Finding Direction for Purpose Research in Hawai'i: A Narrative Review

Purpose is an important construct across contexts and cultures, with evidence suggesting it is strongly related to health, health behaviors, discrimination, and experiences of trauma. In this narrative review of the research on purpose in Hawai'i, the authors identify, critically analyze, and synthesize the extant literature found through a comprehensive literature search. It then discusses important cultural considerations for engaging in purpose research in Hawai'i, broadly, and with the Indigenous people of Hawai'i (Kānaka Maoli). The review presents findings on how sense of purpose levels differ between Hawai'i and the continental United States and risk factors or strengths critical in shaping the development of purpose in Hawai'i. Potential future directions for this line of inquiry conclude this review, with a particular emphasis on the need for integration of Kanaka Maoli ontology and values.

What are you Reading? A Glimpse Into What is Captivating Health Promotion Professionals

Story telling is one of the most time honored methods for conveying ideas, inspiring action and offering insights into the foibles and ferment of the human condition. This editorial offers a glimpse into what is sparking the imaginations and passions of health promotion professionals by simply asking them 'what are you reading?' Those who shared the books currently sitting alongside their reading chairs were not asked to select books that were related to improving health and well-being. Still, it came as no surprise that contributors to this article uniformly described plots, characters and narratives that illuminate how life circumstances can accost health and jeopardize well-being. What's more, you will see that in fiction, non-fiction and fanciful fables alike, health promotion professionals extract inspiration from these books and find ways to apply the moral of these stories toward the improvement of our profession.

Purpose in life and cognitive health: a 28-year prospective study

OBJECTIVES

To examine the prospective association between purpose in life measured at three points across middle and older adulthood and cognitive outcomes assessed 8-28 years later.

DESIGN

Prospective Study.

SETTING

Wisconsin Longitudinal Study of Aging (WLS).

PARTICIPANTS

WLS participants who reported on their purpose in life at Round 4 (1992-1994; Mage = 52.58), Round 5 (2003-2007; Mage = 63.74), and/or Round 6 (2010-2012; Mage = 70.25) and were administered a cognitive battery at Round 7 (2020; Mage = 79.94) were included in the analysis (N = 4,632).

MEASUREMENTS

Participants completed the Ryff measure of purpose in life and were administered the telephone interview for cognitive status and measures of verbal fluency, digit ordering, and numeric reasoning.

RESULTS

Purpose in life measured at age 52 was related to better global cognitive function and verbal fluency but unrelated to dementia at age 80. In contrast, purpose in life at ages 63-70 was associated with lower likelihood of dementia, as well as better global cognitive function and verbal fluency at age 80. The effect sizes were modest (median Beta coefficient = .05; median odds ratio = .85). A slightly steeper decline in purpose in life between ages 52 and 70 was found for individuals with dementia at age 80.

CONCLUSIONS

Purpose in life is associated with healthier cognitive function measured up to 28 years later. Individuals with lower purpose, especially in their 60s or older, and with steeper declines in purpose, are more likely to have dementia at age 80.

Transitioning from Subtyping to Precision Medicine in Parkinson's Disease: A Purpose-Driven Approach

The International Parkinson and Movement Disorder Society (MDS) created a task force (TF) to provide a critical overview of the Parkinson's disease (PD) subtyping field and develop a guidance on future research in PD subtypes. Based on a literature review, we previously concluded that PD subtyping requires an ultimate alignment with principles of precision medicine, and consequently novel approaches were needed to describe heterogeneity at the individual patient level. In this manuscript, we present a novel purpose-driven framework for subtype research as a guidance to clinicians and researchers when proposing to develop, evaluate, or use PD subtypes. Using a formal consensus methodology, we determined that the key purposes of PD subtyping are: (1) to predict disease progression, for both the development of therapies (use in clinical trials) and prognosis counseling, (2) to predict response to treatments, and (3) to identify therapeutic targets for disease modification. For each purpose, we describe the desired product and the research required for its development. Given the current state of knowledge and data resources, we see purpose-driven subtyping as a pragmatic and necessary step on the way to precision medicine. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Self-Acceptance and Purpose in Life Are Mechanisms Linking Adverse Childhood Experiences to Mortality Risk

OBJECTIVE

Adverse childhood experiences (ACEs) are associated with an increased risk of premature mortality, but it is not clear why. Individuals with ACEs tend to have lower self-acceptance and purpose in life, which may be pathways between ACEs and risk of premature mortality. As such, we tested whether purpose and self-acceptance are mechanisms that link ACEs to mortality risk.

METHODS

We used the Midlife in the United States Survey ( N = 6218; mean [standard deviation] = 46.89 [12.94] years) to test whether these factors were indirect pathways between ACEs and mortality hazards over 24 years of follow-up. We used a comprehensive ACE measure that included 20 possible childhood adversities including emotional and physical abuse, household instability, socioeconomic climate, and ill health.

RESULTS

ACEs significantly increased mortality risk (hazard ratio = 1.028, 95% confidence interval = 1.008-1.047, p = .006). Self-acceptance and purpose accounted for an estimated 15% and 4% of the ACEs-mortality relation, respectively. These effects withstood a range of adjustments and sensitivity analyses.

CONCLUSIONS

ACEs may affect mortality risk partially through lower self-acceptance and purpose during adulthood. Given that self-acceptance and purpose may change through intervention, these factors may be useful targets for individuals with ACEs that could lead to a longer life.

Co-design of an intervention exploring meaning and purpose after spinal cord injury

PURPOSE

Rebuilding a strong sense of meaning and purpose following trauma is a vital contributor to post-traumatic growth and adapting well to a spinal cord injury. This project aimed to develop an intervention that used the concept of post-traumatic growth to foster a stronger sense of meaning and purpose in people with a spinal cord injury.

METHODS

Using participatory action research methodology, the intervention was designed in an iterative process with health professionals and people with lived experience of spinal cord injury. We developed a ten-week online group program and delivered two pilot programs to 13 participants. We used their feedback to further refine the program before finalisation.

RESULTS

A participatory action research approach resulted in a positive intervention well received by participants and consumer organisations. Feedback suggests the intervention shows promise for improvements in functional and psychosocial outcomes and has long-term viability.

CONCLUSIONS

The project successfully developed and delivered a novel program that uses the concept of post-traumatic growth to foster a stronger sense of meaning and purpose. Further implementation of the program with larger numbers will allow for evaluation of the program's effectiveness.

Purpose in Life and Risk of Falls: A Meta-Analysis of Cross-Sectional and Prospective Associations

Background and Aim: Purpose in life is an aspect of well-being that is associated with better health outcomes in older adulthood. We examine the association between purpose in life and likelihood of a recent fall and risk of an incident fall over time. Methods: Purpose in life and falls were reported concurrently and falls were reported again up to 16 years later in four established longitudinal studies of older adults (total N = 25,418). Results: A random-effects meta-analysis of the four samples indicated that purpose was associated with a 14% lower likelihood of having fallen recently at baseline (meta-analytic OR = 0.88, 95% CI [0.84-0.92]). Among participants who reported no falls at baseline (N = 15,632), purpose was associated with a nearly 10% lower risk of an incident fall over the up to 16-year follow-up (meta-analytic HR = 0.92, 95% CI [0.90-0.94]). These associations were independent of age, sex, race, ethnicity, and education, were not moderated by these factors, and persisted controlling for physical activity and disease burden. Conclusion and Recommendations: Purpose in life is a meaningful aspect of well-being that may be useful to identify individuals at risk for falling, particularly among individuals without traditional risk factors, and be a target of intervention to reduce fall risk.

Purpose and goal pursuit as a self-sustaining system: Evidence of daily within-person reciprocity among adolescents in self-driven learning

OBJECTIVE

Despite long-standing assumptions that a sense of purpose in life and goal pursuit are mutually supportive, empirical evidence of their reciprocity remains deficient. In the context of a unique out-of-school time program that empowers youth to pursue passions through self-driven learning, we examined whether purpose and one aspect of goal pursuit-perceptions of goal progress-work together to sustain themselves and each other over time.

METHOD

Adolescents (N = 321) completed daily surveys throughout program enrollment (Menrollment  = 69.09 days). Through dynamic structural equation modeling, we derived within-person patterns of day-to-day prediction as well as individual differences in these patterns.

RESULTS

We found purpose and perceived goal progress exhibited significant daily inertia (i.e., autoregressive prediction) and reciprocity (i.e., cross-lagged prediction) at the within-person level. We also found initial evidence suggesting (a) tighter reciprocity was related to greater perceived goal progress overall and (b) people with greater purpose inertia may rely less on making goal progress to sustain momentum.

CONCLUSIONS

With evidence of daily purpose-progress reciprocity, the field can look forward to replicating this work in other contexts, diving deeper into interesting patterns of within-person dynamics, and developing interventions to support youth striving.

Purpose maintained: Adverse childhood experiences and meaning in life

OBJECTIVE

Three studies examined the relationship between adverse childhood experiences and meaning in life, focusing on the facets of meaning-coherence, significance, and purpose.

METHOD

In Study 1 (N = 1804), college students rated adverse childhood experiences, global meaning in life, and its facets. In Study 2 (N = 822), noncollege adults rated childhood trauma, meaning in life facets, attachment style, mood, and neuroticism. In Study 3 (N = 380) college students wrote about a positive and negative childhood memory, rating the facets of meaning immediately after each writing task.

RESULTS

In Studies 1-2, at the level of zero-order correlations, adverse childhood experiences related negatively to coherence, significance, and purpose. Controlling for the other facets, adverse childhood experiences remained negatively related to coherence and significance but were unrelated to purpose. Negative relationships between adverse childhood experiences and coherence and significance maintained controlling for covariates (Study 2). In Study 3, the predicted 3-way interaction showed that after recalling a negative childhood memory, adverse childhood experiences predicted lower significance and coherence but higher purpose.

CONCLUSIONS

Adverse childhood experiences consistently predict lower feelings of coherence and significance but, accounting for these associations, are unrelated to purpose. Purpose may represent a motivational strength emerging out of childhood adversity.

Exploring the spiritual foundations of public health leadership

The Covid-19 pandemic has laid bare the challenges of public health leadership. Faced with criticism, threats, and even violence, many public health leaders have left the field. A healthier future for the nation may well rest on training aspiring public health leaders to build deeper capacity for perseverance, healing, and resilience. Reflecting the growing experience of a team of public health educators at the Harvard T.H. Chan School of Public Health (Harvard Chan), this article offers recommendations for public health schools to recognize, and incorporate into leadership education, themes of spirituality-ie, the way people seek ultimate meaning and purpose and deep connectedness to something larger than themselves. Doing so can serve as a foundation for the lifelong journey of leadership. Over the past decade, Harvard Chan has incorporated meaning, purpose, and connectedness themes to complement more traditional coursework addressing research and translation. While many established leadership frameworks address the "what" and "how" of career development, the spirituality framework can support aspiring leaders to more fully understand their "why" and its alignment with challenging work. Such a deeply personal topic, traditionally kept private, has been shared and nurtured in Harvard Chan classrooms through a range of pedagogical strategies including personal reflection, one-on- one coaching, experiential learning, case discussions, and candid conversations with public health leaders. By encouraging a values-based foundation for decision-making in crises and difficult leadership moments, such grounding can help aspiring leaders navigate the challenges of public health leadership that inevitably lie ahead.

Understanding the Connection Among Ikigai, Well-Being, and Home Robot Acceptance in Japanese Older Adults: Mixed Methods Study

BACKGROUND

Ikigai (meaning or purpose in life) is a concept understood by most older adults in Japan. The term has also garnered international attention, with recent academic attempts to map it to concepts in the Western well-being literature. In addition, efforts to use social and home robots to increase well-being have grown; however, they have mostly focused on hedonic well-being (eg, increasing happiness and decreasing loneliness) rather than eudaimonic well-being (eg, fostering meaning or purpose in life).

OBJECTIVE

First, we explored how Japanese older adults experience ikigai and relate these to concepts in the Western well-being literature. Second, we investigated how a home robot meant to promote ikigai is perceived by older adults.

METHODS

We used a mixed methods research design-including 20 interviews with older adults, a survey of 50 older adults, and 10 interviews with family caregivers. For interviews, we asked questions about older adults' sources of ikigai, happiness, and social support, along with their perception of the robot (QT). For surveys, a number of well-being scales were used, including 2 ikigai scales-ikigai-9 and K-1-and 6 Patient-Reported Outcomes Measurement Information System scales, measuring meaning and purpose, positive affect, satisfaction with participation in social roles, satisfaction with participation in discretionary social activities, companionship, and emotional support. Questions related to the perception and desired adoption of the robot and older adults' health status were also included.

RESULTS

Our results suggest that health is older adults' most common source of ikigai. Additionally, although self-rated health correlated moderately with ikigai and other well-being measures, reported physical limitation did not. As opposed to social roles (work and family), we found that ikigai is more strongly related to satisfaction with discretionary social activities (leisure, hobbies, and friends) for older adults. Moreover, we found that older adults' sources of ikigai included the eudaimonic aspects of vitality, positive relations with others, contribution, accomplishment, purpose, and personal growth, with the first 3 being most common, and the hedonic aspects of positive affect, life satisfaction, and lack of negative affect, with the first 2 being most common. However, the concept of ikigai was most related to eudaimonic well-being, specifically meaning in life, along the dimension of significance. Finally, we found that Japanese older adults have high expectations of a home robot for well-being, mentioning that it should support them in a multitude of ways before they would likely adopt it. However, we report that those with the highest levels of meaning, and satisfaction with their leisure life and friendships, may be most likely to adopt it.

CONCLUSIONS

We outline several ways to improve the robot to increase its acceptance, such as improving its voice, adding functional features, and designing it to support multiple aspects of well-being.

Sense of Meaning and Purpose Making Mitigates the Experience of Stress Among Hawai'i Farmers

Farming is widely acknowledged as being extremely challenging and stressful, yet also potentially very meaningful as farming is an important element of any society and connected to our cultural heritage. Only a few studies have empirically examined the association between sense of purpose in farming and well-being/happiness. This study explored whether a sense of meaning and purpose in being a farmer could mitigate the experience of stress. A cross-sectional survey between November 2021-September 2022 was conducted with a sample of 408 Hawai'i agricultural producers. Descriptive statistics and logistic regressions were conducted to explore factors that predicted farmers' endorsement of high meaning and purpose, and whether meaning and purpose could dampen the impact of stressors on the experience of stress. Results revealed that Hawai'i farmers were highly stressed but also had high sense of meaning and purpose. Predictors of meaning and purpose included operating smaller farms of 1-9 acres and having 51% or greater percentage of income from farming. Meaning and purpose in turn decreased odds of stress, and showed an interaction with stressor intensity such that the stress buffering effect of meaning was more salient for those with lower stressors than those with higher stressors OR = 1.12 (CI = 1.06,1.19). One possible stress management and resilience technique is to highlight and strengthen farmers' sense of meaning and purpose in the farming endeavor.

Life goal selection pattern and purpose in adolescence: A latent class analysis

PURPOSE

This study aims to investigate the goal selection patterns among adolescents and examines the extent to which goals focused on oneself, relationships, and the larger community were associated with variability of daily purpose and mean level sense of purpose in life.

METHODS

Participants were 213 high school students with an average age of 15.18 years in an urban public school district in the Northeast United States. Students were asked to select their three most important goals one time and report on their sense of purpose once a day for 3 weeks in spring of 2022. Latent class analysis was used to classify students by the type of goals selected. Differences in the overall sense of purpose and its subscales by class were examined.

RESULTS

A model with four classes (Self and Inner Circle, Inner Circle, Other-Oriented, and Self-Oriented) best fits the data. There were no statistical group differences in the variability of daily purpose and overall sense of purpose. Only one pairwise comparison was significant and indicated that students in the Other-Oriented group perceived their purpose as more meaningful than students in the Self and Inner Circle group.

CONCLUSIONS

Findings from this study provide a lens into goal prioritization patterns among adolescents. Further, although students who were more likely to select other-oriented goals had somewhat higher perceptions of sense of purpose, findings support the concept of equifinality by suggesting that a sense of purpose may be actualized through a diverse set of specific goals.

Meaning-formation and sense of purpose in Morita therapy

Morita therapy is one of the leading alternative psychotherapeutic approaches that has emerged from Japan and has adapted with notable success to the mores and demands of the Western medical establishment. Although still on the margin, Morita therapy has the potential to offer a viable option for those who seek therapeutic assistance for various neuroses and psychosomatic illnesses that culminate in psychiatric symptoms such as generalized anxiety disorder, obsessive-compulsive disorder, or posttraumatic stress disorder. Diverging considerably from conventional Western psychiatric approaches, Morita therapy has its own modes of conceiving mental illness and offers distinct curative methods that are in some ways akin to the techniques of meaning-centred psychotherapies, but in many other ways are rather different. In this paper, the meaning-formation and the building of a constant sense of purpose in Morita therapy is explored, with a special focus on how these relate to creating a stable psychological framework for the client.

The Beyond-Human Natural World: Providing Meaning and Making Meaning

Much academic and media attention has been focused on how nature contributes to psychological health, yet, most of this focus has been on happiness or hedonic well-being. Although numerous writers and researchers have linked connecting with nature as a pathway to meaning in life, an integrated overview has not yet (to our knowledge) been offered. Our manuscript is thus of both theoretical and practical importance with respect to finding meaning in life. In this hybrid commentary/review paper, we examine the link between meaning in life and relating to the beyond-human natural world. Through presenting supportive empirical research and interdisciplinary insights, we make the case that connecting with the natural world provides us with meaning in various ways. We discuss how nature is a common source of meaning in people's lives and how connecting with nature helps to provide meaning by addressing our need to find coherence, significance/mattering, and purpose (the three aspects comprising the tripartite model of meaning life). We also consider how connecting with nature enhances our experiential appreciation for life, a fourth aspect of meaning in life recently proposed. Our discussion then expands to examining nature as a place of attachment. Going beyond how nature provides us with meaning, we consider how engaging in nature-based activities provides an avenue for many people to build meaningful lives. We close by considering how threats to nature are a threat to meaning in life.

Posttraumatic growth, purpose, and trauma in university survivors of sexual assault

Objective: This study focused on purpose as a key mechanism of posttraumatic growth for university student survivors of sexual assault. Participants: An online survey was completed by 278 participants of various ethnic, racial and gender backgrounds, recruited through email, social media, department subject pools, and Amazon Mechanical Turk. Methods: Researchers used mixed methods, concurrent triangulation approach in which quantitative and qualitative data were collected simultaneously with closed and open-ended questions. Results: Hierarchical multiple regression demonstrated that age, purpose in life, high magnitude stressors, and trauma history were significantly related to posttraumatic growth. Emergent themes described the impacts of sexual assault, how sexual assault impacts purpose, and ways in which purpose impacted posttraumatic growth. Conclusion: Results confirmed the association of purpose with posttraumatic growth as well as other key impacts of trauma that should be investigated further. Next steps include evaluating therapeutic interventions focused on purpose.

Enablers and Barriers of Community Garden Use in New Orleans, Louisiana: An Environmental Assessment and Qualitative Analysis

PURPOSE

To explore factors associated with community garden use.

APPROACH

Environmental assessment of community gardens and semi-structured interviews.

SETTING

New Orleans, Louisiana.

PARTICIPANTS

10 community gardens (environmental assessment), 20 community members (including garden users and non-users) and garden administrators (qualitative interviews).

METHOD

Gardens were assessed based on (1) accessibility, (2) information, (3) design, (4) cleanliness, (5) walkability, (6) parking, and (7) noise. Semi-structured interviews took place over Zoom; transcribed interviews were analyzed using thematic analysis.

RESULTS

Gardens assessed in the environmental assessment ranked high in design and cleanliness but low on accessibility and information availability. Salient themes from the qualitative interviews include skill-building, access to fresh foods, and increased social engagement as enablers of community garden participation, with availability of information and time as both potential enablers of, or barriers to, participation. Community members perceived that gardens could increase fresh food access, while administrators believed that it is not possible for community gardens to produce enough food to create community-wide impact, highlighting instead the importance of the social aspects of the garden as beneficial for health.

CONCLUSION

Community gardens should improve garden physical accessibility and information availability to incentivize use. Community gardens are valued as means for skill-building and social engagement. Future research should prioritize investigating the association between the social aspects of participating in community gardens and health outcomes.

Revealing the Meaning of Cannabis Use as an Occupation: A Scoping Review

Background

Occupational science and occupational therapy typically perceive occupations as promoting health and well-being. However, this perspective overlooks the many occupations that are viewed as illegal, unhealthy, or risky, such as drug use. Due to its negative association with health, drug use is perceived as not holding significance or meaning in people's lives.

Objective

This study explores how individuals perceive and describe the meaning of their cannabis use in the context of their lives, from an occupational perspective.

Methods

A scoping review was conducted using Levac et al.' modifications to Arksey and O'Malley's framework. To examine the peer-reviewed literature, 7 databases were searched using terms related to cannabis and meaning. Descriptive statistics were used to describe the selected studies, and reflexive thematic analysis identified cross-study themes.

Results

Fourteen studies were selected. Most studies have been published since 2008, with 5 published in the last 2 years. Four themes were identified across the studies: (a) preserving life; (b) navigating the routines of everyday life; (c) understanding the self, identity, and belonging; and (d) expanding the view of the world.

Conclusions

Cannabis use was revealed in this study as a support for navigating occupational routines and enhancing occupational repertoires and engagement, feelings of belonging, and collective user identities. As such, substance abuse treatment practices, including those provided by occupational therapists, should recognize the potential significance of cannabis use within people's lives. Using a harm reduction approach, occupational therapists can acknowledge the ways in which clients use cannabis to manage their daily routines, while also focusing on supporting clients to reduce the ill-effects of cannabis. As individuals become more engaged in occupations that are significant in their lives, their need for and meaning of cannabis use may change leading to a possible reduction in its use and a shift in their identity construction.

Parent and Pediatrician Perspectives on Physical Activity Promotion in Pediatric Primary Care: A Preliminary Mixed Methods Study

PURPOSE

To elicit preliminary pediatrician and parent perspectives on physical activity (PA) counseling and identify opportunities for improvement.

DESIGN

Mixed methods, including a cross-sectional survey and semi-structured interviews.

SETTING AND PARTICIPANTS

Primary care pediatricians (N = 73; 40% response rate) within a single large healthcare system and parents of students (N = 20) participating in a local school-based PA program in eastern Massachusetts.

METHODS

Electronic survey of pediatricians assessing opinions of American Academy of Pediatrics (AAP) PA guidelines and potential PA promotion tools; semi-structured qualitative interviews with parents assessing overall discussion, education, and recommendations relating to PA.

ANALYSIS

We report descriptive statistics for survey items and bivariate analyses comparing responses by physician characteristics. We performed thematic analysis of qualitative interviews and present results through an implementation science framework.

RESULTS

In this preliminary study, pediatricians reported adoption, appropriateness, and lower perceived effectiveness of PA counseling. School-based programs and educational materials were most often chosen as PA promotion tools. Responses varied by pediatrician characteristics. While parents reported satisfaction, opportunities for improvement included connections with community resources and continued conversations with the child about PA.

CONCLUSIONS

Pediatricians and parents highlighted gaps in PA counseling in primary care. While results are preliminary given small sample size, this study provides actionable targets to support PA promotion as a preventive health priority in this setting.

Predicting Positive Youth Development from Self-Regulation and Purpose in Early Adolescence

A Positive Youth Development (PYD) perspective emphasizes adolescents' potential for healthy, successful development. Researchers have introduced a variety of constructs that may promote PYD. For example, Intentional Self-Regulation (ISR) enables youth to seek out and use resources in the environment; purpose can help youth navigate and overcome obstacles. We examine connections between ISR, purpose and two PYD outcomes: confidence and connection. Data come from 763 Scottish youth (ages 12-14). We estimated fixed-effects regression models predicting confidence and connection from both ISR and purpose, confirming outcomes were independently associated with one or both predictors. Our findings are especially salient to the field of youth purpose, linking purpose with specific PYD outcomes.

Development and Validation of the Youth Purpose Orientation Scale Among Chinese Sample

INTRODUCTION

Purpose orientation has an important impact on the development of adolescence. An effective instrument is needed to describe the purpose orientation of youth. The aim of this research is to develop a reliable and valid scale to measure life purpose orientations of youth.

METHODS

Study 1 established a preliminary pool of items based on a literature review, an open-form questionnaire, and some expert opinions. Study 2 used exploratory factor analysis and performed internal consistency and reliability tests. The sample consisted of 442 young Chinese students, divided into males (49.3%) and females (50.7%) with an age range of 13 to 22 years. Study 3 performed confirmatory factor analysis and tested the scale's calibration validity and test-retest reliability. The confirmatory sample comprised 91,635 young Chinese students, divided into males (43.2%) and females (56.5%) with an age range of 12 to 23 years. The calibration validity sample consisted of 572 participants, aged 12 to 22. The test-retest reliability sample consisted of 200 participants.

RESULTS

Through exploratory factor analysis, the four-factor structure revealed contains personal growth, social promotion, family well-being, and personal well-being purpose orientations. This four factor-structure revealed a 65.26% cumulative variance. The four factors' alpha reliability was 0.89 for personal growth, 0.87 for social promotion, 0.86 for family well-being, and 0.87 for personal well-being, respectively. Confirmatory factor analysis showed that the model fitting index had a good four-factor structure. The calibration validity and test-retest reliability were acceptable.

CONCLUSION

These findings demonstrated that the 19-item findings demonstrated that the Youth Purpose Orientation Scale is a valid and reliable measure. In future research, it can be used to measure purpose orientation in youth.

Effort feels meaningful

People often dislike effort and avoid it when they can, but effort can also imbue tasks with meaning. This is the case for real-life tasks, but also novel tasks devoid of true purpose. Why does effort feel meaningful, under what conditions, and for whom?

Fish Consumption and Advisory Awareness among a Representative Sample of Wisconsin Adults, 2017-2019

PURPOSE

To examine fish consumption patterns and fish advisory awareness among Wisconsin adults.

DESIGN

Cross-sectional data from population-based survey. Setting: 2017-2019 Wisconsin Behavioral Risk Factor Surveillance System (BRFSS), supplemental fish module.

SUBJECTS

15,757 Wisconsinites aged ≥18 years. Annual response rates ranged 46.1-53.3%.

MEASURES

Fish consumption, advisory awareness, background and demographic characteristics.

ANALYSIS

Weighted binary and multinomial logistic regression.

RESULTS

Most Wisconsinites reported eating fish in the past 30 days, with approximately half (49.8%) consuming less than one fish meal per week. One-fifth of adults reported consuming sportfish. Women were less likely to eat any fish (POR_adj = .6, 95% CI: .5-.7) and sportfish than men (POR_adj = .7, 95% CI: .6-.8). The majority (76.7%) of sportfish consumers were aware of fish advisories. However, women (POR_adj = .7, 95% CI: .5-.9) and black, Indigenous, and people of color (BIPOC) (POR_adj = .4, 95% CI: .2-.7) sportfish consumers were less likely to be aware of fish advisories. Compared to adults aged 18-34 years, adults ≥55 years were twice as likely to eat 1-2 fish meals (vs. less than 1 fish meal) per week (POR_adj = 2.3, 95% CI: 1.8-2.9).

CONCLUSION

Findings indicate that half of all Wisconsinites consumed less fish than recommended by Wisconsin fish advisories, and women and BIPOC respondents were less likely to be aware of advisories. Educational efforts are needed to improve fish consumption habits.

A Scoping Review on the Concept of Physician Caring

BACKGROUND

Physicians' interest in the health and well-being of their patients is a tenet of medical practice. Physicians' ability to act upon this interest by caring for and about their patients is central to high-quality clinical medicine and may affect burnout. To date, a strong theoretical and empirical understanding of physician caring does not exist. To establish a practical, evidence-based approach to improve health care delivery and potentially address physician burnout, we sought to identify and synthesize existing conceptual models, frameworks, and definitions of physician caring.

METHODS

We performed a scoping review on physician caring. In November 2019 and September 2020, we searched PubMed MEDLINE, Embase, PsycINFO, CINAHL, and CENTRAL Register of Controlled Trials to identify conceptual models, frameworks, and definitions of physician caring. Eligible articles involved discussion or study of care or caring among medical practitioners. We created a content summary and performed thematic analysis of extracted data.

RESULTS

Of 11,776 articles, we reviewed the full text of 297 articles; 61 articles met inclusion criteria. Commonly identified concepts referenced Peabody's "secret of care" and the ethics of care. In bioethics, caring is described as a virtue. Contradictions exist among concepts of caring, such as whether caring is an attitude, emotion, or behavior, and the role of relationship development. Thematic analysis of all concepts and definitions identified six aspects of physician caring: (1) relational aspects, (2) technical aspects, (3) physician attitudes and characteristics, (4) agency, (5) reciprocity, and (6) physician self-care.

DISCUSSION

Caring is instrumental to clinical medicine. However, scientific understanding of what constitutes caring from physicians is limited by contradictions across concepts. A unifying concept of physician caring does not yet exist. This review proposes six aspects of physician caring which can be used to develop evidence-based approaches to improve health care delivery and potentially mitigate physician burnout.

Are Gross Motor Skill Interventions an Equitable Replacement for Outdoor Free Play Regarding Children's Physical Activity?

PURPOSE

The purpose of this study was to determine if children engaged in equal amounts of physical activity during an established gross motor skill intervention (the Children's Health Activity Motor Program (CHAMP)) and outdoor free play.

DESIGN

Cross-sectional study; sample: Ninety-nine children (Mage = 4.21, 51% boys) were randomly divided into two movement environments: CHAMP (n = 55) or control/outdoor free play (n = 44).

MEASURES

Physical activity was assessed using GT3X+ Actigraph accelerometers worn on the waist across four mornings. Average physical activity across the four days during either CHAMP or outdoor free play was extracted and categorized as light, moderate, vigorous, or MVPA. Physical activity data were reduced in the Actilife software using the cutpoints from Evenson et al.

ANALYSIS

A 2 (treatment) x 2 (sex) mixed measures ANOVA was used to compare the amount of time children spent in light, moderate, vigorous, and MVPA.

RESULTS

There was a significant main effect for treatment for light PA (F(3,95) =13.60, P<.001, partial η2=.125), and post hoc t-tests support that children in the control/outdoor free play group engaged in more light PA compared with children in CHAMP (t95 = -3.75, P<.001).

CONCLUSIONS

Results show that children in CHAMP engaged in less light PA but equal amounts of all other physical activity behaviors than their peers in outdoor free play.

Burns School of Medicine 'Imi Ho'ōla Post-Baccalaureate Program

The 'Imi Ho'ōla Post-Baccalaureate Program is a proven pathway to medicine that has significantly increased the number of underrepresented and disadvantaged students that complete medical school in Hawai'i. A recent program evaluation indicated a relationship between student success and the significance of attitude and purpose from the Learning and Study Strategies Inventory. Curricular innovations in a 5-week introductory course during Phase 1, lay the foundation to promote a healthy attitude with purpose-led activities, such as personalized journal vision covers, weekly journal reflections, a multimedia autobiography, and projects focusing on medical specialties, well-being, and resiliency. Such purposeful innovations are vital for the success of underrepresented students, with the ultimate intent to diversify the physician workforce and to increase the number of physicians serving in underrepresented and underserved communities in Hawai'i and throughout the Pacific.

Association Between Hypertension Management Education and Multiple Healthy Behaviors: A Cross-Sectional Study

PURPOSE

This study aimed to evaluate the association between hypertension management education and the adoption of multiple healthy behaviors.

DESIGN

Cross-sectional study.

SETTING

Data from the 2019 Community Health Survey in Korea.

SUBJECTS

Of the 213,900 participants in the 2019 database, 89,773 (42.0%) were hypertensive and 124,127 (58.0%) were normotensive.

MEASURES

Secondary data analysis included a 1:1 computer-assisted personal interview. "Multiple healthy behaviors" included not smoking, not drinking excessively, and walking briskly. "Hypertension management education" referred to information on hypertension management that participants received from clinics, hospitals, and public health centers, outside consultation with a doctor.

ANALYSIS

The association between hypertension management education and the adoption of multiple healthy behaviors was evaluated using multiple logistic regression.

RESULTS

In total, 89,773 (42.0%) participants were hypertensive. Among 61,589 patients with diagnosed hypertension, only 7,719 (12.5%) received hypertension management education. Participants who received such education were more likely to adopt multiple healthy behaviors (odds ratio [OR] = 1.27, 95% confidence interval [CI]: 1.21-1.34) than their counterparts (OR = 0.91, 95% CI: 0.89-0.93). Participants with undiagnosed hypertension were least likely to adopt multiple healthy behaviors (OR = 0.89, 95% CI: 0.86-0.92). No causal relationships were ascertained because of the cross-sectional study design.

CONCLUSIONS

Education can improve the adoption of multiple healthy lifestyles among hypertensive patients. Patients should be encouraged to participate in hypertension management education.

The Influence of Loneliness on the Smoking and Physical Activity of Community-Dwelling Older Adults: Results from the Health and Retirement Study

PURPOSE

To use the loneliness model in examining the influence of loneliness on the number cigarettes smoked per day and the different intensity levels of physical activity among community-dwelling older Americans in the United States.

DESIGN, SETTING, SAMPLE

This study analyzed a nationally representative sample of older adults aged 65+ in two waves (2010 and 2012) of data from the Health and Retirement Study. Response rates for the two waves were 81% and 89.1%. The sample size for smoking model was 199, and for physical activity models was 3018.

MEASURES

Outcomes included number of cigarettes smoked per day and physical activity at three intensity levels: light, moderate, and vigorous. Independent variable was the UCLA loneliness scale.

ANALYSIS

A lagged dependent approach for modeling longitudinal data was adopted. Models controlled for outcomes at the first timepoint (Wave 1), health/physical functioning, and demographic variables.

RESULTS

Loneliness was associated with an increased number of cigarettes smoked per day (β = 2.93, P < .05) and decreased engagement in moderate and vigorous physical activity for older adults (β = .12, P < .05; β = .12, P <. 05), after controlling for these behaviors at baseline and other covariates.

CONCLUSION

The findings call for smoking reduction and physical activity enhancement interventions targeting older adults who have high levels of loneliness. Efforts to enhance social support will be crucial to eradicating the harmful health impact of loneliness. Critical limitations include self-reported measures and unobserved confounders.

Predictors of Non-Compliance with a National Early Care and Education-Based Obesity Prevention Initiative: Go NAPSACC

PURPOSE

The purpose is to examine predictors of intervention non-compliance and develop a risk stratification score.

DESIGN

Prospective cohort.

SETTING

Early care and education (ECE).

SUBJECTS

Early care and education programs (n = 3883) randomly allocated (3:1) to a development (n = 2909) or validation (n = 974) sample.

INTERVENTION

Go NAPSACC provides a structured, web-based process to help improve the health of children around 7 modules (nutrition, physical activity, oral health, breast/infant feeding, farm to ECE, outdoor play, and screen time).

MEASURES

Program characteristics and participation data are collected via Go NAPSACC tool.

ANALYSIS

Multivariable Lasso logistic regression was used to identify predictors. Discriminative ability was based on area under the ROC curve (AUC).

RESULTS

Overall, ECE program non-compliance (lack of valid pre-/post self-assessment) was 65.5%. Six predictors were retained in the final development model: type of program (P = .002), Child and Adult Care Food Program (CACFP) participation (P = .065), acceptance of subsidies (P < .001), past modules attempted (P < .001), past modules completed (P < .001), and action plans created (P < .001). These factors generated a non-compliance risk score which showed good discrimination in the validation sample (AUC: .922, 95% CI: .903-.940).

CONCLUSION

Lack of qualitative data limits the ability to fully understand the context of non-compliance; however, this study demonstrates readily available data captured by Go NAPSACC are strong predictors of future success. Early identification of high-risk programs will inform targets for future implementation strategies geared toward improving program success.

Spanish Validation of the Multidimensional Existential Meaning Scale: Which Dimension of Meaning in Life Is More Associated With Psychopathology in People With Mental Disorders?

BACKGROUND

To assess three dimensions of Meaning in Life (comprehension, purpose, and mattering) the Multidimensional Existential Meaning Scale (MEMS) was developed, however, the MEMS's factorial structure has not yet been confirmed in a Spanish-speaking sample. A question that remains unanswered is which of the three dimensions of MiL are associated with psychopathology in clinical samples.

AIMS

(1) to analyze the psychometric properties of the MEMS in a Spanish non-clinical population, and (2) to identify which of the three dimensions of MiL shows the strongest relationship with depression, anxiety and positive affect in a clinical population.

METHOD

The non-clinical sample, consisted of N = 1106 Spanish adults, and the clinical sample consisted of 88 adults diagnosed with mental disorders. A Confirmatory Factor Analysis and regression analysis were carried out.

RESULTS

The three-factor model for the MEMS showed an acceptable fit, and full invariance across gender groups. In the clinical sample, the mattering dimension had the highest association with depression and anxiety, and purpose with positive affect.

CONCLUSION

The MEMS is an adequate instrument to assess the three dimensions of meaning in Spanish-speaking participants. These results support the importance of evaluating the MiL construct from a multidimensional perspective in clinical samples.

MPOWER: The Impact of a Purpose Program on Adolescents' Intrinsic and Extrinsic Motivations

Purpose has been defined as an active engagement toward goals that are meaningful to the self (i.e., personal meaningfulness) and contribute to the world beyond the self (BTS). These BTS contributions may reflect the intention to meet a wide range of needs from family financial needs to more macro-level concerns, including social injustices. This study investigates the efficacy of a school-based program called MPOWER expressly designed by the authors to cultivate the BTS aspect of purpose. Previous research suggests that the BTS aspect of purpose has beneficial effects on school engagement, goal-setting abilities and orientations, and ultimately school performance. Ninety-four students participated in this study that utilized a randomized, pre-test-post-test between-subjects design to evaluate MPOWER (52 in MPOWER and 42 in the control group). The ANCOVA results indicated a significant increase in the BTS aspect of purpose among program participants, compared to controls. Moreover, participants had higher post-test levels of general self-efficacy and grade point averages, and decreased performance-approach (e.g., playing to be the best, comparing self to others) and performance-avoidance (e.g., avoiding risks of failure, fear of social consequences) goal orientations. Findings can be used to design programs that aim to cultivate students' intentions to contribute to the world beyond themselves, as well as associated personal benefits (i.e., goal orientations, self-efficacy, academic performance).

Low Amount and Intensity of Leisure-time Physical Activity in Asian Indian Adults

PURPOSE

We sought to describe leisure-time, aerobic, and muscle strengthening physical activity (PA) patterns in U.S. Asian Indians, in comparison to other races/ethnicities.

DESIGN, SETTING, AND SAMPLE

We utilized the 2011-2018 National Health Interview Surveys, a set of cross-sectional, nationally representative surveys of the U.S. noninstitutionalized population. Our study population included 257 652 adults who answered PA questions.

MEASURES

PA was classified per 2008 U.S. guidelines and continuously per estimated metabolic equivalents (METs). Race was classified into White, Black, Asian Indian, Other Asian, and American Indian/Alaskan Native/Multiracial.

ANALYSIS

We used survey design-adjusted, multivariable logistic regression to determine odds of sufficient and highly active physical activity levels, adjusting for predisposing, enabling, need, and health care service factors as guided by the Anderson Model. We also used linear regression to determine racial differences in average MET-minutes/week. Analysis was additionally stratified by comorbidity status.

RESULTS

While Asian Indians (N = 3049) demonstrated similar odds of sufficient aerobic PA as Whites (aOR [95% CI]: .97 [.88,1.07]), Asian Indians had 22% lower odds of meeting highly active aerobic PA levels (.78 [.71,0.87]) and 18% lower odds of meeting sufficient muscle strengthening PA levels (.82 [.73,0.91]). This translated to an average 172 (95% CI: 45 300) fewer MET-minutes. Furthermore, this decrease in MET-minutes/week was especially apparent in those without hypertension (β[95% CI]: -164 [-314,-15]) without diabetes (-185 [-319,-52]), and low/normal BMI (-422 [-623,-222]).

CONCLUSION

Asian Indians, especially those without comorbidities, are less likely to engage in high-intensity physical activity than Whites.

Mediation of the Relationship of Acculturation With Glycemic Control in Asian Americans With Diabetes

PURPOSE

To assess the role of physical activity and healthcare access in mediating the association of acculturation with cardiometabolic health in Asian American adults with diabetes.

DESIGN

Cross-sectional study.

SETTING

National Health and Nutrition Examination Survey (NHANES) 2011-2018.

SUBJECTS

Non-pregnant Asian American adults with doctor diagnosed diabetes.

MEASURES

Participants were classified into low, moderate, and high acculturation status. Self-reported leisure-time, work, and transportation-based physical activity were summed for overall physical activity. Health insurance, frequency of healthcare receipt, and glycohemoglobin (HbA1c) check in the past year indicated healthcare access. Cardiometabolic health indicators included HbA1c, total and high density lipoprotein-cholesterol, and systolic and diastolic blood pressure.

ANALYSIS

Linear and logistic regression estimates, standardized using y-standardization, and assessed mediation of acculturation with cardiometabolic health.

RESULTS

Low acculturation was significantly related to greater leisure-time inactivity odds [OR (95% CI) = 2.25 (1.05, 4.82)], overall insufficient activity [OR (95% CI) = 2.30 (1.12, 4.74)], and uninsured status [OR (95% CI) = 5.62 (1.55, 20.41)]. Asian Americans with low acculturation had significantly higher log HbA1c than those with high acculturation (β ± SE = .078 ± .038); however, this association was not significant after adjusting for leisure-time activity. Leisure-time activity mediated 48.9% of acculturation and HbA1c association, and the indirect effect was statistically significant [estimate (95% CI) = .021 (.002, 0.047)].

CONCLUSIONS

Results suggest that promoting sufficient leisure-time activity could improve glycemic control in least acculturated Asian Americans with diabetes.

Humanitarian Athletic Participation and Identity Work

Numerous studies examine youth purpose and volunteerism, but only few investigate how altruistic activities shape identity development within athletic contexts. Endurance-based humanitarian fundraising teams are becoming increasingly popular forms of volunteerism among adolescents and young adults in the United States, but little is known about their developmental role. Twenty-four participants (15–21 years of age; M = 17.42) were interviewed to identify the prominent themes that arose from their experiences while training for and participating in a marathon. A thematic analysis was used to determine the dominant themes that characterized the intersection of humanitarian marathon training and running with aspects of identity work. The majority of the comments of the participants were directly tied to their experiences in running the marathon. Four themes were identified including identity work, faith, purpose, and social connection. More so than exploring their possible selves, a consistent theme throughout the interview with the participants was what they learned about their current selves and the capacities they already possessed during their marathon experience.

The Relationship Between Intolerance of Uncertainty and Employment Anxiety of Graduates During COVID-19: The Moderating Role of Career Planning

COVID-19, which is characterized by uncertainty, makes the employment anxiety of college graduates in the period of career change more and more intense. How to deal with this challenge is particularly important. The present study took career planning as a moderating variable to explore the relationship between intolerance of uncertainty (IU) and employment anxiety, as well as the role of career planning. In this quantitative study, the data of 563 college graduates from different schools were collected by using the Intolerance of Uncertainty Scale-12, Vocational Selection Anxiety Questionnaire of University Graduate, and Career Planning Scale. The final effective sample size was 550 (the overall recovery rate was 97.7%). The results of correlation analysis showed that there was a significant positive correlation between IU and employment anxiety, while there was a significant negative correlation between career planning and IU, as well as the relationship between career planning and employment anxiety. The results of hierarchical regression analysis showed that IU significantly positively predicted the employment anxiety of graduates, and career planning moderated the relationship between IU and employment anxiety. These findings suggested that maintaining a sense of career planning can help college graduates get through smoothly in the face of uncertainty of COVID-19.

What do people find most meaningful? How representations of the self and the world provide meaning in life

OBJECTIVE

Recent theories propose that global meaning in life (MIL) is based on feelings of coherence, purpose, and existential mattering. MIL has also been linked to mental representations-for example, beliefs, values, attitudes, and identities-that serve as "meaning frameworks" for interpreting the world and oneself. Combining these proposals, we predicted that beliefs, values, attitudes, and identities would foster a sense of MIL to the extent that they provide feelings of coherence, purpose, and existential mattering.

METHOD

Using multilevel path analysis, we tested within-person associations of coherence, purpose, and existential mattering with a sense of MIL across three studies (Study 1:208 US MTurk workers; Study 2:106 UK university students; Study 3:296 from a UK nationally representative Prolific sample). We explored the generality of these associations across mental representation types and individual differences.

RESULTS

Participants derived greater MIL most strongly from mental representations that provided sense of purpose, followed by existential mattering. Sense of coherence was less robustly related to MIL across mental representation types and religious orientation.

CONCLUSIONS

Integrating prior theorizing on MIL, we conclude that mental representations function as "meaning frameworks" to the extent that they provide feelings of purpose, mattering, and, sometimes, coherence.

Reasons Things Happen for a Reason: An Integrative Theory of Teleology

Humans default to functions and purposes when asked to explain the existence of mysterious phenomena. Our penchant for teleological reasoning is associated with good outcomes, such as finding meaning in misfortune, but also with bad outcomes, such as dangerous conspiracy theories and misunderstood scientific ideas, both of which pose important social and health problems. Psychological research into the teleological default has long alluded to Daniel Dennett's intentional-systems theory but has not fully engaged with the three intellectual stances at its core (intentional, design, physical). This article distinguishes the intentional stance from the design stance, which untangles some of the present knots in theories of teleology, accounts for diverse forms of teleology, and enhances predictions of when teleological reasoning is more likely to occur. This article examines the evidence for a teleological default considering Dennett's intentional-systems theory, proposes a process model, and clarifies current theoretical debates. It argues that people rationally and often thoughtfully use teleological reasoning in relation to both cognitive and social psychological factors. Implications for theory and future research are discussed.

Sense of Purpose Following a Dementia Diagnostic Appointment: Comparing Self- and Other-Reports of Care Recipients and Care Partners

Objective: Purpose in life tends to decline in older adulthood and it is thought that intact cognitive functioning is required for purposeful living. Thus, it is likely that individuals may perceive older adults who are experiencing cognitive declines associated with dementia as having a reduced sense of purpose. Biases such as these may influence how individuals, especially care partners, interact with those with dementia.

Method: This study examined how sense of purpose changed following a dementia diagnostic appointment for both the person receiving a diagnosis and their care partner. This study also explored how each individual perceived the other member of the dyad’s sense of purpose. Older adults (47 care recipients and 75 care partners, 57% female; M_age = 68.5 years, SD_age = 12.0 years) provided self- and other-report ratings of sense of purpose before and after their appointment at a specialized memory clinic.

Results: Overall, both care recipients and care partners’ sense of purpose declined following a dementia diagnostic appointment [t(85) = 7.01, p < 0.001]. However, when comparing self-reports and other-reports of purpose, care partners reported that care recipients experienced a lower sense of purpose in life than the care recipients reported about themselves.

Conclusions: Care recipients and partners reported less purpose in life following their dementia diagnostic appointment. Care partners may hold certain biases regarding sense of purpose toward care recipients. These findings can inform future work regarding how care recipients and care partners can plan purposeful lives following a dementia diagnosis.

Religious fundamentalism, right-wing authoritarianism, and meaning in life

OBJECTIVE

Two studies examined the relationship between right-wing authoritarianism (RWA) and religious fundamentalism (RF), and tested their unique contributions to meaning in life (MIL).

METHOD

We recruited Amazon Mechanical Turk Participants located in the United States. Studies 1 (N = 827) included measures of RWA, RF, and global MIL. Study 2 (N = 809) additionally included measures of the facets of global MIL (existential significance, purpose, and coherence), and intrinsic religiosity.

RESULTS

In both studies, RWA, RF, and MIL were positively correlated. Partial correlations and structural equation modeling showed that, when modeled together, RF significantly contributes to MIL and RWA facets were either unrelated or negatively related. Study 2 extended these results to show that RF primarily contributed positively to global MIL through existential significance, rather than purpose or coherence. When modeled jointly with intrinsic religiosity, religious fundamentalism no longer contributed to MIL.

CONCLUSIONS

These studies demonstrate that RF positively contributes to the experience of MIL, and that the link between RWA and MIL arises from their mutual overlap with RF. The link between RF and MIL is about religiosity, rather than fundamentalism. Implications are discussed.

Better Later Than Never: Meaning in Late Life

The quest for meaning in life takes on new challenges and directions during late life. This mini-review draws on prior theory to analyze meaningfulness into six discrete dimensions (purpose, value, efficacy, self-worth, mattering, and comprehension) and covers research into how these apply and operate specifically during late life. Limited remaining time, concern with one's legacy, concerns with self-continuity and integration, variable challenges to self-worth, and prioritization of positivity emerge as key themes.

Integrating Diverse Points of View on Intelligence: A 6P Framework and Its Implications

This article introduces a 6P framework for understanding intelligence, as well as the theories and tests that are derived from it. The 6Ps in the framework are purpose, press, problems, persons, processes, and products underlying intelligence. Each of the 6Ps is considered in turn. We argue that although the purpose of intelligence is culturally universal, the other Ps can vary at least somewhat over time and space. A single theory or test of intelligence represents a particular configuration of the 6Ps, but other configurations of the 6Ps might yield different theories and different tests.

Longitudinal Associations Between Physical Activity and Purpose in Life Among Older Adults: A Cross-Lagged Panel Analysis

Objective: The purpose of the current study was to examine the bidirectional relationship between physical activity (PA) and purpose in life in an older adult sample using longitudinal data. Method: Data were collected from three waves (2006, 2010, and 2014) of the Health and Retirement Study. A total of 4591 participants who had complete information of PA and purpose in life at baseline were included in the current study. A series of cross-lagged models were tested separately for vigorous-intensity PA, moderate-intensity PA, and light-intensity PA. Results: While higher levels of purpose in life were associated with more frequent engagement in future vigorous-intensity PA, moderate-intensity PA, and light-intensity PA, none of the PA variables predicted subsequent purpose in life. Discussion: The results did not support a reciprocal relationship between PA and purpose in life in older adults. It is more likely that purpose in life predicts PA, rather than vice versa.

Finding Purpose in the Conservation of Biodiversity by the Commingling of Science and Ethics

Averting the biodiversity crisis requires closing a gap between how humans tend to behave, individually and collectively, and how we ought to behave-"ought to" in the sense of behaviors required to avert the biodiversity crisis. Closing that gap requires synthesizing insight from ethics with insights from social and behavioral sciences. This article contributes to that synthesis, which presents in several provocative hypotheses: (i) Lessening the biodiversity crisis requires promoting pro-conservation behavior among humans. Doing so requires better scientific understanding of how one's sense of purpose in life affects conservation-relevant behaviors. Psychology and virtue-focused ethics indicate that behavior is importantly influenced by one's purpose. However, conservation psychology has neglected inquiries on (a) the influence of one's purpose (both the content and strength of one's purpose) on conservation-related behaviors and (b) how to foster pro-conservation purposes; (ii) lessening the biodiversity crisis requires governance-the regulation of behavior by governments, markets or other organization through various means, including laws, norms, and power-to explicitly take conservation as one of its fundamental purposes and to do so across scales of human behaviors, from local communities to nations and corporations; (iii) lessening the biodiversity crisis requires intervention via governance to nudge human behavior in line with the purpose of conservation without undue infringement on other basic values. Aligning human behavior with conservation is inhibited by the underlying purpose of conservation being underspecified. Adequate specification of conservation's purpose will require additional interdisciplinary research involving insights from ethics, social and behavioral sciences, and conservation biology.

The plasticity of well-being: A training-based framework for the cultivation of human flourishing

Research indicates that core dimensions of psychological well-being can be cultivated through intentional mental training. Despite growing research in this area and an increasing number of interventions designed to improve psychological well-being, the field lacks a unifying framework that clarifies the dimensions of human flourishing that can be cultivated. Here, we integrate evidence from well-being research, cognitive and affective neuroscience, and clinical psychology to highlight four core dimensions of well-being-awareness, connection, insight, and purpose. We discuss the importance of each dimension for psychological well-being, identify mechanisms that underlie their cultivation, and present evidence of their neural and psychological plasticity. This synthesis highlights key insights, as well as important gaps, in the scientific understanding of well-being and how it may be cultivated, thus highlighting future research directions.

mHealth applications to support caregiver needs and engagement during stroke recovery: A content review

Caregiving in stroke results in severe physical, psychological, and social impacts on the caregiver. Over the past few years, researchers have explored the use of mHealth technologies to support healthcare-related activities due to their ability to provide real-time care at any given place or time. The purpose of this content review is to investigate mHealth apps in supporting stroke caregiving engagement based on three aspects: motivation, value, and satisfaction. We searched app stores and repositories for apps related to stroke caregiving published up to September 2020. Extracted apps were reviewed and filtered using inclusion criteria, and then downloaded onto compatible devices to determine eligibility. Results were compared with evidence-based frameworks to identify the ability of these apps in engaging and supporting the caregiver. Forty-seven apps were included in this review that enabled caregivers to support their needs, such as adjustment to new roles and relationships, involvement in care and caring for oneself using several different functionalities. These functionalities include information resources, risk assessment, remote monitoring, data sharing, reminders and so on. However, no single app was identified that focuses on all aspects of stroke caregiving. We also identified several challenges faced by users through their reviews and the factors associated with value and satisfaction. Our findings can add to the knowledge of existing mHealth technologies and their functionalities to support stroke caregiving needs, and the importance of considering user engagement in the design. They can be used by developers and researchers looking to design better mHealth apps for stroke caregiving.

ME-Work: Development and Validation of a Modular Meaning in Work Inventory

As research on meaning in work progresses, access to theoretically integrated, differentiated survey instruments becomes crucial. In response to this demand, the present article introduces ME-Work, a modular inventory to measure meaning in work. Derived from research findings on meaning in life, the ME-Work inventory offers three modules that can be used separately or jointly. Module 1 assesses four facets of meaning in work, i.e., coherence, significance, purpose and belonging; module 2 measures the subjective assessment of work as meaningful or meaningless, and module 3 records the extent to which work is perceived as a source of meaning. We report on the development of the instrument and the results of an exploratory factor analysis in a pilot study of 115 working adults. A further study with 278 working adults provided evidence for construct and incremental validity. Relationships with meaning in life, mental health, job satisfaction, socio-moral climate, burnout and work as meaning were investigated. Confirmatory factor analysis supported the factor structure. Gender-specific analyses of the four facets of meaning's differential predictive power provided additional insights. Practical implications and further research needs are discussed.