Effects of the Color Narrative Preventive Intervention Using Occupational Storytelling: A Randomized Controlled Trial

Enhancing purpose in life is vital in cognitive interventions for older adults, yet its application in occupational therapy remains limited.

To evaluate the effectiveness of the occupation-focused Color Narrative program compared with common Japanese community-based preventive care.

Randomized controlled trial.

Community centers.

Community-dwelling older adults (N = 44).

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).

Primary outcomes included cognitive function (Mini-Mental State Examination- Japanese version [MMSE-J]) 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-Short Form), functional status (FRAIL Scale, Frenchay Activities Index, 12-item Short-Form Health Survey).

A two-way analysis of variance showed significant interactions for MMSE-J, F(1.76, 73.89) = 4.531, p = .017, η2p = .097, and LET, F(1.56, 58.78) = 8.743, p = .001, η2p = .172. Post hoc tests revealed declined and stable MMSE-J scores in the control and intervention groups, respectively (corrected p = .031, Cohen's d = 0.80). LET scores increased in the intervention group (corrected p = .041, Cohen's d = 0.78).

The Color Narrative program enhanced purpose and prevented cognitive decline, highlighting the significance of occupational therapy in preventive care. Plain-Language Summary: This study investigated the impact of the Color Narrative program on improving cognitive health and a sense of purpose in life among older adults. The program included group-based storytelling using 100 color cards as visual prompts, personalized goal setting, and independent engagement in meaningful occupations over 3 mo, followed by a group reflection session. Compared with individuals who participated in a standard community-based health education and recreation program, the participants in this program maintained cognitive function and reported an increased sense of purpose. The findings revealed the significance of maintaining cognitive function and purpose in life in improving older adults' overall well-being. These findings highlight the unique role of occupational therapy, especially the Color Narrative program, in promoting preventive care and supporting healthy aging within communities.