This project uses community-based participatory research (CBPR) to examine the pathways of active living toward recovery and the promotion of health and life quality for urban-dwelling culturally diverse groups of people with mental illness (CDGPMI). Our pre-application community-based work has led to a formal partnership agreement with various community partners representing mental health advocacy, mental health care and research, and mental health policy-making at local, regional, or national levels. Based on the CBPR principle, we will maintain: (a) mutual respect and trust;(b) team-work and equitable participation;(c) co- learning and collective capacity-building;(d) power-sharing and co-ownership of research;(e) a community- oriented bottom-up approach (rather than a top/university-down approach);(f) the integration and synthesis of expertise and resources of CBPR team members;(g) the sustainable development of partnership;(h) a trans- disciplinary and cross-domain approach that overrides the academic-community-practice boundaries;and (i) collective empowerment and proactive actions toward social change. This partnership, along with our Advisory Council including other stakeholders (e.g., culture and mental health advocates), will guide our team to conduct mixed-method studies. First, we will conduct a pilot survey study with CDGPMI (n = 112) to collect preliminary baseline data on the association of leisure behavior (as a context for active living) with recovery, health, and life quality. Then, we will conduct an in-depth multiple case study, using periodical interviews and photovoice with African, Hispanic, Asian, and Caucasian Americans with mental illness (n = 40) who are purposefully chosen based on the survey study findings. This case study will give voices to those individuals about recovery-oriented health and life-quality promotion through active living (with emphasis on actively engaged leisure) from a holistic and ecological perspective, by recognizing cultural, environmental, and mental health care factors, as well as secondary conditions (e.g., social isolation, obesity). Interviews with primary support/care-givers for these individuals will also be conducted to gain additional outsider perspectives. The case-study findings will guide us to develop a CBPR-informed and evidence-based conceptual framework that identifies key personal, social, cultural, and environmental (including mental health care systems) pathways through which active living mediates the processes toward recovery and the promotion of health and life quality for CDGPMI (particularly, through enjoyable and meaningful leisure behavior). This R21 project will lead to our R01 to develop and test/evaluate a recovery-focused active-living and health/life-quality-promotion intervention program for CDGPMI. Our overall research program is relevant to the National Institute of Mental Health (NIMH)'s mission to reduce the burden of mental illness through improving health behaviors and daily functioning of persons with mental disorders (with emphasis on active living and its role in promoting recovery, health, and life quality), and deliver more effective personalized mental health care across diverse populations.

Public Health Relevance

A major contribution of this research is that the project will generate rich and in-depth data/evidence from a culturally diverse sample of urban-dwelling individuals with mental illness based on their lived experiences and perspectives to better conceptualize the roles of active living (particularly, active leisure involvements) in the processes toward their recovery and the promotion of health and life quality. This new data/evidence will extend and advance the existing knowledge in the literature about recovery and health/life-quality promotion among individuals with mental illness by better articulating the mediating roles of active living in the pathways toward recovery-oriented health/life-quality promotion. Importantly, our overall research program links and integrates the domain of recovery and mental health/illness research with the domain of active living and health/life-quality promotion research conceptually, methodologically, and practically. The knowledge/evidence generated from our research will be translated to person-centered, holistic, and strengths-based mental health care practices in communities through the form of a recovery-focused active-living, health-promotion, and life- quality-enhancement intervention program.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Exploratory/Developmental Grants (R21)
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Community Influences on Health Behavior (CIHB)
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Juliano-Bult, Denise M
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Temple University
Schools of Allied Health Profes
United States
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Iwasaki, Yoshitaka; Coyle, Catherine P; Shank, John W (2010) Leisure as a context for active living, recovery, health and life quality for persons with mental illness in a global context. Health Promot Int 25:483-94