{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T07:31:27Z","timestamp":1786692687545,"version":"build-2736575974"},"reference-count":36,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["American Journal of Occupational Therapy"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Importance:<\/jats:title>\n                    <jats:p>Enhancing purpose in life is vital in cognitive interventions for older adults, yet its application in occupational therapy remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the effectiveness of the occupation-focused Color Narrative program compared with common Japanese community-based preventive care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Randomized controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Community centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>\n                      Community-dwelling older adults (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u200944).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention:<\/jats:title>\n                    <jats:p>The Color Narrative program included group-based storytelling using 100 color cards as prompts (90 min), independent engagement in meaningful occupations (3 mo), and group reflection (90 min). Control participants attended health education and group recreational activities (90 min each).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes and Measures:<\/jats:title>\n                    <jats:p>Primary outcomes included cognitive function (Mini-Mental State Examination\u2013 Japanese version [MMSE\u2013J]) and purpose in life (Life Engagement Test [LET]). Secondary outcomes included domain-specific cognitive functions (Digit Span, Tapping Span, Symbol Search, Wisconsin Card Sorting Test), meaning in life (Meaning in Life Questionnaire\u2013Short Form), functional status (FRAIL Scale, Frenchay Activities Index, 12-item Short-Form Health Survey).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A two-way analysis of variance showed significant interactions for MMSE\u2013J,\n                      <jats:italic toggle=\"yes\">F<\/jats:italic>\n                      (1.76, 73.89)\u2009=\u20094.531,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.017, \u03b7\n                      <jats:sup>2<\/jats:sup>\n                      <jats:sub>p\u2009<\/jats:sub>\n                      = .097, and LET,\n                      <jats:italic toggle=\"yes\">F<\/jats:italic>\n                      (1.56, 58.78)\u2009=\u20098.743,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.001, \u03b7\n                      <jats:sup>2<\/jats:sup>\n                      <jats:sub>p\u2009<\/jats:sub>\n                      = .172. Post hoc tests revealed declined and stable MMSE\u2013J scores in the control and intervention groups, respectively (corrected\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.031, Cohen\u2019s\n                      <jats:italic toggle=\"yes\">d\u2009=\u2009<\/jats:italic>\n                      0.80). LET scores increased in the intervention group (corrected\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.041, Cohen\u2019s\n                      <jats:italic toggle=\"yes\">d\u2009=\u2009<\/jats:italic>\n                      0.78).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance:<\/jats:title>\n                    <jats:p>The Color Narrative program enhanced purpose and prevented cognitive decline, highlighting the significance of occupational therapy in preventive care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5014\/ajot.2026.051262","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T16:13:48Z","timestamp":1770740028000},"page":"205-214","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of the Color Narrative Preventive Intervention Using Occupational Storytelling: A Randomized Controlled Trial"],"prefix":"10.1177","volume":"80","author":[{"given":"Risa","family":"Takashima","sequence":"first","affiliation":[{"name":"Risa Takashima, PhD, OT, is Lecturer, Faculty of Health Sciences, Department of Rehabilitation Sciences, Hokkaido University, Sapporo, Hokkaido, Japan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Sawamura","sequence":"additional","affiliation":[{"name":"Daisuke Sawamura, PhD, OT, is Professor, Department of Rehabilitation Sciences, Hokkaido University, Sapporo, Hokkaido, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Yuko Yoshida, PhD, RN, is Lecturer, Department of Nursing, Sapporo University of Health Sciences, Sapporo, Hokkaido, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Yun","sequence":"additional","affiliation":[{"name":"Shan Yun, PhD, is Research Fellow, Department of Rehabilitation Sciences, Hokkaido University, Sapporo, Hokkaido, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Walder","sequence":"additional","affiliation":[{"name":"Kim Walder, PhD, OT, is Lecturer, School of Allied Health, Sport and Social Work, Griffith University, Brisbane, Queensland, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari","family":"Sakaue","sequence":"additional","affiliation":[{"name":"Mari Sakaue, PhD, OT, is Associate Professor, School of Health Sciences, Sapporo Medical University, Sapporo, Hokkaido, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.4270"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2009.208"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.1487"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2021.05.007"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.5014\/ajot.2015.014894"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.5014\/ajot.47.12.1067"},{"key":"e_1_3_2_8_1","first-page":"373","volume-title":"Occupational science: The evolving discipline","author":"Clark F.","year":"1996","unstructured":"Clark F., Larsson E. 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