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| Question |
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| Q1. Gender | (A) Male
(B) Female
(C) Gender nonconforming
(D) Prefer not to say |
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| Q2. Race (select all that apply) | (A) American Indian or Alaska Native
(B) Asian
(C) Black or African American
(D) Native Hawaiian or Other Pacific Islander
(E) White
(F) Prefer not to say |
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| Q3. Ethnicity | (A) Hispanic or Latino
(B) Not Hispanic or Latino
(C) Prefer not to say |
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| Q4. Area of practice (select all that apply) | (A) Physical disability
(B) Mental health
(C) Community practice
(D) School based
(E) Pediatrics
(F) Other |
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| Q5. What is your highest degree level? | (A) Bachelor’s in occupational therapy
(B) Master’s in occupational therapy
(C) Doctorate in occupational therapy
(D) PhD |
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| Q6. What state do you primarily practice in? (drop-down menu) | |
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| Q7. How long have you been practicing as an OT? | (A) 0-5 years
(B) 6-10 years
(C) 10-15 years
(D) 16-20 years
(E) 20+ years |
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| Q8. Can you define self-advocacy as a client issue in occupational therapy? | (A) Yes, and I can explain it well to other people
(B) Yes, but I cannot explain it well to others
(C) Somewhat, I have heard of the concept but I am unsure of how to define it
(D) Not well |
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| Q9. Can you differentiate between self-determination and self-advocacy? | (A) Yes, I understand the difference and can explain it to other people
(B) Yes, I know these are different concepts but find it difficult to explain to others
(C) Somewhat, I have heard these described as being different but unsure of how
(D) Not well |
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| Q10. In your academic or clinical education, were interventions on developing self-advocacy in clients introduced? | (A) Yes, I learned concepts as well as strategies/interventions for addressing self-advocacy as a client factor for use in practice
(B) Yes, I was introduced to concepts of self-advocacy as a client factor but not strategies for use in practice
(C) Somewhat, concepts of self-advocacy as being important were discussed but not as a client factor to intervene upon
(D) No, self-advocacy as a client factor was never presented to me in my academic or clinical education |
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| Q11. If you learned strategies for addressing self-advocacy, how did this occur? | (A) Occupational therapy school
(B) Continued education
(C) Colleagues
(D) Through my own research/experience
(E) I have not learned strategies |
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| Q12. How well prepared do you feel to address self-advocacy with your clients? | (A) Very well prepared
(B) Well prepared
(C) Somewhat prepared
(D) Did not prepare me at all |
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| Q13. How important is it for occupational therapists to address self-advocacy in treatment sessions? | (A) Very important
(B) Moderately important
(C) Somewhat important
(D) Not important |
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| Q14. How confident do you feel in your ability to address self-advocacy during treatment? | (A) Very confident
(B) Moderately confident
(C) Somewhat confident
(D) Not confident at all |
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| Q15. In how many clients do you assess the need for self-advocacy? | (A) All of my clients
(B) Half or more of my clients
(C) Less than half of my clients
(D) None of my clients |
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| Q16. What tools do you use to determine if self-advocacy is a client factor in need of intervention? (select all that apply) | (A) ADLs
(B) IADLs
(C) Knowledge of rights
(D) Knowledge of needs
(E) Other: ___________
(F) I do not assess the need for self-advocacy as a client factor |
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| Q17. Is self-advocacy specifically written into your long- and short-term goals? | (A) Yes, I include self-advocacy in long- and short-term goals
(B) No, I do not include self-advocacy in long- or short-term goals |
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| Q18. If you address self-advocacy, which area of occupation is this most often linked to? (select all that apply) | (A) ADLs
(B) IADLs
(C) Rest and sleep
(D) Education
(E) Work
(F) Play
(G) Leisure
(H) Social participation
(I) I do not address self-advocacy with clients |
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| Q19. In what ways do you address self-advocacy? (select all that apply) | (A) Directly as a part of therapy sessions
(B) Indirectly through teaching skills that relate to self-advocacy
(C) Education of rights
(D) Other: _____________
(E) I do not address self-advocacy |
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| Q20. What intervention approaches do you find to be most successful in addressing self-advocacy? (select all that apply) | (A) Create, promote
(B) Establish, restore
(C) Maintain
(D) Modify
(E) Prevent
(F) None of the above |
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| Q21. What outcome measure do you use to assess change in self-advocacy as a client factor? (select all that apply) | (A) Knowledge about needs in a given ADL/IADL
(B) Knowledge about rights to accommodation
(C) Communication strategies
(D) Implementation of accommodation needs
(E) None of the above |
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