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

## TL;DR

Health professionals trained in the CO-OP approach find it helpful but need more support to use it effectively in practice.

## Contribution

This study explores how health professionals use the CO-OP approach post-training and identifies barriers to its implementation.

## Key findings

- CO-OP training was perceived positively but 66% of professionals wanted more support.
- Only one-third of participants delivered the recommended number of CO-OP sessions.
- Fewer than half used the prescribed outcome measures COPM and PQRS.

## Abstract

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.

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.

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.

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.