Occupational therapy-based advocacy and occupational justice for women: A systematic review

Introduction: Women face limitations in occupational participation due to intersecting social and structural factors, which negatively influence health and well-being. This systematic review examined how occupational therapy-based advocacy and occupational justice approaches have been applied to support women across diverse contexts. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, using 13 keywords across 4 databases. Fifteen studies met the inclusion criteria. Quality assessment and risk of bias were evaluated for all studies. Findings: Most studies were rated as high quality ( n = 10), with the remainder rated as moderate ( n = 5). The majority was qualitative (Level VI), with a small number of conceptual or theoretical studies (Level V), and overall risk of bias was low to moderate. The studies focused on women experiencing intersecting forms of marginalization, including disability, migration, violence, homelessness, and gendered and racialized inequities in employment. Three themes emerged: (1) individual-level empowerment, (2) societal and policy-level advocacy, and (3) professional responsibilities of occupational therapists. Overall, evidence was largely recommendation-based, with limited intervention-focused models. Conclusions: Integrating advocacy and occupational justice frameworks into clinical and community-based occupational therapy have the potential to enhance women’s occupational participation and inform future intervention development, education, and policy engagement.