Promotion of planetary health through climate-sensitive health counselling in occupational therapy-a qualitative interview study in three countries.

Introduction: Occupational therapy and planetary health are closely linked, as human health is influenced by environmental factors such as climate change. Occupational therapists (OTs) can enhance clients' understanding of climate-related health issues and advocate for health-promoting climate action through climate-sensitive health counselling (CSHC). While CSHC has mainly been studied in medical contexts, its implementation in occupational therapy remains unclear. This study explores European experts' perspectives on integrating CSHC into occupational therapy practice. Materials and methods: Six semi-structured interviews were conducted with occupational therapy experts from France, Germany, and the UK. Data were analyzed using content-structuring qualitative content analysis according to Kuckartz (2018). Results: Experts identified healthy and sustainable lifestyles and co-benefits of climate and health as key topics of CSHC in occupational therapy. CSHC can be integrated into routine healthcare and delivered within established therapy settings as well as settings involving well populations. Barriers and facilitators, including ethical tensions between individual and collective health perspectives and the availability of professional networks and movements, influence its implementation. Discussion: CSHC in occupational therapy can contribute to planetary health by supporting health protection and promotion. However, broader planetary health dimensions, such as human systems and environmental threats beyond climate change, are not yet sufficiently addressed. European perspectives and international collaboration may support the further development and implementation of CSHC in occupational therapy.