International health professional perspectives of using the Cognitive Orientation to daily Occupational Performance approach in routine practice.

This reports clinicians' self-reported perspectives, not patient outcomes or a test of CO-OP effectiveness. The sample was recruited through CO-OP instructor networks, ICAN, host organisations, social media and professional contacts, so it may mainly represent motivated clinicians. Most respondents were occupational therapists (170) and from the United Kingdom (64, 35%), with only six physiotherapists and 2 speech and language therapists, so findings may not apply to other professions or countries. No response rate denominator is given; 191 questionnaires were received and 181 were analysed. 3% reported never having formal CO-OP training, so some responses may not reflect certified training. Profession-specific results are not reported, so it is unclear whether barriers differ for physiotherapists or speech and language therapists. Free-text coding was done by one researcher and reviewed by two others, with no formal reliability statistic reported.

The authors declared financial support for this work and/or its publication. The work was partly funded by a research grant from the Royal College of Occupational Therapists, Children, Young People and Families Specialist Section.

Do not read this survey as proof that CO-OP improves patient outcomes or that training alone produces confident, faithful delivery. It reports clinicians' self-reported use and barriers, with no patient outcomes or comparison group.