... A Comprehensive Evaluation of the COTAD Chapters Program M. Emma Baldwin, OTS, PCBIS July 6, 2021 A research project submitted in partial fulfillment for the requirements of the Doctor of Occupational Therapy degree from the University of Indianapolis, School of Occupational Therapy. Under the direction of the DCE advisor: Dr. Brenda Howard, DHSc, OTR A Research Project Titled A Comprehensive Evaluation of the COTAD Chapters Program Submitted to the School of Occupational Therapy at University of Indianapolis in partial fulfillment for the requirements of the Doctor of Occupational Therapy degree. By M. Emma Baldwin, OTS, PCBIS Approved by: Dr. Brenda Howard, DHSc, OTR DCE Advisor & 1st Reader Dr. Ryan Lavalley, PhD, OTR/L 2nd Reader Accepted by the Chair of the School of Occupational Therapy: Kate E. DeCleene Huber, OTR, MS, OTD Chair, School of Occupational Therapy Running Head: COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM A Comprehensive Evaluation of the COTAD Chapters Program M. Emma Baldwin, OTS, PCBIS University of Indianapolis 1 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 2 Abstract Background: This program evaluation seeks to evaluate the effectiveness and sustainability of the Coalition of Occupational Therapy Advocates for Diversity (COTAD) Chapters program, both processes and outcomes of programming. Health disparities, racism, oppression, and injustice in the healthcare field, contextualized with a lack of diversity and diversity awareness of the occupational therapy (OT) profession, prompt the necessity for the COTAD Chapters program. The COTAD Chapters program is a volunteer-run program that empowers and supports OT students into advocacy for increasing diversity in the OT profession and eliminating discrimination and health disparities. Methodology: Through a mixed-methods program evaluation for formative and summative purposes, program evaluators interpreted surveys, interviews, preexisting Chapter data, document review, direct observation, and social media analysis. Results: The results indicate that stakeholders believe the COTAD Chapters program is fulfilling its intended purposes and that Chapters are enacting changes within OT on multiple scales. However, the COTAD Chapters program processes are not yet optimized to accommodate and support students in their efforts as effectively as the administrators would like. Implications: The COTAD Chapters program would benefit from a new structure that accommodates more volunteers, offers more to COTAD Chapters, and continues to promote the impacts and outcomes toward which the COTAD Chapters are already working. Conclusion: The COTAD Chapters program transforms OT education, practice, and research by energizing student advocacy for increased diversity within the OT profession and creating a national network of future generations of action-oriented and empowered OT practitioners. COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 3 Table of Contents Introduction......................................................................................................................................5 Program Description............................................................................................................5 Program Motivations and Assumptions...............................................................................8 Method...........................................................................................................................................11 Ethics..................................................................................................................................11 Study Approach / Design...................................................................................................11 Data Sources......................................................................................................................13 Results............................................................................................................................................19 What Are the COTAD Chapters Processes and Activities? .............................................19 What Are the COTAD Chapters Intended Outcomes?......................................................25 What Are the COTAD Chapters Actual Outcomes? ........................................................30 Discussion......................................................................................................................................61 COTAD Chapters Processes..............................................................................................61 COTAD Chapters Goals and Outcomes............................................................................62 Value of an Occupational Perspective...............................................................................66 Recommendations for Program.........................................................................................66 Limitations.71 Recommendations for Further Research...........................................................................72 Conclusion.....................................................................................................................................73 References......................................................................................................................................75 Appendix A. Full Logic Model......................................................................................................80 Appendix B. Data Map..................................................................................................................81 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 4 Appendix C. Survey Questions and Indicators..............................................................................83 Appendix D. Survey Questions in Chair Transition Form............................................................93 Appendix E. Semi-Structured Interview Questions.......................................................................94 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 5 A Comprehensive Evaluation of the COTAD Chapters Program Founded in 2014, the Coalition of Occupational Therapy Advocates for Diversity (COTAD) is a nonprofit organization within occupational therapy (OT), poised to address systemic racism and oppression, occupational injustice, healthcare equity, and educational decolonization (Coalition of Occupational Therapy Advocates for Diversity [COTAD], n.d.-a). The COTAD Chapters program was formed in 2017 to support students in addressing the aforementioned initiatives, locally and nationally (COTAD, n.d.-b). To date, no evaluations of program processes or outcomes have been completed. Thus, the purpose of this Doctoral Capstone Experience is to evaluate the effectiveness and sustainability of the COTAD Chapters program processes and programming, and to examine the intended and actual outcomes of the program, through completing a mixed-methods program evaluation. Program Description In 2013, a small group of leaders in the American Occupational Therapy Association (AOTA) Emerging Leaders Program formed the COTAD. By 2017, the founders expanded these efforts into the student realm, to increase diversity in the OT profession (A. Anvarizadeh, personal communication, April 9, 2021). A lack of diversity in healthcare workforces can contribute to healthcare inequity (Noone et al., 2016; Phillips & Malone, 2014). Thus, COTAD launched the COTAD Chapters program in OT and OTA programs across the country, first at West Coast University (WCU), to foster safe spaces to grow anti-oppressive practitioners (A. Anvarizadeh, personal communication, April 9, 2021). The program description will describe the COTAD Chapters program activities and processes from 2017-2020, prior to the evaluation and data collection process. Processes changed or implemented in 2021, as a result of the program evaluation process, are outlined in the discussion. COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 6 The COTAD Chapters program leverages volunteers across the country to network with and support students within OT and OTA programs, to work towards increasing the diversity within the OT profession and eliminating discrimination and health disparities (Coalition of Occupational Therapy Advocates for Diversity (COTAD, n.d.-b.; Cohen et al., 2002). With the Chapters programs structure, processes, resources, and COTAD National leader guidance, students reach out to establish Chapters'' to begin or continue work towards diversity, equity, inclusion, justice (DEIJ), anti-racism, and anti-oppression, within their OT and OTA programs. Dr. Anvarizadeh is the current Chair of the COTAD Chapter program with two volunteers assisting her. At minimum, each Chapter has a student Chapter Chair and a facility liaison to support the student-led initiatives, events, and work. Chapter processes require Chairs to attend quarterly All-Chapter Calls, document at least four yearly goals aligned with COTADs mission, and plan and coordinate Chapter events or initiatives. The COTAD Chapters program serves to create new leaders and facilitates long-term and action-oriented commitments within the educational system, to promote and sustain the work outlined in COTADs mission and vision. As the COTAD Chapters program grows, COTAD wants to evaluate its processes and outcomes to prepare the program for growth, and to ensure the program is meeting its goals. A scheme of the COTAD Chapters program is in Figure 1. Figure 1 represents what was known about the COTAD Chapters program prior to initiating this program evaluation project. The following section will describe the visual further. A more detailed program logic model is in Appendix A. The indicators in the logic models guided data collection and evaluation, as seen in Appendix B. COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Figure 1 Simplified Logic Model of the COTAD Chapters Program Evaluation Note. This figure demonstrates the simplified logic model created by the program evaluation team, which can be viewed in more detail at: https://miro.com/app/board/o9J_l7lmKRU=/?moveToWidget=3074457361033864959&cot=14 7 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 8 Program Motivations and Assumptions The Need The following literature review describes the motivations and assumptions that drive the COTAD Chapters program in their efforts against discrimination, inequity, inequality, injustice, oppression, and racism within the OT educational context. Diversity is lacking within the OT profession as compared to the general population (Brown et al., 2011; U.S. Census Bureau, 2019). Increasing the diversity of the OT workforce could improve access to health care for underserved populations, advance cultural humility, strengthen research about marginalized populations and healthcare disparities, and ensure a healthcare system suited for a diverse society (Cohen et al., 2002; Ford et al., 2021). Occupational therapists work with an increasingly diverse population whose occupations are rooted in culture and identity (AOTA, 2020-c.; Hildebrand et al., 2013), which ethically requires OT professionals to learn and implement cultural humility and cultural effectiveness in providing effective, socially-just, and equitable care to all clients (Agner, 2020; AOTA, 2015; Brown et al., 2011; Howard et al., 2018; Landy et al., 2016; Wilson et al., 2015). As the profession attempts to grow toward a more diverse workforce, practitioners and students have the onus to bridge the gap between themselves and their more diverse clientele, through learning cultural humility and cultural effectiveness (Howard et al., 2018; Wilson et al., 2015). Bolding et al. (2020) reported to provide effective occupational therapy, students and practitioners must be able to recognize differences in underrepresented populations health beliefs and behaviors, and address clients needs in ways that are respectful of the clients beliefs, priorities, and preferences. Cultural humility has the potential to reduce health disparities by increasing the effectiveness of health professionals working with diverse clients (Acker, 2017; Agner, 2020). A COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 9 systematic review determined that health patient care outcomes can relate to practitioner levels of implicit biases and identified that most health providers and students have implicit biases (Hall et al., 2015). Therefore, targeting reducing implicit bias at an educational level may improve patient outcomes (Acker, 2017; Hall et al., 2015). AOTA recently stated that increased awareness about oneself, personal biases, and others can promote more equitable care for all people, and the organization articulated the need for OT educators to demonstrate and teach such skills to students (AOTA, 2020-a.; AOTA, 2020-c.). In working to prepare OT and OTA students to work with a diverse population, educators can help the profession begin to address the health disparities that affect minoritized and underrepresented clients within healthcare (AOTA, 2020-c.; Wilson et al., 2015). Student Perceptions Murden (2008) reported that students felt a need for more focus on cultural differences and their influences on occupational therapy delivery to feel competent in their fieldwork experiences. Other studies have indicated that students felt they lacked basic knowledge, clinical skills, and attitudinal awareness in preparation for clinical practice with LGBTQIA+ clients (Acker, 2017; Bolding et al., 2020). OT students also perceived the need for increased factual education about culture to promote adequate patient care, rapport building, family participation, and person-centered goal creation (Cheung et al., 2002; Murden, 2008). Studies indicated that students and the field of OT would benefit from educators reexamining classroom climates, implicit biases, course content, and programmatic policies and construction (Bolding et al., 2020; Dennis et al., 2020), and Trentham et al. (2020) demonstrated that students have the desire to learn. COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 10 Student Safety. Evaluators identified that the need for improved OT educational experiences also arose from a lack of comfort and safety that students with underrepresented identities perceived within their educational programs. Moreover, they identified a cultural disconnect within their curricula and between their majority White faculty and peers (Lucas, 2018). Dennis et al. (2020) found that students from non-majority backgrounds had significantly less trust in institution policies and practices, and less faith that their program supported positive work with people of diverse cultures, than their less diverse classmates. Overt discrimination and racism affected the educational experiences of students from underrepresented groups (Ackerman-Barger et al., 2020; Ford et al., 2021; Lucas, 2018; San & Breen-Franklin, 2019). Studies indicated that fear and microaggressions negatively affected and limited students, which impacted their learning, academic performance, and wellness (Ackerman-Barger et al., 2020; San & Breen-Franklin, 2019). Students in a study by Ackerman-Barger et al. (2020) specified that the provision of informal and formal safe spaces might allow for improved student experiences. To foster positive conversations about DEIJ and engage students in multicultural education to in turn improve patient care, students must feel safe and supported in their environment first (Kumagai & Lypson, 2009; Trentham et al., 2020). Mentorship. Ford et al. (2021) reported diverse students, specifically students of color, had a need for mentorship for connections and relationship building. Trentham et al. (2020) determined that mentor-led small groups enabled students to feel less fear and engage in peer dialogue about diversity and inclusion. Studies indicated that peer mentorship programs mentoring diverse students through the pipeline better allowed students to thrive in school (Edgoose et al., 2019; Noone et al., 2016). Norcross et al. (2020) determined e-mentoring across time zones could provide beneficial support as well. Mentorship for students with COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 11 underrepresented identities was best when individuals could relate to their mentors, and mentors provided technical and emotional support (Edgoose et al., 2019; Ford et al., 2021). Why Action is Needed Students identified needs related to DEIJ, anti-racism, and anti-oppression within their OT programs, pipelines into OT schools, and the OT profession. AOTAs Commitment to Diversity, Equity, and Inclusion states that AOTA supports all efforts towards DEIJ within OT practice, education, research, policy development, and advocacy (AOTA, 2020-c.). However, Taff & Blash (2017) identified that initiatives and statements are only the start of efforts towards DEIJ, anti-oppression, and anti-racism within OT. Educational programs are not solely able to equip students to address these challenges (Taff & Blash, 2017). Honest reflection and conversation within individual, institutional, and professional contexts are insufficient if not followed by understanding, commitment, and action (Taff & Blash, 2017, p. 81). Johnson & Lavalley (2020) stated that OT must address the influence of racism on occupation to prevent producing new forms of racism and reproducing old forms of racism. As the COTAD Chapters program seeks to take overt action against all forms of discrimination, inequity, inequality, injustice, oppression, and racism in the educational context, a program evaluation is warranted to determine the effectiveness of its actions. Method Ethics The UIndy Human Research Protections Program approved this study as non-human subjects research. Study Approach / Design COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 12 A team of OT professionals guided a program evaluation of the COTAD Chapters program in 2021. The team primarily included Emma Baldwin, OTS, PCBIS and Dr. Ryan Lavalley, PhD, OTR/L. Dr. Brenda Howard, DHSc, OTR., COTAD and the University of Indianapolis Occupational Therapy Doctorate (UIndy OTD) program also provided input about evaluation priorities, processes, and methods. The team completed a program evaluation using a mixed-methods approach to evaluate processes, activities, outcomes, and impacts of the COTAD Chapters program from 2017 until 2020. The team collected additional data following changes made in 2021. The evaluation team conducted this program evaluation for both formative and summative purposes according to Saunders et al. (2005). The formative evaluation provided feedback about the COTAD Chapters programs theoretical framework, design, activities, and operation, whereas the summative evaluation identified COTAD Chapters program outcomes and impacts (Scaffa & Reitz, 2014). To conduct a formative and summative program evaluation, the evaluation team completed a logic model, combining the theory and outcome approaches (W.K. Kellogg Foundation, 2004, Chapter 1). The evaluation team used six methods of quantitative and qualitative data collection, as described in Table 1. Appendix B provides additional details about the evaluation sources and types of analysis conducted. Due to the intended student-oriented impacts of the COTAD Chapters program and the student-oriented nature of the Chapters, the evaluation team particularly attended to student responses in the program evaluation results and discussion; however, the team still incorporated and analyzed faculty feedback. COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 13 Table 1. Data Collection Methods Data source Surveys What the team evaluated Experiences and outcomes of involvement with the COTAD Chapters program, from the following stakeholders: COTAD Chapter student leaders and volunteers, COTAD Chapter faculty liaisons, & COTAD National leadership Responses from students about their needs following COTAD national events (from their Ignite series) Responses about students experiences from newly implemented (2021) Chapter Chair transition surveys Interviews Process changes and improvements over time, experience and outcomes of being a COTAD Chapters program volunteer leader Preexisting Chapter Data Analysis Activities, events, goals, and outcomes Student leadership experiences Chapter locations and universities Document Review o Meeting Minutes o Google Drive Documents o COTAD Courier o COTAD Media o COTAD Website COTAD Chapter meetings, activities held, national reach Direct Observation COTAD Chapters program processes, organizational experiences, and outcomes Reach of COTAD Chapters programs Social media reach and use Social Media Data Analysis Data Sources Surveys To capture program outcomes and determine program effectiveness, the evaluation team conducted online surveys about the experiences of student COTAD Chapter leaders, faculty liaisons, and COTAD National leaders (see Appendix C). The program evaluation survey included multiple-choice questions with Likert scale-like questions. To ensure validity, the COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 14 evaluation team sought feedback from involved parties to refine question content and phrasing. Between May 14th and June 3rd of 2021, the evaluation team sent out the survey and two additional email reminders to stakeholders whose emails were in the COTAD database. They disseminated 465 surveys: 247 to current and past COTAD Chapter chairs, 87 to Chapter student volunteers and members, 109 to past and present faculty liaisons, and 22 to COTAD National leaders. The program evaluators also interpreted student responses from previously conducted needs assessment surveys, transition surveys, national event surveys. New Chapters disseminated needs assessment surveys to 1,545 students prior to founding their COTAD Chapters, which provided the evaluation team with valuable information about initial student needs. The evaluation team also analyzed written answers from 111 student surveys submitted after students attended the 2020-2021 COTAD Ignite Series national events, to see additional needs students identified. The program evaluation team also interpreted survey responses from the newly implemented transition surveys about student leader experiences (see discussion and Appendix D for survey questions). Program Evaluation Survey Participants. The evaluation team received 126 total program evaluation survey responses from COTAD Chapter stakeholders: 66 from students, 49 from faculty, and 11 from COTAD National leaders. Three COTAD National leaders completed interviews. Faculty and students represented 64 of the 93 existent chapters. The demographics of the survey participants are reported in Figures 2-9. As some respondents selected more than one demographic to describe their identities, those with multiple identities are categorized separately and the identities are accounted for in Figures 4-7 and Figure 9. COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Figure 2 Figure 3 Survey Respondent Gender Identity (n=126) Survey Respondent Length of Involvement 15 with COTAD Chapters (n=114) Note. This included students, faculty liaisons, and COTAD National leadership. Note. This included students and faculty liaisons. Figure 4 Student Survey Respondent Racial and/or Ethnic Identity (n=66) COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Figure 5 Faculty Survey Respondent Racial and/or Ethnic Identity (n=49) Figure 6 COTAD Leadership Survey Respondent Racial and/or Ethnic Identity (n=11) 16 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Figure 7 Student Survey Respondent Sexual Orientation (n=66) Figure 8 Faculty Survey Respondent Sexual Orientation (n=49) Figure 9 COTAD Leadership Survey Respondent Sexual Orientation (n=11) 17 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 18 Interviews The first author conducted semi-structured interviews (see Appendix E) with the COTAD Chapters Coordinator and her Support Staff volunteers to understand the previous COTAD Chapters program processes, goals, and activities, and how changes resulting from the program evaluation process have impacted the programs development. The program evaluation team sought feedback from an external individual about the semi-structured interview questions, to ensure validity of questions. The first author and interviewer video- and audio-recorded the interviews for re-interpretation as necessary and took notes during the interviews. Preexisting Data Analysis Following intervention by the program evaluation team (see discussion), administrators collected and stored all data for interpretation on a cloud-based platform called Airtable. These data included individual universities COTAD Chapter information and history, commitment forms, needs assessment results, goals and goal updates, transition surveys, event details, dues payment histories, and other stored documents. The evaluation team used these data to analyze factors of the COTAD Chapters programs functionality, progress, and outcomes. For more information about the data analysis process and indicators, see Appendix C. Document Review Prior to data collection and analysis refinement, Chapters saved documents within Google Drive shared folders. For data collection, investigators reviewed documents about events held, Chapter bylaws, transition testimonials, meeting minutes, and other Chapters advocacy efforts within Google Drive. Additionally, investigators reviewed the COTAD website and COTAD Chapter Media (youtube.com) videos to provide background information about the COTAD Chapters program. COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 19 Direct Observation The evaluation team participated in improvements to the COTAD Chapters program processes throughout the evaluation time, and thus used their experiences, observations, and forms created to note changes to the COTAD Chapters program processes. Social Media Data The evaluation team used public information as of May 24th, 2021, regarding the number of followers each of the COTAD Chapter Instagram social media accounts had, to share metrics and information about the reach of COTAD Chapters. Data Analysis Quantitative data analysis from surveys consisted of descriptive data, including frequencies, counts, and percentages. (Saunders et al., 2005; W.K. Kellogg Foundation, 2004). Investigators used keywords, field notes, quotations, and memoing to synthesize themes and conclusions about qualitative data through multiple close readings (Saunders et al., 2005; W.K. Kellogg Foundation, 2004). Results The purpose of this Doctoral Capstone Experience was to evaluate the effectiveness and sustainability of the COTAD Chapters program processes and programming, and to examine the program's intended and actual outcomes. The program evaluation team achieved this purpose using a mixed-methods approach (Table 1). Results indicated that the COTAD Chapters program processes and outcomes are promoting students to work towards DEIJ, anti-racist, and antioppressive changes in the educational sector of OT. What Are the COTAD Chapters Processes and Activities? COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 20 The COTAD Chapters administrative processes and Chapter activities are in the following paragraphs. The program evaluation team collected data from interviews with COTAD Chapter leadership, surveys, meeting minutes, social media data, and Google Shared Drive interpretation. These data will help the evaluation team understand the sustainability and effectiveness of the COTAD Chapters program. Program Assets & Resources The COTAD Chapters program assets and resources include the people in leadership and the technological platforms used to manage the Chapters work. The COTAD Chapters program Founder and Coordinator, Dr. Arameh Anvarizadeh, OTD, OTR/L, FAOTA, is an occupational therapist, Director of Admissions, and Associate Professor of clinical occupational therapy at the University of Southern California (USC). She was also a Founder and current Chair of COTAD National. The COTAD Chapters program is entirely volunteer led, primarily by the COTAD Chapters Coordinator and Support Staff. The COTAD Chapters Coordinator is responsible for all program management duties, and as the COTAD Chapters program grew, she also attempted to facilitate more attainable Chapter goal creation, by providing Chairs with more structure, guidance, and deadlines. The Support Staff includes Dr. Jabari Hoyte, OTD, OTR/L (COTAD Chapter Dues Manager) and Whitney Harris, MS, OTR/L (COTAD Chapter Groupchat Liaison). Dr. Hoyte is a previous COTAD Chapter Chair and a practicing occupational therapist, who is acting as the Chapter Dues Manager. Ms. Harris began within the program as the first COTAD Chapter Chair at WCU, and now is also a practicing occupational therapist. Since her time as a student, in addition to being the Chapter Groupchat Liaison, Ms. Harris stayed involved in COTAD National through multiple other roles. A COTAD Chapter Document team of three COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 21 volunteers helped create official documents when needed. The program evaluation team suggested and outlined refined roles in the discussion. Throughout the existence of the COTAD Chapters program, administration used Zoom Pro to communicate and host events, and GroupMe to provide the COTAD Chapter Chairs with a group chat. Google Drive was the programs primary data management system, with PDFs, Word documents, and scanned documents stored in a shared drive for each established Chapter. As the program grew, Chapter administration completed fillable PDFs and generalized and streamlined documents and processes. With continual programmatic changes, organization and consistency was challenging to maintain. COTAD Administrators managed the COTAD Chapters program Google Drive, but assigned the current Chapter Chairs responsibility for organizing and maintaining their individual Chapters shared folder. In 2021, the evaluation team introduced the use of Airtable as a dynamic relational database, primarily to streamline data collection processes and analysis within the program evaluation. See the results and discussion for further detail about this process shift. Program Functions and Processes COTAD Chapter program processes were constantly changing and refined throughout the growth of the program. Table 2 outlines the Chapter processes that the Chapters program were using at the end of 2020. Most of the communication, form collection, and organizational data was kept individually by the COTAD Chapter Coordinator. COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 22 Table 2 2017-2020 COTAD Chapter Processes Using Google Drive Creating a Chapter Transitioning and Maintaining a Chapter Required steps: 1. Students disseminate a needs assessment Google Form; COTAD receives all the data 2. COTAD Chapter administrator receives needs assessment feedback and disseminates the results to pending Chapters 3. Pending Chapters use needs assessment results to complete the commitment form 4. Pending Chapters create goals for Chapter on the commitment form 5. Pending Chapters provide the official names of Chapter Chair(s) and Faculty Liaison(s) 6. Pending Chapters pay dues ($100/year) 7. New Chapters complete 1:1 initiation call, discuss their goals and outcome measures 8. New Chapters receive all resources, communication systems, and data management system access Required steps for transitioning: 1. Chair(s) identify new future Chair(s) 2. Chair(s) complete(s) transition form (email to Chapter Coordinator and store in shared folder) 3. Chair(s) set up 1:1 transition meeting with Chapter Coordinator Other required tasks (no set timeline, constantly changed and refined): Fill out logo use and request forms when terms of use are updated (email to Chapter Coordinator and store in shared folder) Outcome and impact tracking: Prior to August 2020: fill out annual initiative form to track goal progress (email to Chapter Coordinator and store in shared folder) After August 2020: prior to quarterly All-Chapter call, fill out goal update form (email to Chapter Coordinator and store in shared folder) Note. During these processes, COTAD Chapters must communicate with COTAD Chapters Coordinator for completion of each numbered step. During the early years of the COTAD Chapters program, COTAD Chapter Chairs often created their Chapter as a committee within their Student OT Associations (SOTA). Students reported formation within SOTA initially reduced the financial burden of COTAD Chapter efforts and provided a standard election procedure. The structure of Chapters was open to interpretation, to suit the needs of the Chapter. As time went on, integrating COTAD Chapters into SOTA became a less popular option due to administrative challenges, lack of flexibility, and COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 23 limited room for growth. Once formed, students acted as Chapter Chairs to implement DEIJ efforts as a COTAD Chapter within their OT program, with access to guidance from COTAD Chapter leadership. Chapter Chairs attended mandatory quarterly All-Chapter calls to discuss COTAD National updates and COTAD Chapter updates. Until August of 2020, Chapters completed and submitted a yearly commitment form, explaining progress toward their goals and committing to another year of work. Starting in August of 2020, Chapters filled out a goal update form prior to each quarterly All-Chapter Call, to update progress about each goal and summarize the quarter. Both forms were in PDF or Word document format, submitted to the COTAD Chapter Coordinator through email, and then stored in the appropriate shared drives. Once a year, COTAD awarded a Chapter the COTAD Chapter of the Year award and shared their accomplishments with the COTAD community. Due to interest from COTAD National in improving the efficiency and sustainability of the COTAD Chapters program as soon as possible, this program evaluation describes recommendations that the Chapter administrators ultimately implemented following, and sometimes during, the program evaluation process to improve infrastructure, organize, and streamline processes. Themes from Interviews General Challenges: Chapter Formation, Carryover, and Organization. In the program evaluation interviews (see Appendix E for questions), COTAD Chapter administrators reported multiple challenges with the sustainability and effectiveness of the 2017-2020 Chapter processes. The Chapter Coordinator shared that the COTAD Chapter creation process was complicated for students trying to initiate the process and could take months. The interviews identified that potential Chapters sometimes fell through when students did not have the ability to follow through with all steps. The Google Drive was difficult for administrators to keep COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 24 organized, and not all Chapters would upload all required documents. They reported the quick turnover of student leaders often caused poor Chapter Chair transition support, and delayed follow-through with dues payment. The COTAD Chapter Groupchat Liaison reported that the group chats would benefit from more interactive engagement, to promote communication between peers. Time Challenges. Two of three Chapter administrators shared the hours required of administrative duties (Dues Manager: 5 hours per week, Coordinator: 40 hours per week) were too much for them to maintain. The COTAD Chapter Coordinator reported receiving an average of 10-15 emails a day, from new and existing Chapters about process steps, inquiries, and meeting requests. Dr. Anvarizadeh also reported the 1:1 transitions and initiation calls required the biggest time commitment and became repetitive. Themes from Surveys National Leadership is Involved. In the program evaluation survey (see Appendix C for questions), COTAD National leaders reported involvement with the COTAD Chapters program on a smaller scale. 82% of leaders reported that they helped local university Chapters, interacted on social media with Chapters, or spoke as a guest at COTAD Chapter events. Due to COTAD administrative procedures, National leaders also helped problem solve and provide ideas about the COTAD Chapter and processes at COTAD Board meetings. The quarterly All-Chapter Call consistently had three to four COTAD National leaders, which meeting minutes also confirmed. Chapters as a Pipeline for Leaders. COTAD National Leaders survey responses (see Appendix C for questions) also showed that two COTAD Chapter Chairs continued to stay involved with COTAD following their original Chapter leadership role. Seven previous COTAD Chapter Chairs became paying members of the COTAD National Membership and two became COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 25 COTAD National leaders. Surveys also indicated COTAD National provided leadership opportunities for three previous Chapter Chairs within breakout sessions at the 2020-2021 COTAD National Ignite Series events. Four COTAD National leaders recently published an article with two previous COTAD Chapter Chairs, three COTAD National leaders offered support and mentorship to two previous COTAD Chapter Chairs during their Doctoral Capstone Experiences (DCE), and one reported they assisted a student to use COTADs network to further their research. The AOTA Annual Conference and Expo was a major networking opportunity between COTAD National leaders and COTAD Chapter students. Collaborations on short courses, interactions at exhibit hall booths, and participation in volunteer and community events brought both types of leaders together in collaborative efforts towards DEIJ initiatives. What Are the COTAD Chapters Intended Outcomes? The primary intended outcomes of the COTAD Chapters program were to increase diversity and decrease discrimination in the OT profession (see Figure 1). Program evaluators used the COTAD website (COTAD, n.d.-b), the lived experience of Dr. Lavalley as a COTAD Board Member, Chapter documentation, and conversations with the COTAD Chapters team to inform all intended impacts of the COTAD Chapters program (see Appendix A). Program evaluators also explored intended outcomes apparent within the needs assessments, Ignite surveys, program evaluation surveys, and goal documentation. Themes from Needs Assessments: Culture, Diversity, and Open Discussions in an Educational Setting Prior to becoming an official Chapter, 1,545 students at all 93 COTAD Chapter-affiliated universities completed a needs assessment survey about their OT and OTA programs needs related to diversity, equity, inclusion, justice (DEIJ), anti-oppression, and anti-racism. Students COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 26 reported what aspects of DEIJ need to be addressed within their OT programs, provided choices between: culture and occupations, microaggressions, occupational justice, privilege, and unconscious bias. Figure 10 displays the frequency of responses, with culture and occupations occurring the most. Additionally, the most common write-in answers were diversity which appeared 14 times, and racism which appeared 13 times. The needs assessment top answers about beneficial activities for respective programs appear in Figure 11. Of particular note is that students expressed the need for open discussions more in 2021, following the start of the pandemic and the murder of George Floyd (The New York Times, 2020). Interpretation and analysis of this observation is outside the scope of this paper but could be explored in further research studies. Figure 10 DEIJ Aspects Programs Should Address from Chapter Needs Assessment Respondents (n=1,545) COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 27 Figure 11 Beneficial Program Activities from Chapter Needs Assessment Respondents (n=1,545) Themes from Ignite Surveys: DEIJ Activities and Support in an Educational Setting COTAD National leadership collected feedback from students who attended COTAD Ignite national events, which continued to assess student needs and informed the intended outcomes of the Chapters program. The themes from the 111 students who responded indicate that in addition to their program supports, students wished for further DEIJ education, events, safe spaces, advocacy, action, and support. Students stated they wanted to be heard, seen, and to feel more included and comfortable within their OT communities. Theme from Leadership Surveys: A More Diverse Workforce for Occupational Therapy Regarding intended impact, COTAD Leadership survey responses (see Appendix C for questions) indicated a consensus that they hoped the COTAD Chapters program would impact the entire field of OT, by producing what one survey respondent called a more diverse workforce with a more equitable distribution of services and power. Leaders shared that if the COTAD Chapters program can increase the number of practitioners who understand diverse COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 28 individuals lived experiences, or the number who could work to understand and appreciate them, the field of OT will be better prepared to address the needs of all clients. Themes from Goal Documentation: Activating Chapters and Advocating in Spaces The results of the COTAD Chapters needs assessments (n=1,545) informed the Chapters intended goals. Chapters documented 504 total goals: 382 in progress, 81 closed and updated with new goals, 37 completed, and four needing assistance. The most frequent words used within the Chapters goals are displayed in Figure 12. Thematic analysis uncovered that goals addressed topics of: getting involved in diverse communities, establishing and developing their Chapters, hosting events of all types, and holding open dialogues in safe spaces. Chapters also identified goals towards creating active allies. Figure 12 Word Frequency Within Reported Chapter Goals COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 29 Themes from Student Surveys: Assistance in Navigation and Safety in an Educational Setting The survey administered to students for this program evaluation (n=66) did not explicitly ask students what their hopeful impact of the COTAD Chapters program was (see Appendix C for questions). However, themes that emerged from these surveys showed that Chapters would benefit from additional resources and programming opportunities from COTAD National leaders, funding assistance, help with collaborations between Chapters, and clearer program structures. Chapters also requested guidance about events, research, ethics of advocacy, and forming a new chapter. Data showed Chapters thought they would benefit from help navigating power dynamics and feeling safe in their respective educational settings, as they attempted to enact DEIJ, anti-racist and anti-oppression efforts within their program. Valued Work of COTAD Chapters: Impacting Diversity for Individuals, Communities, or Populations Program evaluators were able to identify the valued work of COTAD Chapters using the COTAD Chapter of the Year Award. After Chapter members nominated their Chapters for this award, three to four COTAD National leaders used a rubric of criteria to judge the application and evaluate which Chapter had the most meaningful impacts on individuals, communities, and populations that year. COTAD National leaders identified that these impacts were valuable as they aligned with the COTAD National mission and vision. In 2021, the National Board for Certification in Occupational Therapy (NBCOT) committed to sponsoring the COTAD/NBCOT Chapter of the Year award to promote diversity in the OT profession. They provided winners with study materials and waived one exam fee. Exemplary projects from the previous Chapter of the Year winners included advocating for curricular changes in their programs, collaborating on holistic admissions initiatives, creating COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 30 mentorship programs for students who are Black, Indigenous, or People of Color (BIPOC), and hosting career days or school visits for high school students who may have historically been excluded from exposure to occupational therapy as a profession. Other programming included hosting mental health check-ins'' for underrepresented students, fundraising for diverse students to attend national advocacy and networking events, and holding interactive workshops promoting learning various languages. What Are the COTAD Chapters Actual Outcomes? Preexisting Chapters data and the program evaluation surveys provided the evaluation team with the most comprehensive and measurable perceived outcomes of the COTAD Chapters program. Below are the actual outcomes explored in this study from the COTAD Chapters Program. The program evaluation team collected data from preexisting Chapters data, goal and transition documentation, and surveys with students, faculty, and COTAD Leadership. Themes from Preexisting Chapters Data Growth and Regions of the Programs. To understand the measurable outcomes of the COTAD Chapters program, the evaluation team sought to understand the growth of the program first. From 2017 to 2021, the number of COTAD Chapters grew from one to 93. COTAD Chapters growth is shown in Figure 13. To date there have been 123 Faculty Liaisons, and 440 students involved the program: 344 Chairs or Vice-Chairs, and 96 Chapter Members. Student Chapters were located in 34 of the 50 U.S. states (see Figure 14). Comprehensively, fewer Chapters existed in the West and Southwest United States than the rest of the country. COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Figure 13 Growth of COTAD Chapters 31 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Figure 14 COTAD Chapter Location Map 32 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 33 Chapters are Promoting Appropriate Content and Working for Sustainability. The program evaluators used Chapter goal documentation to examine the content Chapters promoted and the sustainability of individual Chapters. At the time of writing, Chairs marked 382 documented goals as in progress, and 37 as completed. Themes emerged that Chapters were meeting these goals by facilitating events, holding open discussions, and hosting guest speakers. Qualitative thematic analysis identified that Chapters events and conversations focused on efforts about DEIJ, anti-racism, and anti-oppression within the OT profession. These events highlighted experiences of oppressed groups such as non-White, queer, or disabled persons. Program evaluators identified themes that Chapters met sustainability goals by creating Chapter bylaws and sustainable Chapter processes, and completed community engagement goals through outreach programs and volunteer efforts. Documentation noted that goals became closed when they were too vague or unattainable, or when the worldwide COVID-19 pandemic and sudden conversion from in-person graduate programs to virtual or hybrid formats prevented progress towards goals in 2020 and 2021. For example, goals that would require in-person events like potlucks and retreats had to be restructured to allow for virtual, distanced programming. Themes emerged that Chairs marked goals as needs assistance when they required help finding and sharing resources, communicating and working with administration for curricular and environmental changes, and combating barriers in terms of community outreach and Chapter engagement. Chapters Formal Events and Other Activities: Promoting Learning, Discussion, and Outreach Program evaluators used documents from Google Drives and newly implemented Chapter event documentation data (see discussion) to understand Chapters efforts and outcomes. Chapters documented 101 events, 13 retroactively from May 2020-December 2020, and 88 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 34 beginning in January of 2021. Documentation indicated that 2,956 total individuals nationwide attended Chapter events, with an average of 29 attendees per event. Chapter Chairs reported events or achievements during their time as Chair in the 33 submitted transition surveys. Documented events were 63.4% formal events, and 36.6% other activities, and more details on the type of events from transition surveys and event documentation are in Table 3. Results indicated that formal events revolved around celebrating and learning about diversity, reaching outward, helping OT students, and building community. Other activities typically involved fostering discussions and providing volunteer opportunities. Based on themes that emerged from student data, panels and virtual events occurred more commonly in 2020 and 2021, which coincided with the COVID-19 pandemic. COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Table 3. Types of Events Formal Events Celebrating Diversity and Learning about DEIJ, AntiOppression and Anti-Racism Cultural holiday celebrations Podcast, journal, and book clubs Events about systemic racism DEIJ training sessions Bias workshops Cultural and identity-based Activities of Daily Living (ADL) learning sessions Disability topic events Panels and guest speakers highlighting various underrepresented groups Occupational Justice (OJ) info sessions Support for OT Students Mock interview workshops Local mentoring and mentorship events and opportunities Inter-Chapter collaborations Reaching Out Community outreach events OT info sessions at high schools Community volunteering Social media campaigns Interprofessional collaborations Advocacy efforts to state and national organizations Other Fostering Activities Discussions Providing Volunteer and Fundraiser Opportunities Streaming parties Open dialogues Moments of Solidarity Safe space provisions Listening sessions for support Resource sharing Bias incident addressing Brainstorming and advocating for curricular changes Blood drives Clothing drives Fundraisers and walks for causes Fundraisers for local businesses Content and Focus of Quarterly All-Chapter Calls 35 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 36 The quarterly All-Chapter Call minutes indicate that each meeting consisted of COTAD National updates, COTAD Chapters program updates and support, and then individual COTAD Chapter updates from students. Attendance at mandatory All-Chapter Calls almost doubled in August of 2020 and continued to increase since that time (see Figure 15). The most common topics COTAD Chapters activities addressed, according to the first three All-Chapter Call minutes (August 2019-May 2020), are displayed in Figure 16. Figure 15 Quarterly All-Chapter Call Student Attendance COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 37 Figure 16 Common Quarterly Call Topics Note. The larger the word, the more frequently the topics were addressed in the All-Chapter Calls. Beginning in August of 2020, individual Chapter updates took place in breakout rooms in the following Chapter calls; thus, the minutes only recorded summaries of what groups discussed. The 2019 minutes showed that Chapters hosted cultural potlucks, held DEIJ trainings and retreats, attended Disability Pride Parades, educated attendees about pronoun usage and biased language, and hosted speakers. In May of 2020, the Chapters shared they were working COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 38 on readjusting plans to allow for virtual events. The August 2020 minutes indicate that Chapters struggled with a lack of faculty buy-in following the murder of George Floyd on May 25, 2020, which sparked protests nationally (The New York Times, 2020). Additionally, Chapters held watch parties for COTAD National events (such as the Ignite Series), advocated for Blackowned businesses, shared resource lists for further learning, discussed best strategies for increased engagement, and attempted virtual distance events due to the pandemic. According to the December 2020 minutes, Chapters discussed Chapter collaborations, virtual events, advice for facing adversity, and ideas for writing advocacy letters to faculty. The April 2021 AllChapter Call minutes noted that many National and programmatic updates did not allow time for breakout room updates and discussion. Social Media Increasing Reach COTAD Chapters reported using social media for outreach, community building, and communication. The most common form of social media Chapters used was Instagram (IG), with 54 Chapters (58.1%) confirming they managed an IG accounts on which they used the COTAD Chapters logo to advertise for one or more COTAD Chapter event. The survey also indicated that Chapters used Facebook and LinkedIn, yet these numbers were not reported or accessible to the evaluation team. There were 7,329 users following COTAD Chapters IG accounts, with an average of 138 followers per account. One COTAD National leader reported that they believed Chapter events reached more attendees outside of their schools Chapter when Chapters conducted virtual events and advertised on social media. The program evaluation surveys also indicated that Chapter Chairs witnessed current OT practitioners attending their virtual COTAD Chapter events, accessed through advertisements on social media. The program evaluation team COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 39 was not able to obtain data about the exact reach of virtual events or the number of current practitioners who attended. Chapter Sustainability and Resource Storage Chapters stored materials and accomplishments in their Google Shared Drive to preserve resources and maintain institutional history and data for future Chapter Chairs. Nearly 20% of Chapters documented standards, bylaws, and constitutions they created to provide future COTAD Chapter Chairs with structure and consistent expectations. Four Chapters created newsletters, and one provided their annual performance report summarizing all their COTAD Chapter actions and outcomes from the year. Three Chapters reported they presented their advocacy work and examples of Chapter efforts at local and state OT conferences. Themes from Student Surveys Increased Program Awareness and Receptiveness, Ambiguous Responsiveness. Items on the program evaluation student survey asked for measurable and perceived outcomes following COTAD Chapters efforts (see Appendix C for questions). Responses showed that 74.2% of students believed their programs experienced changes in awareness and receptiveness towards DEIJ initiatives during their time with their COTAD Chapter, resulting from COTAD Chapter initiatives (see Figure 17). Data displayed in Figure 18 show the students observations of institutional changes resulting from COTAD Chapters work. Student data indicate a wide variety of OT department responsiveness towards COTAD Chapters initiatives (see Figure 19). COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Figure 17 Program Awareness and Receptiveness Towards DEIJ Initiatives: According to Student Responses (n=66) Figure 18 Student Reported Programmatic Change, in Order of Frequency (n=66) 40 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 41 Figure 19 Program Responsiveness to COTAD Chapter Initiatives: According to Student Responses (n=66) Perceived Influence on Program Admissions. Although 69.7% of students reported they did not notice any changes to their programs admissions processes to increase diversity, the remainder of students reported observing changes while involved in their COTAD Chapter (see Figure 20). Figure 20 Program Admissions Changes to Promote Diversity: According to Student Responses (n=66) COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 42 There were 10.6% of students who claimed their COTAD Chapter's efforts changed their programs admissions processes. The students who identified changes to admissions specified the changes included diversifying advertisements, advertising COTAD Chapters, increasing student access for prospective student questions, asking students for input and ideas for more inclusive admissions, holding virtual COTAD Chapter info sessions, and increasing admissions outreach to pre-OT and local high school students. Student Safety. The COTAD Chapters program hoped to increase students feelings of safety, which program evaluators addressed by asking students to rate their feelings of safety within their program before and after they became involved with their COTAD Chapter. Many students reported feeling very and mostly safe, 65% before and 82% after becoming involved in the COTAD Chapters program (see Figure 21). Data indicate that 26 students felt an increase in safety following involvement in their COTAD Chapter, 38 felt no change, and two felt a decrease in safety (see Figure 22). Figure 21 Student Safety Ratings Before & After Becoming Involved in COTAD Chapter (n=66) COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 43 Figure 22 Individual Students Safety Rating Changes (n=66) Increase in Perceived Safety. When asked to describe their COTAD Chapters impact on their perceived safety within their program, students who felt an increase of safety described that they felt like they were no longer alone, and they had found a safe space to be themselves. One said, I feel safer knowing I am supported and more similar to my peers than originally expected. Of the 26 students who reported feeling increased safety after their COTAD Chapter, 24 reported at least one racial, ethnic, or sexual orientation underrepresented identity. Students reported the COTAD Chapters provided increased support by helping them find students with similar values and lived experiences. One stated, I feel safe knowing there is support within the program for students who are a part of an underrepresented community. They reported COTAD Chapters provided students with a community of natural support, both locally and nationally, and especially within the COTAD Chapter group chats. Qualitative reports showed students felt safer because of the support shown by their program, and due to relationships formed with faculty COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 44 through COTAD Chapter work. Qualitative comments also included reports that students felt empowered and more comfortable in advocating, speaking out, and standing up against injustice and discrimination, both as students from underrepresented groups and as allies. One student said that their COTAD Chapter was the only thing they liked about their OT program. No Change in Perceived Safety. Out of the 38 students who reported no change in perceived safety, 20 reported at least one underrepresented identity, and 18 reported they were cisgender, heterosexual, and White. Qualitative comments indicated that the students with majority identities who felt no change in perceived safety reported high levels of safety to start with, and explained they felt safe advocating and comfortable being themselves. One reported that they felt more aware of other classmates discomforts, and they felt comfortable advocating with and for them. One student shared I feel that my friends feel safer, yet they did not feel an increase in perceived safety themselves. Two students reported their Chapters were too new to notice a difference in safety, and another mentioned that the virtual format of COTAD Chapters during the pandemic made it hard to feel safe or assess safety levels. Another student shared they did not feel a change in safety because they [hadnt] seen any tangible change within the program [but] faculty have shown that they are somewhat responsive to the students' suggestions. Themes indicated that students noted slow growth of support within their program, and thus some had not yet witnessed movement towards positive change. Decrease in Perceived Safety. All six students who reported feeling unsafe also reported at least one underrepresented identity. They reported that they felt at risk for retribution by faculty for speaking [up], and that they didnt feel safe, free, accepted, or comfortable. One student identified that it was specifically their classmates actions and words that made them feel unsafe in the classroom. The two students who reported decreased feelings of safety explained COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 45 that once they got involved with the COTAD Chapters program, they became more aware of pushback towards DEIJ initiatives. One reported the allyship of their faculty and program was performative, as they visibly showed support of their Chapter yet they did not follow through with small acts of assistance. The other stated they noticed their program was smaller and less open-minded than they expected, and that they did not expect to receive so much negative feedback on COTAD Chapter initiatives. Challenges Related to Student Roles and Slow Progress. Despite all the successes and activities Chapters facilitated, student surveys identified that students faced challenges with promoting their respective COTAD Chapters initiatives. Chapter Chairs reported numerous challenges related to COVID-19 and 2020, including zoom-fatigue, emotional exhaustion, time limitations, virtual event planning, virtual miscommunications, and providing safe and vulnerable spaces virtually. Students also reported challenges with political barriers and defensiveness within conversations. Other prominent challenges included a lack of classmate and faculty involvement or buy-in, faculty liaison disengagement, and a lack of funding and school support. Multiple schools reported barriers due to program and faculty push-back, censoring, and institutional bullying. Program flexibility about the Chapters structure, limited startup resources, and continual changes of the COTAD Chapters program were also themes that challenged some Chapters. Students experienced performative allyship from faculty and programs, and one Chair stated that their program claimed the Chapters achievements as their own, without providing support. Chairs also recognized that lack of respect for student leaders limited Chapter progress towards goals. Chairs noted slow progress toward change, and one Chair stated, progress and change [are] slow within academia, so it was challenging to advocate for change within the program and see it implemented, within the time we are students. COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 46 Themes from Faculty Surveys Increased Awareness & Receptiveness. Faculty liaisons answered the same questions as students regarding changes in awareness and receptiveness towards DEIJ initiatives (see Appendix C for questions). Data indicate that 59.2% of faculty noticed changes in awareness and receptiveness resulting from COTAD Chapter efforts, and 67.3% noted they saw changes due to outside factors (see Figure 23). Faculty reported institutional or programmatic changes resulting from COTAD Chapter work; these changes are displayed in Figure 24. One faculty member reported they thought current OT students benefitted from the COTAD Chapters program the most. Figure 23 Program Awareness and Receptiveness Towards DEIJ Initiatives: According to Faculty Responses (n=49) COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 47 Figure 24 Faculty Reported Programmatic Change, in Order of Frequency (n=49) Many Changes to Admissions. Data showed 71.4% of faculty reported changes to admissions to promote more diversity within their respective OT and OTA programs, with 20% of those attributing at least some changes due to COTAD Chapter efforts (see Figure 25). Figure 25 Program Admissions Changes to Promote Diversity: According to Faculty Responses (n=49) COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 48 Reported admissions changes included: changes to admissions language, interview questions, and test score requirements, virtual interview options and financial considerations for students who need it, diversity statements on admissions pages, COTAD Chapter information sessions at interview days and orientations, and more scholarships for diverse students. There were 39 faculty whose program had undergone an admissions process while acting as Chapter liaison, and 30.8% of them reported observable changes in the diversity of admitted students (see Figure 26). Faculty who reported observable changes in admitted-student diversity identified which types of diverse identities increased; 91.7% of them reported noting increases in students of Color (see Figure 27). Figure 26 Admitted-Student Diversity Changes: According to Faculty Responses (n=39) Note. Only faculty who said their program underwent an admissions process during their time as a Faculty Liaison responded to this question. COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 49 Figure 27 Increase in Admitted-Student Diversity of Who? According to Faculty Responses (n=12) Note. Only faculty who stated that admitted-student diversity appeared to have increased since their Chapters existence answered this question. Many Curricular Changes. Figure 28 shows faculty responses when asked about curricular changes related to DEIJ and the driving forces behind them. Data indicated 13 distinct types of curricular changes identified by faculty (see Figure 29). Themes from faculty surveys indicated that some faculty and programs began to request course content feedback and suggestions from students. Two faculty admitted that changes were implemented slower than they wished, sometimes one faculty at a time. One faculty reported that the university listens more when changes are student driven. COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 50 Figure 28 DEIJ-Related Curricular Changes: According to Faculty Responses (n=49) Figure 29 Faculty Reported DEIJ-Related Curricular Change, in Order of Frequency (n=49) Other Changes. Faculty and students reported other concrete changes in response to the 2020 racism-based violence (The New York Times, 2020), but reportedly not all changes resulted from a COTAD Chapters effort. This program evaluation will only report on the COTAD Chapter or student-initiated change. Qualitative data shows faculty reported intentional changes including founding student led COTAD Chapters at their university, increasing support of COTAD Chapter initiatives, and encouraging participation in COTAD National events. COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 51 However, one faculty liaison stated in my opinion, my program thinks being able to say we have a COTAD Chapter is sufficient. I was the only faculty member who knew [of] or was involved in COTAD prior to 2020. Themes from Student Transition Surveys COTAD Chapter Chairs documented 189 Chapter Chair transitions since the beginning of the COTAD Chapters program and completed 33 transition surveys once the new data management system was implemented in 2021 (see discussion). In the open-ended question transition surveys (see Appendix D), outgoing Chairs reflected on the benefits of leading and participating in their COTAD Chapter. Chapters Provided Resources for Learning. Chapter Chairs reported that COTAD Chapters provided resources and afforded them a greater understanding about DEIJ, anti-racism, and anti-oppression, than their OT and OTA programs could provide. One outgoing Chapter Chair shared, it has been an incredible, eye-opening, and meaningful journey that has impacted me. What a valuable learning experience it was! It was truly motivating to be a part of this community and it was an honor to have this role. Through Chapter work, outgoing Chapter Chairs also reported they became more aware of the needs of their local communities. Chapters Supported Growth of Leadership Skills. Qualitative data from the transition surveys indicated that the student work through the COTAD Chapters program improved student leadership skills and confidence, ignited their passions, and provided them with inspiration. Data indicate students felt responsibility and accountability for the profession and grew out of their comfort levels. Students documented increased comfort with public speaking, making and giving presentations, and educating others. One student stated, this journey taught me how to speak up so that you are heard, showed me the leadership skills I have, and challenged me beyond my COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 52 comfort level. Never did I think I would be the face of the force, but it proved brown women can have leadership [roles] and that we can be professional." One Chapter Chair identified that the facilitation of leadership roles allowed them to step out of a passive role in addressing social justice issues and racism. Instead, they said they actively engaged in these topics, which provided them with relief and empowered them to address the problems and challenges they faced. Qualitative data analysis also indicated that students also felt perseverance through difficulties in their time with their Chapter was rewarding. Themes from COTAD National Leadership Surveys In the program evaluation survey, COTAD National Leaders shared their views on how the COTAD Chapters program benefited students, the OT profession, and beyond (see Appendix C for questions). Chapter Benefits to Students. Learning and Leadership. In the program evaluation surveys, COTAD National leadership shared students gained a greater understanding of DEIJ topics through participation in a COTAD Chapter and said this learning allowed students to be more prepared for working with diverse clients. Both National leadership and Chapter Chairs reported students learned organizational and long-term planning, problem solving, and navigating of hierarchical educational structures through participation in this program. A common theme throughout COTAD National leadership survey responses was that the program taught advocacy and empowered students to remain vigilant to continue to do DEIJ work. COTAD National leadership qualitative data analysis specified that Chapters allow students to have a unified voice to advocate to their university on behalf of themselves, their clients, or others. COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 53 Community. According to qualitative data analysis, the feeling of community provided by the COTAD Chapters program allowed students to advocate for each other, stand in solidarity together, and feel like they were not alone. National leadership shared that the community also allowed national networking and connections between diverse students, further facilitating problem solving and student efforts to act towards COTADs mission. The connections to COTAD National leadership provided resources and inspiration to students, and both National leadership and students noted the benefits of mentorship from both previous COTAD Chapter Chairs and national leaders. Safe Spaces. National leadership data analysis identified that the Chapters program supported students in ways that universities could not. Qualitative data analysis identified that both students and leadership agreed that COTAD Chapters afforded students with a new and safe space to facilitate and participate in meaningful group conversations within their programs and created a welcoming space for people of all diverse backgrounds. Students called these safe and brave spaces, and said they allowed the sharing of different perspectives and lived experiences. Chapter Benefits to the OT Profession: Future Leaders, and Transformative and Inclusive Practice. The program evaluation with COTAD National leadership indicated that the leadership strongly believed the COTAD Chapters program benefited the profession of OT. Leaders reported that they believed the Chapters program would help create future leaders to work towards justice in their practice, by creating a compassionate student body to enter the OT workforce. Data showed leaders thought the program played a pertinent role in increasing the OT professions awareness of the need for increased diversity, cultural humility, and cultural responsiveness, facilitating a more transformative and inclusive practice. A COTAD National leader stated they hoped the Chapters program would help [address] systemic oppression and COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 54 inequality at the root of the oppression, by challenging educational institutions to actively enact anti-oppression strategies and inclusive practices. By having more conversations about this work, a COTAD National leader claimed that they hoped it would foster a culture of accountability and inclusivity in the foundation of the OT profession the educational system. Other Chapter Benefits: Addressing Health Disparities and Building Momentum. National leadership surveys indicated that they believed that the aforementioned changes would in turn improve OT patient care and the outcomes of diverse clients, by also decreasing health inequities. COTAD National leadership claimed that patients and clients would benefit from a more diverse and diverse-aware field of practitioners serving them. They shared that increased visibility of diverse professionals of all backgrounds could impact the OT profession and the community beyond it, and observed that Chapter media content creates a wave of opportunities to learn and find resources for the OT community. Respondents reported that the more people who gain awareness and engage in this work, the more informed our communities will be. By sending the message that COTAD and the COTAD Chapters program is doing the work, the leaders hoped these messages will impact other professions and show that these efforts matter. Themes from Both Faculty and Student Surveys High Satisfaction and Leadership Accessibility. Overall, 86.4% of students and 87.8% of faculty were mostly to very satisfied, with the remainder reporting somewhat and slight satisfaction (see Figure 30). COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 55 Figure 30 COTAD Chapter Stakeholders Reported Satisfaction with the COTAD Chapters Program According to program evaluation survey responses, 86.8% of students respondents found COTAD Chapter leadership mostly to very accessible when they needed assistance with their COTAD Chapter (see Figure 31). Chapter Chairs provided the topics they sought assistance from leadership for, and 64.1% of Chapter Chair respondents reported they needed assistance to transition roles within a Chapter (see Figure 32). Figure 31 Student Chapter Chair Reported Accessibility of COTAD Leadership When Needed (n=53) COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 56 Figure 32 Student Chapter Chair Reported Topics Requiring Assistance From Leadership (n=53) Ideas for Improvement: Support, Networking, and Resources. Additionally, students and faculty provided comments about the COTAD Chapters and improvements they wished the COTAD Chapters could make. Data indicated that categories of improvement students wished COTAD could help Chapters with were how to drive more change, advocate within specific roles, support Faculty Liaisons best, improve COTAD Chapter processes, and receive more specific resources (see Table 4). Table 5 shows additional innovative event and resource ideas that Chapter Chairs suggested. Table 4 Survey Respondent Ideas for COTAD Chapters Program Improvement Categories of Improvement Specific Recommendations or Requests How to drive more change Students requested help advocating to faculty (for curricular and policy changes) Students requested help advocating to faculty for more holistic and inclusive admissions Students requested help promoting faculty buy-in to COTAD Chapter initiatives COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Categories of Improvement 57 Specific Recommendations or Requests Students and faculty requested help increasing attendance at COTAD Chapter events Students requested financial support to allow them to afford guest speaker fees, room rental fees, and promotional items Students requested help and guidance on how to gather and disseminate research on COTAD Chapter efforts How to advocate appropriately, respectfully, and effectively within certain roles Students requested help navigating power dynamics with faculty Students requested specific training for allies doing advocacy work How to best support Faculty Liaisons Students requested help providing more resources to faculty Faculty felt overwhelmed with resources provided and multiple resource channels (COTAD Ed, COTAD Chapter efforts, and COTAD National programs) Faculty requested a faculty liaison community How to improve COTAD Chapter processes Students requested assistance coordinating collaborations with other Chapters Students requested more help setting up their Chapter Students requested help separating their COTAD Chapter from their SOTA organization Students requested a more standard set of guidelines or expectations for set-up Students requested more ease of communication and resource access for all members of their COTAD Chapter, rather than simply the COTAD Chapter Chairs Students requested clear updates and explanations of structural changes on the COTAD Chapters program level How to receive more specific resources Students and faculty requested additional event and activity ideas Students and faculty requested starter kits, Chapter instructions, transition guidance Students and faculty requested templates and outlines for Chapter documents and processes Students requested training on advocacy to help them stay up to date on current events and proper language and terminology Students requested additional guest speaker resources and connections COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 58 Table 5 Survey Respondent Innovative Ideas for COTAD Chapter Program Implementation Innovative Idea Themes Specific Innovative Ideas Additional Events Chapter networking ideas DEIJ student conference about national student efforts Fieldwork preparation events Promote COTAD Chapters at state conferences Additional Resources COTAD Chapter newsletter COTAD merchandise NBCOT study tips Employment connections Policy updates Thankfulness. Although students reported it was challenging to balance schoolwork and COTAD Chapter advocacy, many reported they want to continue to volunteer for COTAD at a national level. Overall, the students were grateful and thankful for the support COTAD Chapters provided and for the opportunities for their voices to be heard. One student stated, every OT program should have a COTAD Chapter. The education and experiences are invaluable, and some students might not otherwise get this exposure before becoming OT practitioners. Institutional Impacts: Movement Toward the Cause Data collected across the entire program evaluation indicated themes of institutional impacts. Student surveys, social media data, and program evaluation surveys were crucial in understanding the institutional impacts. National leadership believed the COTAD Chapters program increased awareness of DEIJ, anti-oppression, and anti-racism within OT and OTA programs at universities, and created a more culturally humble and fluid environment. Surveys indicated Chapters provided students opportunities to engage in these topics, and topics not in COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 59 the structured curriculums. COTAD National leadership shared that due to COTAD Chapters, universities gained the ability to identify student leaders in this type of work, for feedback or perspective on DEIJ-specific programmatic issues, strategic plans, or goals that could help increase funding. Additionally, qualitative data analysis indicated that COTAD National leaders thought the efforts of COTAD Chapters encouraged universities to embrace holistic admissions and hiring, and the existence of COTAD Chapters increased the programs appeal to diverse students. Across the data, student advocacy impacted OT programs. As goals of COTAD Chapters program included influencing DEIJ, anti-oppressive, and anti-racist change and policies institutionally, (see Appendix A), surveys requested information from both faculty and students about programmatic statements and advocacy letters written. Data show that nearly half of OT and OTA programs represented by COTAD Chapters faculty and students put out a statement about racism and race-based violence (see Figure 33). Figure 33 Programmatic Actions Since March of 2020: About Racism and Race-Based Violence COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 60 Approximately 19.7% of student respondents reported and shared letters they wrote to their faculty or programs, advocating for marginalized communities and student needs following hate crimes, civil disruptions, and important social changes. Two students stated they did not advocate to their program about making a statement due to fear of retaliation from administration and faculty. Another example of COTAD Chapter impacts on their institution is demonstrated in Figure 34. Not only does this image show impacts on the institution, but it also shows the power of social media in sharing and spreading efforts and movement towards DEIJ causes. Figure 34 Example of a COTAD Chapter Institutional Impact Note. This image depicts a screenshot of the COTAD National Board group chat, sharing a sign they saw a COTAD Chapter share on social media. The sign was shown on a bathroom door, stating the University does not discriminate based on gender identity or expression. You are allowed to use the restroom with which you identify. The sign identifies the location of single-stall restrooms on their campus. Leadership reported that this sign was posted after a COTAD Chapter requested a speaker from the Board and that the speaker encouraged them to make institutional changes. COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 61 Discussion The program evaluation team sought to determine the effectiveness of the COTAD Chapters program processes and programming, and to examine the programs intended and actual outcomes. This purpose was met through mixed methods, collecting data from semistructured interviews, document review, surveys, direct observation, preexisting data, and social media. Results demonstrated that the COTAD Chapters program processes are constantly changing to meet the growth of the program and would benefit from a refined structure. Further, results demonstrated that the outcomes of the COTAD Chapters program support COTADs mission by working toward increasing diversity within the OT profession through the support and empowerment of OT students. The COTAD Chapters program is succeeding, but can improve in working towards its intended outcomes by promoting national growth and use of social media to spread advocacy efforts, addressing and supporting student safety, and providing more resources and assistance for students learning to navigate and engage in advocacy work. COTAD Chapters Processes Challenges with COTAD Chapters Program Processes The program evaluation results show that the COTAD Chapters program administrative processes evolved to adapt as the program grew. However, the administrators' time commitments and workloads were not divided sustainably and previous COTAD Chapter Chairs had limited opportunities to grow into leadership roles that would continue to support the program. Thus, the ever-changing processes were complicated and confusing to students and faculty involved in the program, which sometimes caused Chapters to request increased support. The increased support was often especially related to Chapters administration and structure, transitioning Chapter Chair leadership, and forming new Chapters. COTAD Chapter administration had limited capacity to COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 62 address these needs on a programmatic/systemic level, which increased time managing and supporting individual Chapters. Additionally, Google Drive was not sufficiently effective at organizing all the data and resources throughout the programs continual changes, and GroupMe did not have enough capabilities to effectively benefit the Chapters as the primary communication platform. Implications for Processes and Administration The findings related to COTAD Chapter processes demonstrate a need for a bigger team and a newly defined administrative structure, to decrease administrative burden and improve student experiences. The COTAD Chapters program would benefit from creating a new structure that outlines a transparent pipeline to allow students to continue to volunteer with the Chapters program following their role as a Chapter Chair. Provision of recommendations or additional resources to answer questions about forming a new COTAD Chapters and transitioning Chapter Chairs would also decrease administrative burden by helping students. Additionally, this program evaluation prompted reconsideration and suggested exploration of new COTAD Chapters Program organization and communication platforms. COTAD Chapters Goals and Outcomes COTAD Chapters Goals are Successful The COTAD Chapters program is addressing and achieving outcomes that are the vision of the COTAD National organization. The COTAD Chapters program intended to activate Chapters within the OT educational system to help promote open discussions, educate about culture and diversity, hold DEIJ activities, improve student support, and safely navigate advocacy. Nationally, the Chapters program intended to create a more diverse workforce within OT and positively impact diversity and reduce healthcare disparities within the contexts of COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 63 individuals, communities, and populations. Respondent demographics demonstrated that the identities of students affiliated with Chapters and COTAD National leaders were more diverse than Chapter faculty liaisons. This program evaluation also informed evaluators that COTAD Chapters appear to have more active Chapters in the Midwest and the East than in the West and the Southwest. COTAD Chapters social media presence increased the reach of COTAD Chapters, and the advertising of virtual events spread their efforts wider than ever before. Student Experiences Differed As COTAD Chapter efforts are intended to be student led, the evaluation team purposefully attended to the experiences and responses of students. Widely, results showed that students felt the COTAD Chapters program and the existence of their own respective Chapters improved their student experiences, promoted their growth, and allowed them to engage in local and nationwide advocacy. However, it appeared that advocacy efforts for underrepresented groups sometimes omitted disability as an underrepresented group. Students had differing experiences related to feelings of safety, depending on individual experiences with Chapter advocacy within their program. Results also indicated that living with underrepresented identities within OT programs may influence feelings of students' perceptions of safety. Program Satisfaction Most students appeared highly satisfied with the COTAD Chapters program, but it is important to note that a few students reported lesser satisfaction. The evaluation team observed that often reports of lesser satisfaction resulted from barriers and challenges students faced within OT programs that prevented their Chapters from making progress towards change, rather than from the Chapters program itself. Faculty had higher satisfaction in the COTAD Chapters program, and reported more change to receptiveness and awareness, curriculums, and COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 64 admissions. It is possible that programmatic admissions processes procedures may have caused faculty to be more aware of changes than students. Impact on OT Programs COTAD Chapters impacted their OT programs in terms of DEIJ, anti-racism, and antioppression, by improving receptiveness and awareness, curriculum and policy, and sometimes admissions. Although Chapters impacted their OT programs, results showed that students encountered varying degrees of responsiveness from OT program administration. Some program administration and faculty met student advocacy with performative allyship, and some promised change that they did not deliver. Many changes that OT programs implemented to date were small and immediate fixes, rather than systemic and programmatic changes. Both faculty and students had different impressions of progress and demonstrated that it was challenging to determine whether changes made within programs were truly motivated by the Chapters efforts or other factors. Students also appeared to be more likely to attribute changes to their Chapters efforts than faculty. Impact Beyond OT Programs In line with the programs intended impacts, the COTAD Chapters program has demonstrated positive impacts on communities, the OT profession, and beyond. Results demonstrated that the COTAD Chapters program has created student leaders who would continue this work within the OT profession after graduating, which has been apparent in students' comments. suggestions, and willingness to stay involved and improve the program. Implications for Outcomes COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 65 Opportunities for Improving General Outcomes. The results of the COTAD Chapters program evaluation in terms of outcomes has important implications for the future of the program and further research. It is important for the Chapters program to investigate the regional distribution of Chapters and to find ways to promote a presence in OT programs across the nation. As Edgoose et al. (2019) found, mentorship and support from individuals who can relate to students with marginalized identities is beneficial, which demonstrates the need to also promote increased diversity in faculty and COTAD Chapter faculty liaisons. Advocates also need to make an effort to ensure disability is included in their advocacy efforts. Social media and virtual events have the potential to spread the work and impact of the COTAD Chapters exponentially, including to current practitioners and those in the OT professional world. Chapters may be impacting current OT practitioner skills and awareness, in addition to students. Opportunities for Improving Student Safety. The COTAD Chapters program must be intentional in supporting students with marginalized identities, especially those who engage in this work. It is important to note that when people engage in advocacy, they will often find discomfort in situations, and conversations that create tension, rather than safe spaces. Asking students to exist in COTAD Chapters and create advocacy efforts within their programs mean that the COTAD Chapters program is asking students to step into the tension of this work. Therefore, these students may need support at the national level, and assistance to find and navigate safety within spaces with responsive faculty and mentors. Students also may feel safer and more satisfied with their Chapters efforts if programmatic changes related to DEIJ are more transparent. Students challenges with roles, power dynamics, slow changes, and performative allyship demonstrate that there are opportunities for the COTAD Chapters program to provide more training and support for students engaging in these efforts. COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 66 Value of an Occupational Perspective Approaching the program evaluation through an occupational lens provided valuable insight. The program evaluation team essentially completed an occupational (activity) analysis of the COTAD Chapters program (AOTA, 2020-b.). Once discerning the specific occupations and contexts that needed to be addressed, they determined the demands of the occupations and activities, and used specific quality measurements to assess performance patterns and skills (AOTA, 2020-b.). Similar to the therapy process, once the occupational analysis was completed, the evaluation team synthesized the data and developed an intervention plan (AOTA, 2020-b.). The recommendations for the program act as the intervention plan, as they encourage occupational balance for volunteer administrators, promote principles of universal design for accessibility, and emphasize sustainability, efficiency, and continuous data collection (AOTA, 2020-b.). Recommendations for Program Implemented Within the Program Evaluation Process Changes to Data and Procedural Organization. Due to the data collected during this program evaluation, the COTAD Chapters program implemented various changes during the program evaluation process to improve efficiency and sustainability. Following observation and interviews with the COTAD Chapter Coordinator and Support Staff about old chapter processes and roles, the evaluation team disseminated the new roles and processes, and oriented the team to Airtable, a new cloud collaboration system to support data analysis and organization. In April of 2021, to preserve the continuity of the COTAD Chapters program processes, the COTAD Chapters coordinator requested the team replace all PDF forms with fillable forms on Airtable to collect future information and preserve processes for further data evaluation. The team COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 67 collaborated with the COTAD Chapter Coordinator to ensure that the forms created preserved the integrity of the program, and intentionally collected meaningful data. New and improved processes included an initiation form, needs assessment form, goal and goal update form, commitment form, transition form, event submission form, and automated dues renewal emails. The evaluation team beta tested forms and new processes, and then disseminated them to students in May of 2021. The links were embedded on the COTAD website (COTAD, n.d.-b) for full student access in June of 2021. The Airtable implementations greatly decreased the workload and logistical efforts of the Chapter Coordinator. However, the COTAD Chapter Coordinator reported even with these changes, her workload was only lessened to ~35 hours per week. Table 6 outlines the refined processes for creating and maintaining a COTAD Chapter. Table 6 2021 Refined COTAD Chapter Processes Using Airtable Creating a Chapter Required steps: 1. Students complete initiation form 2. Students complete needs assessment results form 3. Students complete new goal form 4. Students complete commitment form 1. Pay dues ($100/year) 2. Identify Chapter Chair(s) and Faculty Liaison(s) 5. Schedule a meeting for 1:1 meeting Maintaining and Transitioning a Chapter Required steps for transitioning: 1. Chair(s) identify new future Chair(s) or faculty transitioning 2. Chairs complete chair/faculty transition form in Airtable 3. Chapter admins reach out to schedule 1:1 transition meeting Other required tasks (no set timeline, complete Airtable form) Fill out logo permission form Fill out goal update form prior to each AllChapter Call and new goal form if necessary Fill out event submission form prior to events Note. Now, Chapters only engage with Chapter Coordinator or assigned Chapter leadership after final numbered step, rather than throughout the processes. COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 68 Changes to Other Program Processes. Office Hours Implementation. In 2021, five previous COTAD Chapter Chairs began the COTAD Chapter Monthly Office Hours for current Chapter Chairs, to improve engagement, communication, and increase volunteer opportunities for previous Chapter Chairs. COTAD Chapter Office Hours occurred every other month, in the months other events were not offered. At Office Hours, Chapter Chairs asked any questions they may have about processes and procedures, received supported from their COTAD community, and discussed any issues they encountered as COTAD Chapter Chairs. To date, 11 students attended the four one-hour office hours that previous Chapter Chairs offered. According to the office hour minutes, students expressed gratitude for access to advice, mentorship, and support from the COTAD Chapter Support Team at these meetings. Most questions revolved around clarifying transitioning and new Chapter processes, collaborating with other Chapters, increasing Chapter engagement, managing time better during grad school, and staying involved with COTAD after passing on the Chapter Chair role. Communication Platform Changes. Additionally, in early 2021, the primary communication platform changed from GroupMe to Slack, an instant communication platform with channels, to allow for more functionality for communication, following suggestions from students. 1:1 Call Time Reduction. Also in 2021, to lessen the time required for 1:1 transition and initiation Zoom Chapter Chair calls, the Chapter Coordinator requested the evaluation team create two Intro to the COTAD Chapters program videos to reduce required communication about COTAD Chapters program history and program logistics. Following a discussion with the COTAD Chapter Coordinator, the COTAD quarterly All-Chapter Call was changed to a COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 69 trimester All-Chapter Call to promote sustainability, reduce time commitment, eliminate holiday scheduling issues, and allow other programming for COTAD Chapter Chairs. Due to the increasing number of Chapters, administration increased the length of the calls to an hour and a half, and Chapters gave updates n breakout rooms rather than one-by-one to all attendees. Outcomes of the Chapter Process Changes. Based on COTAD Chapter administration interviews and continuous data collection throughout the program evaluation process, the changes were well received. All three individuals reported that the changes began to address the primary problems identified, and that they were necessary to optimize processes and promote program sustainability. However, program evaluators have suggested further changes to further reduce the time commitment and logistical workload of the COTAD Chapter Coordinator and improve support for Chapter Chairs. Yet To Be Implemented Recommendations for Organizational Structural Changes. Despite the changes already implemented, the program evaluators have further suggestions to improve COTAD Chapter processes and outcomes. First, program evaluators suggest that the COTAD Chapters program adapt a new leadership structure shown in Figure 35. This programmatic structure outlines roles and delegates tasks to multiple volunteers under a chain of command. The evaluation team recommends COTAD National creates positions for a COTAD Chapter team to divide up the workload, including primary Chapter committee positions for: Dues and Airtable management Chapter Chair transitioning support New Chapter management Student ambassador support and organization COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 70 Figure 35 Recommended COTAD Chapters Structure Note. This figure demonstrates the simplified COTAD Chapters program recommended structure, created by the program evaluation team, viewable at: https://miro.com/app/board/o9J_l7lmKRU=/?moveToWidget=3074457361033864958&cot=14 This recommended structure uses Airtable for all management and forms, designates that there is one individual person in charge of dues management and uses Airtable for ongoing organization, data collection, and Chapter management. It also divides new Chapter and existing Chapter support for decreased workload, and creates a definitive pipeline for leaders to COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 71 volunteer, grow, and learn. It also allows for previous Chapter Chairs to stay involved through volunteering with the COTAD Chapters committee. If the Chapter coordination roles continue to require substantial amounts of volunteer time, the Chapter Coordinator shared that the program may need a full-time paid employee to run the program. Other Recommendations for COTAD Chapters Program Administration. Engaging Chapter Chairs in the new communication platform (Slack), using training and prompts, to promote more beneficial communication with the Chapters community on the new platform Creating a structure for faculty liaison renewal each year as they transition Chapter Chairs, to promote student safety and comfort in engaging in this work with responsive mentorship and support Providing more resources for student involvement and advocacy about holistic admissions within their programs, to increase transparency and drive change to recruit a more diverse workforce Taking notes within future trimester All-Chapter Call breakout rooms, to maintain continuous data about COTAD Chapter happenings, ideas, and concerns Recruiting Chapters regionally and attending to why regions may or may not be starting COTAD Chapters, to promote nationwide growth of the program The program evaluation team suggested changes to the COTAD Chapter leadership, and the implementation of change is being strategized after the conclusion of this program evaluation. Limitations This program evaluation is not without limitation. The scope of the program evaluation was so large that program evaluators had to determine what data collection and interpretation COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 72 was within and what was not within the bounds of this evaluation. Additionally, the changes implemented during the program evaluation process made data and data analysis less straightforward. Preexisting Chapter data was incomplete prior to the process refinement, which caused data collection to be incomplete. The mixed-methods approach attempted to mitigate possible weaknesses and gaps in data. Previously, the COTAD Chapters program did not collect the actual impacts of Chapter efforts, so the program evaluation team was required to collect accounts of what individuals perceived in surveys. The individuals surveyed were volunteer leaders affiliated with the COTAD Chapters program, and thus may represent a biased group. Their personal accounts were not standardized and may have differed due to varying experiences and points of view. Moreover, investigators assumptions regarding positive outcomes of the COTAD Chapters program may have influenced results. Respondents may have interpreted questions on the program evaluation survey differently, including the Likert-style items that did not include numbers, which may have affected results. Some faculty and students noted that their answers may lack validity, as they reported their Chapters effects from afar in the wake of distance-learning and virtual events. Additionally, the first writer disseminated the survey initially from a non-school affiliated email, which caused some survey requests to go to spam. The program evaluation team caught the mistake and sent all follow up emails from a school affiliated email. In data collection, the reach of social media and events may not have been measured accurately by the number of followers or attendees, as evaluators had no way to determine whether individuals followed multiple accounts or attended multiple events. Recommendations for Further Research COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 73 The evaluation team recommends that the COTAD Chapters program solicit feedback from all affiliated students and event attendees, rather than only the leaders, to interpret feedback from a less biased sample. This program evaluation suggests a need for further exploration of the relationships between faculty and students in engaging in advocacy work, and their effects on students perceived safety in OT schools. It may be enlightening to interpret the survey responses of those with marginalized identities individually and interview those willing, to examine the relationship between identity and experiences within the COTAD Chapters program and OT programs. Further research can explore comparisons between data collected in this program evaluation, such as student perceived safety vs. race, gender, or sexual orientation, or number of years involved vs. perceptions of change. In the future, the COTAD Chapters program could investigate the uneven regional distribution of Chapters. They could also further evaluate the impact of George Floyds death on Chapter efforts, goals, and outcomes (New York Times, 2020). Conclusion Overall, the COTAD Chapters program has been effective in both processes and programming, and it would benefit from improvements to processes and support it provides. The efforts and impacts of COTAD Chapters align with the mission of COTAD National. Chapter stakeholders have observed change enacted by the COTAD Chapters program and demonstrate great commitment toward continuing efforts to create change and a better future for the entire OT profession. The wide community of support provides a great foundation for nationwide advocacy to activate DEIJ, anti-racist, and anti-oppressive efforts within all sectors of OT. The COTAD Chapters program formidably transforms OT education, practice, and research by COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM energizing student advocacy for increased diversity within the OT profession and creating a national network of future generations of action-oriented and empowered OT practitioners. 74 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 75 References Acker, G. M. (2017). Transphobia among students majoring in the helping professions. Journal of Homosexuality, 64(14), 2011-2029. http://dx.doi.org/10.1080/00918369.2017.1293404 American Occupational Therapy Association (AOTA)(2020-a.). Educators guide for addressing cultural awareness, humility, and dexterity in occupational therapy curricula. American Journal of Occupational Therapy, 74(3), 7413420003. https://doi.org/10.5014/ajot.2020.74S3005 American Occupational Therapy Association (AOTA)(2020-b.). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(2), 1-87. https://doi.org/10.5014/ajot.2020.74S2001 American Occupational Therapy Association (AOTA)(2020-c.). Occupational therapys commitment to diversity, equity, and inclusion. American Journal of Occupational Therapy, 74(3), 7413410030. https://doi.org/10. 5014/ajot.2020.74S3002 Agner, J. (2020). The issue isMoving from cultural competence to cultural humility in occupational therapy: A paradigm shift. American Journal of Occupational Therapy, 74, 7404347010. https://doi.org/10.5014/ajot.2020.038067 Bolding, D. J., Rodriguez, V., Nguyen, H., & Drabble, L. A. (2020). Survey of occupational therapy students' attitudes, knowledge and preparedness for treating LGBT clients. Journal of Occupational Therapy Education, 4(2), 1-15. https://doi.org/10.26681/jote.2020.040203 Brown, E.V.D., Muoz, J.P., & Powell, J.M. (2011). Multicultural training in the United States: A survey of occupational therapy programs. Occupational Therapy in Health Care, 25(23), 178-193. https://doi.org/10.3109/07380577.2011.560240 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 76 Coalition of Occupational Therapy Advocates for Diversity (COTAD)(n.d.-a). Coalition of Occupational Therapy Advocates for Diversity: About. Retrieved April 30, 2021, from https://www.cotad.org/about Coalition of Occupational Therapy Advocates for Diversity (COTAD)(n.d.-b). Coalition of occupational therapy advocates for diversity: COTAD chapters. Retrieved April 30, 2021, from https://www.cotad.org/about-cotad-chapters Cohen, J. J., Gabriel, B. A., & Terrell, C. (2002). The case for diversity in the health care workforce. Health Affairs, 21(5), 90-102. https://doi.org/10.1377/hlthaff.21.5.90 Dennis, C., Edwards, A., Erb, M., Guszek, K., McIlroy, E., & Marko, M. (2020). OT students perceptions of diversity and inclusion. American Journal of Occupational Therapy, 74(4), 7411510300p1. https://doi.org/10.5014/ajot.2020.74S1-PO6028 Edgoose, J. Y., Steinkamp, L., Vang, K., Hampton, A., & Dosch, N. (2019). A qualitative study of undergraduate racial and ethnic minority experiences and perspectives on striving to enter careers in the health professions. WMJ: Official publication of the State Medical Society of Wisconsin, 118(2), 60-64. Ford, A. R., Smith, D. L., & Banister, G. E. (2021). Recruitment and retention of occupational therapy practitioners and students of color: A qualitative study. American Journal of Occupational Therapy, 75, 7501205150p1-7501205150p8. https://doi.org/10.5014/ajot.2021.039446 Hall, W., Chapman, M., Lee, K., Merino, Y., Thomas, T., Payne, K., Eng, E., Day, S. H., & Coyne-Beasley, T. (2015). Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: A systematic review. American Journal of Public Health 105(12), e60-e76. https://doi.org/10.2105/AJPH.2015.302903 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 77 Hildebrand, K., Lewis, L., Pizur-Barnekow, K., Schefkind, S., Stankey, R., Stoffel, A., & Wilson, L. (2013). Frequently asked questions: How can occupational therapy strive towards culturally sensitive practices? American Occupational Therapy Association. Retrieved from https://www.aota.org/~/media/Corporate/Files/Secure/Practice/Multicultu ral/FAQCulturalSensitivity.pdf Howard, B., Kennell, B., & Winistorfer, W. (2018). Advisory opinion for the ethics commission: Cultural competence and ethical practice. American Occupational Therapy Association. 1-12. Retrieved from https://www.aota.org/~/media/Corporate/Files/Practice/Ethics/Advi sory/AOTA-CulturalCompetenceAdvisory-Author-correction-5-2-18.pdf Kumagai, A. K., & Lypson, M. L. (2009). Beyond cultural competence: Critical consciousness, social justice, and multicultural education. Academic Medicine, 84(6), 782-787. https://doi.org/10.1097/acm.0b013e3181a42398 Landy, R., Cameron, C., Au, A., Cameron, D., OBrien, K. K., Robrigado, K., Baxter, L., Cockburn, L., OHearn, S., Oliver, B., & Nixon, S. A. (2016). Educational strategies to enhance reflexivity among clinicians and health professional students: A scoping study. Forum Qualitative Sozialforschung / Forum: Qualitative Social Research, 17(3), 14. http://nbn-resolving.de/urn:nbn:de:0114-fqs1603140 Lucas, C. (2018). Occupational therapy professionals of color: Perceptions of the academic experience. American Journal of Occupational Therapy, 72, 7211505099p1. https://doi.org/10.5014/ajot.2018.72S1-PO3014 Murden, R. (2008). Occupational therapy students perceptions of their cultural awareness and competency. Occupational Therapy International, 15(3), 191-203. https://doi.org/10.1002/oti.253 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 78 Noone, J., Wros, P., Cortez, D., Najjar, R., & Magdaleno, L. (2016). Advancing health equity through student empowerment and professional success: A statewide approach. Journal of Nursing Education, 55(6), 316-322. http://dx.doi.org.ezproxy.uindy.edu/10.3928/01484834-20160516-03 Norcross, J., Lachter, L. G., Doyle, N., Niemeyer, L., & Jacobs, K. (2020). Equal peer-mentoring as a tool for professional and academic development: Evaluation of an online ementoring program for doctoral students. American Journal of Occupational Therapy, 74, 7411520491. https://doi.org/10.5014/ajot.2020.74S1-PO7322 Phillips, J., & Malone, B. (2014). Increasing racial/ethnic diversity in nursing to reduce health disparities and achieve health equity. Public Health Reports (1974-), 129(2), 45-50. Retrieved June 23, 2021, from http://www.jstor.org/stable/23646785 San, S., & Breen-Franklin, A. (2019). Experiences of LGBTQ college students: Identity, health, and participation. American Journal of Occupational Therapy, 73(4), 1, 7311505116p1. https://doi.org/10.5014/ajot.2019.73S1-PO3011 Saunders, R. P., Evans, M. H., & Joshi, P. (2005). Developing a process evaluation plan for assessing health promotion program implementation: A how-to guide. Health Promotion Practice, 6(2), 134-147. https://doi.org/10.1177/1524839904273387 Scaffa, M. E., & Reitz, S. M. (2014). Occupational therapy in community-based practice settings (3rd ed.). F.A. Davis Company. Taff, S.D. & Blash, D. (2017). Diversity and inclusion in occupational therapy: Where we are, where we must go. Occupational Therapy In Health Care, 31(1), 72-83. https://doi.org/10.1080/07380577.2016.1270479 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 79 The New York Times. (2020, September 8). How George Floyd Died, and What Happened Next. The New York Times. https://www.nytimes.com/article/george-floyd.html Trentham, B. L., Langlois, S., Sangrar, R., Stier, J., Cockburn, L., Cameron, D., Renwick, R., & DSouza, C. (2020). Student engagement in peer dialogue about diversity and inclusion. Journal of Occupational Therapy Education, 4(3), 1-19. https://doi.org/10.26681/jote.2020.040304 U.S. Census Bureau. (2019). Quick facts: United States. https://www.census.gov/quickfacts/fact/table/US/PST045219 Wilson, S., Anvarizadeh, A., Drazen, C. H., Holland, D., Kwebetchou, N., Reyes Smith, C., & Skownronski, J. (2015). Diversity in the workforce: Perspectives from emerging leaders. OT Practice, 20(21), 19-21. W.K. Kellogg Foundation (2004). Logic model development guide. W.K. Kellogg Foundation. https://www.betterevaluation.org/sites/default/files/LogicModelGuidepdf1.pdf COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Appendix A Full Logic Model Note. This full logic model is viewable at: https://miro.com/app/board/o9J_l7lmKRU=/?moveToWidget=3074457361033864942&cot=14 80 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Appendix B Data Map 81 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 82 Note. The full data map is viewable at: https://miro.com/app/board/o9J_l7lmKRU=/?moveToWidget=3074457361033864746&cot=14 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 83 Appendix C Survey Questions and Indicators Item on Survey Potential Answers Intended Recipients Indicator What is/was your affiliation with the COTAD Chapters program? Faculty Liaison Student Chapter Chair Other Student Affiliation COTAD National Leadership All Demographic information, all indicators How long have you been involved with your COTAD Chapter? Less than 1 year 1 year 2 years 3+ years Faculty liaisons, student chapter chairs, other student affiliations Demographic information, all indicators related to COTAD Chapters What is your current gender identity? Please select all that apply. Cisgender man Cisgender woman Transgender man Transgender woman Genderqueer / genderfluid Decline to answer Additional gender category / other All Create a diverse network, for diverse students to diverse OTs / Access to COTAD Leadership If you answered other, what current gender identity do you wish to report? Write-in answer Those who answer other above Create a diverse network, for diverse students to diverse OTs / Access to COTAD Leadership Do you think of yourself as...? (select all that apply) All Create a diverse network, for diverse students to diverse OTs / Access to COTAD Leadership Lesbian, gay, or homosexual Straight or heterosexual Bisexual / pansexual Queer Dont know Prefer not to say Other COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Item on Survey Potential Answers Intended Recipients 84 Indicator If you answered other on the previous question, what do you wish to report? Write in answer Those who answer other above Create a diverse network, for diverse students to diverse OTs / Access to COTAD Leadership How do you describe your racial and/or ethnic identity? Please select all that apply. White or European American Black or African American Latin@ or Latine Asian or Asian American Native American, Native Alaskan, Native Hawaiian Prefer not to say Other All Create a diverse network, for diverse students to diverse OTs / Access to COTAD Leadership If you answered other, what racial or ethnic identity do you wish to report? Write in answer Those who answer other above Create a diverse network, for diverse students to diverse OTs / Access to COTAD Leadership What is your school/institution affiliation? Select from all COTAD affiliated institutions Faculty liaisons, student chapter chairs, other student affiliations Demographic information, all indicators related to COTAD Chapters Has your institution gone through (at least) one admissions cycle, while you were a faculty liaison for a COTAD Chapter? Yes No Faculty liaisons Improve inclusive admissions processes to improve access to OT COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 85 Item on Survey Potential Answers Intended Recipients Indicator Which statement comes closest to your institution's experience? (please select all that apply) A. Your OT program has undergone changes in awareness and receptiveness towards diversity, equity, inclusion, and justice initiatives because of your COTAD Chapter. B. Your OT program has undergone changes in awareness and receptiveness towards diversity, equity, inclusion, and justice initiatives because of outside factors. C. Your OT program has not undergone changes in awareness and receptiveness towards diversity, equity, inclusion, and justice initiatives. Faculty liaisons, student chapter chairs, other student affiliations Schools implement new DEIJ efforts and education at COTAD Chapter universities / Improve awareness, person by person, that DEI and DEI awareness must improve within OT Please describe the changes you have witnessed because of your program's COTAD Chapter. Write in answer Those who answer A above Schools implement new DEIJ efforts and education at COTAD Chapter universities / Improve awareness, person by person Which statement comes closest to your views about your OT curriculum? (please select all that apply) A. Your COTAD Chapter's efforts have caused positive curricular changes related to diversity, equity, inclusion, and justice. B. Other factors have caused positive curricular changes related to diversity, equity, inclusion, and justice. C. There have been no curriculum changes related to diversity, equity, inclusion, and justice. Faculty liaisons Schools implement new DEIJ efforts and education at COTAD Chapter universities COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Item on Survey Potential Answers Intended Recipients 86 Indicator Please describe the curricular changes (related to diversity, equity, inclusion, and justice) you have witnessed because of your program's COTAD Chapter. Write in answer Those who answer A above Schools implement new DEIJ efforts and education at COTAD Chapter universities Which statement most closely describes your impression of changes to your program's admissions processes? A. The admissions process for your program has changed to promote more diversity within your program because of your COTAD Chapter's efforts. B. The admissions process for your program has changed to promote more diversity within your program because of other factors. The admissions process for your program has not changed to promote more diversity within your program. Faculty liaisons, student chapter chairs, other student affiliations Improve inclusive admissions processes to improve access to OT Please describe how your admissions process has changed because of your program's COTAD Chapter. Write in answer Those who answer A above Improve inclusive admissions processes to improve access to OT Which statement comes closest to your view? A. You have seen more diversity in your admitted students since your COTAD Chapter's existence. B. You have not seen more diversity in your admitted students since your COTAD Chapter's existence. You don't know. Faculty liaisons, student chapter chairs, other student affiliations Improve inclusive admissions processes to improve access to OT / Increase diversity within the profession COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Item on Survey Potential Answers Intended Recipients 87 Indicator We have increased our diversity of admitted students in the following populations: (please select all that apply) Students of color Queer students Disabled Students Other minoritized religious, cultural, or ethnic backgrounds Those who answer A above Improve inclusive admissions processes to improve access to OT / Increase diversity within the profession How would you describe your program and OT department's responsiveness towards COTAD Chapter initiatives? Very responsive Mostly responsive Somewhat responsive Slightly responsive Not responsive Student chapter chairs, other student affiliations Schools implement new DEIJ efforts and education at COTAD Chapter universities Before becoming involved in your program's COTAD Chapter, how safe did you feel within your program? Note defining safety as: how comfortable, included, and free from harm or risk you feel within your program. Very safe Mostly safe Somewhat safe Slightly safe Not safe Student chapter chairs, other student affiliations Increase safety of OT students in their programs, at their universities, and beyond COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Item on Survey Potential Answers Very safe Mostly safe Somewhat safe Slightly safe Not safe 88 Intended Recipients Indicator Student chapter chairs, other student affiliations Increase safety of OT students in their programs, at their universities, and beyond After becoming involved in your program's COTAD Chapter, how safe do you feel within your program? Note defining safety as: how comfortable, included, and free from harm or risk you feel within your program. How has COTAD support and having a COTAD Chapter affected your feelings of safety and comfort within your program/university? Note defining safety as: how comfortable, included, and free from harm or risk you feel within your program. Write in answer Student chapter chairs, other student affiliations Increase safety of OT students in their programs, at their universities, and beyond Which most closely aligns with your program's actions since March of 2020? A. Your program put out a statement about racism and race-based violence. B. Your program did not put out a statement about racism and racebased violence, but referred you to a statement made by the larger institution. C. Your program did not make or refer to a statement at all. Faculty liaisons, student chapter chairs, other student affiliations Schools implement new DEIJ efforts and education at COTAD Chapter universities COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Item on Survey Potential Answers Intended Recipients 89 Indicator If your program put out a statement (mentioned above), please attach an image or PDF of your program's statement. Place for file attachment here Those who answer A above Schools implement new DEIJ efforts and education at COTAD Chapter universities Which most closely describes your COTAD Chapter's actions regarding your program putting out a statement after March of 2020 regarding racism and race-based violence? A. COTAD Chapter members urged faculty to address these topics prior to a statement coming out. B. COTAD Chapter members urged faculty to address these topics and no statement was put out. C. Your COTAD Chapter did not explicitly urge faculty to address these topics prior to the statement your program put out. D. Your COTAD Chapter did not explicitly urge faculty to address these topics and no statement was put out by your program. Student chapter chairs, other student affiliations Students learn advocacy and leadership skills Those who answer A or B above Students learn advocacy and leadership skills If COTAD Chapter Place for file attachment here members wrote a letter to faculty/our program (mentioned above), please attach an image or PDF of your letter. COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Item on Survey Potential Answers Intended Recipients 90 Indicator What other statements or concrete actions did your program take in regards to other forms of DEI outside of antiracism (e.g. queer, disability inclusion) in response to your COTAD Chapter's advocacy? Write in answer Faculty liaisons, student chapter chairs, other student affiliations Schools implement new DEIJ efforts and education at COTAD Chapter universities Throughout your time as a COTAD Chapter leader, how accessible would you say COTAD National leadership was? Student chapter chairs Access to COTAD Leadership / Mentorship availability / Create a diverse network, for diverse students to diverse OTs When you needed assistance from COTAD National leadership, what was it typically in reference to? (Please select all that apply) Leadership skills / management / conflict resolution COTAD Chapter events Airtable / forms / dues Transitioning in or out of a COTAD Chapter leadership role COTAD Chapter structure Other (please specify) Student chapter chairs Access to COTAD Leadership / Mentorship availability If you answered "other" above, what did you typically need assistance with? Write in answer Those who answer other above Access to COTAD Leadership / Mentorship availability Very accessible Mostly accessible Somewhat accessible Slightly accessible Not accessible COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Item on Survey Potential Answers Very satisfied Mostly satisfied Somewhat satisfied Slightly satisfied Not satisfied Intended Recipients 91 Indicator How satisfied are you with the COTAD Chapters program overall? Faculty Student liaisons, Chapters student chapter chairs, other student affiliations What else would you like COTAD to provide for you or your Chapter at the National level? Write in answer Student chapter chairs, other student affiliations Student Chapters / Mentorship availability Please add any additional comments or feedback about the COTAD Chapters program. Write in answer Faculty liaisons, student chapter chairs, other student affiliations Student Chapters / Mentorship availability How have you interacted with the COTAD Chapters program in any capacity in the past? Write in answer COTAD National leadership Create a diverse network, for diverse students to diverse OTs / Mentorship availability / Volunteer opportunities / Access to COTAD Leadership What benefits do you believe the COTAD Chapters program offers to the OT profession? Write in answer COTAD National leadership Welcoming answers to support all Outcomes indicators COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Item on Survey Potential Answers Intended Recipients 92 Indicator What benefits do you believe the COTAD Chapters program offers to students? Write in answer COTAD National leadership Welcoming answers to support all Outcomes: Summative indicators What benefits do you believe the COTAD Chapters program offers to universities? Write in answer COTAD National leadership Welcoming answers to support all Outcomes: Summative indicators What benefits do you believe the COTAD Chapters program offers to any additional people or groups? Write in answer COTAD National leadership Welcoming answers to support all Outcomes: Summative indicators How have you, as a Write in answer COTAD National leader, interacted with members of COTAD Chapters or the COTAD Chapters program at past AOTA Conferences? COTAD National leadership Volunteer opportunities COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM Appendix D Survey Questions in Chair Transition Form 1. What benefits did you personally gain from your general participation in your COTAD Chapter? 2. What benefits did you personally gain from leading your COTAD Chapter? 3. What positive achievements did your COTAD Chapter accomplish during your time as Chair? 4. What challenges or barriers did you face in your COTAD Chapter work? 5. Other general feedback or reflections: 93 COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 94 Appendix E Semi-Structured Interview Questions Questions for All: What is your role with the COTAD Chapters program? Who are the other people you work closely with for the COTAD Chapters program and what are their roles? Before 2021, how many hours a week (or month) would you estimate that you spent working with the COTAD Chapters program in an administrative capacity? Now that the recent (2021) changes have been somewhat implemented, how many hours a week would you estimate that you spend working with the COTAD Chapters program in an administrative capacity? What does your new role look like (especially welcoming and orienting new chapters)? How have the changes we have made within 2021 impacted your workload? How was the COTAD Chapter improvement process for you, and how does it feel now? What do you think still needs to be improved within the COTAD Chapters program? Questions for Chapter Coordinator (and others if their role overlaps with these questions): Before 2021, how long were your 1:1 meetings with chapter leaders and faculty liaisons? Since the recent changes, how long are your 1:1 meetings with chapter leaders and faculty liaisons? Now, after we have made some changes, what do the processes of welcoming and forming new chapters look like? Now, after we have made some changes, what do the processes of transitioning chapter leadership look like? COMPREHENSIVE EVALUATION OF THE COTAD CHAPTERS PROGRAM 95 How do you determine the winner of the COTAD Chapter of the Year award? What are the criteria? What do you envision for the COTAD Chapters Program in the next 5 years? ...