The health-promoting potential of creative and social occupations: Proposal for an exploratory study of adults with and without inflammatory arthritis

Over 4.6 million Canadians have arthritis, 60% of whom report disruption in a range of valued life occupations. Yet regular participation in satisfying occupations promotes physical and mental well-being. Physical activity is known to improve health. I posit similar benefits may accrue from engaging in other occupations. According to the Do-Live-Well framework, “what you do everyday matters” and a variety of activities contributes to overall health and well-being (Moll et al., 2015). I propose to study creative and social activities as predictors of health among adults with inflammatory arthritis (IA) and healthy age/sex-matched controls. Recent discoveries in measuring cellular aging allow us to supplement self-reported health with a biological marker: telomere length (TL). Telomeres cap and protect chromosomes. Immune cell aging and poor health are marked by short telomeres, and telomere attrition is observed in chronic health conditions like arthritis due to inflammation (Steer et al., 2007). Physical and meditative activities preserve TL and promote health, possibly due to stress reduction (To-Miles & Backman, 2016). My proposed project asks: Does socializing with others and expressing creativity have similar potential? Purpose: To explore the relationship between social and creative occupations with health and well-being as the first step for future intervention trials. H1: Social and creative activities are associated with health outcomes, controlling for age, sex, BMI, socioeconomic status, and physical activity. H2: Stress is a significant mediator between social and/or creative activities and health. H3: There are significant between-group differences (IA vs healthy controls; male vs female) in the association between activities and health. Methods: A cross-sectional study with a 1-year follow up will be conducted with non-smoking adults, 75 with IA and 75 healthy controls. Health outcomes include TL and self-reported health (SF-36). TL will be measured from saliva samples and analyzed by an external lab with extensive experience in telomere analyses (www.dnagenotek.com). Personal Projects Analysis (Little, 1983) will measure creative and social activity traits. Stress as a potential mediating variable will be measured by the Perceived Stress Scale. A one-year follow-up will allow us to assess the stability of predictor variables, as well as the relationship between activities and health outcomes. 150 participants allow for conservative regression analyses with 15 variables to examine associations between occupations and health measures. Implications: Occupational science draws from diverse perspectives to understand how occupations affect people’s lives. Occupation as a determinant of health is a core assumption in occupational science. Using a biomarker such as telomeres corroborates self-reported health, and is a novel approach that will objectively measure the relationship between meaningful occupations and health. Findings would inform lifestyle recommendations and occupation-based theoretical frameworks for public health (e.g., Do-Live-Well) on promoting occupational participation to advance health and well-being. Keywords: - Biomarker - Well-being - Inflammatory arthritis Questions/objectives for discussion period: This interactive poster discussion invites critical comments on the study and its research design. In addition, I seek to ask the following questions during the discussion period: Can occupational science be advanced using basic science and/or biomarkers, such as telomeres? Do diverse forms of occupations affect health and well-being differently, and if so, how? How should occupational science be used to inform lifestyle recommendations, and what are its limits