Developing an inventory of ongoing/unpublished arts and narrative-based approaches as knowledge translation strategies in health care

Lifting the curtain on the emergency department crisis: a multi-method reception study of Larry Saves the Canadian Healthcare System

BACKGROUND

Despite growing evidence of the potential of arts-based modalities to translate knowledge and spark discussion on complex issues, applications to health policy are rare. This study explored the potential of a research-based theatrical video to increase public capacity and motivation to engage with the complex issues that make Emergency Department wait times such an intractable problem.

METHODS

Larry Saves the Canadian Healthcare System is a digital musical micro-series developed from extensive research examining system-level causes of Emergency crowding and the ineffectiveness of prevailing approaches. We released individual episodes and a revised full-length version on YouTube, using organic promotion strategies and paid advertising. We used YouTube Analytics to track views, engagement and viewer demographics, and content-analyzed viewer comments. We also conducted five university-based screenings; 92 students completed questionnaires, rating Larry on 16 descriptors using a 7-point Likert scale.

RESULTS

From June 2022 through May 2023, Larry garnered over 100,000 views (76,752 of the full-length version, 35,535 of episodes), 1329 likes, 2780 shares, and 139 comments. Views and watch time were higher among women and positively associated with age. Among YouTube comments, the predominating themes were praise for the video and criticism of the healthcare system. Many commenters applauded the show's accuracy, humor, and/or resonance with their experience; several shared healthcare horror stories. Students overwhelmingly agreed with all positive and disagreed with all negative descriptors, and nearly unanimously deemed the video informative, thought-provoking, and entertaining. Most also affirmed that it had increased their knowledge, interest, and confidence to participate in discussions about healthcare issues. Neither gender, primary language, nor employment in healthcare predicted ratings, but graduate students and those 25+ years old evaluated the video most positively.

DISCUSSION

These findings highlight the promise of research-informed musical satire to inform and invigorate discourse on an urgent health policy problem. Larry has reached tens of thousands of viewers, garnered excellent feedback, and received high student ratings. Further research should directly assess educational and behavioural outcomes and explore what facilitative strategies could maximize this knowledge translation product's potential to foster informed, impactful policy dialogue.

Co-creating an arts-based eye health education strategy in Zanzibar: process, outcomes and lessons learnt

Introduction

Published examples of health programme co-creation are scarce and we found none in the field of eye care. We described the outcomes and lessons learnt from the ZANZIbar Arts for Children’s Eyesight (ZANZI-ACE) eye health programme co-creation process.

Methods

We used a 2.5-day stakeholder workshop (number of participants=34) to develop the ZANZI-ACE intervention, which aimed to use music performances in eye health education to improve child eye health service uptake in Zanzibar. A Zanzibar-wide music competition was then launched to encourage local participation, followed by a judging session to select three pieces as the ZANZI-ACE eye health programme intervention materials.

Results

The barriers to the improved uptake of child eye health services raised by the participants were mainly cultural and social. Sensitising parents, teachers, children and community members with proper eye health knowledge was the key to addressing these barriers. The goal of sensitisation is to improve children’s vision so that they can achieve their fullest potential. Music and song ranked highest among the proposed art forms, so three music pieces were chosen as the ZANZI-ACE eye health programme intervention materials. A detailed ZANZI-ACE implementation strategy, a theory of change and key performance outcomes indicators were developed.

Conclusion

The co-creation process and outcomes of the ZANZI-ACE eye health programme show that engaging a diverse group of stakeholders is critical to developing locally relevant health programmes. The lessons learnt from the process will prove useful to researchers who aspire to design innovative health programmes.

Dialoguing With Images: An Expressive Arts Method for Health Research

Despite the increasing integration of arts-based methods within qualitative research, few expressive arts methods have been studied to understand their process, rationale and impact on the inquiry process. We conducted a grounded theory study on family experiences of paediatric HSCT where we simultaneously adapted and studied a 'dialoguing with images' (DI) expressive arts process as method. Fifteen family members participated in two interviews, drew an image and were guided through the DI method. We articulate the social process shared by researchers, participants and the images as they co-constructed knowledge through the DI method. The four distinct phases of the method include: 1) containing the imaginative space within an outer and inner frame, 2) creating an embodied image: image work is an expressive, generative process, 3) a shared, participatory aesthetic interpretation and 4) crystallizing stories of illness. The findings are grounded in expressive arts theory and philosophy, hermeneutics and analytical art psychotherapy theory.

Empirical Evaluation of Rainbow Reflections: A Comic Book Anthology on Body Image for Queer Men

Gay, bisexual, and queer (GBQ) men are at higher risk of negative body image. As having a negative body image is related to negative mood, sexual, and health outcomes, identifying and providing community-friendly tools for GBQ men is important. This paper describes the creation and evaluation of Rainbow Reflections, a comic anthology developed to promote awareness of and communication about body image. Rainbow Reflections includes comics from 38 trans- and cis-GBQ artists who drew inspiration from personal narratives based on pre-determined themes in the empirical literature and interactive inserts based on evidence-based practice. To evaluate Rainbow Reflections, 167 trans- and cis-GBQ men completed pre-post measures before/after viewing a selection of comics and responded to an open-ended question about their experience. Overall, participants rated the comic book positively, with a majority (61.1%) indicating that they would recommend the book to a friend. After viewing the comics, participants reported greater comfort with initiating conversations about body image, greater satisfaction with their bodies, and reported higher estimates of how common body image concerns are for queer men. Themes that emerged from open-ended responses included participants reflecting on personal struggles (~ 30%), relating with the stories of others (~ 22%), reflecting on the standards of queer men (~ 18%), recognizing cis-privilege (~ 11%), reflecting on others' struggles (~ 9%), negative feedback about the comics (~ 7%), and balancing masculine and feminine (~ 3%). Results of the study provide preliminary evidence for Rainbow Reflections as an effective community-friendly tool to promote awareness of and communication about body image for GBQ men.