OTSH 65: Journal Club - Promoting Mental Health in the Cafeteria



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Welcome to the show notes for the Episode 65 of the OT School House Podcast.


In episode 65, we are having a discussion about a recent journal article that looks at school-based occupational therapists' role and capabilities in implementing a mental health tier 1 MTSS intervention. Today's article is titled The Comfortable Cafeteria Program for Promoting Student Participation and Enjoyment: An Outcome Study. This journal comes from the American Journal of occupational therapy and it was published in 2018. The research study itself occurred in 2014, and 2015, The Authors are Susan Bazyk. Luis Demirjian, Francis Horvath, and Laurie Doxsey.


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OTSH Episode 65 Transcription
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Jayson Davies 00:00

Hey there, everyone. Welcome to Episode 65 of the OT School House podcast. We are doing things a little bit different today. No guests, just you and me. And a journal article straight from the American Journal of Occupational Therapy, we are going to be looking at the article titled The comfortable cafeteria program for promoting student participation and enjoyment and outcome study. And, as you likely know, I am a huge advocate for RTI and MTS s in the schools, especially when it comes to OT helping out OTs with that process. And so I'm going to share with you a little bit more exactly why we're looking at this article after the break. But first, I want to highlight the primary author of this article, Dr. Susan Bazyk. Dr. Susan Bazyk is an occupational therapist and Fellow of the American Occupational Therapy Association. She is professor emeritus of the Occupational Therapy Program at Cleveland State University where she taught for 34 years. She is the project director of every moment counts, which was launched in 2012. And the main topic of today's journal article, this multi pronged mental health promotion initiative focuses on helping all children and youth participate successfully throughout the day and academic and non academic settings. Her current efforts focus on building capacity of OT practitioners and interdisciplinary teams to do this work. longtime listeners of the OT School House podcast may recognize her from Episode 36 of the OT School House podcast when we highlighted every moment counts and the comfortable cafeteria program which we are going to dive into.


Jayson Davies 01:43

Although Dr. Bazyk won't be joining us today to talk about this article, I am proud to announce that she will be speaking at the OT School House back to school conference later in August. And to learn more about this conference you can head over to OT School House.com forward slash back to school. And in case your hands and eyes are a little preoccupied right now let me share with you a little description about what she will be presenting.


Jayson Davies 02:09

Dr. Bazyk knows the small moments make a big difference in how children feel and function in school. Research confirms that positive interactions and experiences such as enjoying lunch, having fun during recess. These help children feel positive and connected to school. Every moment counts as a mental health promotion initiative developed to help all children and youth become mentally healthy in order to succeed in school, at home and in the community. Participants aka you and me will learn about a multi tiered public health approach to mental health involving promotion, prevention and intervention and be introduced to every moment counts occupation based programs, not just the one we're talking about today. Comfortable cafeteria, not just the one we're talking about today, the comfortable cafeteria, but also refreshing recess, calm moment cards and making leisure matter.


Jayson Davies 03:03

And while she's been on the podcast before to talk about some of those programs, I am excited to sit there and watch her present all of her knowledge that she has and how she focuses on knowledge translation to help kids throughout all school programs. If you'd like to hear from Dr. Bazyk as well at the back to school conference, be sure to head over to OT School House.com forward slash back to school to reserve your spot. Now stick with me just a moment as I cue the intro and we'll be right back to discuss the journal article.


Amazing Narrator 03:34

Hello and welcome to the OT School House podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started. Here is your host Jayson Davies. Class is officially in session.


Jayson Davies 03:51

Hello and welcome back everyone. I hope that intro just put a little pep in your step I know some of you probably haven't memorized and some of you we probably even kind of novel long as she introduces myself and the podcast. I know I can't listen to it without kind of getting a little happy and and just doing that. So welcome back to Episode 65 of the OT school health podcast. Man that number is getting bigger. I can't believe it's been 65 episodes now but I'm excited to be here with you today we're doing a journal article which is a little different haven't done a journal article in a bit but I'm excited for it. I know many of you don't have the time to read articles. As much as you may or may not want to. I know you don't have the time to so I'm here to help you out with that. Again, this is an article with the primary author as Susan Bazyk, Dr. Susan Bazyk and I'm excited to share this with you so I'm not gonna really waste your time any longer. Let's go ahead and dive into it.


Jayson Davies 04:47

Today's article is titled The Comfortable Cafeteria Program for Promoting Student Participation and Enjoyment: An Outcome Study. This journal comes from the American Journal of occupational therapy and it was published in 2018.


Jayson Davies 05:00

Although the actual research study itself occurred in 2014, and 2015, the authors, there are four of them, are Susan Bazyk. Luis Demirjian, Francis Horvath, and Laurie Doxsey. Susan Bazyk, who I mentioned earlier is the program director at every moment counts. Louise is an occupational therapy consultant at every moment counts. And Francis and Laurie are both school based occupational therapist in the state of Ohio.


Jayson Davies 05:28

Now, the reason we are looking at this article and having a discussion about this particular article is because I get so many questions from everyone on social media, in my email about how to move on from your typical fine motor and sensory based programs at ot. So many of you want to help more students. So many of you want to really see kids in the natural environment, as opposed to working with them, one on one in the OT room, the OT hallway, or whatever that might be. And so that's why we are talking about this article today. And what I want to bring to the forefront of your brain as we talk about this today is something you already know and I'm just going to, like I said bring it to the forefront of your brain is that mental health and wellness is such an area of demand right now, whether it's in an application, that was the push of a button promises to make you happier for five minutes every day, or accessing a therapist online, via again, a push of a button with mental health and wellness coming to the forefront of everyone's brains. So is it also coming to the forefront of schools. And that's what leads us to today's article as using occupations as a way to promote mental health, specifically in the natural context. And that brings us to this specific article. Before I jump into the methodologies and the outcomes of the article, I do want to briefly discuss some of the research that they found while completing their own project. And here's a few snippets of that. They found that research shows that when students enjoy lunch or when they have good friend and then when they perceive school personnel as supportive and caring for the students then more feel more connected to school. This connectedness in turn, enhances classroom engagement, academic performance, and school completion rates. That was found in an article by bloom in 2005. The authors also make a point that past research has shown that a positive cafeteria atmosphere results in children eating more of their lunch, which is great for growing kids, right. And they also have fewer behavioral problems. And it also so happens that the cafeteria is an important location for students to develop adaptive strategies for physical health and social interaction. It is a time for them to relax and take a break and socialize with their peers before returning back to their classroom. Now for students who are primarily in a special education class and have limited access to the general education classes, this is also their primary time to interact and learn from their typical developing peers. Along with recess, lunch is sometimes the only time that they have to spend with kids outside of their classroom. And the last key point that I want to bring to your attention is that at lunchtime, there is a very large discrepancy between the amount of adults to the amount of children that are in one place at a time. Typically, in a classroom, you have maybe a one to 30 ratio. Well, they found that a majority of the schools had closer to a one to 50 ratio inside of the cafeteria, so maybe one to 52 to 100, or potentially 350 kids at a time. Alright, so now let's talk about the goals that the research team had. Overall, they wanted to measure the outcomes of the comfortable cafeteria program, I'll get more into what that program


Jayson Davies 08:50

looks like in just a moment. But these goals, they had three specific goals, where they wanted to measure the outcomes for both the students as well as the supervisors, and then also the therapist. So there are three goals. Let me read them here for you. First, does participation in the comfortable cafeteria program affects student perceptions of participation and enjoyment of lunchtime? Number two, does participation in the program resulting cafeteria supervisors enhanced knowledge of and perceived ability to be effective in the cafeteria? And three, what is occupational therapists overall assessment of the comfortable cafeteria program after implementation? So in order to measure that they had three different groups of participants, they had the students who were 366 in total that actually took the pre and post test. They had 18 cafeteria supervisors and for Midwestern school based occupational therapist who had been trained in every moment counts building capacity initiative. So now we get to the good part. What did they actually do? What did the therapist do?


Jayson Davies 10:00

What did the supervisors do all of that? Well, I'm gonna kind of spoil the surprise right now first, you can get this entire program the cafeteria, comfortable cafeteria program at every moment. counts.org 100% free, Sue Bazyk, the director at every moment counts has it up on her website 100% free and you can get it, you can learn all about it. In synopsis, this is a six week program, in which the Occupational Therapist supports the entire school team, really, the Occupational Therapist provides education to the cafeteria supervisors as well as other relevant stakeholders. So maybe there's some parent volunteers, maybe the administrators need to kind of know what's going on. Right. So the OT provides that training, then the OT also provides a weekly embedded activities to address the weekly theme. It's a six week program, six weekly themes, though T goes in during lunchtime to do that. And then the final part of the program is kind of the maintenance part of the program. And that is when the Occupational Therapist continues to provide ongoing coaching of supervisors such as modeling positive social interactions and offering additional activities that the supervisors can then implement in the cafeteria. Without the occupational therapist. I know you want to know what those six themes are. So I went ahead and went over to every moment counts.org click on the comfortable cafeteria program. And I can tell you right now I'm just looking at the website. Those six week themes are week one kickoff, friendship, conversations, including others sensory input and healthy foods. Those are your six weekly themes. So after you are done with those six weekly themes, then you continue to work with the lunchtime supervisors on you know, an as needed basis to provide them ongoing support.


Jayson Davies 11:51

Now that you know a little bit about the actual program, let's look at the assessments that they used. Quantitative data was taken one week prior in a pretest. And one week after the program post test for both the students and the supervisors. In addition, they also got some qualitative data through a group session with the students and a few of the supervisors. For the students, they use what is called a visual analog scale, I had never heard of this. But what it is is basically a small piece of paper exactly 100 millimeters in length. And when they asked the student a question, they would mark were on that paper they feel in that paper would kind of be like a Likert scale and might have some happy faces on it or something. But instead of picking only one of four options, the stude