Abstract
In this editorial, AJOT Editor-in-Chief Stacey Reynolds shares how the special issue on Diversity, Equity, Inclusion, Justice, Accessibility, and Belonging in Occupational Therapy Practice and Education was developed. From the establishment of the journal’s first-ever Diversity, Equity, and Inclusion (DEI) Committee to the creation of a robust collection of research focused on DEI, Dr. Reynolds reflects on lessons learned and how the process of developing the special issue has helped shape the future of the American Journal of Occupational Therapy.
In this editorial, AJOT Editor-in-Chief Stacey Reynolds shares how the special issue on Diversity, Equity, Inclusion, Justice, Accessibility, and Belonging in Occupational Therapy Practice and Education was developed.
Stacey Reynolds, PhD, OTR/L, FAOTA
The idea for a special issue of the American Journal of Occupational Therapy (AJOT) focused on diversity, equity, inclusion, justice, accessibility, and belonging (DEIJAB) was first proposed in 2020, at the start of my tenure as Editor-in-Chief. During that time, a convergence of major national and international events exacerbated systemic inequities for marginalized communities and highlighted disparities in wealth, access to health care, employment, and treatment by law enforcement. Calls for action were widespread, with many organizations, universities, and systems implementing new training programs and policies to support diversity, equity, and inclusion (DEI) efforts. In addition, new funding sources emerged to combat systemic racism and societal disparities.
Here at AJOT, we launched several initiatives in response. We established the journal’s first-ever DEI Committee; increased the demographic and racial diversity of our official reviewer pool and Editorial Board; and solicited manuscripts on DEI, occupational justice, and access to services. These efforts culminated in 2022 with the creation of a robust special collection of research focused on DEI, a collection to which we continue to add. However, we felt that 2020 was not the right time to begin work on a full special issue because we believed this emerging area of occupational therapy research needed time to evolve—time for authors to design and conduct studies that would meet AJOT’s rigorous standards.
Fast forward to today: Just four-and-a-half years later, we are proud to publish an entire special issue (25 articles) devoted to DEIJAB. This accomplishment reflects the dedication of our guest editorial team and the AJOT Editorial Board. It is also the most challenging special issue we have ever undertaken. Along the way, I have learned a great deal—not only from the authors whose work is included in this issue but also from those whose submissions we were unable to publish. In this editorial, I reflect on the lessons learned and how this process has helped shape the future of AJOT.
Listening
As Editor-in-Chief, communicating with authors is a routine part of my role. However, during the creation of this special issue, truly listening to authors’ experiences with navigating the review process became critical. One author team courageously shared their frustration and hurt after receiving a review that inadvertently perpetuated antisemitic stereotypes and biases about the Jewish-American community. Another team expressed frustration with conflicting feedback from reviewers, which, after several rounds, failed to advance their paper toward publication. Some authors candidly shared how aspects of the review process felt invalidating—particularly when their work amplified the voices of underrepresented groups.
Listening to these experiences was not always comfortable. As Meman (2018) observed, discomfort can signal an opportunity for learning, catharsis, and growth. I recognized that my discomfort stemmed from a fear of having failed the journal and the occupational therapy community, yet rather than succumbing to defensiveness, I knew I needed to reflect critically on AJOT’s systems and acknowledge where they had fallen short.
This reflection also required listening to the AJOT Editorial Board, which includes 15 Associate Editors, and to the guest editors who partnered with us on this special issue. These colleagues brought a wealth of expertise and unique perspectives. Through our discussions, I gained a deeper understanding of the nuanced challenges of DEIJAB scholarship, such as balancing community-based knowledge with conventional standards of scientific rigor. Our conversations also underscored the ethical responsibility of publishing work about marginalized groups without perpetuating harm as well as the labor-intensive process of guiding reviewers through these complexities.
Although AJOT’s peer review process is designed to be transparent, fair, and rigorous, it became clear that it is not immune to bias.
Learning
Listening to my peers underscored that DEIJAB work demands intentionality—not only in the manuscripts we select but also in how we approach every step of the editorial process. I learned that assessing the rigor of peer reviews must include examining them for cultural or racial bias. Reviewers who are experts in one marginalized community may inadvertently hold biases about other communities. Addressing these biases requires humility, reflection, and collaboration.
Ultimately, as Editor-in-Chief, it is my responsibility to navigate these issues, yet successful navigation depends on seeking input from others who can broaden my perspectives and enrich my cultural understanding. Discussions with the Editorial Board and American Occupational Therapy Association leadership reinforced the reality that fostering DEIJAB is not just about publishing articles on these topics; it is about embedding these principles into how we operate as a journal. This requires humility, flexibility, and a willingness to grow together as a team.
Most important, I learned that listening must lead to action. By hearing and addressing authors’ concerns, we can ensure that AJOT becomes a more inclusive and supportive platform for all voices.
Leading
In response to the challenges shared during the creation of this special issue, the AJOT Editorial Board has taken several actionable steps to improve our processes. Addressing biased reviews: We developed a protocol for handling potentially biased reviews. When an Associate Editor identifies bias, the steps include ▪ bringing the review to my attention as Editor- in-Chief, ▪ soliciting input from a cultural expert to evaluate the review, and ▪ requesting feedback from an additional reviewer, if needed. Training and capacity building: To support bias-free publishing, we are creating a training video on the use of inclusive and bias-free language, which will be posted on the AJOT website in 2025. Expanding representation: We are broadening the composition of the AJOT DEI Committee to include more diverse perspectives. Engaging the next generation: In 2025, we will conduct a student survey to learn how the next generation of occupational therapists envisions the journal evolving over the next 5 years.
Reviews found to perpetuate bias, stigma, or racism will not be sent to authors. Reviewers responsible for such feedback will first be coached on why their review was problematic. If issues persist, they will be removed from the AJOT system.
These ongoing efforts are a direct response to the feedback we have received from authors and the invaluable contributions of our volunteer editors.
Summary and Conclusion
More than 50 articles were submitted for this special issue on DEIJAB, and narrowing these down to the 25 most rigorous and impactful was no small feat. We are proud to share this important work and hope that it will inspire growth and transformation in occupational therapy practice, scholarship, and education worldwide.
I am equally proud of the growth within the AJOT team over the past year and the actionable steps we have taken to make AJOT a more inclusive and equitable platform. Listening, learning, and leading are ongoing processes, and they are essential for creating meaningful change.