This presentation was conducted at the 2014 American Occupational Therapy Association Conference in Baltimore, MD on April 5, 2014.

1.  
Perspectives from Emerging Leaders

2.  Cristina Reyes Smith, OTD, OTR/L
o Medical University of South Carolina (Charleston, SC)
 Arameh Anvarizadeh, OTD, OTR/L
o California Children’s Services (Los Angeles, CA)
 D’Andre Holland, OTD, OTR/L
o Every Child Achieves (Los Angeles, CA)
 Catherine Hoyt Drazen, OTD, OTR/L
o Washington University in St. Louis (St. Louis, MO)
 Nadine Kwebetchou, MS, OTR/L
o VA Palo Alto (Palo Alto, CA)
 Stacy Wilson, MS, OTR/L
o WakeMed Health and Hospital (Raleigh, NC)

3.  Rationale and Background
 Focus Group Results and Discussion
 Personal Perspectives
 Moving Toward the Diverse Workforce of the
Centennial Vision

4. 

5. We envision that occupational therapy is a
powerful, widely recognized, science-driven, and
evidence-based profession with a globally connected
and diverse workforce meeting society's
occupational needs.
(AOTA, 2007)

6.  di·ver·si·ty
noun də-ˈvər-sə-tē, dī-
: the quality or state of having many different
forms, types, ideas, etc.
: the state of having people who are different races or
who have different cultures in a group or organization
(Merriam Webster, Inc., n.d.)

7. Diversity
Age
Education
Gender
Nationality
Race/
Ethnicity
Religion
Sexual
orientation
Socio-
economic
status

8.  Population (2012): 313, 873, 685
o Under 5 years: 6.4%
o Under 18 years: 23.5%
o 19 to 64 years: 62.8%
o 65 and over: 13.7%
o Female: 50.8%
o White, alone: 63.0%
o Black/African American, alone: 13.1%
o American Indian/Alaska: 1.2%
o Asian, alone: 5.1%
o Two or more races: 2.4%
o Hispanic/Latino: 16.9%
(U.S. Department of Commerce,
2014)

9. (U.S. Department of Commerce, 2014)

10.  AOTA Academic Programs Annual Data Report: 2011-
2012
(AOTA, 2012

11.  AOTA Faculty Workforce Survey (December 2010)
(AOTA,
2010)

12. 0
10
20
30
40
50
60
70
White Black AIAN Asian NHPI Two or
More
Races
Hispanic
2012
2035
2060
(As cited by U.S. Census Bureau, Population Division in Census.gov, n.d., p. 4
AIAN=American Indian and Alaska Native; NHPI=Native Hawaiians and Other Pacific Islanders

13.  AOTA Academic Programs Annual Data Report: 2011-
2012
(AOTA, 201

14.  AOTA Academic Programs Annual Data Report: 2011-
2012
(AOTA, 201

15.  AOTA Faculty Workforce Survey (December 2010)
(AOTA, 2010)

16.  B.1.3: Demonstrate knowledge and understanding of the concepts
of human behavior... including but not limited to introductory
sociology or introductory anthropology.
 B.1.4: Apply knowledge of the role of the
sociocultural, socioeconomic and diversity factors and lifestyle
choices in contemporary society to meet the needs of individuals
and communities.
 B.1.5: Demonstrate an understanding of the ethical and practical
considerations that affect the health and wellness needs of those
who are experiencing or are at risk for social injustice, occupational
deprivation and disparity in the receipt of services.
 B.2.9: Express support for the QOL, well being and occupation of
the individual, group or population...considering the context
(cultural, personal, temporal, virtual).
(AOTA, 2011)

17.  B.4.7: Consider factors that might bias assessment results, such as
culture, disability status, and situational variables related to the
individual and context.
 B.5.20: Effectively interact through written, oral, and nonverbal
communications with the client, family, significant
others, communities, colleagues, other health providers and the
public.
 B.5.33: Provide population-based occupational therapy intervention
that addresses occupational needs as identified by the community.
 B.6.3: Integrate current social, economic, political, geographic and
demographic factors to promote policy development and the
provision of OT services.
 B.7.9 (OTD only): Demonstrate knowledge of and the ability to write
program development plans for provision of services to individuals
and populations.
(AOTA, 2011)

18.  ―Occupational therapy practitioners have the responsibility to
intervene with individuals and communities to limit the effects
of inequities that result in health disparities. Practitioners have
knowledge and skills in evaluating and intervening with
individuals and groups who face
physical, social, emotional, or cultural challenges to
participation. Further, the American Occupational Therapy
Association (AOTA) supports advocacy to increase access to
health services for persons in need, and efforts to lessen or
eliminate health disparities are consistent with the
Occupational Therapy Code of Ethics and Ethics Standards
(2010) (AOTA, 2010).‖
(AOTA, 2013)

19. Benefits and drawbacks to diversity:
o Pros: Increased creativity and innovation
o Con: increased conflict through a variety of ideas and
beliefs presents
o Mediating factors to negative effects of diversity are:
1. Leadership
2. Communication
(Dreachslin, Weech-Maldonado, & Dansky, 2004)
 ―Leaders who are able to validate alternative realities and
appreciate different perspectives appear to moderate the
potential negative effects of racial diversity on team
communication processes and strengthen the positive aspects
of diversity‖
(Dreachslin, Hunt, & Sprainer, 2000, p. 1403)

20.  ―Minorities receiving care in hospitals with a less diverse
inpatient population may face greater barriers to health
care than those receiving care in hospitals with a more
diverse patient population.‖
(Weech-Maldonado et al., 2012, p. 821)
―There is a need for occupational therapy to deepen its
understanding of how the experience of being a minority
group client within a therapeutic relationship intersects with
the process and outcomes of occupational therapy.‖
(Kirsh, Trentham, & Cole, 2006)

21.  ―Diversity will only be achieved if the primary focus is on:
what is happening within the pipeline…Emphasizing
talent development opens up many new approaches for
science training outside of traditional degree programs.‖
(McGee, Saran, & Krulwich, 2012)
 Literature is scarce on the long-term benefits of
workplace diversity in OT:
o (Kirsh, Trentham, & Cole, 2006)
o (Trentham, Cockburn, Cameron, & Iwama, 2007)

22.  Imbed cultural competency training into OT curriculums
(Nochajski, & Matteliano, 2008)
 Fieldwork education with underserved populations and
international fieldwork opportunities (Kirsh et al., 2006)
 Promote self-reflection into OT students’ own cultural
identities (Kirsh et al., 2006)
 Explore qualitative literature which depicts the
experiences of minority groups who receive OT (Kirsh et
al., 2006)
 Include discussions in academia of discrepancies in
Westernized versus non Westernized cultural values
(Iwama, 2003; Kinebanian & Stomph, 1992)

23.  Podsiadlowski et al., 2013:
o Organizational paradigms to diversity
• Discrimination and fairness
• Access and legitimacy
• Learning and effectiveness
 Suarez-Balcazar et al., 2011:
o Self-reflection
o Integrating culture in the occupational therapy process
o Developing organizational support for change
 Dass and Parker, 1999:
o Resistance to organizational support for change

24.  Dynamic between client and provider can be compromised by
sociocultural mismatches
 Competence connotes a theory that can be mastered
 Cultural humility indicates:
o Lifelong commitment to self-evaluation and self-critique
o Addressing power imbalances in the provider/client dynamic
o Developing partnerships with communities
 Focus on student education to examine individual patterns of
unintentional and intentional racism, classism, homophobia
(Tervalon & Murray-Garcia, 1998)

25.  …transculturally competent therapists are skilled at working
with the client to:
o identify how meanings are created and/or expressed
through occupation
o acknowledge systemic barriers to inclusion and are able to
advocate for their amelioration
o open to learning about the lived experience of their clients
o knowledgeable about their {clients} values and health
beliefs
o insightful about their own values and assumptions
regarding what are good and right and true
o can monitor their own tendency towards ethnocentricity
(Trentham, Cockburn, Cameron, & Iwama, 2007)

26.  Cultural fluidity (Shippy, 2009):
o Able to adapt to different cultures--expert and learner
 Cultural humility (Tervalon & Murray-Garcia, 1998):
o Every interaction is multicultural; must be aware of personal bias
 Transcultural competence (Kirsh et al., 2006):
o Ability to function effectively within a given role with a diversity of
individuals whose cultural perspectives differ from one’s own
• Cultural sensitivity is viewed as one aspect of transcultural
competence.
 Cultural proficiency (AAFP, n.d.):
o Knowledge, skills, and attitudes which enable people to work
well with, effectively respond, and support people in cross-
cultural settings

27.  ―Another promising strategy might be to make use of
―influential‖ therapists….In our opinion, knowledge
brokers could be very important, especially in the last
stages of implementation—change and maintenance.‖
(Ketelaar, Russell, & Gorter, 2008)
 ―For research findings to effectively influence health
services’ delivery of care needs an intermediary…an
emerging role therefore exists for knowledge
brokers, supported by knowledge brokering resources
and agencies, to fill the gap.‖
(Lomas, 2007)

28.  Therapists value interactive and hands-on continuing
education but rely most heavily on their peers when
accessing, evaluating, and implementing new
knowledge.
 Trials involving educationally influential therapists are
indicated.
 Continuing education research is needed to identify
organizational conditions conducive to therapists’
learning and knowledge translation.
(Rappolt & Tassone, 2002)

29. 

30. 1. What does diversity mean to you?
2. How do you define diversity?
3. What are 2-3 things that you have observed, done or
could do to promote diversity in the workforce?
4. What do you feel is the importance of diversity in the
workforce?
5. Is there anything else you would like to share?

31. Focus Group Results
17 (23%) 21 (28%)
Participants by region (n=75):
32 (43%)
1 (1%)
Not reported 3 (4%)

32. Yes 33%
No 67%
20-29 41%
30-39 23%
40-49 17%
50-59 13%
60-69 5%
Student 33%
OTR/L 49%
COTA 3%
Research 7%
Educator 8%

35.  ―I am reminded that we as a profession need to keep our eyes
fresh to continually adjust our modes of operation. Only then
can we provide the best patient care and more fully promote a
richer QOL.‖
 ―Diversity tends to be boxed into groups, but it is a really
broad concept on more than race, gender, religion and
sexuality.‖
 It is extremely important. No pt is the same meaning having
diversity in the workforce helps us as OTs provide more pt
centered practice and increases the comfort and relatability
pts feel with us.

36.  Its important for patients of different cultures to see we have
employee diversity as well
 ―Equality does not equal diversity -> makes working together
interesting.‖
 I realize there are many types of diversity, as we discussed.
Some areas, such as rural may only have 1 OT for hundreds
of miles. In these cases there is not a lot of opportunity for a
diverse professional pool. I feel the therapist needs to be
diverse in their understanding of cultures that they do not
belong to. There is such an opportunity to learn from our
clients too. Maybe this is considered cultural sensitivity, but
we also need to be diverse in our own self to be effective.

37. Politically-
correct
Phenomeno
n vs.
Problem
Changing
terminology

38. 
Lived Experiences of Emerging Leaders

45. 

46. 1. What does ―diversity‖ mean to you? How does
diversity relate to your workplace?
2. What are some strategies that you have
observed, implemented, or could do to promote diversity
in the workforce?
3. Discuss the concepts of cultural competence, cultural
humility, cultural fluidity, and trans-cultural care. Why are
these different? Do they matter? Why or why not?

47. 1. What were some of the perspectives discussed
by your group? Were there any insights or
epiphanies you would like to share?
2. Are there any other supports or barriers to
promoting diversity in your workplace or
university that you have observed?

48.  Invest in people—it can make all the difference
 Tell people who you are and what you do. Advocate for
what you are doing, and look for teachable moments
 Be an advocate in/for your community. Look for
volunteer opportunities to speak at local schools or
career fairs
 Create volunteer/observation opportunities for youth
 Do not underestimate the one minute elevator speech.
You can change a life in a minute
 Provide opportunities for structured and unstructured
mentorship on multiple organizational levels
 Provide financial support for Conference and/or
Conclave
 Strategize inclusion of OT in career interest tools/events

49. Move Beyond
Cultural
Competenc
e

50. 

51.  Cristina Reyes Smith, OTD, OTR/L; Medical University of South
Carolina (Charleston, SC); (843) 814-7917; smithcris@musc.edu
 Arameh Anvarizadeh, OTD, OTR/L; California Children’s Services
(Los Angeles, CA); (213) 820-3260; anvariza@gmail.com
 D’Andre Holland, OTD, OTR/L; Every Child Achieves (Los
Angeles, CA); (317) 445-8573; deehollandOT1209@gmail.com
 Catherine Hoyt Drazen, OTD, OTR/L; Washington University in St.
Louis (St. Louis, MO); (301) 467-0177; hoytc@wusm.wustl.edu
 Nadine Kwebetchou, MS, OTR/L; VA Palo Alto (Palo Alto, CA);
(443) 562 -3774; nadine.kwebetchou@gmail.com
 Stacy Wilson, MS, OTR/L; WakeMed Health and Hospital
(Raleigh, NC); (336) 847-0093; mrstacywilson@gmail.com

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