ArticleResearch square2026
The Rural Community-Based Occupational Therapy Model (Rural CB-OT): Community-Codesigned Solution to support Aging in Place in Rural Underserved Areas.
Article in Research square, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
Importance: Rural older populations experience barriers to accessing rehabilitation, occupational therapy (OT), and aging-in-place services. Access may be enhanced by service models designed by underserved communities to fit local resources and priorities. Objective: To describe the process and outcomes of a community-led codesign in rural Appalachia, Ohio, to co-create a locally tailored, community-based rehabilitation service model that supports aging in place. Design: Community-based participatory research involving a regional Steering Committee that selected a target county and codesigners. Codesigners participated in two workshops guided by a double-diamond framework and informed by rehabilitation-access maps, user personas, and evidence-based program options. Steering Committee feedback refined the model and helped identify transferable and adaptable implementation components. Setting: Medically-underserved rural Appalachia, Ohio. Participants: Seven committee members and five county-level codesigners representing public health, aging services, and community organizations. Outcomes and Measures: Community-generated rehabilitation service model and its core and adaptable implementation components. Results: Codesigners developed the Rural Community-Based Occupational Therapy (Rural CB-OT) concept, comprising six core components: community-based OT, trusted community hub, multiple service-delivery modes, task sharing, local health-system and community partnerships, and community-academic partnerships. Participants also identified context-sensitive implementation options, including team structure, population scope, hub selection, and funding. Conclusions and Relevance: Rural CB-OT offers a preliminary framework for expanding community-based OT in underserved rural communities while illustrating how evidence-informed, community-led codesign can generate locally owned rehabilitation solutions with transferable core components and adaptable implementation features. Future research should focus on further coproduction, implementation, and evaluation of Rural CB-OT and the underlying codesign approach. Plain-Language Summary: Community stakeholders in rural Appalachia used local data and evidence-informed resources to codesign Rural CB-OT, a community-based occupational therapy model intended to improve access to rehabilitation and support aging in place. Rather than selecting a single program, participants developed a flexible service framework that could support multiple rehabilitation needs while adapting to local resources and priorities.
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