in every field (e.g. working with clients on the risk of eviction after a motor vehicle accident, working for clients pro bono in private practice). Pragmatic and ethical challenges. Practitioners in acute care are having to discharge clients back to homelessness, and OTs working in physical rehabilitation are having difficulties assessing or treating clients with no home.
Differences between practice & vision. Results show that in practice (Q4 & Q5) and priorities (Q11) at this time, OTs use assessment of occupational needs and performance skills training. On what strategies need to be developed (Q8), answers were focused on community building and support in transition into housing. The priority for research (Q12) was best strategies to integrate OT services within the larger homeless sector. This shows a distinction between current practices and a vision for future OT practice.
Methods
Survey development: The 13 survey questions (see handout), stem from the findings of our scoping review, and focus on the experiences of service provision of occupational therapists working with the target population, as well as the vision of all Canadian occupational therapists regarding this area of practice. The questions also examine practice and knowledge development needs of occupational therapists working in this area. Four basic demographic questions were also included. The survey has been created through an online platform through McGill University, LimeSurvey.
References
Bronfenbrenner, U. (1994). Ecological models of human development. In International Encyclopedia of Education, 3(2), Oxford: Elsevier.
Roy, L., Vallée, C., Kirsh, B.H., Marshall, C.A., Marval, M. & Low, A. (2017). Occupation-based practices and homelessness: A scoping review, Canadian Journal of Occupational Therapy, 1-13.
Townsend, E.A. & Polatajko, H.J. (2013). Enabling occupation II: Advancing an occupational therapy vision for health, well-being, & justice through occupation [2nd edition]. CAOT Publications ACE: Ottawa, Ontario.
Results
The results presented today are descriptive, covering demographics and questions Q1, Q2, Q4, Q5, Q8, Q11, Q12. The questions not covered today (Q3, Q6, Q7, Q9, Q13) have more in-depth responses and will be further analyzed and presented in future articles as follows:
“OT Practice” Article: Q6, Q7, Q9 on practices and experiences of Canadian OTs with persons experiencing, at risk of, and transitioning from homelessness. 
“OT Vision” Article: Q11, Q12, Q13 vision of Canadian OTs on the integration of the profession within the homeless sector. 
Contact Information
Foundational study
Roy, L., Vallée, C., Kirsh, B.H., Marshall, C.A., Marval, M. & Low, A. (2017). Occupation-based practices and homelessness: A scoping review, Canadian Journal of Occupational Therapy, 1-13.

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