The responsiveness and clinical utility of the Australian therapy outcome measure for indigenous clients.
Nick Sheahan, Rosamund Harrington, Alison Nelson and 5 others
PMID 39501443WHAT IT FOUND
In 34 urban First Australian adults, ATOMIC goal ratings rose from 1.82 to 8.00 on a 0 to 10 transformed scale post-intervention, and clients and clinicians described the tool as flexible, culturally responsive, and useful for goal setting.
Key findings
01In 34 First Australian clients, ATOMIC goal ratings rose from 1.82 to 8.00 on a 0 to 10 transformed scale after intervention, with a statistically significant increase.
02The pre-post change had a Cohen effect size of 2.1, which the paper describes as large.
03Qualitative findings identified four themes, including that the ATOMIC is clinically useful, acceptable to clients and clinicians, and supports culturally responsive goal setting.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The responsiveness result comes from before and after ratings in one urban service with no comparison group, so it shows that scores changed, not what caused the change. The qualitative part was small, with four client interviews and seven clinicians in a focus group. All participants came from one large urban centre, so the findings may not transfer to other locations or to the wider First Australian population. Clients were recruited through the clinicians they were working with, and therapists were from the same service, so familiarity with the ATOMIC may have shaped their views. Interview participants declined transcript review, so client themes were not checked in the same way as clinician themes.
Declared interests
The paper states no other known conflicts and no significant financial support. One author was involved in designing the ATOMIC but not in data collection. Two researchers worked at the health service studied, and one reported to the chief executive and worked with the cultural integrity lead.
The easy way to misread this
Do not read the rise from 1.82 to 8.00 as proof that occupational therapy caused improvement. The study compared ATOMIC goal ratings before and after intervention at one urban service with no comparison group, so it shows that the measure detected change, not that the intervention produced the change.