@article {KIM2020101200, title = {How does art making work? Testing the hypothesized mechanisms of art making on pain experience}, journal = {Complementary Therapies in Clinical Practice}, volume = {40}, year = {2020}, abstract = {Background and purpose: Pain is a multidimensional experience that requires a holistic pain management approach. Art making, a holistic, mind-body-spirit approach, has been used as a pain management strategy. Although findings of empirical studies point toward several potential mechanisms through which art making activity may affect the pain experience, these mechanisms have not yet been tested. Therefore, the purpose of this study is to evaluate whether perceived control, self-efficacy, spirituality, and mood mediate the effect of art making activity on pain. Materials and methods This study is a secondary analysis of cross-sectional survey data collected in 2014 for the Health and Retirement Study (HRS). Data from a national sample of 731 adults, 50 years of age or older were analyzed for the current study. Participants completed a health survey which included measures of art engagement (representing {\textquoteleft}effect of art making{\textquoteright} in this study), pain severity and interference, and proposed mediating variables (e.g., perceived control, self-efficacy, spirituality and mood). The joint significance test was used to test hypothesized mediation. Result We found that positive mood mediated the effects of art engagement on pain, but perceived control, self-efficacy, spirituality, and negative mood did not. Engagement in art making activity was associated with more positive mood (β = 0.213, p = .001). In turn, greater positive mood was associated with lower pain severity (β = -.147, p = .010) and pain interference (β = -.519, p = .034). Conclusion Results of this study provide preliminary evidence that engagement in art making activity impacts pain experience by enhancing positive mood. A large prospective study examining the hypothesized mediating relationship is necessary to confirm our findings.}, keywords = {Art making, Holistic health, pain}, issn = {1744-3881}, doi = {10.1016/j.ctcp.2020.101200}, author = {Kyung Soo Kim and Kristine L Kwekkeboom and Jee-Seon Kim} }