Graduation Year


Document Type


Degree Type

Open Access Capstone

Degree Name

Doctor of Occupational Therapy (OTD)


Occupational Therapy


Background: Adults under age 65 living in skilled nursing facilities is a growing population and lack of occupational engagement in skilled nursing facilities is well documented. There is also a documented lack of training programs for skilled nursing facility staff to appropriately care for this population’s occupational needs. Occupational Therapists are uniquely qualified to educate and train skilled nursing facility staff in the occupational engagement needs of this group. Purpose: There is a lack of documented research regarding adults under age 65 living in skilled nursing facility and training programs for staff that care for this group. To address this gap in knowledge, the purpose of this study is to examine the relationship between staff training and the knowledge and perceived competence of staff related to promotion of occupational engagement in adults under age 65 living in skilled nursing facilities. Theoretical Framework: This research project is guided by four theories: the social ecological model for the overall research project, cognitive constructivism for the design of the educational program, self-determination theory for development of outcome measure related to perceived confidence of participants, and occupational justice theory for guidance related to the issues of occupational justice and deprivation related to this topic. Methods: This pre-experimental one group pretest and posttest research design explored the effects of an occupation-based training program for skilled nursing facility activities professionals on the participant’s knowledge and perceived competence. The primary locations for this study were two skilled nursing facilities in Cincinnati, Ohio. Eight participants total were recruited from both locations. Inclusion criteria included: able to speak English, able to read and write, currently work with adults under age 65 in their work setting, have worked at the research study site for at least 3 months, and able to give their own informed consent. This research study incorporated quantitative research methods with training content delivered in a webinar format and data collected via two written outcome measures. Results: Eight activities professionals participated in this study. Statistical analysis of pre and post test data indicated a statistically significant improvement in knowledge and perceived competence of participants following participation in an occupation-based training program. Conclusions: Skilled nursing facility staff could benefit from occupation-based training in order to meet the occupation needs of adults under age 65 living in skilled nursing facilities. Occupational therapists have the necessary skills to act as a consultant and educator to the staff in skilled nursing facilities in order to improve occupational engagement and quality of life for all residents.

Faculty Mentor

Renee Causey-Upton PHD, OTD, OTR/L

Department Affiliation

Occupational Therapy

Committee Member

Leah Simpkins OTD, OTR/L, CPAM

Department Affiliation

Occupational Therapy

Department Affiliation

Occupational Therapy


I would like to acknowledge and thank all of the people who guided me and supported me on this educational journey. I would like to thank Dr. Renee Causey-Upton and Dr. Leah Simpkins for their support and guidance throughout the course of capstone project. Their expertise was invaluable in bringing this project to fruition. I would also like to thank Dr. Shirley O’Brien and Dr. Dana Howell for their support and guidance throughout the course of my educational journey over the last few years. I would like to thank my family for their support throughout my journey including their endless help with all manner of tasks while I was busy completing my education. The support of my husband and both of my children was crucial for me to be able to complete this journey.

IRB Approval Number (if applicable)