Abstract
At the end of 2014, the American Journal of Occupational Therapy (AJOT) will change editors, and I will retire from this position after 6 years of serving the journal. In that time, the journal has changed considerably and made many advances. In this editorial, I outline those advances and make recommendations for the journal’s future editorship.
Sharon A. Gutman, PhD, OTR, FAOTA
In the past 5 years, the journal has consistently received more than 200 yearly submissions and published more than 86 articles per volume through 6 yearly issues (Table 1). Increasingly, many of its articles have been published in an online-only format to reduce publication costs and increase publication space.
AJOT Acceptance Rate and Total Publications, 2008–2014
Note. AJOT = American Journal of Occupational Therapy; NA = not available.
Practice Area
In the past 7 years of collected demographic data, (1) rehabilitation, disability, and participation and (2) children and youth continue to be the two primary practice areas addressed in studies published in AJOT (Table 2)—a finding mirroring practice trends of the profession’s membership (American Occupational Therapy Association [AOTA], 2009). Although AOTA (2014) has made calls to increase productive aging research, the number of productive aging articles published in AJOT per year consistently falls well below that of rehabilitation and pediatric research. This finding is concerning because the U.S. population is aging, and many related professionals (e.g., driver rehabilitation specialists, neuropsychologists, physical therapists) are competing for reimbursement for age-related services traditionally provided by occupational therapy practitioners. Such professionals are also compiling a body of research evidence demonstrating support for the effectiveness of their services. Similarly of concern is the low number of mental health research articles published in AJOT per year over the past 6 years. Despite the need for occupational therapy mental health services in newly emerging (e.g., the school and foster home systems; military personnel, returning veterans, and their families; homeless shelters and supportive residences) and traditional practice settings, occupational therapy researchers have not compiled the needed research evidence demonstrating the effectiveness and cost- and time-efficiency of occupational therapy services with mental health populations.
Practice Area, Research Type, and Level of Evidence: AJOT Articles, 2008–2014
Note. AJOT = American Journal of Occupational Therapy.
Research Type
This year, 2014, marked the 5th successive year in which intervention effectiveness studies outnumbered any other research article type published in AJOT. This finding is particularly promising and suggests that the profession has embraced the need to generate evidence supporting the effectiveness of occupational therapy services for insurers, consumers, legislators, and other health professionals (see Table 2). This is also the 5th successive year in which more Level I studies (i.e., systematic reviews, meta-analyses, randomized controlled trials) were published than those at any other evidence level (evidence levels are based on the AOTA Evidence-Based Practice Project’s model; Lieberman & Scheer, 2002). Although this finding is positive, it must be examined cautiously. The majority of Level I studies published in AJOT in 2014 were systematic reviews based on research evidence compiled by competing health care professionals (Table 3). The profession must stop relying on related health professionals’ research to support occupational therapy intervention effectiveness as a rationale for service reimbursement. Insurers do not pay for services that are perceived as redundant. Occupational therapy researchers must begin to generate their own intervention effectiveness research and publish such studies in occupational therapy journals; otherwise, such research will often not be understood as involving occupational therapists and will only serve to lower our own professional journals’ impact factor (IF; the journal metric commonly viewed as the measure of a profession’s scholarly output).
Breakdown of AJOT 2014 Research Articles by Practice Area, Research Type, and Evidence Level
Note. N = 77. AJOT = American Journal of Occupational Therapy.
Research Funding
In the past 6 years of compiled demographics, AJOT authors have continued to receive funding from the National Institutes of Health, other U.S. federal funders, and U.S. foundation funding (Table 4). A large percentage of funding has also been received by international occupational therapy researchers publishing in AJOT. Between 42% and 51% of all studies published in AJOT in the past 6 years have received funding, a finding suggesting that occupational therapy researchers are implementing research that has the potential to have a positive impact on the welfare and health of society’s members across the lifespan. The profession is increasingly producing skilled, competent researchers able to compete for limited research funds. Funders are increasingly understanding that society’s members highly value the ability to participate in desired daily activities despite impairment.
Funding of AJOT Research Articles, 2009–2014
Note. Some studies received funding from multiple sources. AJOT = American Journal of Occupational Therapy.
Impact Factor
The 2013 impact factor (IF) scores—the scores compiled by the Journal Citation Reports (JCR) that reflect the number of times a journal is cited in 2- and 5-year time periods (see Table 5)—suggests that the journal's IF has remained strong in the past 6 years and is comparable to competitor journals in the Rehabilitation Division of the JCR. AJOT is now ranked 19 out of 69 journals in the Rehabilitation subsection of the Social Science division of JCR. To maintain this competitive standing, the journal must become more rigorous in the level of published research studies. In future years, AJOT’s IF will also likely be influenced by the recent indexing of several other occupational therapy journals in JCR. When AJOT publications are cited by other occupational therapy journals indexed in JCR, AJOT’s IF increases. The recent addition of several major occupational therapy journals to JCR promotes the entire profession and provides acknowledgment of all occupational therapy research.
AJOT Impact Factor Scores, 1999–2013
Note. AJOT = American Journal of Occupational Therapy; IF = impact factor; NA = not available.
AJOT Advancements in the Past 6 Years
AJOT has achieved considerable accomplishments in the past 6 years:
The journal is now ranked as the No. 1 occupational therapy journal in JCR and 19th (of 69) in the rehabilitation subsection. The 5-yr impact factor has steadily increased and has more than doubled since 2007.
Increases in the following per-volume metrics have been made: total number of research articles published, number of studies examining intervention effectiveness, number of studies examining instrument development and testing, and the number of studies at Level I or II evidence.
The number of published research studies with high levels of rigor continues to increase.
Reciprocal access agreements have been developed with the British Journal of Occupational Therapy and the Canadian Journal of Occupational Therapy.
AJOT has joined 25 other rehabilitation journals in the adoption of the EQUATOR Network Reporting Guidelines to increase transparent clinical research reporting that can be easily evaluated for methodological rigor and applicability to clinical populations.
AJOT has decreased the acceptance-to-publication length from 1.5 yr to 10 mo. In 2014, AJOT moved to an online platform that will allow articles to be published online approximately 3 mo after acceptance.
Recommendations for Future Advancement
As I hand over the journal to new editorship, I recommend the following to continue future advancement:
Maintain the emphasis on intervention effectiveness studies to build a solid foundation of evidence supporting occupational therapy services (for insurers, consumers, legislators, and other health professionals).
Maintain the emphasis on instrument development and testing studies that are needed to demonstrate reliability and validity of occupational therapy assessments so that occupational therapy services can be measured for effectiveness.
Encourage efficiency studies that provide information about patient satisfaction, cost- and time-efficiency, patient adherence, and intervention safety. Such studies are lacking in our research knowledge base and must be generated to provide further support for intervention reimbursement.
Continue efforts to monitor and increase the IF. Although this journal metric should not be viewed as the sole measurement of success, the scientific community uses the IF to judge the quality of a profession’s research. The IF of the profession’s flagship journal should reflect the highest quality research generated by the profession. When members of the profession consistently publish randomized controlled trials outside of its own professional journals, the IFs of those professional journals decrease and the profession’s scholarship is viewed by the external scholarly community as mediocre.
I greatly thank AJOT associate editors and reviewers for their contributions to the enhanced journal quality achieved over the past 6 years. I also thank AJOT authors and readers for the privilege of serving as the journal’s editor-in-chief between 2008 and 2014, and I wish continued success and good fortune to both the journal and my successor.