Remoteness’ power: Discussing occupational therapy practice outside urban areas

Introduction/Rationale: There are a variety of terms that have described occupational therapy practice in non-urban urban spaces, however, the terms used are often indeterminate and vague, and vary according to language and study aims and methodologies.
Objectives: We present an alternative to overcome the challenge to describing the global context and up-scaling OT practice in non-urban areas.
Method/Approach: After concluding a global scoping review on occupational therapy services in non-urban areas (results presented elsewhere) we have identified that very few articles present definition of their context. Insufficient clarity, variety of terms, and inconsistency in occupational therapy literature have required the authors to seek concepts from human geography to unify the field.
Results: Occupational therapy has several sources of underpinning knowledge, including social science, anthropology, psychology, but we have spent little time considering human geography in examining the environmental context in both health provision and ways of living. We propose that structuration theory has potential for cross context analysis of occupational therapy service in non-urban areas. Structuration considers the intersection of structures (physical, social, political, cultural), personal agency, and power and can be used to identify the influence of remoteness on health outcomes and, consequently, occupational therapy practice.
Conclusion: We suggest that a series of national analyses using structuration theory would allow international comparison of non-urban occupational therapy practice, as the theory does not rely solely on geographical terms (e.g. distance from urban centres), but also on social and power relations to define context.