Background: Calls for embracing the potential and responsibility of occupational therapy to address socio-political conditions that perpetuate occupational injustices have materialized in the literature. However, to reach beyond traditional frameworks informing practices, this social agenda requires the incorporation of diverse epistemological and methodological approaches to support action commensurate with social transformative goals. Aim: Our intent is to present a methodological approach that can help extend the ways of thinking or frameworks used in occupational therapy and science to support the ongoing development of practices with and for individuals and collectives affected by marginalizing conditions. Method: We describe the epistemological and theoretical underpinnings of a methodological approach drawing on Freire and Bakhtin’s work. Results: Integrating our shared experience taking part in an example study, we discuss the unique advantages of co-generating data using two methods aligned with this approach; dialogical interviews and critical reflexivity. Discussion: Key considerations when employing this approach are presented, based on its proposed epistemological and theoretical stance and our shared experiences engaging in it. Significance: A critical dialogical approach offers one way forward in expanding occupational therapy and science scholarship by promoting collaborative knowledge generation and examination of taken-for-granted understandings that shape individuals assumptions and actions.

Occupational therapy is underpinned by the premise that engagement in occupation is fundamental to health and well-being. Through occupations, people are able to orchestrate their lives in ways that enable them not only to survive, but also to experience human flourishing. Through occupation, people can develop and maintain their families, neighbourhoods and communities as sources of belonging, opportunities and common action. Occupation, therefore, is not only important to each individual, but also, through collective occupation, people develop the kind of lives that they live together. Occupation is an essential factor in life quality, the experience of being human and the social transformation of individuals and of the societies of which people are a part. This article describes the formation of an International Think Tank for Occupation based social transformation. It begins with a brief overview of the conditions and context that underpinned the development of the group, and the milestones achieved to date in the establishment of a global network.

Public health improvement has long been an important focus for the United Kingdom Department of Health. The Allied Health Professions (AHP) Federation has 84,000 members, such a large number of AHP professionals should play a role in public health initiatives, but it is not clear if they or the AHP students who will be the future healthcare workforce feel themselves equipped to do so. Our aim was to understand the perceptions of AHP students about their role in delivering public health advice. AHP students were recruited in one teaching university from different departments. Participants were final year AHP students who had completed all clinical placements related to their course. All students were emailed an invitation to participate, and those interested were asked to contact the researchers to participate in one of several focus groups. Data were recorded, transcribed, and analysed using framework analysis by two independent researchers. Nineteen students were recruited and participated in four focus groups. The main themes produced by the data analysis were: understanding of public health issues, perceptions of their role in this, challenges and opportunities to develop a public health role, and preparation for a public health role. AHP students felt that they had a role in public health advice-giving, but barriers to providing this advice included their own lack of confidence and knowledge, time, and the environment of the clinical placement. They considered that there should be more teaching on public health issues, and that these should feature in both the curriculum and on clinical placement.

Background: Exercise is a recognised element of health-care management of mental-health conditions. In primary health care, it has been delivered through exercise referral schemes (ERS). The National Institute for Health and Care Excellence has highlighted uncertainty regarding the effectiveness of ERS in improving exercise participation and health outcomes among those referred for mental-health reasons. This review aims, therefore, to evaluate ERSs for individuals who are referred specifically for mental-health reasons. Methods: Studies were reviewed that assessed the effectiveness of ERSs in improving initiation of and/or adherence to exercise and/or their effectiveness in improving long-term participation in exercise and health outcomes among primary care patients who had been referred to the scheme for mental-health reasons. The data were extracted and their quality assessed. Data were analysed through a narrative synthesis approach. Results: Nine studies met the eligibility criteria. Three assessed clinical effectiveness of the schemes, eight assessed ERS uptake and/or adherence to the exercise schedule, and two assessed the impact of the ERSs on long-term exercise levels. In one study, it was found that ERSs that were based in leisure centres significantly improved long-term symptoms in those who had been referred due to their mental ill health (P<0.05). ERSs that involved face-to-face consultations and telephone calls had the highest rates of mean uptake (91.5%) and adherence (71.7%), but a difference was observed between uptake/adherence in trials (86.8%/55.3%) and in routine practice (57.9%/37.2%). ERSs that included face-to-face consultations and telephone calls increased the amount of long-term physical activity that was undertaken by people who had been referred for mental-health reasons (P=0.003). Conclusions: Uptake and effectiveness of ERSs for mental health conditions was related to programme content and setting with more effective programmes providing both face-to-face and telephone consultations. Good uptake of yoga among those referred for mental health reasons suggests that mindful exercise options should be investigated further. Existing ERSs could be improved through application of individual tailoring and the provision of more face-to-face consultations, and social support. Further research is required to identify the types of ERSs that are most clinically effective for those with mental ill health.