{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T08:16:09Z","timestamp":1788509769821,"version":"build-2803163510"},"reference-count":39,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["American Journal of Occupational Therapy"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>\n                    <jats:bold>Importance:<\/jats:bold>\n                    Stakeholder voices advance client-centered, culturally responsive occupational therapy research.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Objective:<\/jats:bold>\n                    To describe how engagement of culturally diverse, multilingual, and multidisciplinary stakeholders shaped a project aimed at culturally adapting an evidence-based autism intervention.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design:<\/jats:bold>\n                    A mixed-methods design was used to evaluate stakeholder engagement. Quantitative data were used to measure engagement frequency and quality, and qualitative data captured stakeholders\u2019 experiences.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Setting:<\/jats:bold>\n                    Engagement activities conducted online and in person at a local community setting.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Participants:<\/jats:bold>\n                    Twenty-five stakeholders\u20147 parents or caregivers of autistic children, 3 autistic adults, 4 occupational therapy practitioners, 2 psychologists, 3 medical doctors, 3 cultural experts, and 3 teachers\u2014were recruited through snowball sampling.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Method:<\/jats:bold>\n                    Stakeholders engaged in activities designed to support a project that evaluates two methods of engagement and completes the cultural adaptation of an evidence-based intervention. Activities were guided by the foundational expectations for partnerships as outlined by the Patient-Centered Outcomes Research Institute.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Outcomes and Measures:<\/jats:bold>\n                    The Stakeholder-Centric Engagement Evaluation measured engagement on a Likert scale ranging from 1 (\n                    <jats:italic toggle=\"yes\">never\/poor<\/jats:italic>\n                    ) to 5 (\n                    <jats:italic toggle=\"yes\">always\/excellent<\/jats:italic>\n                    ) for how often and how well engagement occurred. Qualitative data were collected using open questions in the survey.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Engagement frequency (\n                    <jats:italic toggle=\"yes\">M<\/jats:italic>\n                    \u2009=\u20094.45,\n                    <jats:italic toggle=\"yes\">SD<\/jats:italic>\n                    \u2009=\u20090.24) and quality (\n                    <jats:italic toggle=\"yes\">M<\/jats:italic>\n                    \u2009=\u20094.29,\n                    <jats:italic toggle=\"yes\">SD<\/jats:italic>\n                    \u2009=\u20090.23) were highly rated. Open-ended responses indicated that stakeholders were satisfied with their engagement and interested in additional capacity-building; their feedback shaped the main project in areas including recruitment, retention, data monitoring, and dissemination.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions and Relevance:<\/jats:bold>\n                    Stakeholders rated their research experiences highly. Engagement is vital to integrating lived experiences and cultural context into occupational therapy, advancing health equity through culturally responsive, client-centered care.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Plain-Language Summary:<\/jats:bold>\n                    The main project aimed to culturally adapt an evidence-based occupational therapy intervention for Hispanic and Latino autistic children and compare two methods of engagement. Hispanic and Latino families often face barriers accessing culturally and linguistically appropriate services and being included in research. This work was needed to ensure interventions are relevant, equitable, and supportive of their needs. The voices of those impacted by this work were included to guide the research process. We engaged 25 people\u2014including parents, autistic adults, occupational therapy practitioners, psychologists, teachers, and cultural experts\u2014to work closely with the research team. They supported the team through advisory boards and helped shape the project in important ways, such as improving how families are invited to join and how information is shared. Meetings were held mostly on Zoom, with some held in person. We measured how often and how meaningfully stakeholders were involved, and both were rated very highly. This shows that strong partnerships are possible and valuable. Listening to community voices can help ensure that research is more relevant, respectful, and effective. Projects such as this can make occupational therapy more accessible for children and families from different cultural and language backgrounds, ultimately improving health equity and quality of care.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Positionality Statement:<\/jats:bold>\n                    We use the terms\n                    <jats:italic toggle=\"yes\">Hispanic<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">Latino<\/jats:italic>\n                    throughout this article to support inclusivity. The term\n                    <jats:italic toggle=\"yes\">Hispanic<\/jats:italic>\n                    typically refers to people with Spanish ancestry or Spanish as a primary language; however, it is sometimes viewed as problematic because of its association with Spanish colonization. In contrast,\n                    <jats:italic toggle=\"yes\">Latino<\/jats:italic>\n                    refers to people from Latin America, including the Caribbean. Given the variation in individual and community preferences, we acknowledge the complexity of these identities (\n                    <jats:xref ref-type=\"bibr\">Mart\u00ednez &amp; Gonzalez, 2021<\/jats:xref>\n                    ). Furthermore, we implement the identity-first terminology for autistic persons on the basis of their preference for using such language (\n                    <jats:xref ref-type=\"bibr\">Taboas et\u00a0al., 2023<\/jats:xref>\n                    ). The first author, Lady Rios-Vega, identifies as a Latina. She is an occupational therapy practitioner and researcher who has served minoritized families. We acknowledge that her perspectives may influence how data are presented. In addition, the diverse backgrounds and experiences of all contributing authors shape our work, guiding us to pursue our objectives with a strong focus on equity and inclusivity. The senior author, Roseann Schaaf, identifies as a White woman from a middle-class background. She is an occupational therapy practitioner and an experienced autism researcher. She acknowledges the potential impact of her privileged positionality in studying the experiences of marginalized communities, and she is committed to mitigating any biases that may arise from her own perspective.\n                  <\/jats:p>","DOI":"10.5014\/ajot.2026.051447","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T16:19:42Z","timestamp":1779985182000},"page":"699-708","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Integrating Stakeholder Voices to Improve Occupational Therapy Research for Minoritized Autistic Hispanic and Latino Communities"],"prefix":"10.1177","volume":"80","author":[{"given":"Lady","family":"Rios-Vega","sequence":"first","affiliation":[{"name":"Lady Rios-Vega, OTD, OTR\/L, CASI, is Research Associate, Jefferson Autism Center of Excellence, and Professor, Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, PA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Rising","sequence":"additional","affiliation":[{"name":"Kristin Rising, MD, MSHP, is Professor, Department of Emergency Medicine, Sidney Kimmel Medical College; Executive Director, Center for Connected Care, Thomas Jefferson University; and Chief Medical Officer, IMPACT Institute, Jefferson Health, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Freedman","sequence":"additional","affiliation":[{"name":"Brian Freedman, PhD, is Director, Swank Autism Center, Nemours Children\u2019s Hospital Wilmington, Delaware, and Associate Professor of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Fields","sequence":"additional","affiliation":[{"name":"J. Matthew Fields, MD, is Professor of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa Ross","family":"DeCamp","sequence":"additional","affiliation":[{"name":"Lisa Ross DeCamp, MD, MSPH, is Associate Professor of Pediatrics, University of Colorado School of Medicine, Children\u2019s Hospital Colorado, and Faculty Investigator, Adult &amp; Child Center for Outcomes Research &amp; Delivery Science (ACCORDS), University of Colorado Anschutz, Aurora."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Martinsen","sequence":"additional","affiliation":[{"name":"Erin Martinsen, MPH, PTA, is Research Coordinator Senior, Jefferson Autism Center of Excellence, Thomas Jefferson University, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Ramos","sequence":"additional","affiliation":[{"name":"Julian Ramos, B.S, is Research Coordinator Assistant, Jefferson Autism Center of Excellence, Thomas Jefferson University, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Arroyo","sequence":"additional","affiliation":[{"name":"John Arroyo, is Community Partner, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roseann C.","family":"Schaaf","sequence":"additional","affiliation":[{"name":"Roseann C. Schaaf, PhD, OTR\/L, FAOTA, is Director, Jefferson Autism Center of Excellence, Thomas Jefferson University, Philadelphia, PA; Professor, Department of Occupational Therapy and Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, PA; and Director of Research, Collaborative in Ayres Sensory Integration\u00ae, Redondo Beach, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"e_1_3_1_2_1","doi-asserted-by":"publisher","DOI":"10.5014\/ajot.2025.051023"},{"key":"e_1_3_1_3_1","first-page":"7412410010","article-title":"Occupational therapy practice framework: Domain and process (4th ed.)","volume":"74","author":"American Occupational Therapy Association","year":"2020","unstructured":"American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). 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