Workforce policy and management affects the capacity of occupational therapists to meet population needs. However, the use of research and evidence in workforce planning to influence policy and planning has been limited. The need exists to foster development and utilization of scientifically-sound, solution-oriented and context-sensitive occupational therapy workforce research. Actions involve developing workforce research structures, networks, and agendas to generate needed evidence, and systematically using evidence to inform and evaluate policies, planning, regulation, and management practices.

Problem and opportunity

Occupational therapy workforce research is important for informing evidence-based professional advocacy and workforce strengthening activities. A scoping review found weaknesses in the volume, growth, design, methods, funding, geographical distribution, and content coverage of global occupational therapy workforce research; these weaknesses limit the development of the knowledge base for workforce strengthening activities.

Identified weaknesses of occupational therapy workforce research^{9 16 17 23}

An overreliance on cross-sectional, descriptive studies without follow-up, and a lack of longitudinal studies and experimental approaches.
Studies are typically small, with convenience samples, often from single settings/regions and with limited subgroup analyses, making results not generalizable or representative of the workforce and their strata.
Limited use of inferential statistics and standardized instruments.
Research findings that are often outdated, despite the need for workforce research to be context-sensitive and reflect updates in policies, health systems, labour markets, socio-demographics, and other key contextual variables.
Lower rates of funding support for occupational therapy workforce research (20%)¹⁶ than for general health workforce research or overall rehabilitation research (>50%).⁴⁸
LMICs accounting for a total of 11% of the occupational therapy workforce research publications,¹⁶ despite these countries collectively accounting for over 75% of the global population need for rehabilitation services.⁴
The lack of an internationally articulated workforce research agenda, with specific countries investigating particular topics; for example, Australia addressing factors affecting recruitment and retention in underserved rural and remote areas, the United States investigating supply-demand shortages, and Canada studying the integration of internationally-educated therapists.¹⁷
No structured research programmes, hubs, teams, or networks, with studies often conducted as ‘one-off’ student projects, reflecting the lack an organized agenda for occupational therapy workforce research.²³

Opportunities for advancement of occupational therapy

An increasing number of occupational therapists are educated at master or doctoral levels, especially in high-income nations, and able to carry out the investigations if provided with needed support.⁹
Availability of research funding or opportunity to participate in cross-professional studies result in the greater use of advanced scientific methods (e.g., inferential statistics).¹⁶
Opportunities exist for taking advantage of the existing exploratory research findings, for informing more advanced study designs. For example, qualitative research and cross-sectional surveys on recruitment and retention determinants in rural areas can lead to discrete-experiment-choice studies and/or cohort studies on recruitment and retention, and then to trials on the impact of recruitment and retention packages for underserved rural areas.^{9 17}

Objectives

Long-Term Goals (three cycles of four years)

Scientifically sound workforce research projects and programmes explicitly impact or shape workforce policies, planning and management practices for strengthening the occupational therapy workforce.

Short-Terms Goals (one cycle of four years)

Research publications, funding rates, and the methodological quality of the occupational therapy workforce research are improved.
Research centres, programmes, hubs, or networks producing systematic, continuous, explicit research on the occupational therapy workforce are developed or strengthened.
Formal workforce research development plans are established for advancing the development and use of the workforce research on the occupational therapy workforce.

Specific actions and tasks

The specific actions focus on producing sound research, developing supportive funding mechanisms and research structures, and engaging interested parties toward improved relevancy and implementation of workforce research.

Produce scientifically-sound, population-centred, and solution-oriented occupational therapy workforce research.

a. Leverage the use of existing workforce datasets for producing secondary research or determine representative samples of participants for an improved generalisability of the primary workforce research.

b. Use cross-sectional survey and qualitative studies to inform the development or understand the implementation impact of more advanced and solution-oriented studies, such as longitudinal studies, experimental research, or action research.

c. Develop experimental studies that assess the real-world effectiveness and implementation of solutions for addressing workforce issues (e.g., human resources programmes for improved performance; policies or packages for improved recruitment and retention in underserved areas).

d. Develop cross-professional and profession-specific workforce research to compare workforce research findings from occupational therapists with other professionals to identify findings that shape profession-specific and common health workforce policies and practices.

Develop funding mechanisms, research structures, research training structures, and networks to build national and cross-national capacity to advance occupational therapy workforce research.

a. Promote earmarked funding mechanisms for the study of the occupational therapy workforce and its strengthening to improve equity of population access to occupational therapy.

b. Develop research hubs, centres, networks, or workforce programmes of research for conducting workforce research, both profession-specific and cross-professional.

c. Develop health-services research education capacity for a workforce-related research agenda for or inclusive of the occupational therapy workforce.

Engage interested parties in the development and use of occupational therapy workforce research.

a. Build partnerships with interested parties (e.g., end-users; decision makers) toward shaping and carrying an occupational therapy workforce research development agenda.

b. Use workforce evidence, tools, and frameworks and consult with stakeholders to establish research questions and methods.

c. Promote the use of occupational therapy workforce research findings to inform health workforce policy, planning, regulatory, management, and professional advocacy practices, through knowledge translation and implementation research.

d. Build coalitions of interested parties, researchers, and agents of change to develop research proposals and apply for funding on workforce research addressing substantive population need and disparity gaps.

e. Evaluate impact not merely in scholarly metrics (e.g., publications, impact factors), but also in terms of workforce policy, planning, and practice changes and, ultimately, in the resultant population benefit.