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Healthy lifestyle is important to decrease health risks in individuals living with chronic pain. From an occupational therapy perspective, human health and lifestyle are linked to occupational engagement in meaningful everyday activities. This study is aimed at investigating the effect of including occupational engagement in chronic pain interventions on lifestyle. Methods. In this systematic review (PROSPERO reg. CRD42020159279), we included randomized controlled trials (RCTs) on interventions involving occupational engagement (i.e., occupational performance based on involvement, choice, positive meaning, and commitment) and assessing modifiable lifestyle factors: physical activity, body anthropometrics, alcohol consumption, smoking, stress, and sleep. We sought the databases Ovid MEDLINE, Embase, PsycINFO, CINAHL, Cochrane, Scopus, Web of Science, OTseeker, ClinicalTrials.gov, OpenGrey, and the web engine Google Scholar and citations and references of relevant publications. We evaluated methodological quality with the Cochrane risk-of-bias tool 2.0, determined the overall evidence certainty using the GRADE methodology, and performed meta-analysis when two or more trials reported on the outcomes. Results. Of the 9526 items identified, 286 were full text screened. We included twelve articles with eleven RCTs comprising 995 adults and assessing physical activity, sleep quality, stress, and Body Mass Index. Sufficient data for meta-analysis was only available for physical activity and sleep quality. The meta-analysis suggested a moderate increase in physical activity after behavioral interventions for fibromyalgia and musculoskeletal pain (<jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mtext>SMD<\/a:mtext>\n                        <a:mo>=<\/a:mo>\n                        <a:mn>0.69<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula> (0.29; 1.09)) and a small increase in sleep quality up to 6 months after multidisciplinary self-management of fibromyalgia (<jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mtext>SMD<\/c:mtext>\n                        <c:mo>=<\/c:mo>\n                        <c:mn>0.35<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula> (95% CI 0.08; 0.61)). The overall certainty of the evidence was deemed low. Conclusion. Including occupational engagement in chronic pain interventions may increase short-term physical activity and long-term sleep quality. Due to the few available RCTs including occupational engagement in chronic pain treatment for adults living with chronic pain, further high-quality RCTs are needed and will likely change the conclusion.<\/jats:p>","DOI":"10.1155\/2022\/7082159","type":"journal-article","created":{"date-parts":[[2022,6,14]],"date-time":"2022-06-14T01:35:10Z","timestamp":1655170510000},"page":"1-15","source":"Crossref","is-referenced-by-count":10,"title":["The Effect of Occupational Engagement on Lifestyle in Adults Living with Chronic Pain: A Systematic Review and Meta-analysis"],"prefix":"10.1155","volume":"2022","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3694-4236","authenticated-orcid":true,"given":"Svetlana Solgaard","family":"Nielsen","sequence":"first","affiliation":[{"name":"Research Unit for User Perspectives, Department of Public Health, University of Southern Denmark, J. B. Winsloews Vej 9B, 5000 Odense C, Denmark"},{"name":"The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, N\u00e6stved-Slagelse-Ringsted Hospitals, Region Zealand, Faelledvej 2C, 4200 Slagelse, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4336-7059","authenticated-orcid":true,"given":"S\u00f8ren T.","family":"Skou","sequence":"additional","affiliation":[{"name":"The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, N\u00e6stved-Slagelse-Ringsted Hospitals, Region Zealand, Faelledvej 2C, 4200 Slagelse, Denmark"},{"name":"Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1395-4156","authenticated-orcid":true,"given":"Anette Enemark","family":"Larsen","sequence":"additional","affiliation":[{"name":"Department of Therapy and Midwifery Studies, Faculty of Health Sciences, University College Copenhagen, Sigurdsgade 26, 2200 Copenhagen N, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9717-918X","authenticated-orcid":true,"given":"Alessio","family":"Bricca","sequence":"additional","affiliation":[{"name":"The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, N\u00e6stved-Slagelse-Ringsted Hospitals, Region Zealand, Faelledvej 2C, 4200 Slagelse, Denmark"},{"name":"Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1629-1864","authenticated-orcid":true,"given":"Jens","family":"S\u00f8ndergaard","sequence":"additional","affiliation":[{"name":"Research Unit for General Practice, Department of Public Health, University of Southern Denmark, J. 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