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Despite higher need, occupational therapy services are maldistributed to urban locations. Publications about non\u2010urban services discuss predominantly outreach\u2010based, individualist, rehabilitation for specified diagnoses\/age groups. However, given this population level inequity, it is unclear why individualist focussed services are more commonly discussed. Understanding intentions expressed in publications about non\u2010urban service design may identify assumptions\/limitations to current approaches and contribute to improved future services.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Each of 117 publications identified in a scoping review was read by two reviewers to independently identify themes. Provisional themes were discussed and modified in an iterative process to develop final themes\/subthemes. The first author reinterrogated the publications and coded data to identify relevant examples to support the identified themes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three key themes and nine subthemes were identified. Hegemonic perspectives were found in the themes (i) <jats:italic>Extension of urban practice<\/jats:italic> and (ii) <jats:italic>Austerity<\/jats:italic>, particularly in the Global North. Non\u2010urban services were typically extended to non\u2010urban contexts underpinned by austerity and neoliberal values such that non\u2010urban persons and their context were problematised rather than service or funding design. A counter\u2010hegemonic perspective was found in the theme (iii) <jats:italic>Responses to situational realities<\/jats:italic> more commonly in Global South publications, which valued non\u2010urban contexts, and focussed on developing non\u2010urban communities and promoting justice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The hegemonic paradigm links occupational therapy services with neoliberal notions of individualism, private provision of care, and efficiency\/market value, rather than the occupational therapy values for justice. The profession must consider our role in perpetuating injustice for non\u2010urban people and consider if and how more contextually tailored counter hegemonic place\u2010based paradigms can be developed from and with regional, rural, and remote practice.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1440-1630.12844","type":"journal-article","created":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T05:49:50Z","timestamp":1664862590000},"page":"142-156","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Extension, austerity, and emergence: Themes identified from a global scoping review of non\u2010urban occupational therapy services"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3421-7406","authenticated-orcid":false,"given":"Karen","family":"Hayes","sequence":"first","affiliation":[{"name":"School of Allied Health, Exercise and Sports Sciences Charles Sturt University  Port Macquarie New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6104-4168","authenticated-orcid":false,"given":"Vagner","family":"Dos Santos","sequence":"additional","affiliation":[{"name":"School of Allied Health, Exercise and Sports Sciences Charles Sturt University  Port Macquarie New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moses","family":"Costigan","sequence":"additional","affiliation":[{"name":"Manning Mental Health Unit NSW Health  Taree New South Wales Australia"},{"name":"Providence Wellbeing  Port Macquarie New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle","family":"Morante","sequence":"additional","affiliation":[{"name":"Port Macquarie Base Hospital NSW Health  Port Macquarie New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,10,3]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3109\/11038128.2013.853098"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1590\/s0102-6992-201934010009"},{"key":"e_1_2_12_4_1","unstructured":"Australian Government Department of Health. 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