Occupational Therapy Home Safety Intervention via Telehealth

  • Lori E. Breeden University of Indianapolis


Photography can be an effective addition for education-based telehealth services delivered by an occupational therapist.  In this study, photography was used as antecedent to telehealth sessions delivered by an occupational therapist focused on narrative learning about home safety.  After taking photographs of past home safety challenges, six participants experienced three web-based occupational therapy sessions each.  Sessions were recorded and transcribed.  Data were examined using content analysis.  A content analysis identified the following themes as well as an understanding of the learning process.  Analyses yielded themes of: the value of photos to support learning, the value of narrative learning related to home safety education, abstract versus concrete learners.  Procedural findings are included to support future endeavors.  Findings indicate that within a wellness context, home safety education for older adults can be delivered effectively via telehealth when using photography as a part of an occupational therapy intervention.


Author Biography

Lori E. Breeden, University of Indianapolis
Lori Breeden is an Assistant Professor in the School of Occupational Therapy at the University of Indianapolis.  She teaches Neuroscience in Occupational Therapy, OT Process II & III which focus on intervention, and an elective on Telehealth. Professional interests include rehab seating and positioning, spasticity management and recovery of hemiplegic upper extremities.

Lori's research interests include client education, stroke recovery, OT delivery via telehealth, the contribution of photovoice and photoethnographic research to the understanding of participation in meaningful occupation with a chronic illness or disability.

She received her EdD in Adult, Higher & Community Education from Ball State University, her MS in Occupational Therapy, and BS in Psychology from the University of Indianapolis.


American Occupational Therapy Association. (2010). Workforce trends in occupational therapy. Retrieved from http: //www.aota.org/-/media/Corporate/Files/EducationCareers/Prospective/Workforce-trends-in-OT.PDF

Berg, C. A., Johnson, M. M. S., Meegan, S. P., & Strough, J. (2003). Collaborative problem-solving interaction in young and old married couples. Discourse Processes, 35, 33-58.

Broady, T., Chan, A., & Caputi, P. (2010). Comparison of older and younger adults’ attitudes towards and abilities with computers: implications for training and learning. British Journal of Educational Technology, 41, 473-485.

Centers for Disease Control and Prevention (2010). The cost of falls among older adults. Retrieved from http://www.cdc.gov/HomeandRecreationalSafety/Falls/fallcost.html

Chiu, T., & Oliver, R. (2006). Factor analysis and construct validity of the SAFER-HOME. Occupational Therapy Journal of Research: Occupation, Participation and Health, 26, 132-142.

Chiu, T., Oliver, R., Ascott, P., Choo, L.C., Davis, T., Gaya, A., Goldsilver, P., McWhirter, M., & Letts, L. (2006). Development of the SAFER-HOME v.3. COTA Comprehensive Rehabilitation and Mental Health Services. Retrieved from http://www.teamgrant.ca/M-THAC%20Greatest%20Hits/M-


Clark, C. M. (2010). Narrative learning: It’s contours and its possibilities. New Directions for Adult and Continuing Education, 126, 3-11. doi: 10.1002/ace.367

Clark, C. M., & Rossiter (2008). Narrative learning in adulthood. New Directions for Adult and Continuing Education, 119, 61-70. doi: 10.1002/ace.302

Clemson, L., Cusick, A., & Fozzard, C. (1999). Managing risk and exerting control: Determining follow through with falls prevention. Disability and Rehabilitation, 21, 531-541.

Collier, J. & Collier, M. (1986). Interviewing with photographs. Visual anthropology: photography as a research method. Albuquerque, NM: University of New Mexico Press.

Creswell, J. W. (2013). Qualitative inquiry and research design: Choosing among five approaches (3rd ed.). Thousand Oaks, CA: Sage Publications.

Crotty, M. (1998). Introduction: The research process. Foundations of social science research: Meaning and perspective in the research process (pp. 1-17). Crows Nest, NSW: Sage Publications.

Dahlin-Ivanoff, S., Sonn, U., & Svensson, E. (2002). A health education program for elderly persons with visual impairments and perceived security in the performance of daily occupations: a randomized study. American Journal of Occupational Therapy, 56, 322-330. doi: 10.5014/ajot.56.3.322

Dixon, R. A. (1996). Collaborative memory and aging. In D. J. Herrmann, C. McEvoy, C. Hertzog, P. Hertel, & M. K. Johnson (Eds.), Basic and applied memory research: Theory in context (pp. 359-383). Mahwah, NJ: Lawrence Erlbaum Associates Inc.

Dixon, R. A., & Gould, O. N. (1996). Adults telling and retelling stories collaboratively. In P. B. Baltes & U.M. Staudinger (Eds.), Interactive minds: Life-span perspectives on the social foundation of cognition (pp. 221-241). New York: Cambridge University Press.

Fleming, D. (2002). Falls among older Americans: CDC prevention efforts. Senate Subcommittee on Aging Committee on Health, Education, Labor and Pensions. Retrieved from http://www.hhs.gov/asl/testify/t020611.html

Gidman, J. (2013). Listening to stories: Valuing knowledge from patient experience. Nurse Education in Practice, 13, 192-196.

Harper, D. (2002). Talking about pictures: A case for photo elicitation. Visual Studies, 17(1), 13-26. doi: 10.1080/14725860220137345

Janzen, K., Perry, B., & Edwards, M. (2011). Becoming real: Using the artistic pedagogical technology of photovoice as a medium to becoming real to one another in the online educative environment. International Journal of Nursing Education Scholarship, 8, 1-17.

Latz, A. (2012). Toward a new conceptualization of photovoice: Blending the photographic as method and self-reflection. Journal of Visual Literacy, 31, 49-70.

Lindeman, E. C., (1989). The meaning of adult education. New York: New Republic. (Original work published 1926).

Merriam, S. B., Caffarella, R. S., & Baumgartner, L. M. (2007). Learning in adulthood: A comprehensive guide, (3rd ed.), San Francisco, CA: John Wiley & Sons, Inc., Jossey-Bass.

Mezirow, J. (2000). Learning as transformation: Critical perspectives on a theory in progress [Kindle version]. San Francisco, CA: Jossey-Bass.

Morris, D., Henegar, J., Khanin, S., Oberle, G., & Thacker, S. (2014). Analysis of touch used by occupational therapy practitioners in skilled nursing facilities. Occupational Therapy International, vol. 21, 133-142. doi: 10.1002/oti.1374.

National Safety Council (2013). Near miss reporting systems. Workplace training documents. As found: http://www.nsc.org/WorkplaceTrainingDocuments/Near-Miss-Reporting-Systems.pdf

Naufel, K. Z., & Beike, D. R. (2009). Abstract thought emphasizes goal performance; Concrete Thought Emphasizes Goal Completion. North American Journal of Psychology, 11(1), 97-110.

Radomski, M.V., (2011). The Issue is…More than good intentions: Advancing adherence to therapy recommendations. American Journal of Occupational Therapy, 65, 471-477.

Ravitch, D. (2007). EdSpeak: A glossary of education terms, phrases, buzzwords and jargon. Alexandria, VA: Association for Supervision and Curriculum Development.

Reilly, M. (1962). Eleanor Clark Slagle lecture series. Occupational therapy can be one of the greatest ideas of the twentieth century. American Journal of Occupational Therapy, 16, 1-9. Retrieved from http://www.aota.org/Practitioners/Resources/Slagle/1961.aspx

Rogers, D.T. (2015). Further validation of the learning alliance inventory: The roles of working alliance, rapport, and immediacy in student learning. Teaching of Psychology, 42(1), 19-25.

Schank, R., & Berman, T. (2006). Living stories: Designing story-based educational experiences. Narrative Inquiry, 16, 220-228.

Schemm, R. L., & Gitlin, L. N. (1998). How occupational therapists teach older patients to use bathing and dressing devices in rehabilitation. American Journal of Occupational Therapy, 52, 276-282. doi: 10.5014/ajot.52.4.276

Stake, R. (2006). Multiple case study analysis. New York, NY: The Guilford Press.

Stevens, J. A., Corso, P.S., Finkelstein, E. A, Miller, T.R., (2006). The costs of fatal and non-fatal falls among older adults. Injury Prevention, 12, 290-295.

Strough, J., Cheng, S., & Swenson, L. (2002). Preferences for collaborative and individual everyday problem solving in later adulthood. International Journal of Behavioral Development, 26, 26-35.

Tickle-Dengan, L., & Rosenthal, R. (1990). The nature of rapport and its nonverbal correlates. Psychological Inquiry, 1, 285-293.

Tinetti, M., Baker, D., Dutcher, J., Vincent, J., & Rozett, R. (1997). Reducing the risk of falls among older adults in the community. Berkeley, CA: Peaceable Kingdom Press.

VSee (2013). HIPAA video chat + EHR screen share. VSee brochure. Retrieved from http://vsee.com/files/vseebrochure.pdf

VSee (2013). Features. Retrieved from http://vsee.com/features

VSee (2013). Telemedicine. Retrieved from http://vsee.com/telemedicine.

VSee (2013). Security. Retrieved from http://vsee.com/security.

Werner, J., Carlson, M., Jordan-Marsh, M., & Clark, F. (2011). Predictors of computer use in community-dwelling, ethnically diverse older adults. Human Factors: The Journal of the Human Factors and Ergonomics Society, 53, 431-447.

Yin, R. K. (2009). Case study research: Design and method (4th ed.)[Kindle version]. Thousand Oaks, CA: Sage.

How to Cite
Breeden, L. E. (2016). Occupational Therapy Home Safety Intervention via Telehealth. International Journal of Telerehabilitation, 8(1), 29–40. https://doi.org/10.5195/ijt.2016.6183