Missed Opportunties: Advancing Canadian Occupational Therapy Practice for Harm Reduction Among Women who Consume Alcohol

Abstract

Increasingly harmful patterns of alcohol use are being noted among Canadian women, resulting in increased social, economic, mental health, and physical health-related costs. Harm reduction is an approach to alcohol use care that may mitigate negative consequences; however, Canadian occupational therapists may be missing opportunities to address alcohol use through harm reduction. This study aimed to advance Canadian occupational therapy practices for harm reduction among women who consume alcohol by meeting the following objectives: 1. Describe the current state of education for occupational therapy students and the learning needs for practicing occupational therapists related to harm reduction and alcohol use among women. 2. Describe the perspectives and experiences of occupational therapists related to implementing harm reduction strategies for alcohol use. 3. Develop and evaluate a clinical resource to support the use of harm reduction practices within occupational therapy for alcohol use among women. This study involved two phases. In Phase 1, an environmental scan was completed utilizing a mixed methods data collection approach. The scan involved an online search of educational and occupational therapy practice resources, an online survey sent to Canadian university occupational therapy programs, and semi-structured interviews with Canadian occupational therapists. Findings indicated support for the role of occupational therapists within substance use care. Nonetheless, several barriers may contribute to missed opportunities for effective occupational therapy intervention, including occupational therapy scope of practice and professional role clarity, ethical questions and challenges, comfort in engaging clients around discussions about substance use, and knowledge and education. In Phase 2, an online course using a knowledge-to-action framework was developed and evaluated with practicing occupational therapists. Findings from the evaluation indicated that the course positively impacted learning outcomes, most notably participants’ self-reported ability to describe low-risk drinking guidelines, describe the effects of increasing alcohol use and harm among women, and describe the role occupational therapists play in alcohol screening and harm reduction. This dissertation demonstrates that self-directed online education for occupational therapists is a promising knowledge dissemination tool for advancing Canadian occupational therapy practices for harm reduction among women who consume alcohol.