Strengthening sense of coherence: Evidence from a physical activity intervention targeting vulnerable adults

Sense of coherence (SOC), a concept that refers to individuals’ abilities to manage, comprehend, and find meaning in their lives and the world around them, has been shown to be an important predictor of health outcomes. While SOC was initially hypothesized to be static after early-adulthood, there is growing evidence that health interventions can strengthen SOC. In this study, we accordingly examined whether SOC could be strengthened among adults in the context of a physical activity intervention. This intervention, Communities on the Move, was conducted in the Netherlands, and was primarily targeted at older adults from socially vulnerable backgrounds. Four cohorts were followed for 18 months each, between 2012 and 2016. The SOC-3 questionnaire was used to collect data on SOC at baseline (T(0)) and after eighteen months (T(3)), with information on 117 participants in both of these waves. To assess the change in SOC between T(0) and T(3), ordered logistic regressions were performed, as well as mixed ordered logistic regressions with random intercepts for group and program location. This study found evidence that SOC significantly changed from T(0) to T(3). Participants with weak SOC at baseline reported a median one-point stronger SOC at T(3) (on a 6-point scale), while those with moderate or strong SOC at baseline reported a median change of zero points between T(0) and T(3). Further, based on the results of the regression analyses, those with weaker SOC scores were most likely to have stronger SOC at T(3): having a weak SOC at baseline was associated with a 76% probability of stronger SOC, and a 4% probability of weaker SOC at T(3). These results indicated that SOC may be strengthened in vulnerable older adults, particularly when their SOC is initially low.