Participation Is Associated With Well-Being Among Community-Based Veterans: An Investigation of Coping Ability, Meaningful Activity, and Social Support as Mediating Mechanisms

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.