title: A qualitative study of high level wellness, health and happiness
Creators: name: Allen, Connie
Publisher: name: Griffith University
Year: 2017
Subjects: subject: High level wellness
subject: Experiential learning
subject: Health and happiness
subject: Salutogenic health promotion

description: The World Health Organization (1946/2006) recognises that everyone has the right to enjoy the highest possible standard of physical, mental and social wellbeing (high level wellness, health and happiness), regardless of their socioeconomic circumstances, ethnicity or beliefs. Decades of research have provided a good understanding of the factors that facilitate high level wellness, including healthy food, physical activity, supportive relationships and equitable access to money, power and resources (Commission on Social Determinants of Health, 2008; Donaldson, Dollwet, &amp; Rao, 2015; World Health Organization, 2015b, 2017a). However, relatively few people appear to be flourishing (Huppert &amp; So, 2013; Keyes &amp; Simoes, 2012), suggesting that this growing body of knowledge on wellness determinants has not translated into ‘high level wellness for all’. Qualitative research on the lived experience of high level wellness could complement existing initiatives, by providing new perspectives on what this way of being is, and how people attain and maintain it. This information could benefit a range of audiences, including people who have not experienced high level wellness first hand, or known anyone who has. This study aimed to provide a new understanding of high level wellness, based on interviews with 25 Australian adults. It focused on two research questions: (1) ‘What is high level wellness?’, and (2) ‘How do people attain and maintain this way of being?’ Participants were recruited via traditional and social media (i.e., newspapers, radio, television, Facebook, Linked In, Twitter and email). These people were over the age of 18, lived in South East Queensland (Australia), and reported a high (or very high) level of ‘wellness’, ‘health’ and ‘happiness’. The 20 female participants ranged from 25 to 65 years of age (M=43.6), whereas the five males were aged between 41 and 60 (M=53.4). Participants lived in Brisbane (n=14), Gold Coast (n=7), Logan (n=2), Ipswich (n=1) and the Sunshine Coast (n=1). Household income levels were described as low (n=7), medium (n=12) and high (n=4), with two participants not disclosing this information. Intensive, semi-structured interviews were used to generate rich, qualitative data. Each participant was provided with an opportunity to discuss their understanding of high level wellness (including what types of words they used to describe it), their wellness journeys, what helped (and what made it harder), how they were similar to (and different from) less healthy happy people, and how others could become more healthy and happy. They also reflected on the type of day that made them feel particularly healthy and happy, and the type of day that did not. Follow up questions were used to elicit more information, and participants were asked to comment on data patterns after providing their own responses. Each of the interviews lasted between 35 and 259 minutes (M=84 minutes). They were audio-recorded with participant consent, and transcribed into 470 pages (300,000 words) of data. Pseudonyms were used to conceal participant identities. The data collection and analysis process was informed by Charmaz’ (2014) constructivist grounded theory method. Grounded theory methods provide “systematic, yet flexible guidelines” to enable researchers to develop theories directly from qualitative data (Charmaz, 2014, p. 1). Constructivist grounded theorists tend to focus on ‘what’, ‘how’ and ‘why’ questions to develop an abstract understanding (theory) of a phenomenon from interview transcripts (Charmaz, 2008, 2014, 2017a). The data collected in this study was analysed in three phases. Phase one began while the interviews were being conducted by: (1) undertaking initial coding, (2) comparing data, codes, categories and category properties in memos, and (3) exploring data patterns with participants. The second phase returned to the two research questions; developing a summary of each person’s wellness journey, recoding the data to identify information that might help to explain what high level wellness is, and crafting this information into a potentially generalisable definition. This was followed by selective codes and memos on several steps in a circular experiential learning process, as a way of testing tentative hypotheses about the data (abductive reasoning). This led to the development of a theoretical process and model. Phase three enabled participants to provide feedback on their wellness journey summaries (n=24 respondents) and the wellness theory (definition, process and model) developed from their data (n=7 respondents). Participants suggested that the theory reflected their experiences (resonance), and had the potential to help less healthy, happy people (usefulness); confirming two of Charmaz’ four grounded theory criteria (the others are originality and credibility). Participants also provided ideas for improvement, which were incorporated into the process, model and journeys. This research process suggested that high level wellness is the sense of peace (wellbeing) that comes from knowing, liking and being one's best self. Tuning into the presence or absence of this sensation prompts some people to move towards the people, places, perceptions and practices that align with their needs, values, energisers, strengths and joys; away from those that do not. There are three steps in this circular experiential learning process: (1) assessing the situation, (2) trying an action and reviewing the consequences, and (3) integrating lessons. This self-initiated learning process requires self-commitment, reflection on inner and outer circumstances (presence and awareness), and the ability to become one’s best (not perfect) self—including access to relevant resources (e.g., social support). People can initiate many learning cycles throughout their lives, in relation to a wide range of factors. Over time, this can result in the adoption of several qualities and actions, which people express in their own unique ways (e.g., spending time with positive people and/or pets, doing something of value for themselves and others, finding a way of eating and moving that works for them, and not taking themselves too seriously). People start becoming what they perceive to be the best version of themselves, feel at peace, and flourish; while staying open to new opportunities to grow. This process of becoming one’s best self through experiential learning was labelled an ‘experiential learning theory of high level wellness’ in this dissertation. For the purposes of this study, theory is defined as a statement of relationships between abstract concepts; one of many possible ways of understanding a phenomenon (Charmaz, 2014). The theoretical assertions described in this dissertation are partial, conditional and contextual, situated in a particular place and time, in line with the nature of constructivist grounded theory studies (Charmaz, 2014). They also appear to be resonant, useful, original and credible, addressing Charmaz’ (2014) four grounded theory criteria. It is important to note that constructivist grounded theory studies do not aspire to explain, predict, measure or control people’s behaviour—they just articulate one way of understanding an experience (in this case, high level wellness), based on the researcher’s interpretation of participant data (Charmaz, 2014). The data-based (substantive) theory articulated in this dissertation connects existing concepts (e.g., self-actualisation and eudaimonic wellbeing) to a novel conceptualisation of experiential learning, and a quiet sense of peace as an inner compass. Additional studies could determine whether this understanding of high level wellness holds true within other populations and contexts (i.e., whether this substantive theory could become a formal theory). One way of doing this would be to: (1) sample for other people who self-identify as having a high (or very high) level of wellness, health and happiness, (2) follow the same interview guide, and (3) use this theory as an analytical framework, while staying open to new possibilities. Researchers and practitioners could also explore practical applications of this high level wellness theory by helping individuals and communities to design, implement and evaluate their own experiential learning processes, accompanied by broader efforts to ensure that everyone can access relevant resources (e.g., liveable incomes, affordable housing, services and so forth). These initiatives could be underpinned by ‘holistic, ecological, salutogenic health promotion’ principles and values (Gregg &amp; O'Hara, 2007) and empowering, participatory facilitation frameworks, such as action research (Stringer, 2014) and positive deviance (Herington &amp; van de Fliert, 2017). This dissertation describes the high level wellness theory developed in this study, including links to relevant data and literature.