Laughter and humour interventions for well-being in older adults: A systematic review and intervention classification.

OBJECTIVES: To assess the potential of laughter and humour interventions to increase well-being in a general population of adults aged 60 plus; and to develop a classification to compare approaches and potential benefits of different intervention types. DESIGN: A systematic search of Web of Science, PubMed/MEDLINE, PsychInfo, AMED, and PsychArticles used inclusive terms relating to laughter and humour interventions. A realist synthesis approach enabled heterogeneous interventions to be compared pragmatically. SETTING: Five laughter interventions, and one humour intervention, using one or more outcome related to well-being, were considered for inclusion after screening 178 primary research papers. The five laughter interventions, representing a sample of 369 participants, were retained. MAIN OUTCOME MEASURES: Well-being related outcome measures reported in each intervention informed efficacy; Joanna Briggs Institute tools appraised design; and a realist approach enabled heterogeneous interventions to be measured on their overall potential to provide an evidence base. RESULTS: Well-being related measures demonstrated at least one significant positive effect in all interventions. Confounding factors inherent in the intervention types were observed. Individual participant laughter was not reported. CONCLUSIONS: Laughter and humour interventions appear to enhance well-being. There is insufficient evidence for the potential of laughter itself to increase well-being as interventions contained a range of confounding factors and did not measure participant laughter. Interventions that isolate, track, and measure the parameters of individual laughter are recommended to build evidence for these potentially attractive and low-risk interventions. The classification proposed may guide the development of both evidence-oriented and population-appropriate intervention designs.

Integrating user perspectives into the development of a web-based weight management intervention.

The objective of this study was to adapt the design of our weight management intervention to the needs, expectations and capabilities of potential users. In study 1, we interviewed 25 people about their experiences of weight management. The findings of these interviews were combined with findings from existing theory and research in a process of 'intervention planning' that informed the design of the intervention. Study 2 comprised in-depth think-aloud studies with a further 16 people interested in using a web-based intervention to manage their weight, in order to elicit reactions to the intervention techniques and materials. In study 1, overly intrusive and restrictive aspects of eating self-regulation were commonly cited reasons for failure to maintain weight management long-term. We therefore designed an intervention with a more flexible approach to autonomous self-regulation. This approach was broadly welcomed in study 2, but there were indications that some participants might have difficulty effectively implementing self-regulation techniques independently. A flexible and autonomous approach to changing eating habits is attractive to potential intervention users but may be difficult for some users to implement successfully.

A synthesis of qualitative research on overweight and obese people's views and experiences of weight management.

The effectiveness of existing weight management programmes may be improved by understanding overweight and obese people's perceptions of the reasons for successful and unsuccessful weight management. Many qualitative studies have investigated overweight and obese adults' experiences with weight management. This paper presents findings of a meta-ethnography that synthesized 17 qualitative studies of overweight and obese adults' weight management experiences, principally in the context of behavioural weight management programmes. Twelve themes were derived describing factors that overweight and obese people identify as relevant to weight management: health concerns, expectations towards weight management, attributions for weight gain, psychological barriers, psychological facilitators, self-perception and body image, stigmatization, socio-cultural factors, environmental barriers, environmental facilitators, experiences with weight management programmes and positive outcomes of programme participation. Interventions that address all of the modifiable factors identified in this review are likely to appear credible to participants and will engage with the intra- and extra-individual factors that they perceive as affecting their weight management efforts.