This paper provides an overview of the current state of the arts and health field in England, through an examination of practice, research and policy developments. Five features of arts and health practice are identified: the scale of the sector, regional variations, mapping of arts and health initiatives, recent conferences and symposia, and the role of key agencies supporting arts and health initiatives. Eight areas of arts and health research activity are considered: retrospective qualitative evaluations, prospective evaluations with some quantitative assessments, experimental research on arts and health initiatives, economic evaluations of arts interventions, systematic reviews of arts and health research, theory development to underpin research efforts, and the establishment of dedicated arts and health research centres and research programmes. The final section considers three 2007 arts and health publications from the Department of Health and Arts Council England. There has been disappointment that the policy recommendations in these documents have not been acted upon. At the time of writing, however, there are some signs of renewed efforts to encourage national leadership from the Department of Health.
Purpose -This review article seeks to draw on experience in the UK to describe the different forms that arts in health activity can take and to examine the challenges for research in this field. Design/methodology/approach -A case study is used to describe the kind of arts in health project that intends to enhance the social capital of its community and to show how difficult it is to measure the effects of this work using conventional measures of health improvement. However, those who are responsible for providing funding for arts in health are increasingly demanding results that indicate a measurable health gain from the projects. Findings -A literature review of the evaluation of arts in health projects in the UK has shown that few aim at direct health improvement but rather at intermediate indicators of health gain, such as raising awareness of health issues and social activity and participation. This suggests that artists instinctively locate their work as having value within a social model of health where improvements in social inclusion and social cohesion are the important indicators which may go on to lead to long-term improvements to the health of the community in which they are working. Originality/value -Understanding the nature of this work has implications for the kind of research appropriate to measure its effect and the timescale required for such research.
As the field of arts in health grows in scale and diversity, it needs to affirm a set of shared principles and describe what constitutes 'best practice'. This article recounts the production of guidelines for good practice in participatory arts in health care, based on consultations with practitioners in the arts and health sectors in Ireland in [2008][2009]. It considers why it was difficult and inappropriate to formalize a code of practice but explains how guidelines for good practice within an ethical framework were collectively agreed. It argues that the arts in health practitioner is not the individual artist but rather a partnership between diverse professional interests with common principles and values that govern engagement with participants and inform the planning, delivery and evaluation of the practice. It considers issues of quality and risk and proposes that benchmarking best practice should be the next step.
This article originates in current research into community-based arts in health. Arts in health is now a diverse field of practice, and community-based arts in health interventions have extended the work beyond healthcare settings into public health. Examples of this work can now be found internationally in different health systems and cultural contexts. The paper argues that researchers need to understand the processes through which community-based arts in health projects evolve, and how they work holistically in their attempt to produce therapeutic and social benefits for both individuals and communities, and to connect with a cultural base in healthcare services themselves. A development model that might be adapted to assist in analysing this is the World Health Organisation Quality of Life Index (WHOQOL). Issues raised in the paper around community engagement, healthy choice and self-esteem are then illustrated in case examples of community-based arts in health practice in South Africa and England; namely the DramAide and Siyazama projects in KwaZulu-Natal, and Looking Well Healthy Living Centre in North Yorkshire. In South Africa there are arts and media projects attempting to raise awareness about HIV/AIDS through mass messaging, but they also recognize that they lack models of longer-term community engagement. Looking Well by contrast addresses health issues identified by the community itself in ways that are personal, empathic and domesticated. But there are also similarities among these projects in their aims to generate a range of social, educational and economic benefits within a community-health framework, and they are successfully regenerating traditional cultural forms to create public participation in health promotion. Process evaluation may provide a framework in which community-based arts in health projects, especially if they are networked together to share practice and thinking, can assess their ability to address health inequalities and focus better on health outcomes.
An account is provided of a UK national seminar series on Arts, Health and Wellbeing funded by the Economic and Social Research Council during 2012–13. Four seminars were organised addressing current issues and challenges facing the field. Details of the programme and its outputs are available online. A central concern of the seminar programme was to provide a foundation for creating a UK national network for researchers in the field to help promote evidence-based policy and practice. With funding from Lankelly Chase Foundation, and the support of the Royal Society for Public Health, a Special interest Group for Arts, Health and Wellbeing was launched in 2015.
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