Conceptualizing Community Development from an Occupational Therapy Perspective
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Despite our theoretical commitment to community development (CD) approaches in occupational therapy, current practice models focus on individual interventions, rather than identifying how occupational therapists (OTs) can contribute at a community level. Consequently, OTs attempting to work with communities may not have clear guidance on methods of community engagement or strategies for addressing community level issues. This research examined three cases of OTs working in CD in different regions of Canada in order to 1) generate in-depth interpretive case descriptions of CD practice; and 2) conceptualize CD from the perspective and practices of occupational therapy. Data collection in each case occurred over three weeks and included approximately 30 hours of observations, document reviews and 14 interviews with health professionals and program participants. Constructivist grounded theory informed data analysis. The conceptual framework generated from the cross-case analysis describes the context of CD in which the OTs bridged the health and community sectors. The OTs were in community-focused positions located within regional health authorities. The OTs strategically used both professional and personal self to enable more equitable power sharing between health services, community agencies and consumers, creating opportunities for meaningful engagement with and in communities. Four main CD strategies contributed to this power shift: 1) building consumer and community capacity, 2) nurturing community partnerships, 3) influencing the health care system, and 4) linking sectors and resources. These OTs focused on a set of core values while drawing on their professional experiences. Individual, organizational and community-level changes resulted from these CD initiatives. The conceptualizations developed in this study can inform the practice of OTs by identifying potential CD strategies for enabling occupations with communities and sensitizing OTs to historical contextual tensions and power inequities. From this, the applicability of current occupational therapy models to communities can be extended, enhancing reflexive CD practice.