Facilitators and barriers to community occupational therapy in France: Towards broadening the scope of practice of occupational therapists
Facilitants et obstacles à l’ergothérapie communautaire en France :  vers l’élargissement du champ de pratique des ergothérapeutes
Creators: name: Jouve, Cédrine Amandine
name: Lévesque, Marie-Hélène
name: Levasseur, Mélanie
Publisher: name: Communauté pour l’Avancement de la Recherche Appliquée Francophone en Ergothérapie (CARAFE)
Year: 2022
Subjects: Ergothérapie communautaire
Promotion de la santé
Participation occupationnelle
Community-based occupational therapy
Health promotion
Occupational participation

description: Context. For social, political or economic reasons, some communities are at increased risk of insecurity, social exclusion and occupational injustice. To reduce these situations, it is important to promote their health. Despite their expertise and the potential for occupational therapists to contribute to the promotion of community health, little is known about the development of community occupational therapy, particularly in France. 
Objective. This study aimed to identify the elements that enable and impede the development of community-based occupational therapy practice in France. 
Method. A qualitative clinical research study was conducted with seven French occupational therapists working in community settings using semi-structured individual interviews.
Results.  Aged 23 to 53 years (median=43; semi-interquartile range 7.5), occupational therapists were predominantly female (n=6; 85.7%) with additional training (n=6; 85.7%). Elements enabling the development of community occupational therapy were its novelty, strong compatibility with values of community health, health policies further moving toward community principles, and occupational therapists’ knowledge and skills of this practice. 
Conclusion. A commitment toward community-based practice would broaden the scope of intervention of occupational therapists to respond to emerging social issues in France. To eventually implement community-based occupational therapy, it is important to continue studies exploring how these enabling elements can be levers and barriers reduced.
Keywords
Community-based occupational therapy, health promotion, occupational participation
description: Contexte. La réduction des inégalités sociales et de santé constitue une importante priorité de santé publique. Au-delà des conduites individuelles, et en raison de forces systémiques et structurelles plus vastes, certaines communautés présentent un risque accru de situations de précarité susceptibles d’entraver leurs possibilités occupationnelles et leur capacité à maintenir une bonne santé. Afin de réduire ces risques, il importe pour les ergothérapeutes d’utiliser les leviers de la promotion de la santé et de mieux comprendre les facteurs d’influence à la mise en oeuvre d’interventions à l’échelle de la communauté.Objectif. Cette étude visait à identifier les éléments facilitant ou limitant le développement d’une pratique communautaire de l’ergothérapie en France.Méthode. Une étude qualitative de type recherche clinique a été réalisée auprès de sept ergothérapeutes français intervenant en milieu communautaire au moyen d’entretiens individuels semi dirigés.Résultats. Les éléments favorisant le développement de l’ergothérapie communautaire sont sa nouveauté, sa forte compatibilité de valeurs avec la santé communautaire, les politiques de santé s’orientant davantage vers des principes communautaires, ainsi que les connaissances et les compétences des ergothérapeutes dans cette pratique. Les éléments faisant obstacle au développement de l’ergothérapie communautaire sont la perception de la complexité de la pratique et la façon de la définir, le nombre limité de stages et les lacunes de la formation en ergothérapie, les difficultés de financement ainsi que le nombre restreint d’ergothérapeutes engagés dans ce domaine.Conclusion. L’engagement envers la pratique communautaire élargirait le champ d’intervention des ergothérapeutes pour répondre aux défis sociaux émergents en France. Dans l’optique d’une éventuelle implantation de l’ergothérapie communautaire, il importe de poursuivre les études en explorant comment ces éléments favorisants peuvent être des leviers et les obstacles être réduits.
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Context. Reducing social and health inequities is an important public health priority. Beyond individual behaviors, and because of broader systemic and structural forces, residents of some communities are at increased risk of precarious situations that may impede their occupational opportunities and ability to remain healthy. To reduce these risks, occupational therapists need to mobilize the levers of health promotion and better understand the factors influencing the implementation of community-level interventions.Objective. This study aimed to identify the elements that enable and impede the development of community-based occupational therapy practice in France.Method. A qualitative clinical research study was conducted with seven French occupational therapists working in community settings using semi-structured individual interviews.Results. Elements enabling the development of community occupational therapy were its novelty, strong compatibility with values of community health, health policies further moving toward community principles, and occupational therapists’ knowledge and skills in this practice. Barriers to the development of community-basedoccupational therapy include the perceived complexity of the practice and how it is defined, the limited number of internships and gaps in occupational therapy education, funding challenges, and the limited number of occupational therapists involved in this field.Conclusion. A commitment toward community-based practice would broaden the scope of intervention of occupational therapists to respond to emerging social issues in France. To eventually implement community-based occupational therapy, it is important to continue studies exploring how these enabling elements can be levers and how barriers can be reduced.