Increasing number of special needs students in mainstream school has imposed great challenge on educators as they are compelled to provide an inclusive classroom (Lim, 2016). However, limited knowledge on the broad scope of special needs and accessibility barrier to reach out to professionals such as occupational therapists (OT) results in delayed identification or provision of appropriate support for students with special needs (Kaur, 2013; Teng, 2017). As such, this doctoral project proposes an innovative tele-health service delivery model that utilizes the Teachable (2019) online software to create a 3-tiered intervention program. The intervention consists of 1) e-learning modules on the broad perspectives of classroom attention and participation, 2) e-consultation to seek OT support and, 3) discussion forum for educators and OT to discuss on scenarios and cases. This project is also a cost-effective service delivery model as the subscription plan and time-based e-consultation fees is aimed to cover the cost of running the online platform. Grant approval from Singapore Association of Occupational Therapists (SAOT) would be utilized for the start-up cost. Evaluation of the program content and service delivery model would be carried out as online survey using the Teachable platform. The evaluation outcome and dissemination activities to promote the program would aid in expanding the program as a teacher education curriculum for inclusive practice. The long-term impact of this program is to change the inclusive practice paradigm to a student-centered, holistic, performance-based paradigm!

According to the Macro, Meso, and Micro levels (3Ms), the 3Ms of Occupational Engagement: Awareness of Entitlement and Support Programs for People with Disabilities (People of Determination) in the United Arab Emirates (AESPPD) is an educational program focused on educational programs designed to increase awareness of policies, regulations, and entitlements in the United Arab Emirates (UAE). Promoting occupational justice, social justice, and improving employment are ways to break down social stigmas for people with disabilities (people of determination). Using a hybrid model of in-person and telehealth, the 24-week program proposed in this doctoral program will provide education on and facilitate access to entitlement and support programs for clients, caregivers, and occupational therapy students in the UAE and globally. The author aims to reduce the environmental barriers, including the lack of accessible community locations and transportation, as well as limited access to rehabilitation programs (WHO, 2001; WHO, 2006; Zhou et al., 2020). Reduced limitation to often necessary services results in success with paid employment (Andersen & Olsen, 2019; Bondia, 2019; Haza, 2019; Silva et al., 2019). Environmental barriers result in challenges in an individual's ability to support themselves financially, maintain healthy social participation, and engage in meaningful occupations (Adams et al., 2012; Marshall, 2009; Sheppard & Frost, 2016; WHO, 2011; WHO RCWP, 2018). The program will promote access, independence, opportunity, and change for this target population through awareness of occupational injustice and barriers to engagement (Hammell, 2008); collective occupations for change (Frank & Santos, 2020); awareness of cultural norms (Frank & Santos, 2020); policies and civil rights act change (WHO, 2011); developing intentional attendance using telehealth (Fogelberg & Frauwirth, 2010; Frank & Muriithi, 2015). Consequently, corresponding to the 3Ms telehealth program, the author can engage in employment and social participation for people with disabilities (people of determination) in the UAE and globally.

The transgender and gender diverse (TGD) patient population consists of a diverse group of people with unique needs who have, unfortunately, been underserved by the medical community. These individuals share a disproportionate burden of discrimination and disease when compared to cisgender persons. However, despite this, they continue to receive inequitable treatment, and transgender health topics still comprise just a small portion of medical education training. While efforts to improve awareness and training regarding transgender health care needs are underway, these take time to gain traction. It also relies heavily on changing medical providers’ own biases. Telemedicine has been proposed as a way to potentially bridge the gap and increase the access and availability of quality, informed medical care to this community. Although telemedicine has demonstrated its ability to do this in other areas of medicine, the existing research on whether it has the capacity to do so for transgender health care delivery is scant. The majority of the existing literature on the topic consists of retrospective qualitative feedback provided during a time where telemedicine was still emerging as a commonplace medium through which medical care is provided. Therefore, this thesis proposes to perform a randomized controlled trial investigating whether instituting a hybrid telemedicine approach has the capability to expand the accessibility of specialty transgender health care services as compared to fully in person medical care while maintaining a high standard of health care quality and patient satisfaction. This study would have the capacity to help inform future health care policy and provide support for continued telemedicine offerings and reimbursement moving forward.

he purpose of the current study was to evaluate the use of behavior skills training via telehealth to teach job interview skills to emerging adults with ASD. Additionally, the study examined if following intervention, skills were able to generalize to new interviewers. 2 undergraduate and 1 graduate student with ASD participated in the study, and received intervention for 3 behaviors: (1) appropriately answering questions, (2) asking appropriate questions, and (3) engaging in appropriate body language. The current study used a multiple baseline design across behaviors. Results from the study indicated BST via telehealth was effective in teaching job interviews skills. Each participant remained at mastery during generalization and did not require a booster session. Social validity ratings completed by each participant indicated they found the intervention method to be fair, effective, and efficient for the identifed need. Limitations and directions for future research are discussed.

Effective patient-provider communication (PPC) involves conveying sufficient information to a patient such that the treatment is agreed upon and implemented accurately. Furthermore, a patient must feel adequately involved in the treatment process. With the advent of the COVID-19 pandemic, many clinical visits were shifted online. Although telemedicine was successful in meeting pandemic-specific goals, such as lowering personal contact, it changes the communicative context. Both patients and providers get less input from body language (nonverbal communication) and rely more on verbal communication. Furthermore, the number of telemedicine visits conducted remains elevated over pre-pandemic levels. Much of what is known about effective PPC is derived from studies in in-person contexts, with little information available in virtual contexts. Given that even occasional lapses in optimal PPC can have severe effects on patient outcomes, it is essential to understand PPC in various settings to optimize patient outcomes in the long run. This study was a secondary data analysis of the UCF Student Health Services Patient Satisfaction Questionnaire. A total of 6645 survey results from January 2021 to November 2022 were analyzed to compare patient perceptions of PPC variables and overall satisfaction with the clinical visit. The results indicated that there was no statistically significant difference in overall satisfaction and PPC variables between telemedicine and in-person visits. However, the results revealed that different PPC variables contributed to overall satisfaction with telemedicine and in-person visits. Keywords: patient-provider communication, telemedicine, telehealth, COVID-19, patient satisfaction, college

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This thesis investigates methods for remote collaboration and communication within a Mixed Reality (MR) rehabilitation environment. Based on the research on remote communication methods and an interview with an occupational therapist with previous experience in MR rehabilitation, a video and audio stream communication method was chosen to be implemented. The implementation consists of two applications, one patient application developed for HoloLens 2 and one therapist application for Android devices. The latter was tested on professional occupational therapists to investigate the feasibility of the method.  The result of the test indicated that the general attitude toward remote rehabilitation was positive. However, the chosen method did not allow the therapist to see the patient's face and surroundings which was a problem for a majority of the test participants. The cognitive workload for the therapist when communicating with the patient was in magnitude to similar tasks and the application was relatively easy to navigate.

Measurement Based Care (MBC) is considered to be an evidence-based practice. Despite its well-documented efficacy, it is underutilized in the clinical community for various reasons, including clinician and patient buy-in. A key component to the successful implementation of MBC is the routine administration of Patient Reported Outcome Measures (PROMs). There is a lack of research describing the utilization of MBC in a telehealth setting. As technological innovations continue, a greater number of clinics are offering telemental health services. Additionally, the COVID-19 pandemic caused a majority of underprepared clinics to begin implementing telehealth. The present study sought to evaluate patient compliance with PROMs in MBC after an abrupt shift to telehealth due to the COVID-19 pandemic. Participants were collected from a clinical population at a community based psychological training clinic. The participants were separated into groups: modality 1 (in-person services, n = 17), modality 2 (telehealth services, n = 17), and modality 3 (hybrid of modalities 1 and 2, n = 10), to assess the effect of modality on mean PROM compliance. The participants were separated into groups adult (≥18 years of age, n = 23) and child (<18 years of age, n = 17), to assess the effect of maturity on mean PROM compliance. Results showed that mean PROM compliance was significantly higher in the in-person modality than the telehealth modality. Results also showed that PROM compliance was significantly higher in adults than in children. There was not a significant interaction effect of modality and maturity on PROM compliance. Additionally, results showed that PROM compliance decreased significantly after the switch from in-person services to telehealth services in the hybrid modality. These findings show that clinics may face significant barriers to the implementation of MBC after a sudden shift to telehealth caused by an unforeseen stressful event. / M.S. / Measurement-Based Care (MBC) is an effective practice for the treatment of patients in psychological practices. It is a collaborative process that involves the clinician and patient tracking treatment progress and outcomes through the use of consistently administered measures known as Patient Reported Outcome Measures (PROMs). Although MBC has been shown to be effective, there is little literature regarding its use in a telehealth setting. As a greater number of clinics begin offering telehealth services, questions regarding patient adherence to interventions have arisen. Furthermore, the global COVID-19 pandemic forced a majority of underprepared clinics to offer telehealth services. The current study sought to better understand potential barriers to the implementation of MBC in a telehealth setting. Participants were collected from patients receiving therapy at a community based psychological training clinic. The participants were separated into the groups: in-person services (n = 17), telehealth services (n = 17), and hybrid of in-person and telehealth (n = 10), to assess the effect of modality on mean PROM compliance. The participants were separated into groups adult (≥18 years of age, n = 23) and child (<18 years of age, n = 17), to assess the effect of maturity on mean PROM compliance. Results showed that patients in the in-person therapy group were more likely to complete their measures than patients in the telehealth therapy group, regardless of their maturity. Additionally, adult patients were more likely to complete their measures than child patients, regardless of the modality. Results also showed that patients who experienced both in-person and telehealth services were more likely to complete their measures before the switch to telehealth. These findings show that clinics may face significant barriers to the implementation of MBC after a sudden shift to telehealth caused by an unforeseen stressful event.