Developing and Implementing an Occupation-Based Practice Service Delivery Model for Stroke Survivors in a Rural Thai Community Rehabilitation Center: Mixed Methods Feasibility Study.

Participants demonstrated statistically significant improvements in occupational performance and satisfaction as measured by the Canadian Occupational Performance Measure after the OBP intervention.

• Sample size was 7 stroke survivors at a rural community rehabilitation center in Doi Lor community, Chiang Mai Province, Thailand.
• The intervention consisted of 14 sessions spanning 7 weeks.
• Statistical significance was reported at P=.02 for the Canadian Occupational Performance Measure.
• The study used a 1-group pretest-posttest design, meaning there was no control group for comparison.
• The Canadian Occupational Performance Measure assessed both performance and satisfaction domains.

Participants achieved higher levels of goal attainment on the goal attainment scaling following the OBP intervention.

• Goal attainment scaling results were statistically significant at P=.02.
• Goal attainment scaling was used as one of three quantitative outcome measures assessed before and after the intervention.
• The same 7 stroke survivor participants were assessed on this measure.
• The intervention was delivered by a single trained occupational therapist.

Participants showed improved overall quality of life as assessed by the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF) after the intervention.

• Quality of life improvement was statistically significant at P=.02.
• The WHOQOL-BREF was the third quantitative outcome measure used in the study.
• All three quantitative outcome measures yielded the same p-value of P=.02.
• The study used an embedded mixed methods feasibility design, meaning these results are preliminary in nature.

Qualitative analysis of the occupational therapist's experience identified two themes related to client-centered outcomes and professional confidence.

• Data were collected through a semistructured interview with the single occupational therapist who implemented the model.
• The two themes identified were: 'facilitating client-centered outcomes through OBP implementation' and 'enhancing professional confidence and supporting the practical implementation of OBP in community-based practice.'
• The occupational therapist described the model as practical and feasible.
• The therapist reported increased confidence in delivering occupation-based interventions.
• The qualitative component used a qualitative descriptive approach embedded within the broader mixed methods design.

The OBP service delivery model was developed based on three foundational frameworks specific to occupational therapy and stroke rehabilitation.

• The model was grounded in the Dynamic Model of Occupation-Based Practice, the Occupational Therapy Practice Framework Fourth Edition, and evidence-based stroke rehabilitation principles.
• The model was implemented by a single trained occupational therapist.
• The model was designed for community-based stroke rehabilitation contexts, specifically addressing a gap in rural settings.
• The study noted that existing OBP evidence is predominantly derived from hospital-based settings.

The occupational therapist reported the model had potential applicability within long-term, community-based occupational therapy services.

• This finding emerged from the qualitative interview component of the study.
• The study was explicitly framed as a feasibility study, suggesting these findings are intended to inform future larger-scale implementation.
• The rural community context of the study (Doi Lor community, Chiang Mai Province) was identified as an area with limited access to hospital-based rehabilitation services.
• The model's components included therapist preparation, client-centered goal setting, and outcome-focused intervention.