Importance: Occupational therapy practitioners can use therapeutic activity to promote veterans’ well-being, but the mechanisms through which participation promotes well-being are poorly understood. Objective: To examine whether coping ability, meaningful activity, and social support mediate the relationship between participation and two indicators of veterans’ overall well-being: life meaning (psychological well-being) and life satisfaction (subjective well-being). Design: Explanatory cross-sectional design. We used two multiple mediation models to test whether coping ability, meaningful activity, and social support explained the relationship between participation and both life meaning and life satisfaction. Models were adjusted for demographic characteristics and service-related health conditions (e.g., posttraumatic stress disorder). Setting: Community. Participants: Three hundred eighty-nine community-based veterans attending college. Intervention: None. Outcomes and Measures: Measures of participation, coping ability, meaningful activity, social support, life meaning, life satisfaction, and service-related health conditions. Results: Meaningfulness of activity partially explained the relationship between participation and both psychological well-being (B = 0.16, standard error [SE] = 0.04, 99% confidence interval [CI] [0.07, 0.27]) and subjective well-being (B = 0.14, SE = 0.03, 99% CI [0.07, 0.24]). Social support partially explained the relationship between participation and subjective well-being (B = 0.05, SE = 0.02, 99% CI [0.01, 0.11]). These findings persisted when symptoms of service-related health conditions were accounted for. Conclusions and Relevance: Veterans’ participation is associated with a greater sense of meaningful activity and social support, which in turn promotes psychological and subjective well-being. Occupational therapy practitioners may promote veterans’ well-being by supporting engagement in activities that elicit meaning and enable social interaction, although further study is needed. What This Article Adds: This is among the first studies to test mechanisms underlying the relationship between veterans’ engagement in activities and their overall well-being. Results may inform treatment theories for activity-based interventions in the veteran population. For example, results indicate that occupational therapy interventions that facilitate engagement in meaningful and shared activities could be developed to promote veterans’ well-being.

Importance: Occupational therapists can foster student veterans’ resilience, but targets for intervention must be developed. Objective: To explain factors influencing student veterans’ successful adaptation to past combat exposure, we hypothesized that participants with high life meaning would have greater levels of protective factors and lower levels of health conditions than those with low life meaning. Design: Longitudinal panel study with two measurements. Participants were classified by level of combat exposure (high–low) and life meaning (high–low) at follow-up, yielding four possible classifications (e.g., resilient group: high combat exposure, high life meaning). Linear mixed models were fit to obtain adjusted means of protective factors and health conditions for each classification; independent-samples t tests were used to examine differences between classifications. Setting: Community. Participants: Convenience sample of 153 combat-exposed student veterans. Outcomes and Measures: Psychometrically sound measures of combat exposure, life meaning, protective factors (social and instructor autonomy support, coping ability, academic self-efficacy, social–community participation, and meaningful activity), and health conditions (posttraumatic stress [PTSD], depression, somatic symptoms). Results: Groups with high life meaning at follow-up in response to both levels of combat exposure reported greater meaningful activity and coping ability and fewer depressive symptoms. Participants with high life meaning in response to low combat exposure had greater social support and fewer somatic symptoms; participants with high life meaning in response to high combat exposure had lower PTSD. Conclusions and Relevance: Occupational therapists may foster student veterans’ resilience by promoting meaningful activity, social support, and coping ability while managing symptoms of health conditions. What This Article Adds: To the best of our knowledge, this study is the first to offer empirical support for potential targets of occupational therapy intervention that address student veterans’ successful adaptation to combat exposure. Findings suggest that researchers should develop and test interventions that facilitate successful engagement in meaningful and shared activities and that occupational therapists should work within multidisciplinary teams to bolster coping ability and manage symptoms of combat-related health conditions.

OBJECTIVE. We examined the feasibility of Aging Well by Design, a Lifestyle Redesign^®–inspired intervention for community-dwelling older adults. The original Lifestyle Redesign program was shortened to 3 mo and implemented as a community outreach program of a major health care system. METHOD. Community-dwelling older adults participated in the 12-wk program, which emphasized an occupational approach to healthy aging. Outcomes evaluated were recruitment, attendance, resource use, participant satisfaction, and subjective benefit to participants. RESULTS. The 13 participants, ages 66–88 yr, attended an average of 10 of 12 sessions. The intervention was completed as planned, physical resources were suitable, and financial resources were adequate. Participants expressed satisfaction with the program’s facilitator, group discussions, and materials. Perceived benefits were social relationships, awareness of community resources, and change in attitude toward aging. CONCLUSION. Implementation of a 3-mo Lifestyle Redesign–inspired program within a health care system was feasible.

OBJECTIVE. To examine differences in psychosocial protective factors (social support, meaningful occupation, and academic self-efficacy) and health-related vulnerability factors (posttraumatic stress, depression, and somatic symptoms) contributing to resilience in post-9/11 veterans with service-related injuries and nonveterans in postsecondary education. METHOD. A cross-sectional, matched-participants design using propensity score matching was used to test differences in mean levels of protective and vulnerability factors between injured veterans (n = 26) and nonveterans (n = 19); zero-order correlations explored relationships among study variables. RESULTS. The veteran sample demonstrated lower levels of psychosocial protective factors and higher levels of health-related vulnerability factors compared with nonveterans (|0.49| to |1.56|). Psychosocial protective factors were consistently negatively associated with health-related vulnerability factors (−.27 to −.63). CONCLUSION. Post-9/11 veterans with service-related injuries are at a substantial disadvantage in terms of resilience; lower protective factors and elevated vulnerability factors may increase their risk for poor campus integration and impede academic achievement.

Date Presented 4/16/2015 Among post-9/11 veterans with service-related trauma who were in college, lower social support, lower meaningful occupation, and lower academic self-efficacy—as well as higher posttraumatic stress, higher depression, and higher somatic pain—were found when they were compared with a matched sample. This highlights the need for occupational therapy services.

OBJECTIVE. This study evaluated the measurement characteristics of the Engagement in Meaningful Activities Survey (EMAS) in an age-diverse sample. METHOD. The sample included 154 older adults and 122 college students (age range = 18–100 yr). A Rasch–Andrich rating scale model was used to evaluate the EMAS. Analyses addressed rating scale design, person and item fit, item hierarchy, model unidimensionality, and differential item functioning. RESULTS. Category functioning was improved by reducing the EMAS item responses to four categories. Adequate person response validity was established, and all but one EMAS item demonstrated an ideal fit to the Rasch measurement model. After establishing the item hierarchy, I found the EMAS to be a unidimensional measure. Differential item functioning was not detected using Bonferroni-adjusted statistical criteria. CONCLUSION. The results confirm the potential to validly measure subjective qualities of meaningful activity participation. The EMAS can be used to evaluate processes and outcomes central to occupational therapy practice and to aid in the design of therapeutic occupations.