Prescribing laughter to increase well-being in healthy adults: An exploratory mixed methods feasibility study of the Laughie

Introduction: Calls for a practical laughter prescription have been made by the medical community. This research developed the Laughie and evaluated its impact to elicit laughter and increase well-being in healthy adults. The Laughie is a user-created one minute recording of the user's laughter, operated by re-playing it while laughing simultaneously. Methods: A mixed methods preliminary feasibility study was conducted between March and May 2018. Twenty-one participants aged 25-93 (x = 51, SD = 20) created a Laughie and were instructed to laugh with it three times a day for seven days, documenting each trial. Well-being was measured prior to and post-intervention using the World Health Organization (WHO five-item) well-being index. Interviews were analysed using thematic analysis. Evaluation considered the Feasibility, Reach-out, Acceptability, Maintenance, Efficacy, Implementation and Tailorability (FRAME-IT) of the Laughie. Results: The Laughie elicited laughter for most of the one minute in 89% of 420 Laughie trials; immediate well-being increased in 70% of them. Absolute overall WHO well-being scores increased post-intervention by 16%. Laughie evaluation using FRAME-IT showed the Laughie was feasible, acceptable, and tailorable. Four smart laughter techniques that facilitated maintenance/usage were identified. Conclusions: The Laughie was feasible, enjoyable, and effective as a laughter prescription in eliciting laughter. Fourteen participants reported absolute well-being increases of 10% or more. Ten participants found their laughter self-contagious. Smart laughter (laughing in a smart way for a smart reason on a smartphone) is a convenient way to harness the benefits of laughter. FRAME-IT is proposed as a practical planning and evaluation framework.