Participation, Meaningful Activity, and Social Support Among U.S. Student Service Members/Veterans

Engagement in Meaningful Activity Mediates the Relationship Between Stressful Life Events and Functional Resilience

Resilience during stressful life events is a priority for administering the most client-centered care as possible. Occupational therapy practitioners have the unique opportunity to support resilience through promoting meaningful participation. The current study aims to understand the associations between meaningful activity engagement, resilience, and stressful life events. We specifically focused on answering if meaningful participation mediates the relationship between stressful life events and resilience. 492 participants from a non-clinical convenience sample of Amazon's MTurk completed the study. Participants completed an online survey and reported their experiences of stressful life events, resilience, well-being, and meaningful participation. We used SPSS and PROCESS to analyze our data. Stressful event severity and resilience were inversely related. When accounting for the effect of meaningful participation, the relationship became non-significant, indicating evidence of mediation. Implications: Focusing on measuring meaningful participation may be worth studying in further research.

Community engagement and loneliness in older adults in China: mediation effects of social support in the wake of COVID-19

Introduction

Loneliness is a key indicator of well-being in older adults. Drawing from the ecological model of aging, the active aging perspective, and the convoy model of social relations, this study investigates the extent community engagement influences loneliness and whether the relationship is mediated by social support during the COVID-19 pandemic.

Methods

Data was collected from 1,067 retired older adults in a cross-sectional design in Chengdu, China in 2022. Structural equation modeling was conducted to examine the direct and indirect effects of community engagement on loneliness through the hypothesized mediator of social support.

Results

The results show community engagement was positively associated with social support (β = 0.26, p < 0.001) and social support was negatively related to loneliness (β = -0.41, p < 0.001). Social support fully mediated the relationship between community engagement and loneliness. Additionally, community engagement had an indirect effect on loneliness via social support (β = -0.11, p < 0.001).

Discussion

The findings from the moderation analysis suggests community engagement and social support are likely to have large effects on loneliness for older adults over the age of 70 and who have low educational attainment. The findings suggest community engagement could be an important factor for improving social support and reducing loneliness amongst retired, older adults in China, especially in the wake of the COVID-19 pandemic where millions of individuals were isolated for extended periods of time.

Post-concussive symptoms mediate the relationship between sleep problems and participation restrictions among veterans with mild traumatic brain injury

Background

Sleep problems are common among Veterans with mild traumatic brain injury (mTBI) and may contribute to participation restrictions. However, explanatory mechanisms underlying this relationship are poorly understood. Sleep problems are associated with post-concussive symptoms (e.g., headaches). In turn, post-concussive symptoms contribute to participation restrictions. We hypothesized that post-concussive symptom severity mediates the purported relationship between sleep problems and participation restrictions among Veterans with mTBI.

Materials and Methods

This study was a retrospective analysis of clinical data among 8,733 Veterans with mTBI receiving Veterans Health Administration outpatient care. Sleep problems (yes/no) were identified using the sleep-related item from the Neurobehavioral Symptom Inventory (NSI). Post-concussive symptoms were measured using remaining NSI items. Participation restrictions were measured using the Mayo-Portland Adaptability Inventory Participation Index. We specified a latent variable path model to estimate relationships between: (1) sleep problems and three latent indicators of post-concussive symptoms [vestibular-sensory (e.g., headache)]; mood-behavioral [e.g., anxiety]; cognitive [e.g., forgetfulness]); and, (2) the three latent indicators of post-concussive symptoms and two latent indicators of participation restrictions (social and community participation [e.g., leisure activities]; productivity [e.g., financial management]). We examined the indirect effects of sleep problems upon participation restrictions, as mediated by post-concussive symptoms. Estimates were adjusted for sociodemographic factors (e.g., age), injury characteristics (e.g., blast), and co-morbid conditions (e.g., depression).

Results

87% of Veterans reported sleep problems. Sleep problems were associated with greater social and community participation restrictions, as mediated by mood-behavioral (β = 0.41, p < 0.001) and cognitive symptoms (β = 0.13, p < 0.001). There was no evidence that vestibular-sensory symptoms mediated this relationship (β = -0.01, p = 0.48). Sleep problems were associated with greater productivity restrictions, as mediated by vestibular-sensory (β = 0.16, p < 0.001) and cognitive symptoms (β = 0.14, p < 0.001). There was no evidence that mood-behavioral symptoms mediated this relationship (β = 0.02, p = 0.37).

Discussion

Findings suggest that evidence-based sleep treatment should occupy a prominent role in the rehabilitation of Veterans with mTBI. Indirect effects of sleep problems differed when considering impact on social and community participation vs. productivity, informing individualized rehabilitative care for Veterans with mTBI.

Reducing the Influence of Perceived Stress on Subjective Well-Being of Student Veterans With and Without Disabilities: The Protective Role of Positive Traits and Social Support

The transition from the regimented environment of military service to a less structured college lifestyle can be stressful for student veterans with and without disabilities, which highlights the importance of exploring protective person-environmental contextual factors that can help student veterans with and without disabilities manage their stress effectively, leading to enhanced well-being. The purpose of this cross-sectional correlational design study was to examine the role of positive person-environment contextual factors, including hope, resilience, core self-evaluations, and social support, to reduce the influence of perceived stress on the subjective well-being (SWB) of student veterans with and without disabilities. The sample included 205 student veterans (71.7% males; 80.5% White; Mage = 29.32; 39% with service-connected disability). Findings suggested that core self-evaluations and social support partially mediated the relationship between perceived stress and SWB in student veterans with and without disabilities. Implications for clinicians, university counselors, and university staff are also discussed.

An assessment of sense of belonging in higher education among student service members/veterans

The health, well-being, and integration of student service members/veterans (SSM/Vs) into higher education has become a growing focal point for college health practitioners and researchers. Methods: Secondary data analysis of "Campus Climate and Culture" module of the Healthy Minds Study (HMS), which included 8211 students. Analyses examined whether military status was associated with sense of belonging. Results: The relationship between military-affiliation and sense of belonging (low versus high) was statistically significant [χ² (2, 8211) = 10.855, p < 0.01], such that 42% of SSM/V reported low sense of belonging compared to their Reservist (33%) and civilian (28%) counterparts. Even after controlling for age, sex, year in school, and grade point average, SSM/V status (OR = 0.16, Wald = 6.17; p < 0.05), was negatively associated with sense of belonging. Conclusions: Results highlight a need for strategic college health initiatives to foster institutional inclusion and cohort building among SSM/V in higher education.

Combat exposure undermines student veterans' achievement of a meaningful life through its association with health-related symptoms: A longitudinal study

Objective: To understand whether symptoms of health conditions explain the negative association between combat exposure and student Veterans' achievement of a meaningful life. Participants: 153 combat Veterans enrolled in college between November 2013 and April 2018. Methods: Through an online survey, participants reported combat exposure, health status (symptoms of conditions such as depression), and aspects of a meaningful life (belonging, self-understanding, and doing) at two time points. Path analysis was used to explore whether baseline health status mediated the relationship between combat exposure and belonging, self-understanding, and doing at follow-up. Results: Indirect effects indicated that the negative influence of combat on student Veterans' sense of belonging, self-understanding, and doing at follow-up was mediated by poor health at baseline. Conclusions: Combat exposure may contribute to the development of health conditions, which in turn limit student Veterans' experience of three aspects of a meaningful life: a sense of belonging, self-understanding, and doing.