Posttraumatic growth, health-related quality of life and subjective happiness among Great East Japan Earthquake survivors attending a community knitting program to perform acts of kindness


Yarn Alive (YA) is a non-profit organization that was started after the 2011 Great East JapanEarthquake to support women through a knitting group that provided social support, creativeexpression, and opportunities to practice acts of kindness. In this study, we examined whetherYA changed the level of posttraumatic growth (PTG), health-related quality of life (HRQOL),and subjective happiness as measured by the subjective happiness scale (SHS). We conducteda retrospective correlational study through administering a cross-sectional survey to 98 YAparticipants and 97 YA non-participants in May-July 2017. Questionnaires were received from72 YA participants (response rate=73.5%) and 63 non-participants (response rate=64.9%).Data was analyzed by conducting descriptive, correlational, and multiple linear regressionanalyses. Participation in the YA program was shown to have a positive impact on HRQOL(R2=.18, adjusted R2=.15, p<.0001) and SHS (R2=.07, adjusted R2=.05, p=.013), which ispositively correlated with time. Participants with a high school education or less seemed tobenefit more from the program than those with at least a college or university degree (R2=.18,adjusted R2=.15, p<.0001). We also found the spiritual domain of PTG to be higher amongYA participants (t=2.9, p=.004) and overall PTG to be positively associated with incrementalimpact experienced during the disaster (R2=.12, adjusted R2=.11, p<.0001). This study showsthat formal academia-led evaluation of grassroots community programs can yield informationthat may help direct resources to the most appropriate and acceptable programs by thecommunity and strengthen their implementation.

DOI Code: 10.1285/i24212113v7i2p39

Keywords: Great East Japan Earthquake; Posttraumatic Growth; Quality of Life; Subjective Happiness; Participatory Research; Behavioral science.


Abd El-Sallam, A.A, Kayhan, S, & Zoubir, A.M. (2003). Bootstrap and backward elimination based approaches for model selection. 1, 152-157, Vol.1. Rome, Italy, Proc. 4th IEEE Workshop on Signal Processing Advances in Wireless Communications.

Aknin, L.B., Hamlin, J.K., Dunn, E.W. (2012). Giving leads to happiness in young children. PLoS One, 7(6), e39211.

Amrhein, V., Greeland, S., & McShane, B. (2019). Retire statistical significance. Nature, 567, 305-307.

Bekele, T., Rourke, S.B., Tucker, R., Greene S., Sobota, M., Koornstra, J., Monette, J., Rueda, S., Bacon, J., Watson, J., Hwang, S.W., Dunn, J., Guenter, D., & The Positive Spaces Healthy Places Team. (2013). Direct and indirect effects of perceived social support on health-related quality of life in persons living with HIV/AIDS. AIDS Care, 25(3), 337-346.

Burt, E.L., & Atkinson, J. (2012). The relationship between quilting and well-being. Journal of Public Health, 34(1), 54-9.

Cabinet Office of Government of Japan. (2013). White book of aging society.

Cadell, S., Regehr, C., & Hemsworth, D. (2003). Factors contributing to posttraumatic growth: a proposed structural equation model. The American Journal of Orthopsychiatry, 73(3), 279-87.

Calhoun, L. G., & Tedeschi, R. G. (1996). Post traumatic growth inventory. Center for Care Innovations.

Calhoun. L.G., Tedeschi. R.G., Cann. A., & Hanks. E.A. (2010). Positive outcomes following bereavement: paths to posttraumatic growth. Psychologica Belgica, 50(1&2), 125-43.

Cann, A., Calhoun, L.G., Tedeschi, R.G., Kilmer, R.P., Gil-Rivas, V., Vishnevsky, T., & Danhauer, S.C. (2010). The Core Beliefs Inventory: A brief measure of disruption in the assumptive world. Anxiety, Stress, and Coping, 23(1), 19-34.

Chapman, B., Duberstein, P., & Lyness, J.M. (2007). Personality traits, education, and health-related quality of life among older adult primary care patients. Journal of Gerontology: Psychological Sciences, 62B(6), 343–352. 10.1093/geronb/62.6.p343.

Centers for Disease Control and Prevention. (1999). Framework for program evaluation in public health. MMWR 48(No. RR-11).

Colville, G., & Cream, P. (2009). Posttraumatic growth in parents after a child’s admission to intensive care: Maybe Nietzsche was right? Intensive Care Medicine, 35, 919–923.

Coppock, D. L. (2016). Cast off the shackles of academia! Use participatory approaches to tackle real-world problems with underserved populations. Rangelands, 38(1), 5-13.

Harada, N., Shigemura, J., Tanichi, M., Kawaida, K., Takahashi, S., & Yasukata, K. (2015). Mental health and psychological impacts from the 2011 Great East Japan Earthquake Disaster: A systematic literature review. Disaster and Military Medicine, 1, 17.

Hébert, J.R., Adams, S.A., Ureda, J.R., Young, V.M., Brandt, H.M., Heiney, S.P., …& Friedman, D.B. (2018). Accelerating research collaborations between academia and federally qualified health centers: Suggestions shaped by history. Public Health Reports (1974), 133(1), 22-28.

Horswill, S.C., Desgagné, G., Parkerson, H.A., Carleton, R.N., & Asmundson, G.J.G. (2016). A psychometric evaluation of hierarchical and oblique versions of five variants of the Posttraumatic Growth Inventory. Psychiatry Research, 246, 438-446.

Ibañez, G.E., Khatchikian, N., Buck, C.A., Weisshaar, D.L., Abush‐Kirsh., T., Lavizzo, E.A, & Norris, F.H. (2003). Qualitative analysis of social support and conflict among Mexican and Mexican-American disaster survivors. Journal of Community Psychology, 31(1), 1-23.

Japan Geological Society. (2011). Report of earthquake and tsunami after disaster.

Khachadourian, V., Armenian, H.K., Demirchyan, A., & Goenjian, A. (2015). Loss and psychosocial factors as determinants of quality of life in a cohort of earthquake survivors. Health and Quality of Life Outcomes, 13(1), 13.

Lamont, A., & Ranaweera, N.A. (2019). Knit one, play one: comparing the effects of amateur knitting and amateur music participation on happiness and well-being. Applied Research in Quality Life.

Lau, F. (2017). Methods for correlational studies. In C. Kuziemsky (Ed.), Handbook of health evaluation: An evidence-based approach [Internet]. University of Victoria.

Lyubomirsky, S. (1999). Subjective happiness scale.

Lyubomirsky, S., Boehm, J.K., Kasri, F & Zehm, K. (2011). The cognitive and hedonic costs of dwelling on achievement-related negative experiences. Emotion (Washington, D.C.), 11(5), 1152-1167.

Lyubomirsky, S., & Lepper, H.S. (1999). A measure of subjective happiness: Preliminary reliability and construct validation. Social Indicators Research, 46(2), 137-55.

Miyagi Prefecture Earthquake and Recovery Division. (2017). Chapter 1: Great East Japan Earthquake overview.

National Police Agency of Japan. (2017). Damage situation and police countermeasures associated with 2011 Tohoku district-off the Pacific Ocean earthquake.

Noble W.S. (2009). How does multiple testing correction work? Nature biotechnology, 27(12), 1135–1137.

O'Connell, K.A., & Skevington, S.M. (2005). The relevance of spirituality, religion and personal beliefs to health‐related quality of life: Themes from focus groups in Britain. British Journal of Health Psychology, 10(3), 379-398.

Otake, K., Shimai, S., Tanaka-Matsumi, J., Otsui, K., & Fredrickson, B. (2006). Happy people become happier through kindness: A counting kindness intervention. Journal of Happiness Studies, 7(3), 361–375.

Painter, J.M., Gray, K., McGinn, M.M., Mostoufi, S., & Hoerster, K.D. (2016). The relationships of posttraumatic stress disorder and depression symptoms with health-related quality of life and the role of social support among Veterans. Quality of Life Research, 25, 2657–2667.

Riley, J., Corkhill, B., & Morris, C. (2013). The benefits of knitting for personal and social well-being in adulthood: Findings from an international survey. British Journal of Occupational Therapy, 76(2), 50-7.

Schultz, J.M., Benjamin, B.A., & Altmaier, E.M. (2010). Pathways to posttraumatic growth: The contributions of forgiveness and importance of religion and spirituality. Psychology of Religion and Spirituality, 2(2), 104-114.

Shakespeare-Finch, J., & Barrington, A. (2012). Behavioural changes add validity to the construct of posttraumatic growth. Journal of Traumatic Stress, 25, 433–439.

Shaw, A., Joseph, S., & Linley, P.A. (2005). Religion, spirituality, and posttraumatic growth: A systematic review. Mental Health, Religion & Culture, 8(1), 1-11.

Shimai, S., Otake, K., Utsuki, N., Ikemi, A., & Lyubomirsky, S. (2004). Development of a Japanese version of the Subjective Happiness Scale (SHS), and examination of its validity and reliability. [Nihon koshu eisei zasshi] Japanese Journal of Public Health, 51(10), 845-53.

Shimbo, T., Goto, M., Morimoto, T., Hira, K., Takemura, M., Matsui, K., Yoshida, A., & Fukui, T. (2004). Association between patient education and health-related quality of life in patients with Parkinson’s disease. Quality of Life Research, 13, 81-89.

Stewart, J., Swartz, L., & Ward, C. (2012). The personal politics of disaster: Narratives of survivors of a South African shanty town fire. Journal of Community Psychology, 40(4), 422-437.

Taku. K., Cann. A., Tedeschi. R.G., & Calhoun. L.G. (2015). Core beliefs shaken by an earthquake correlate with posttraumatic growth. Psychological Trauma: Theory, Research, Practice and Policy, 7(6), 563-9. https.//

Taku. K., Calhoun. L. G., Tedeschi, R. G., Gil-Rivas V, Kilmer, R.P., & Cann A. (2007). Examining posttraumatic growth among Japanese university students. Journal of Anxiety Stress and Coping, 20(4), 353-367.

Taku, K., Tedeschi, R. G., Cann, A., & Calhoun, L.G. (2009). The culture of disclosure: Effects of perceived reactions to disclosure on posttraumatic growth and distress in Japan. Journal of Social and Clinical Psychology, 29(10), 1226-1243.

Tedeschi, R.G., & Calhoun, L.G. (1995). Trauma and transformation: Growing in the aftermath of suffering. Sage.

Tedeschi, R.G., & Calhoun, L.G. (1996). The posttraumatic growth inventory: measuring the positive legacy of trauma. Journal of Traumatic Stress, 9(3), 455-71.

Tedeschi, R.G., & Calhoun, L.G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 1–18.

Tokuda, Y., Okubo, T., Ohde, S., Jacobs, J., Takahashi, O., Omata, F., Yanai, H., Hinohara, S., & Fukui, T. (2009). Assessing items on the SF-8 Japanese version for health-related quality of life: a psychometric analysis based on the nominal categories model of item response theory. Value in Health: The Journal of the International Society for Pharmacoeconomics and Outcomes Research, 12(4), 568-73.

Tomita, M., Takahashi, M., Tagaya, N., Kakuta, M., Kai, I., & Muto, T. (2017). Structural equation modeling of the relationship between posttraumatic growth and psychosocial factors in women with breast cancer. Psycho-oncology, 26(8), 1198-1204.

Ware, J.E., & Sherbourne, C.D. (1992). The MOS 36-Item Short-Form Health Survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30(6), 473-83.

Ware, J., Snow, K., Kosinski, M., Gandek, B., & New England Medical Center Hospital. Health Institute. (1993). SF-36 health survey: Manual and interpretation guide. The Health Institute, New England Medical Center.

Ware, J.E., Kosinski, M., Dewey, J.E., & Gandek, B. (2001). How to score and interpret single-item health status measures: A manual for users of the sf-8 health survey. Quality Metric Inc.

Yamazaki, M., Minami, Y., Sasaki, H., & Sumi, M. (2011). The psychosocial response to the 2011 Tohoku earthquake. Bulletin of the World Health Organization, 1(89), 9-623.

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