Laughter and humour interventions appear to enhance well-being. There is insufficient evidence for the potential of laughter itself to increase well-being as interventions contained a range of confounding factors and did not measure participant laughter. Interventions that isolate, track, and measure the parameters of individual laughter are recommended to build evidence for these potentially attractive and low-risk interventions. The classification proposed may guide the development of both evidence-oriented and population-appropriate intervention designs.

Introduction: The accessibility of laughter and humour make them attractive choices for selfcare, and integrative medicine. There is a growing body of literature, but both fields are fragmented and the overall evidence has not been systematically reviewed. The relationship between health and personal development is increasingly recognized. This review scopes the evidence for laughter and humour interventions from the perspective of their potential benefits on personal development. Methods: A systematic scoping review used Joanna Briggs guidelines and the Preferred Reporting Items for Systematic Reviews Scoping Review extension (PRISMA-ScR). Allpopulation laughter and humour interventions described in primary and secondary research from 1970, and in English, were searched in Web of Science and PubMed/Medline. Results: Analysis of 240 primary research articles (k), and 11 systematic reviews (K), identified k = 564 discrete articles with studies involving 574,611 participants (n). Twelve large studies (n >15,000) contributed 77% of participants. Classification analysis found more research relating to humour (k = 445, n = 334,996) than laughter (k = 119, n = 239,615) and identified diverse personal development outcomes associated with Biological, Psychological, Social, Environmental, and Behavioural (BPSE-B) factors. Conclusion:This review presents growing evidence for the diverse applications and benefits of laughter and humour. Multiple opportunities for self-care and interventional applications are described. The consideration of personal development outcomes may support tailored applications according to specific needs and objectives. An umbrella Personal Development Sensitivity: InternalTheory of laughter and humour, inclusive humour and laughter definitions, and a humourlaughter-affect model are proposed to unify the fields.

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 replaying it while laughing simultaneously. Methods: A mixed methods preliminary feasibility study was conducted between March and May 2018. Twenty-one participants aged 25 to 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

Objectives This research is the first study to investigate the potential effects of a laughter prescription on both psychological health and objective sleep parameters in university students. The primary objective is to evaluate the feasibility of prescribing laughter to inform a larger randomised controlled trial. Secondary objectives are to assess if a two-week laughter prescription improves subjective and objective sleep outcomes, wellbeing, and/or psychological health outcomes. Trial design To assess the feasibility of a randomised controlled trial for laughter prescription in relation to sleep, psychological health, and wellbeing. Forty university students will be recruited and randomised to one of two conditions (control/experimental). Methods Wrist actigraphy and sleep diaries will be used to estimate sleep outcomes during a one-week baseline testing phase and across the two-week intervention. The experimental group will be shown how to record a Laughie (a 1-min recording of their joyful laughter on their smartphone) and prescribed to laugh with it three times daily for 14 days (the control group will only track sleep). All participants will complete the WHO (Five) Well-being Index, and Hospital Anxiety and Depression Scale pre- and post-intervention. The CONSORT checklist, and the Feasibility, Reach-out, Acceptability, Maintenance, Efficacy, Implementation, and Tailorabilty (FRAME-IT) framework will guide intervention planning and evaluation. Participant interviews will be analysed using Differential Qualitative Analysis (DQA). Results The feasibility of a two-week laughter prescription in university students and its impact on sleep, wellbeing, and/or psychological health outcomes will be assessed. Conclusions Zayed University Research Ethics Committee approved the study in July 2019. The research will be completed following protocol publication. Trial registration ClinicalTrials.gov . ID: NCT04171245. Date of registration: 18 October 2019.

Purpose The purpose of this paper is to meet Ros Ben-Moshe, a cancer survivor – or rather thriver – and lecturer in positive psychology at La Trobe University, describes how she uses laughter to boost levity and mental health. Design/methodology/approach This case study is divided into two parts: an autoethnographic life story of Ros Ben-Moshe, followed by 10 questions and answers. Findings Regular laughter is an enjoyable way to stimulate the feel-good chemicals dopamine, oxytocin, serotonin and endorphins. A laughter mindset is an important tool for overall wellbeing. It can help build connections and re-frame negative situations. Research limitations/implications This is a personal narrative and gives the perspective of one person who harnessed the benefits of laughter following a cancer diagnosis. Practical implications Laughter can be used strategically to reset our internal mindset and prime ourselves towards optimal mental health and wellbeing, even while struggling with serious health issues. Research into how and when to prescribe laughter for mental health and overall wellbeing is therefore of interest. Social implications Social laughter is important and rewarding. For those anxious about social laughter, finding people to laugh with who do not judge you is recommended, as are affirmations to lessen anxiety. Originality/value To the best of the authors’ knowledge, this is the first case study and interview with a cancer survivor on the topic of laughter, cancer and mental health.