Evidence-based practice is critical but challenging in mental health. Rigorous research-proven interventions often do not yield expected results in the clinical practice. This study aimed to explore factors contributing to the effectiveness of Occupational Connections (OC)-an intervention for promotion of engagement in meaningful occupations in serious mental illness (SMI)-based on case series study of three quasi-experimental studies. The studies focused on people with SMI, admitted to intensive mental health services participated in the OC, as well as on a control condition group. Similar evaluation procedures throughout these studies addressed primary outcomes of participation dimensions and recovery orientation, as well as secondary outcomes of functional capacity, cognition, and symptom severity. Patterns of changes in outcome measures varied between the three studies as to direction and extension. In the OC groups, 29-60% of the outcome measurements were changed, in comparison to 29-43% of measurements in the control groups. The secondary outcomes were consistently improved in the OC (18-100% of measurements) in comparison to the control (18-67%). The analysis of the studies revealed that clinical effectiveness of participation-oriented intervention varied dependent on interplay between the clinical context, clinician actions, served persons' characteristics, and evidence-building process. These factors should be considered to maximize research benefits for practice.
Keywords: clinical practice; effectiveness; inpatient setting; knowledge translation; occupation-oriented intervention; participation in daily life.