What question did this study set out to answer?

Investigate the ecological factors across macro, meso, and micro levels that shape service delivery among school-based occupational therapy practitioners.

August 15, 2026Journal of Occupational Therapy Schools & Early Intervention

A Preliminary Evaluation of the Ecological Influences on School-Based Practice: A Qualitative Research Study

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Investigate the ecological factors across macro, meso, and micro levels that shape service delivery among school-based occupational therapy practitioners.
Conducted focus groups with school-based occupational therapy practitioners (N=21) across the United States.
Analyzed qualitative data using reflexive thematic analysis within the participation-focused knowledge translation framework.
Macro-level policy demands and a lack of classroom handwriting instruction increase referral volumes, even as recognition of mental health and universal design expands practitioner roles.
Meso-level institutional structures and conflicting administrative expectations create substantial variability in practitioner workloads and multi-tiered support integration.
Micro-level practice relies on clinical reasoning, data-driven decision-making, and interprofessional collaboration to maintain client-centered care amidst structural constraints.

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Implication

Qualitative study uncovers multilevel ecological influences shaping school-based occupational therapy, highlighting the need for systemic alignment to support student participation.

Cite This Study

Schmidt et al. (2026) studied this question.

synapsesocial.com/papers/6a8019db75c2e31742c861e9 https://doi.org/10.1080/19411243.2026.2718182

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Implication

Qualitative study uncovers multilevel ecological influences shaping school-based occupational therapy, highlighting the need for systemic alignment to support student participation.

A Preliminary Evaluation of the Ecological Influences on School-Based Practice: A Qualitative Research Study

Key Points

Discussion

Implication

Cite This Study

A Preliminary Evaluation of the Ecological Influences on School-Based Practice: A Qualitative Research Study

Key Points

Discussion

Implication

Cite This Study

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