Culturally responsive occupational therapy practice with First Nations Peoples-A scoping review

Area of Science:

• Health equity and Indigenous health.
• Occupational therapy practice and cultural safety.
• Social determinants of health and anti-racism.

Background:

• First Nations Peoples face systemic health inequities, necessitating cultural safety as a counterforce.
• Racism is a significant health determinant requiring proactive interventions.
• Indigenous Allied Health Australia (IAHA) promotes cultural responsiveness to foster safe healthcare environments.

Purpose of the Study:

• To identify features of culturally responsive occupational therapy (OT) practice with First Nations Peoples.
• To evaluate the alignment of these OT practices with the IAHA Cultural Responsiveness in Action Framework.

Main Methods:

• A systematic scoping review of multiple databases (CINAHL, Emcare, MEDLINE, PsychInfo, Scopus).
• Mapping examples of culturally responsive OT practice to the six IAHA Framework capabilities.
• Confirmation of findings by First Nations co-authors.

Main Results:

• Occupational therapy (OT) practice demonstrated varying alignment with the six IAHA capabilities.
• Key findings include the importance of relationship-building, self-reflection on cultural biases, and addressing Western practice limitations.
• Privileging First Nations Peoples' voices and leadership is essential.

Conclusions:

• Inconsistent application of IAHA capabilities can lead to culturally unsafe experiences for First Nations Peoples.
• Occupational therapists (OTs) must critically examine their practices for potential reinforcement of oppressive systems.
• Upholding client-centered care necessitates respecting First Nations leadership and decolonizing OT foundations.