Special issue on the Accelerating Clinical Trials and Outcomes Research (ACTOR) Conference.

Susan H. Lin, ScD, OTR/L, is Director of Research, American Occupational Therapy Association, 4720 Montgomery Lane, Suite 200, Bethesda, MD 20814-3449; [email protected] Many occupational therapy practitioners enter the profession to help improve people’s lives, but how do we know that our treatments work? The answer lies not with techniques and modalities; instead, our treatments work because of theories and research. The role of research in education, practice, and policy continues to grow, and accordingly research is highlighted in the Centennial Vision with the words “science-driven” and “evidence-based” (American Occupational Therapy Association [AOTA], 2007). The emphasis on research is timely given the increasing health care needs of society, and yetwe havemade little progress in generating the evidence needed to support our role in today’s rapidly changing health care environment. An examination of studies published in the American Journal of Occupational Therapy (AJOT ) between 1995 and 2005 revealed that the number of highly controlled studies (Level I and II) did not increase (Dirette, Rozich, & Viau, 2009), prompting an editorial emphasizing the urgent need for effectiveness studies (Gutman, 2008). As a result, the percentage of effectiveness studies published in AJOT has steadily increased from 24% in 2008 to 48% in 2011 (Gutman, 2011). Additional progress has been made in increasing research capacity, as evidenced by the addition of 15 research doctoral programs over the past 15 years and the increasing number of occupational therapists receiving postdoctoral fellowships and career development (K) awards. Meanwhile, the Research Advisory Panel of AOTA and the American Occupational Therapy Foundation (AOTF), chaired by Joan Rogers, developed a research agenda for the profession emphasizing intervention research as a priority (AOTA & AOTF, 2011). Despite the proliferation of clinical trials in medical science, clinical trials that examine complex rehabilitation interventions and longterm outcomes have been conducted at a slower rate because of the wide scope of factors related to disability and goals and the difficulty in standardizing treatments and outcomes (Johnston et al., 2009). Moreover, methods and models of service delivery may influence rehabilitation outcomes as much as individual components (i.e., therapies; Whyte & Hart, 2003). Thus, a limited number of Level I studies are available from rehabilitation and disability research to guide practice.