 span educational, social, and environmental domains (Scaffa, Reitz, & Pizzi, 2010). Scaffa and colleagues (2010) articulate that effective use of occupational therapy models directed at community health outcomes requires careful consideration of intrinsic (person-specific) and extrinsic (environmental specific) factors that impact perceptions of wellbeing and quality of life. The authors reference Baum, Bass-Haugen, and Chrostiansen’s (2005) use of the term situational analysis which is defined as “a process that involves the collection of information and the analysis of factors intrinsic and extrinsic to the individual, the organization or the population to determine the occupational performance issues that will impact the ability to reach client-centered goals” (p. 372; as quoted by Scaffa, Reitz, & Pizzi, 2010, p. 216).
Table 3 represents the authors’ recommended components of a situational analysis for the purpose of designing community-health interventions, and how those apply to the goal of impacting the incidence of postpartum depression (Baum et al., 2005; as quoted by Scaffa, Reitz, & Pizzi, 2010, p. 216).
Situational Analysis Component and the Application to
Postpartum Depression (PPD):
A general description of the population, including health behaviors, disease, injury, and disability incidence and prevalence statistics.
Impacts postpartum women within one year of giving birth
Prevalent in 1:7 women nationally, how does this compare to community prevalence?
Implied adverse mental health outcomes for the childbearing woman
Positive correlates to adverse impact on neonatal/child development
An environmental scan to identify environmental enablers and barriers.
What percentage of the childbearing population has access to healthcare coverage? How is it being utilized?
What percentage of OBGYN or pediatric clinics are actively screening for PPD?
What is their correlated rate of referral for mental health services?
What programs exist in the community to support maternal role transitions?
What community based social programs exist specifically for the postpartum population (e.g., postpartum exercise classes, postpartum yoga, book clubs, support groups, information sharing groups)
Interviews with stakeholders to ascertain community goals related to health and occupation.
Obstetrics and Gynecological clinics
Pediatric Medicine clinics
Community hospitals/birthing centers
… to determine service goals and gaps in provisions of care that elicit positive impact to client populations served.
Measures of health status and intrinsic factors to determine the constraints and capabilities for occupational performance.
Quantitative data extraction to determine frequency and severity scores on PPD screening tools (e.g., the Edinburgh Postnatal Depression Scale [EDPS] and Patient Health Questionaire [PHQ-9]) within the community
Use of survey to generate qualitative data inventory to determine perceptions of occupational impact upon postpartum population within the community
Measures of occupational participation and community engagement.
How are existing programs within the community being accessed and utilized?
What methods of advertising reach the greatest number of potential women in need (e.g., social media platforms, web-based advertising, doctor office pamphlets, direct inquiry to healthcare professionals)?
Collect quantitative/qualitative data regarding perceived needs and interests for occupational resources/outlets or programs that may be implemented.
(adapted from Scaffa, Reitz, & Pizzi, 2010, p. 216)
The desired outcomes of occupational therapy intervention at the community level are congruent with the objectives for outcomes at the individualized level of care. As outlined within the OTPF, the primary objectives of occupational intervention are to achieve health and wellness; prevention of injury, disease, and disability; occupational performance; role competence; adaptation; client satisfaction; and quality of life (AOTA, 2014; Scaffa, Reitz, & Pizzi, 2010). To achieve these outcomes, intervention may potentially in