Abstract
Natural disasters and aging societies are increasingly prevalent globally. To improve environmental injustice and contribute to social good, the Tzu Chi Recycling Program engages older adult volunteers in recycling usable materials into eco-friendly blankets for disaster survivors. Drawing on life span and ecological systems theories, this study examined the longitudinal effects of this program on older adults’ mental and physical health. Using a quasi-experimental longitudinal design, data were collected from older adults at recycling stations (intervention group, n = 36) and community centers (control group, n = 36) in rural areas in Southern Taiwan. Findings from two-way repeated measures analysis of variance show that the program significantly improved older adults’ self-compassion, compassion for others, depression, hostility, happiness, and hypertension. Older adults built resilience and contributed to environmental sustainability and social good, which suggest a new avenue for social work practitioners and policy-makers to address social and environmental challenges.
Keywords
There is an increasing rate of natural disasters around the world that cause numerous deaths and push many disaster survivors into poverty. In 2017, 96 million people in 122 countries were affected by 318 disasters linked to natural hazards including floods, storms, earthquakes, and drought. More than 9,500 people lost their lives with direct economic losses estimated at $314 billion. Major disaster events worldwide pushed 24 million people into poverty, causing environmental injustice (UN News, 2017; Wallemacq, 2018). The social work profession has emphasized the interdependent relationship between individuals and their environment. Mor Barak’s (2018) theoretical perspective of social good has conceptualized environmental justice as actions aimed at providing clean, healthy, and safe environment for vulnerable populations affected by disasters and environmental degradation. As the “baby boomer” generation ages, a large volunteer pool of retired older adults is available to engage in environmental initiatives and address the severe global issue of environmental injustice. Scholars have pointed out that many older adults wish to make positive contributions that would benefit future generations (Bushway, Dickinson, Stedman, Wagenet, & Weinstein, 2011; Ehlman & Ligon, 2012; Erikson & Erikson, 1997). Civic engagement through environmental volunteerism of older adults has the potential to enrich older volunteers’ lives and benefit the community and the environment (Bushway et al., 2011). The literature suggests substantial benefits for older adults who engage in volunteer activities such as improved physical functioning, self-rated health, and psychological well-being (Greenfield & Marks, 2004; Lum & Lightfoot, 2005; Morrow-Howell, Hinterlong, Rozario, & Tang, 2003).
However, limited empirical studies exist that demonstrate positive effects of environmental volunteering on physical activity, physical health, and psychological well-being among older adults. Older adults seem less likely to get involved in environmental volunteering than younger people (Pillemer et al., 2017). Very few older adults participate in environmental volunteer activities. The rate of environmental volunteerism was much lower among people aged 65 years or older compared to other age groups (Pillemer et al., 2017). A wide variety of barriers prevents older adults from engaging in environmental issues, including insufficient knowledge about environmental issues, lack of awareness of opportunities for environmental stewardship in local communities, lack of access to resources, and incompatibility between models used by environmental organizations and older adults’ needs (Bushway et al., 2011; Howgate, 2008; Pillemer, Fuller-Rowell, Reid, & Wells, 2010). Some environmental volunteer activities such as water quality monitoring or trail cleanup are solitary tasks that lack opportunities for social engagement for older adults (Pillemer et al., 2017). Scholars in the field of aging suggest a strong need for developing environmental volunteering opportunities that are tailored specifically for older adults to accommodate recruiting them to environmental organizations (Bushway et al., 2011; Librett, Yore, Buchner, & Schmid, 2005; Pillemer et al., 2010; Pillemer et al., 2017).
During the past 20 years, many older adults with chronic disease in Taiwan have participated in the Tzu Chi Recycling Program (TCRP) in their local communities to promote environmental protection and sustainable lifestyles (Hsiao, Hsu, Boudreaux, & Ting, 2019). The program is operated through the Buddhist Compassion Relief Tzu Chi Foundation, an international humanitarian organization with more than 10 million members worldwide in 57 countries. The foundation provides services for charity, medical care, education, international disaster relief, bone marrow donation, and environmental sustainability. Responding to a public call to recycle voluntarily, many program participants have donated their homes, garages, and land to build community-based recycling stations in Taiwan (Innovation Seeds, 2016; Tzu Chi Foundation, 2010). Driven by a belief in the interconnections between human lifestyles and the frequency of natural disasters, more than 105,457 local residents with diversity in age, gender, social class, and profession have participated in a TCRP, and 10,752 recycling stations existed globally in 2016 (Taiwan Buddhist Tzu Chi Foundation, 2016). Proceeds derived from the TCRP are used to promote environmental justice or giveback to the community. Recycled plastic bottles are transformed into eco-friendly blankets for international disaster efforts (e.g., 2011 Japan Tsunami, 2012; Thomas Fire), benefiting more than a million disaster survivors globally (DA.AI Technology, 2018). Several studies used either qualitative interviews or observations to explore the effects of the TCRP model. These qualitative findings suggest multilevel effects of the program on individuals’ well-being and family relationships (Her, 2008; Hsiao et al., 2019), particularly positive effects on participants’ physical and mental health. Nevertheless, none of these studies investigated the long-term effects of the program on older environmental volunteers.
Distinguished from science-based environmental programs led by scientific experts (Pillemer et al., 2017), the grassroots and peer-led approach developed by older recycling volunteers may address a wide array of barriers that prevent older adults from engaging in environmental volunteering. TCRP, as a sustainable model characterized by local residents with diversity in age, social class, and profession recycling collectively and voluntarily to support disaster-hit communities and a clean and beautiful planet, exemplifies the proposed social good conceptual framework developed by Mor Barak (2018). To fill this gap in the literature of social work practice and aging, this study used longitudinal data with a quasi-experimental design to examine the effectiveness of the TCRP as an environmental sustainability model in promoting older adults’ physiological and psychological well-being.
Theoretical Background and Literature Review
Life-Span Developmental Theory and Environmental Volunteerism
Life-span developmental theory suggests that older adults desire to engage in activities that improve the world and promote well-being for future generations (Ehlman & Ligon, 2012; Erikson & Erikson, 1997; McAdams, 2006). Generativity has been considered a key factor motivating older adults to make positive contribution to the environment (Ehlman & Ligon, 2012; Erikson & Erikson, 1997; Pillemer et al., 2010). Research has shown that older adults who volunteered felt that they benefited from taking actions to nurture the environment and became connected to create a better world even though they may not live to enjoy the results of their work (Bushway et al., 2011; Pillemer et al., 2017). In the United States, the majority of older adults who volunteer for environmental protection typically engage in preservation of parks, conservation efforts of water and plants, or beautification programs for gardens or landscapes (Bushway et al., 2011). Pillemer et al. (2017) developed the Retirees in Service to the Environment program specifically to recruit older adults for environmental volunteering. Their structured program includes science-based educational sessions taught by experts, promotion of leadership skills and social interaction in the group, and opportunities for hands-on activities. The researchers found that older adults who were new to environmental volunteering had significant improvement in feelings of attachment to others, social support, and generativity (Pillemer et al., 2017).
Wells and Evans (2003) found that access to nature mediates the detrimental effects of stress on psychological distress. Other studies suggested that exposure to nature could improve cognitive function (Berman, Jonides, & Kaplan, 2008). Literature on environmental volunteerism shows that exposure to nature and connection to the outdoors, which includes activities such as cleaning natural areas, testing water stream quality, and restoring habitats, promotes social interaction among older adults and improves cognitive function, self-esteem, stress reduction, and psychological well-being (Miles, Sullivan, & Kuo, 1998; Pillemer et al., 2010; Rowe & Kahn, 1997). Moreover, sense of place is considered another factor that motivates older adults to volunteer for environmental protection. Bushway, Dickinson, Stedman, Wagenet, and Weinstein (2011) proposed that outdoor environmental volunteerism might be associated with open-ended meaning, which makes it congruent with religious ideology. This is defined as meanings and attachments that individuals develop for the local places in which they live and foster behaviors of environmental protection (Bushway et al., 2011). Older adults tend to protect settings they care about and aspire to make places better (i.e., neighborhoods, communities; Brehm, Eisenhauer, & Stedman, 2008). Scholars have suggested that older adults are more likely to volunteer to improve their communities through interacting with their settings (Cutchin, 2001; Hay, 1998).
In addition to positive effects on older adults’ psychological well-being, environmental volunteerism seems to have substantial benefits for their physical activity (Librett et al., 2005) and physical health such as decreasing hypertension (Burr, Tavares, & Mutchler, 2011) and improving longevity (Jenkinson et al., 2013; Okun, Yeung, & Brown, 2013; Takano, Nakamura, & Watanabe, 2002). Findings of a national study examining the relationship between environmental volunteering and physical activity among 2,032 respondents showed that compared with volunteers in a control group (involved in nonenvironmental activities) environmental volunteers were 2.6 times more likely to meet the federal guidelines for physical activity (Librett et al., 2005). Using longitudinal data (from 1974 to 1994) of the Alameda County Study of health and mortality, Pillemer, Fuller-Rowell, Reid, and Wells (2010) found that 155 environmental volunteers in midlife engaged in more physical activity, reported better self-reported health, and experienced less depressive symptoms over a 20-year period. However, limitations related to the measurement of environmental volunteering in this study (employing a dummy variable to indicate respondents’ level of involvement in an environmental group) prevented the researchers from inferring causal relationships between environmental volunteerism and participants’ well-being. The authors noted that it was possible that physically fit respondents were more likely to engage in environmental volunteerism rather than the other way around.
Ecological Systems Theory, Compassion, and Environmental Volunteerism
Ecological systems theory (Bronfenbrenner, 1979) highlights the interdependence between individuals and their environment. Witnessing more large-scale natural disasters that lead to damaged homes, scattering of families, and loss of life, many older adults in Taiwan engage in recycling activities, driven by their compassion for survivors who suffer from national disasters (Hsiao et al., 2019). They acknowledge the association between extravagant lifestyles and wasteful consumption of natural resources and climate change and voluntarily take actions to protect the environment through recycling reusable resources (Hsiao et al., 2019). Compassion is a feeling that originates from witnessing the suffering of others and generates a desire to help. Compassion reflects a specific emotion that promotes cooperation and the protection of the vulnerable and those who suffer (Goetz, Keltner, & Simon-Thomas, 2010). Researchers have termed empathic distress the emotion that arises when people apply compassion to their experience of pain in response to the suffering of others (Ekman, 2003; Hoffman, 1981). During this process, people often mirror the distressed emotions of those around them, experiencing emotional resonance and connection (Hatfield, Cacioppo, & Rapson, 1993).
Neff (2003) proposed three main components of self-compassion: (a) kindness, which means understanding the pain and failure of oneself and others, rather than being harshly self-critical; (b) common humanity, which means regarding one’s experiences as part of broader human experience, rather than separating them; and (c) mindfulness, which means being aware of painful thoughts and feelings, rather than overidentifying. Research has shown that self-compassion assists people to restructure and maintain positivity about painful events while experiencing and embracing stronger feelings of empathy (Leary, Tate, Adams, Allen, & Hancock, 2007; Neff, Hsieh, & Dejitterat, 2005). Self-compassionate people prefer to rely more on positive cognitive restructuring and less on evasion and avoidance strategies. People with a high level of self-compassion use less dire terms to discuss negative events. Allen and Leary (2010) contended that Neff’s (2003) three components of self-compassion positively stimulate psychological well-being.
Self-compassion helps increase self-control (Adams & Leary, 2007) and decrease self-criticism (Neff, Kirkpatrick, & Rude, 2007). Gilbert and Procter (2006) used a compassionate mind training program for patients with mental health issues of high shame and self-criticism and found a consistent decrease in depression, feelings of inferiority, submissive behavior, shame, and self-attacking tendencies after patients completed twelve 2-hr sessions. Therefore, a self-compassion mind-set could help individuals cope with stressful events by employing positive cognitive strategies. A mind-set of self-compassion has the potential for reducing the impact of negative emotions and thoughts and promoting resilience, which as a core value of the social work profession. Very limited research has examined the association between compassion, environmental volunteerism, and well-being among older adults. The effects of environmental volunteering programs that cultivate compassion among older adults deserve further investigation by scholars in the field of social work.
Most findings relevant to environmental volunteerism among older adults are from cross-sectional studies. Very few empirical studies have examined outcomes of a specific type of environmental volunteerism among older adults over time in two aspects: physical health and mental health. Our research addresses some of the gaps in previous research in this area. Using a quasi-experimental design with intervention and control groups, our study’s objectives were 2-fold (a) to examine longitudinal effects of environmental volunteerism on older participants’ self-compassion, compassion for others, and psychological and physiological well-being; and (b) to examine differences between older participants and nonparticipants in the environmental volunteerism program with respect to self-compassion, compassion for others, and psychological and physiological well-being.
Method
Social Cause of TCRP and Disaster Relief Efforts
In the 1980s and 1990s, Taiwan experienced rapid industrialization as the so-called Asian Tiger’s economy expanded (Heller, 1998). However, Taiwan’s economic development also caused environmental side effects, including mountains of trash that lined the streets, landfills, and toxic waste dumps (Hsiao et al., 2019). The founder of Tzu Chi, Master Cheng Yen, acknowledged the public’s overconsumption of finite natural resources and the severity of the resulting environmental degradation. During a speech in Taichung in August 1990, she made a public appeal for environmental protection by calling on the audience to recycle voluntarily (Da Ai News, 2010; Shih, 2008; Tzu Chi Foundation, 2010). An audience member, as the first volunteer to initiate Tzu Chi’s Recycling Program, she began to recycle waste in her daily life, and she donated all the money she received from the sale of her recyclables to charity (Da Ai News, 2010; Tzu Chi Foundation, 2010). Through her advocacy and recruitment in the local community, the recycling program expanded from her neighborhood to the entire country. Many volunteers, typically retired older adults or people with chronic diseases or disabilities, collect, sort, and reclaim reusable resources at recycling stations set up and operated by themselves in any space available in their local community. This results in unique and varied locations (e.g., front yard of a volunteer’s home, public garage, donated land, or abandoned lots). All volunteers receive intensive orientation training on environmental justice and protection and how to live a sustainable life at recycling stations adorned with educational posters highlighting environmental sustainability and climate change. In collaboration with the DA.AI Technology, recycled materials collected by environmental volunteers are regenerated into raw textile materials to produce eco-friendly blankets for more than 810,000 disaster survivors around the world (e.g., Hurricane Sandy survivors in New York; Hurricane Harvey survivors in Houston; wildfire survivors in California; Syrian refugees in Jordan, Turkey, and Germany; tsunami survivors in Japan and Indonesia; DA.AI Technology, 2018). Founded in December 2008, DA.AI Technology (2018) is Taiwan’s first nonprofit company dedicated to producing eco-friendly products and one of the world’s first nonprofit companies to donate 100% of its net proceeds to charity. Globally, there are 10,752 recycling stations including 8,925 recycling stations in Taiwan (Taiwan Buddhist Tzu Chi Foundation, 2016).
Sample and Data Collection Procedures
This study used a quasi-experimental design with 72 participants in the intervention (n = 36) and control (n = 36) groups. Using convenience sampling, our research team members, who were medical professionals in the Department of Community Medicine of Dalin Tzu Chi Hospital, recruited participants at Tzu Chi recycling stations in Yunlin and Chiayi for the research group. We recruited control group members from senior centers in the same neighborhoods, close to the hospital in Southern Taiwan. Regarding inclusion criteria, older adults were eligible for participation in the TCRP group (intervention) if they were (a) aged 60 years or older and (b) participated in recycling activities at the stations at least 1 day a week (self-reported by the participants). Older adults were eligible for the community center (control) group if they were (a) aged 60 years or older, (b) attended productive aging activities (i.e., meal and nutrition program, health educational workshops, and wellness program) at a senior center in the community at least once a week, and (c) didn’t participate in any volunteering or recycling activities. Exclusion criteria included (a) severe mental disorders such as schizophrenia, severe depression, or receipt of medication for mental disorder, (b) dementia, (c) substance abuse, (d) acute or chronic infectious disease, and (e) malignant tumor.
A team of interviewers proficient in speaking Taiwanese dialect completed training workshops on conducting surveys. Study subjects who met inclusion criteria for either groups were recruited to participate in this study. Interviewers read the survey questions to the participants. Before the intervention began in January 2013, 114 older adults (74 in TCRP group and 40 in control group) provided consent for participation, completed a health examination (e.g., weight, blood pressure, and blood test) conducted by the community medicine department, and completed a pretest survey with assistance from the interviewers. Within the 1 year of the study, 42 participants dropped out due to illness, refusal to participate, or inconvenient transportation in the rural areas (38 in TCRP group and 4 in control group). Seventy-two participants (36 in TCRP group and 36 in control group) in both groups completed a second health examination and a posttest survey. The Dalin Tzu Chi Hospital’s institutional review board approved the study based on standards for research with human subjects.
Measures
Self-compassion
Developed by Neff (2003), the Self-Compassion Scale (SCS) is a 26-item self-report scale that measures six dimensions of compassion: self-kindness, self-judgment, common humanity, isolation, mindfulness, and overidentification. Internal consistency for the original 26-item SCS was .92 and six-factor model fitted the data well (non-normed fit index [NNFI] = .90; comparative fit index [CFI] = .91). Items on all subscales were rated on a 5-point scale (1 = never to 5 = always). The items of three subscales—Self-Judgment, Isolation, and Overidentification—were reverse coded. Scores were summed up for all items, with an overall score ranging from 26 to 130. Higher scores indicated higher levels of self-compassion. Cronbach’s α for this study was .90.
Compassion
Developed by Pommier (2011), the Compassion Scale (CS) is a 24-item self-report scale that measures six dimensions: kindness, indifference, common humanity, separation, mindfulness, and disengagement. Internal consistency for the original 24-item CS was .90, and six-factor model fitted the data well (NNFI = .90; CFI = .91). Items on all subscales were rated on a 5-point scale (1 = never to 5 = always). The items of three subscales—Indifference, Separation, and Disengagement—were reverse coded. Scores were summed for all items, with an overall range of 24–120. Higher scores indicated higher levels of compassion for others. Cronbach’s α for this study was .87.
Geriatric depression
The Geriatric Depression Scale was originally developed by Yesavage et al. (1982) and translated by Liao et al. (2004) into a Chinese version. After adapting certain items of the Chinese version of the Geriatric Depression Scale and testing among Taiwanese older adults with high level of internal consistency of .94, a revised version called the Taiwan Geriatric Depression Scale (TGDS) was developed. TGDS has been considered as a sensitive, valid, and reliable measure for older adults’ outpatients in Taiwan. All items were rated as yes or no. This scale with dichotomous measurement is strongly recommended to be used in grassroots medical settings. Cronbach’s α for this study was .94.
Hostility
Adapted from the Chinese Hostility Inventory (CHI) based on clinical practicality, a Short-Form Hostility Scale was developed by Weng et al. (2008) with 20 items that measure four dimensions: hostility cognition (individual inclination to cognition of suspicion, cynicism, injustice, indignation, and jealousy); hostility affect (individual inclination to emotionally experience boredom, impatience, and anger); hostility expression (individual tendency to express hostility via words or actions); and hostility suppression (individual tendency to either suppress hostile feelings or release them in a passive and indirect manner). CHI has good validity (NNFI = .83; CFI = .85) with internal consistency of the original four subscales ranging from .73 to .78. All items were rated on a 5-point Likert-type scale. For this study, Cronbach’s α was .89.
Happiness
The Chinese Happiness Inventory was developed by Lu (1998) and features 48 items that measure the level of happiness among people in Taiwan. The inventory’s internal consistency (Cronbach’s α) of the original scale was .95, and its test–retest reliability was .66. The authors developed a shorter version of the Chinese Happiness Inventory with 10 items, which was used for this study. Cronbach’s α was .92.
Physiological health
The Community Health Department at Dalin Tzu Chi Hospital provided medical records of patients who consented to participate in this study. Medical records of participants (from enrollment to the end of the project in a year) included height, weight, blood pressure, and laboratory results such as blood test, total cholesterol, low-density lipoprotein cholesterol, triglycerides, blood glucose, C-reactive protein, and cortisol.
Data Analysis Procedures
SPSS Version 18.0 was used for data analysis. χ2 tests and t tests were used for descriptive statistical analysis to examine differences between the intervention and control groups with respect to demographics, mental health, and physiological health at baseline. A two-way repeated measurement analysis of variance (ANOVA) was conducted to test the main effects of type of group on compassion for others, self-compassion, mental health, and physiological health and interaction effects of type of group and time interval (before and after the intervention) on the outcomes.
Results
Sample Demographics
Table 1 features descriptive statistics for the sample characteristics. Eighty-four percentage of participants were women. The mean age was 72.17 (standard deviation [SD] = 7.48), ranging from 60 to 92 years. The majority of participants (52%) were illiterate, and 29% had received elementary education. Only two participants graduated from college. More than 50% of all participants were married, whereas approximately 38% lived alone.
Sample Characteristics of TCRP Group and Control Group.
Note. TCRP = Tzu Chi Recycling Program; SD = standard deviation.
In the TCRP group, participants’ mean age was 71.54 (SD = 7.30), and the majority were women (75%) and married (64%). Forty-nine percentage were illiterate. Their control counterparts’ mean age was 72.82 (SD = 7.71), 92% were women, and approximately half were married and illiterate. It is important to note that at baseline, there were no statistically significant differences between the intervention and the control groups with respect to age, education, marital status, compassion, social support, hostility, happiness, and all the physiological health indicators. The only significant difference between the two groups was the level of depression (M = 2.28, 95% CI [0.08, 4.48], p < .05) before the intervention. The control group was more depressed than the intervention group was.
A two-way repeated measurement ANOVA was conducted to examine differences in compassion for others, self-compassion, mental health, and physiological health between the TCRP group and control group before and after the intervention.
Effects on Self-Compassion
In terms of subdimensions of self-compassion, Table 2 shows statistically significant interactions between the effects of group (TCRP vs. control) and time interval (pretest vs. posttest) on self-kindness, F(1, 70) = 6.789, p < .05, and self-judgment, F(1, 70) = 4.457, p < .05. A significant main effect of self-kindness was found for the control group, M = −1.67, F(1, 35) = 7.675, 95% CI [−3.22, −0.18], p < .05, but not for the TCRP group, which indicates that without receiving the intervention, control group participants’ level of self-kindness significantly decreased after 1 year, whereas the TCRP participants’ level of self-kindness remained the same.
ANOVA of Difference in Self-Compassion Between the TCRP Group and the Control Group Before and After the Intervention.
Note. ANOVA = analysis of variance; TCRP = Tzu Chi Recycling Program; CI = confidence interval; SD = standard deviation.
*p < .05.
In terms of self-compassion, a significant interaction effect, F(1, 70) = 6.910, p < .05, was found for both groups after 1 year. There was a significant main effect in the control group on self-compassion, M = −7.97, F(1, 35) = 12.252, 95% CI [−13.65, −2.29], p < .05, but not in the TCRP group. This indicates that the level of self-compassion significantly decreased among control group participants but remained unchanged among TCRP participants.
Effects on Compassion for Others
With respect to compassion for others, Table 3 shows statistically significant interactions between the effects of group (intervention vs. control) and time interval (pretest vs. posttest) on common humanity, F(1, 70) = 7.356, p < .05, and disengagement, F(1, 70) = 5.285, p < .05. Significant main effects of the TCRP group on common humanity, M = 1.84, F(1, 35) = 7.658, 95% CI [0.36, 3.32], p < .05, were found, whereas there were no main effects for the control group. The recycling program increased older participants’ sense of common humanity. In terms of compassion for others, a significant interaction effect, F(1, 70) = 8.640, p < .05, was found for both groups after 1 year.
ANOVA of Difference in Compassion for Others Between the TCRP Group and the Control Group Before and After the Intervention.
Note. ANOVA = analysis of variance; TCRP = Tzu Chi Recycling Program; CI = confidence interval; SD = standard deviation.
*p < .05.
Effects on Psychological Well-Being
Table 4 shows that in terms of psychological well-being, there were statistically significant interactions between the effects of group (TCRP vs. control) and time interval (pretest vs. posttest) on depression, F(1, 70) = 5.741, p < .05, hostility affect, F(1, 70) = 7.531, p < .05, hostility suppression, F(1, 70) = 3.960, p < .05, and happiness, F(1, 70) = 38.401, p < .05. There were significant main effects of the TCRP group on hostility affect, M = −1.55, F(1, 35) = 11.687, 95% CI [−2.65, −0.45], p < .05, hostility suppression, M = −2.19, F(1, 35) = 7.042, 95% CI [−4.24, −0.14], p < .05, and happiness, M = 4.29, F(1, 35) = 7.042, 95% CI [1.77, 7.61], p < .05, but there were no main effects of the control group on these outcome variables, apart from happiness, M = −4.80, 95% CI [−8.18, −1.42], p < .05. Results of simple main effects analysis showed that in 1 year, TCRP participants’ level of happiness significantly increased, whereas levels of hostility affect and hostility suppression significantly decreased. In contrast, control participants’ level of happiness significantly decreased.
ANOVA of Difference in Psychological Well-Being Between the TCRP Group and the Control Group Before and After the Intervention.
Note. ANOVA = analysis of variance; TCRP = Tzu Chi Recycling Program; CI = confidence interval; SD = standard deviation.
*p < .05.
Although there were no statistically significant interactions between the effects of group (TCRP vs. control) and time interval (pretest vs. posttest) on hostility, F(1, 70) = 2.808, p > .05, hostility cognition, F(1, 70) = 2.617, p > .05, and hostility expression, F(1, 70) = 3.026, p > .05, there were statistically significant main effects of the TCRP group on these outcome variables. Results of simple main effects analysis showed that in 1 year, TCRP participants’ level of hostility decreased, M = −5.69, 95% CI [−10.81, −0.57], p < .05, hostility cognition decreased, M = −8.59, 95% CI [−10.16, −7.02], p < .05, and hostility expression decreased, M = −1.30, 95% CI [−2.54, −0.06], p < .05.
Effects on Physiological Well-Being
Table 5 shows that among various indicators of physiological well-being, there were statistically significant interactions between the effects of group (TCRP vs. control) and time interval (pretest vs. posttest) on blood pressure, F(1, 70) = 5.48, p < .05. Simple main effect analysis showed that level of blood pressure among TCRP participants significantly decreased, M = −6.41, F(1, 35) = 6.181, 95% CI [−12.55, −0.27], p < .05, in 1 year, whereas that of the control group participants had no change over time.
ANOVA of Difference in Physiological Well-Being Between the TCRP Group and the Control Group Before and After the Intervention.
Note. ANOVA = analysis of variance; TCRP = Tzu Chi Recycling Program; CI = confidence interval; SD = standard deviation.
*p < .05.
Discussion
Using 1-year data collected from older adults at recycling stations (intervention group) and community centers (control group), this study examined the long-term effects of the TCRP on Taiwanese older adults’ self-compassion, compassion for others, and psychological and physiological well-being. Results of this study show that the TCRP had significant and long-term effects on cultivating older adults’ compassion for themselves and others and improving their psychological and physiological health in many aspects. The positive outcomes of the program as a peer-led environmentally sustainability model support the social good conceptual framework proposed by Mor Barak (2018): environmental justice and sustainability, diversity and social inclusion, and peace, harmony, and collaboration. From Mor Barak’s (2018) perspective, social good is conceptualized as the outcomes of actions by people from diverse backgrounds aspiring toward peaceful, interdependent, and harmonious societies in clean and just environments. These individuals often shape their identities by working together to achieve this goal and developing a sense of belonging and social inclusion.
After 1 year in the program, older Tzu Chi participants had lower levels of self-judgmental attitudes and maintained their self-kindness and self-compassion over time, whereas participants in the control group seemed to be more judgmental about themselves and had decreased levels of self-kindness and self-compassion. The TCRP helped participants cultivate compassion and build resilience for coping with adversities in life with a positive attitude, which corresponds with findings of previous studies (Adams & Leary, 2007; Neff et al., 2007). Tzu Chi recycling participants who committed themselves to promoting environmental sustainability for social good woke up early in the morning and went to local recycling stations every day to collect, sort, and reclaim reusable resources (e.g., bottles, glass, and paper) at local recycling stations (Hsiao et al., 2019).
Participation in the recycling program also significantly increased older participants’ compassion for others, particularly a feeling of common humanity, whereas older adults in the control group appeared to have a lower level of compassion for others over time. Inspired by the mission of the TCRP to protect the environment and mitigate climate change that causes numerous families to suffer from natural disasters, recycling participants shared a belief in the interconnections between human lifestyles and the frequency of natural disasters and recognized shared humanity (Neff et al., 2007). These findings are in line with the ecological theory, which highlights the interdependence between individuals and their environment (Bronfenbrenner, 1979). These findings are also consistent with previous studies suggesting that when Tzu Chi older participants witness people suffering from environmental injustice or natural disasters, they apply compassion toward these people’s experience of pain in response (Ekman, 2003; Hatfield et al., 1993; Hoffman, 1981) and are motivated to help and protect those in need through devoting themselves to recycling. The sustainable actions they take are in line with Bronfenbrenner’s (1979) theory that individuals can have influences that ripple outward to affect larger surrounding environments (e.g., community and society).
Our findings suggest that the participating in the recycling program appeared to decrease older participants’ level of disengagement in contrast to their control counterparts, who had an increasing level of disengagement over time. One possible explanation is that, to achieve the goal of a better planet, many older recycling participants invited their family members, friends, neighbors, and local residents to work collectively to recycle and educate the public about environmental sustainability (Her, 2008; Hsiao et al., 2019). Their commitment to promoting environmental sustainability helped these older adults gain a sense of achievement and belongingness and expand their social circle, which reflect characteristics of social inclusion, tied to environmental justice, two domain of the social good model proposed by Mor Barak (2018).
In terms of psychological well-being, older participants at the recycling stations had significant reductions in negative outcomes such as depression, hostility affect, and hostility suppression. At the same time, their level of happiness increased significantly. The recycling program also improved significantly the overall psychological well-being of the older participants. All the recycling stations were set up by local residents and were located outdoors with open spaces, which may have helped participants increase their sense of place. Scholars have suggested that exposure to nature and connection to the outdoors can have positive impacts on participants’ psychological well-being and foster behaviors that promote environmental protection aimed at making their communities better (Brehm et al., 2008; Bushway et al., 2011).
In contrast, after 1 year, older adults in the control group reported no significant improvement in psychological outcomes such as depression, hostility affect, hostility expression, and hostility suppression. They had lower levels of happiness compared to their counterparts at the recycling stations after 1 year. However, this result should be interpreted with caution because participants in the control group had higher levels of depression at baseline. It is important to note that during this 1-year study, these older adults recruited at community centers for the control group have attended productive aging activities and wellness programs at least once a week and therefore seemed to have mild improvement in depression at follow-up, although the change was not statistically significant.
With respect to physiological well-being, medical records provided by the hospital showed that program participants’ hypertension significantly improved after the intervention, whereas none of indicators of physical health improved among their counterparts. This suggests that not only physical and social activities at recycling stations (i.e., collecting activity and sorting activity) but possibly the knowledge that they are contributing to the environment helped to improve participants’ blood pressure. Although older adults recruited at community centers as the control group attended regular health promotion activities such as blood pressure checkups, group exercises, and health workshops during the study, these activities did not produce significant changes in their physiological health during the study.
Limitations
Although most of findings from this 1-year longitudinal study supported the theoretical perspectives of generativity (Ehlman & Ligon, 2012; Erikson & Erikson, 1997; McAdams, 2006), the ecological model (Bronfenbrenner, 1979), and social good (Mor Barak, 2018), some methodological pitfalls limit the interpretations and generalizability of the data. First, the quasi-experimental design used by this study affected our ability to infer a causal relationship between the participation in the recycling program and outcomes. Lack of randomization limited the ability to make comparisons between two groups, which poses a threat to internal validity. Second, the measurement of social support used by this study was adapted by the authors to assess various types of support received by older adults in the context of regular daily life, which may not precisely reflect aspects of social support received in the context of recycling or environmental volunteering activities.
Third, among the various indicators of physiological health, blood pressure was the only measure that improved significantly among recycling participants. Recycling activities at local stations included waste collecting, sorting, and recycling. It is not compulsory for participants to join all activities. It, therefore, might take a longer period to determine any significant effects of the recycling program on participants’ physiological health. In addition, older participants in the control group attended various health promotion activities throughout the year, which affected the ability to assess the relationship between group assignment and physiological health. These external factors led to threats to internal validity. Fourth, the use of convenience sampling and the nature of our specific samples, recruited from rural agricultural areas in Taiwan, limit the generalizability of the study findings. The majority of the participants were women who were illiterate, potentially limiting the ability to generalize study findings to male and/or educated older adults at recycling stations and community centers in urban areas or other diverse populations affected by disasters. Fifth, the small sample size poses a threat to both internal and external validity. Therefore, the findings should be interpreted with caution.
Implications for Practice and Future Research
Scholars have claimed that the social work profession has lacked a sustainability perspective with respect to social–environmental problems that are interconnected globally (Chong & Chi, 2019; Hsiao et al., 2019; Mason & Rigg, 2018). The Academy of Social Work and Social Welfare identified, “Strengthening the Social Response to the Human Impacts of Environmental Change” as 1 of its 12 Grand Challenges for the social work profession (Kemp & Palinkas, 2015). Similarly, the International Federation of Social Workers initiated a call within the profession to pay more attention to the critical role of the physical environment and to address concerns related to environmental and social sustainability (Chong & Chi, 2019). There is an urgent need for social workers to address environmental sustainability issues for future generations. However, very limited existing research in the social work literature has examined the benefits of environmental sustainability programs for participants, particularly older adults (Chong & Chi, 2019; Hsiao et al., 2019; Kemp & Palinkas, 2015). From a perspective of social work practice and education, the recycling program tested in our study exemplifies a sustainable model for environmental justice as proposed by Mor Barak’s (2018) social good conceptual framework. The program demonstrates the benefits of an environmental volunteering program for older adults that contributes to individual physical and psychological benefits and to societal social good. Drawing on theoretical perspectives of generativity, ecological theory, and social good, results of this longitudinal study using medical records and self-reported survey data contribute to the social work profession by indicating that the volunteer recycling program improved participants’ self-compassion and compassion for others, social engagement, psychological well-being, and blood pressure.
In line with the ecological model (Bronfenbrenner, 1979), local residents developed this recycling program with the belief that individuals and the environment are closely connected and that achieving harmony between the two can benefit both sides. Each local recycling station has promoted a sense of collective community belongingness and has developed unique strategies that reflected a specific cultural context in achieving the common goal of promoting environmental sustainability (Hsiao et al., 2019). Participating in the program strengthened older adults’ resilience by enhancing their level of compassion and building resilience for coping with adversities in life. Recycling participants and their local communities were empowered by practicing environmental stewardship. This program could serve as a pilot for developing similar interventions for individuals, including disaster survivors, to cultivate a positive attitude for coping with stressful life events through participating in recycling activities with local residents, peers, and family members to promote environmental sustainability.
Future research should examine the effectiveness of volunteer recycling interventions for older adults as an evidence-based practice for social workers. First, using mixed methods with a wide array of approaches including medical records, interviews, and surveys would provide a more in-depth and comprehensive perspective on this type of intervention and its potential multilevel impact at the individual, community, and national levels. Second, a large sample size of recycling participants with diversity in location (urban cities and rural areas), social class, occupation (e.g., elementary school children, college student, adolescents, blue-collar, and white-collar professionals), gender, educational attainment level, identity (e.g., residents, students, and disaster survivors), and race/ethnicity (e.g., Caucasians, African Americans, Asian Americans, and Latinos) should be included in future studies. Third, as a model of environmental sustainability, the Tzu Chi grassroots recycling program featuring cross-sector partnership with DA.AI Technology employs innovative approaches to solving social problems. More local and international studies should be conducted among various stakeholders (e.g., disaster survivors as blanket users, staff members, or managers at businesses) at different levels to provide a thorough perspective on the impacts of this sustainable model of social good.
Conclusion
Climate change has caused numerous natural disasters, resulting in much pain and suffering to individuals, families, and communities around the world. Concurrently, a significant number of countries face population aging and struggle with how to help older adults live productively. In relation to these challenges, the findings of this pilot study, using 1-year longitudinal data, suggest that a volunteer recycling program, viewed within the context of the social good model (Mor Barak, 2018), can improve older adults’ social and physiological well-being and contribute to environmental sustainability. Active and sustained participation in recycling used bottles into eco-friendly blankets to help disaster survivors can enhance social good on many levels including sustainability, environmental justice, and social inclusion. It may not only empower older adults and their local communities but also foster transformative social change for disaster-affected communities. Driven by compassion for the environment and for disaster-hit communities, the pilot study of this peer-led grassroots recycling program demonstrated the benefits to older adults’ physical health, psychological well-being, and social engagement, which may create a new avenue and solution for social work practitioners and scholars in addressing social and environmental challenges.
Footnotes
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
