Date of Award

2026

Document Type

Scholarly Project

Degree Name

Doctor of Occupational Therapy (OTD)

Department

Occupational Therapy

First Advisor

Dr. Karrianna Iseminger

Keywords

telehealth, hand therapy, rural health, occupational therapy, program development

Abstract

Individuals living in rural Wyoming experience significant barriers to accessing specialized hand therapy services, including geographic isolation, limited availability of certified hand therapists, and inconsistent healthcare infrastructure, resulting in delayed rehabilitation and reduced functional outcomes (Hirth et al., 2022; Rural Health Information Hub, 2025). Although telehealth has emerged as a potential solution to improve access, challenges related to clinician training, safety, and adaptation of interventions to virtual environments persist (Feldhacker et al., 2022; Morris, 2024). The purpose of this scholarly project was to develop an evidence-based telehealth hand therapy program to improve access to upper extremity rehabilitation services in rural Wyoming. A comprehensive literature review, contextual needs assessment, and theorydriven program development process were utilized. The Ecology of Human Performance model guided examination of the interaction among person, task, and environmental factors influencing occupational performance, while the PRECEDE–PROCEED model informed identification of barriers, facilitators, and implementation strategies (Dunn, 2017). Ongoing collaboration with a rural outpatient clinic and mentor feedback supported clinical relevance and feasibility. The resulting product is a structured telehealth hand therapy program that includes workflows, clinical tools, and training resources to support consistent and effective service delivery. This program has implications for improving therapist confidence, increasing patient engagement, and reducing disparities in access to care, ultimately supporting improved functional outcomes for individuals in rural and underserved communities.

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