A global scoping review of occupational therapy services provided to populations in non-urban areas: Final results

Introduction/Rationale: Despite approximately 50% global population living in non-urban spaces and experiencing higher incidence of disability and poverty, occupational therapy is poorly represented outside of urban centres and services provided in non-urban spaces is unexplored.
Objectives: Synthesise the evidence describing occupational therapy services provided in non-urban areas globally.
Method: MEDLINE, CINAHLPlus, Emcare and ProQuest (Nursing & Allied Health), searches were conducted to identify English, French, Portuguese, or Spanish language articles from January 2010 – September 2020. Inclusion criteria were services provided by occupational therapists in non-urban areas across all age ranges and health status, via standalone services or multidisciplinary teams. Article data were examined for study and publication location, publication type, research aim and method, service recipient data, context, and services provided.
Results: 1985 unique articles were identified and title/abstract screened. 384 articles were full text screened and 129 articles included in the review. Articles were published in English and Portuguese, with USA, UK, and Australian journals publishing 77% of these papers. 76% of the non-urban populations studied were from countries in the global North, particularly USA (30%) and Australia (28%). Articles included service evaluations, opinion/case study, qualitative reviews, and experimental trials. Services included rehabilitation, community development, paediatric therapy and home modifications/equipment supply, provided by locally based and distant services using telehealth and/or outreach.
Conclusion: Global North groups were overrepresented in non-urban occupational therapy service literature and there is a need for more research to support practice and training aligned with the needs of diverse non-urban populations across the globe.