Understanding the impact of visual arts interventions for people living with dementia: a realist review protocol

Abstract

BackgroundArts-based activities are being increasingly suggested as a valuable activity for people living with dementia in terms of countering the negative aspects of their condition. The potential for such programmes to improve a broad range of psychosocial outcomes is suggested in some studies. However, there is largely an absence of rigorous methodology to demonstrate the benefits, and research results are mixed. Practice variability in terms of the content, contexts and implementation of such interventions raises challenges in terms of identifying an optimal arts programme model that could be adopted by other service providers. Understanding how interventions may have the best chance at broad implementation success and uptake is limited.Methods/DesignA realist review will be undertaken. This aims to understand how visual arts interventions influence outcomes in people living with dementia. The review will explore how the context, that is the circumstances which enable or constrain, affect outcomes through the activation of mechanisms. An early scoping search and a stakeholder survey formulated the preliminary programme theory. A systematic literature search across a broad range of disciplines (arts, humanities, social sciences, health) will be undertaken to identify journal articles and grey literature. Data will be extracted in relation to the programme theory, contextual factors, mechanisms and outcomes and their configurations, background information about the study design and participant characteristics, detail about the quantity (‘dose’) of an intervention, theoretical perspectives proposed by the authors of the paper and further theorising by the reviewer. Thematic connections/patterns will be sought across the extracted data, identifying patterns amongst contextual factors, the mechanisms they trigger and the associated outcomes.DiscussionAlong with stakeholder engagement and validation, this review will help inform the development of an optimal, replicable arts intervention for people with dementia as part of our broader research programme, titled ‘Dementia and Imagination’ (funded by the Arts and Humanities Research Council). Forthcoming work under this programme of research will test this theoretically informed intervention in three different geographical areas of the UK. The production of freely available practice guidance is a key aspect of dissemination.Trial registrationPROSPERO registration number CRD42014008702.

Critical reflections on methodological challenge in arts and dementia evaluation and research

“…Underpinning theoretical frameworks are said to be insufficient (Beard, 2011;Young, Camic, & Tischler, 2016). Causal mechanisms are not well understood (Windle et al, 2014). Persuasive economic evaluation appears elusive, perhaps because of a lack of research designs suitable for robust comparative cost analysis and able to satisfactorily address questions of causality (Fujiwara, Kudrna, & Dolan, 2014).…”

A Taxonomy of Arts Interventions for People With Dementia

“…Realist methodology can develop a theoretical framework for arts interventions. It has been recommended for arts and health research (The All-Party Parliamentary Group (APPG), 2017) and has been used by other arts and dementia projects (Windle et al, 2014).…”

Dementia and Imagination: a mixed-methods protocol for arts and science research

“…The synthesis protocol is published and publicly available. 29 (2) Workshops with stakeholders and artists (up to 40) will explore their practice to understand 'what works' from their perspectives. (3) A survey of organisations delivering arts programmes, people with dementia and their carers who have previously participated in similar activities, to explore what they feel worked best, and why and what was not good practice.…”