International health professional perspectives of using the Cognitive Orientation to daily Occupational Performance approach in routine practice

Background: The Cognitive Orientation to daily Occupational Performance (CO-OP) Approach is an evidence-based intervention that utilizes a problem-solving approach to achieve client-chosen goals. Training is available to support professionals in learning and using the approach effectively. Therapists' perspectives of using the approach in practice post training has not been reported. Methods: Perspectives of CO-OP trained health professionals were gathered using an international online survey. Closed and Likert scale questions were analyzed using descriptive statistics, and free-text responses were coded using content analysis. Results: The dataset compiled responses from 181 participants across 6 continents. CO-OP training was perceived positively, reporting it prepared them well for using CO-OP. However, 66% would like further support to use the approach. Of the recommended 10 individual sessions, only 1/3 of participants provided the recommended dosage. Despite the Canadian Occupational Performance Measure (COPM) and the Performance Quality Rating Scale (PQRS) being prescribed outcome measures in CO-OP, only 63% of respondents used the COPM and 23% the PQRS. Conclusion: Education and training are important to implement evidence-based interventions, but do not always lead to delivering the approach with fidelity. Future research should focus on how to support CO-OP implementation with fidelity, including process evaluation to understand clinical contexts and evaluate its effectiveness when delivered by clinicians.