Date Presented 04/01/2022

We examined the relationships between participation in different extracurricular activities and the overall physical and mental health of OT students across a 2-year period. Participation in certain occupations was associated with positive mental health, and other occupations were linked to poorer physical health. Exploration and promotion of participation in extracurricular occupations may be considered to support OT students’ health.

Primary Author and Speaker: Buwen Yao

Contributing Authors: Sandy C. Takata, Shawn C. Roll

PURPOSE: Engagement in meaningful occupations is crucial to achieving health and well-being (Pemberton & Cox, 2015; Stewart, Fischer, Hirji, & Davis, 2016). Occupational therapy (OT) students learn to promote occupational engagement and health in their educational programs. However, support for monitoring and managing OT students’ own occupational participation and health is often overlooked. No literature exists that describes extracurricular activity participation nor examines the effect of occupational participation on health in OT students. Thus, the purpose of this study was to describe changes in OT students’ participation in extracurricular activities and health across their educational programs and explore the relationship between participation and health.

DESIGN: A descriptive longitudinal study design was used to obtain data from students who enrolled in a two-year OT program and a comparator group of dental hygiene (DH) students with similar demographics. Students with recent histories of acute injury or ongoing chronic medical conditions were excluded.

METHOD: Self-reported surveys were completed three times, at program admission and at the end of the first and second academic years. Overall physical and mental health was measured by the 36-Item Short Form Health Survey (SF-36), which resulted in Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. An activity checklist was used to record the total hours of participation in various activities over the past six months. A total of 62 activities were grouped into eight occupational categories: Fitness, Sports, Creative arts, Leisure, Social, Work, Caregiving, and Animal care. Repeated measures analyses of covariance (ANCOVA) were used to analyze changes in PCS and MCS across the three timepoints. Friedman-Kendall-Smith tests analyzed the changes in participation in extracurricular activities across time. Mixed linear models were constructed to examine the relationship of each occupational category with PCS and MCS, as well as the change of participation with the change of PCS and MCS.

RESULTS: Data were obtained from 136 participants, including 51 OT and 85 DH students. MCS significantly decreased over time across all students (50.4, 47.4, and 48.2, p<0.001), and OT students always had a lower MCS than DH students. A decreasing trend in PCS was noted in OT students (58.8, 57.9, 57.1, p = 0.06), compared to increased PCS in DH students (57.0, 58.0, 58.8, p<0.01). While there was no significant change in participation in social, leisure, animal care, and caregiving activity; the average time in sports, fitness, social, and work decreased across time for both groups (all p<0.01). Of these activities, initiating participation in work/volunteer activities was associated with a decrease in PCS and an increase in MCS (both p<0.05), and initiating participation in animal care was associated with a decrease in PCS (p<0.05).

CONCLUSION: OT students had decreasing physical health across time and worse mental health than DH students. OT students engaged in a smaller variety of activities for shorter durations over the course of their programs. Initiating work/volunteer or animal care activity was associated with worse physical health, while initiating work/volunteer activity was also associated with better mental health.

IMPACT STATEMENT: Although limited to one academic program, these data highlight a potential need for OT educational programs to better account for students’ physical and mental health. Educators should consider ways to inform students on the potential positive and negative effects of participating in extracurricular activities during their OT training and incorporate support for exploring their own level of activity participation.


Pemberton, S., & Cox, D. L. (2015). Synchronisation: Co-ordinating Time and Occupation. Journal of Occupational Science, 22(3), 291-303.

Stewart, K. E., Fischer, T. M., Hirji, R., & Davis, J. A. (2016). Toward the reconceptualization of the relationship between occupation and health and well-being: Vers la reconceptualisation de la relation entre l’occupation et la santé et le bien-être. Canadian Journal of Occupational Therapy, 83(4), 249-259.