Tracking momentary experience in the evaluation of arts-on-prescription services: using mood changes during art workshops to predict global wellbeing change

The impact of arts on prescription on individual health and wellbeing: a systematic review with meta-analysis

Introduction

The evidence-base for the impact of participating in the arts for different aspects of health and wellbeing is growing. Arts on Prescription has gained increasing recognition as a method for fostering connections among individuals and communities, however, to date no systematic review of the impact on individual health and wellbeing has been conducted. This review aims to provide an understanding of individual health and wellbeing outcomes from participation in Arts on Prescription programmes.

Methods

Major electronic databases were systematically searched, including Cochrane Library; Web of Science; ProQuest; CINAHL; Arts & Humanities; Ebsocohost; Pubmed; PsycINFO. Other databases were also used: Google Scholar and websites of specific organizations, e.g., NHS Evidence, Kings Fund, Health foundation, Nuffield Trust and NESTA and University of Florida Arts-in Medicine Repository. The review used PRISMA reporting structures. Critical Appraisal Skills Programme (CASP) templates were used for qualitative and quantitative studies, and the Mixed Methods Appraisal Tool (MMAT) for studies with a mixed methods protocol to assess quality and risk of bias. A narrative review of the qualitative data was conducted. For quantitative outcomes, a meta-analysis for studies that met inclusion criteria was conducted, and a narrative review made of secondary and heterogeneous outcomes and approaches.

Results

7,805 records were identified but only 25 records were included as studies with a focus on the impact on individual health and wellbeing. Studies were conducted in Australia, Denmark, Sweden, United Kingdom, and the United States. Programmes were held in community settings, arts venues, GP surgeries, primary healthcare settings, and one school. Most interventions varied from 8 to 10 weeks and included a wide range of different arts activities. Qualitative themes included social benefits, psychological benefits and progression opportunities. The meta-analysis showed a statistically significant improvement in wellbeing, and the narrative review identified promising outcomes that require further evidential support (e.g., reductions in anxiety and depression).

Discussion

Arts on Prescription programmes are an appropriate intervention for improving psychosocial wellbeing, providing both social and psychological benefits as well as progression opportunities. We discuss the various qualitative and quantitative outcomes, along with potential 'active ingredients' and barriers to participation (physical, psychological and social).

Systematic review registration

PROSPERO, identifier CRD42023408974, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023408974.

Testing the potential therapeutic effects of an online creative arts-based intervention for people with anxiety

BACKGROUND

Creative arts-based interventions are a relatively new addition to the toolkit of psychological treatments for mental afflictions. As such, the therapeutic efficacy of these therapies when conducted remotely via digital media has been under-researched. To address this gap, this study tested the effects of an online creative arts-based intervention to alleviate anxiety.

METHOD

A repeated measures quasi-experimental design was employed on a sample of British adults (N = 41). Data were collected using pre- and post-intervention scores on the General Anxiety Disorder (GAD-7) and Warwick-Edinburgh Mental Wellbeing (WEMWBS) scales.

RESULTS

Inferential analysis procedures consisting of multiple tests for within-subjects effects all showed significantly lower levels of anxiety and higher levels of mental wellbeing post-intervention.

CONCLUSION

Whilst additional confirmatory and longitudinal research is needed, the results of this exploratory study tentatively indicate that creative arts-based "interventions" delivered through digital media may be effective in substantively reducing common symptoms of anxiety.

Videoconference-based Creativity Workshops for mental health staff during the COVID-19 pandemic

BACKGROUND

COVID-19 presented significant challenges to psychiatric staff, while social distancing and remote working necessitated digital communications. NHS England prioritised staff wellbeing. Arts-based creativity interventions appear to improve psychological wellbeing, so this study evaluated online Creativity Workshops as a staff support response for COVID-19-related stress.

METHODS

Participants were staff from a South London NHS psychiatric hospital. Group Creativity Workshops were facilitated via Microsoft Teams. Acceptability data on pre- and post-workshop mood and attitudes were self-reported by participants. Feasibility data were gathered from adherence to number of workshop components delivered.

RESULTS

Eight workshops were delivered in May-September 2020 (N = 55) with high adherence to components. Participants reported significantly increased positive mood and attitudes towards themselves and others; and decreased stress and anxiety.

CONCLUSIONS

Online Creativity Workshops appear feasible and acceptable in reducing stress in psychiatric staff. Integrating a programme of Creativity Workshops within healthcare staff support may benefit staff wellbeing.

Toward Restorative Hospital Environment: Nature and Art in Finnish Hospitals

This study explores the integration of nature and art in recent hospital construction projects in Finland, focusing on public hospitals. Interviews with 15 stakeholders, including hospital executives, workers, designers, artists, and architects, reveal the value placed on nature and nature-themed art in hospital settings. The research question presented was: How nature and art are incorporated in Finnish hospitals in order to achieve a restorative hospital environment? Findings highlight themes that appeared in different hospitals: (1) the desired atmosphere, (2) nature and multisensory experiences, (3) social support, and (4) sense of connection and belonging. Bringing nature inside the hospital, whether through natural elements or artworks, emerges as a promising approach. Despite positive outcomes, challenges such as cost and maintenance persist, indicating the need for further research to optimize these initiatives. Overall, incorporating nature and art in hospitals has the potential to enhance healing and well-being for patients, families, and healthcare workers.

Social prescribing outcomes: a mapping review of the evidence from 13 countries to identify key common outcomes

Introduction

As a means for supporting a range of health and wellbeing goals, social prescribing programs have been implemented around the world. Reflecting a range of contexts, needs, innovation, and programing, a broad array of outcomes has been studied in relation to these programs. As interest in social prescribing grows, more targeted study of key outcomes and in turn evidence synthesis that can inform evidence-based practice, policy, and investment is needed.

Methods and Results

This mapping review identified, described, and synthesized the broad array of social prescribing outcomes that have been studied in 13 countries and maps the outcomes that have been most commonly studied. From 87 articles included in this review, a total of 347 unique outcomes were identified, including 278 unique patient outcomes and 69 unique system outcomes. The most commonly studied categories of patient outcomes were found to be mental health, lifestyle and behavior, and patient/service user experience. The most commonly studied system outcomes were healthcare/service utilization and financial/economic outcomes.

Discussion

This review highlights the value of heterogeneity and mixed methods approaches in outcomes studies for capturing nuanced experiences and outcomes in this nascent area of practice, while contributing to the advancement of evidence synthesis for social prescribing globally by quantifying and offering insight into the outcomes that have been studied to date. It also lays a foundation for the development of key common outcomes and a Core Outcomes Set for social prescribing. Additionally, it identified key outcomes that, given their relationship to critical health and social issues, warrant both broader and deeper study.

Social Prescribing: Systematic Review of the Effectiveness of Psychosocial Community Referral Interventions in Primary Care

Introduction:

Social prescribing (SP) aims to provide targeted psychosocial support and close the gap between medical and non-medical services. This review assesses the effectiveness of community-based SP interventions.

Methods:

We performed a systematic review and qualitative synthesis of interventional studies of community referral interventions focused on facilitating psychosocial support. We considered health-related endpoints, other patient reported outcomes, or health care utilization. Six databases, grey literature, and additional trials registers were searched. Results were screened in a two-step process, followed by data extraction, each by two independent reviewers. If data permitted such, effect sizes were calculated. Risk of bias was assessed with the EPHPP and the Cochrane RoB2 tools.

Results:

We identified 68 reports from 53 different projects, three were controlled studies. Uncontrolled studies with shorter time frames frequently reported positive effects. This could largely not be seen in controlled settings and for longer follow-up periods. Designs, populations, and outcomes evaluated were heterogeneous with high risk of bias for most studies.

Discussion and conclusion:

Current evidence suggests positive effects of SP on a variety of relevant endpoints. Due to quality deficits in the available studies, scope for conclusions concerning clinical relevance and sustainability is limited. Further methodologically rigorous controlled trials are needed.

Mental health and resilience: Arts on Prescription for children and young people in a school setting

OBJECTIVES

Arts on Prescription (AoP) programmes were among the first forms of social prescribing in the UK. Most of the studies of AoP programmes focus on adults and currently there is no published research on the impact of AoP on children and young people. This study investigates the impact of 10 weekly AoP workshops delivered in a school setting on the mental well-being and resilience of adolescents aged 13-16 years at risk of emotional or behavioural problems.

STUDY DESIGN

The study design used is a longitudinal cohort study of an AoP programme implemented in 10 schools in the East of England.

METHODS

Changes in mental well-being and resilience of school children were assessed using the Warwick-Edinburgh Mental Well-being Scale (WEMWBS), and the True Resilience Scale applied pre- and post-intervention, with follow-up at 3 months. In total, 91 young people participated in the programme and 65 completed pre- and post-intervention measures.

RESULTS

Data from the WEMWBS and True Resilience Scale indicated that the AoP Programme had a positive impact on both well-being and resilience of participants with a statistically significant increase recorded immediately post-intervention. However, these improvements were not sustained upon observation at 3-month follow-up.

CONCLUSION

This article presents the first indication of the effectiveness of a programme of AoP workshops on the mental well-being and resilience of children and young people. It suggests the potential of AoP as a means of support the mental health and well-being of secondary school aged children.

Can Social Prescribing Foster Individual and Community Well-Being? A Systematic Review of the Evidence

Social prescribing programmes (SP) are person-centred coaching schemes meant to help participants improve individual circumstances, thereby to reduce demand on health and social care. SP could be an innovative means to improve preventive and public health in the pursuit of universal financially sustainable healthcare. Given its potential, our systematic review assesses type, content, and quality of evidence available regarding SP effectiveness at the individual, system, and community levels. We examine the impact of SP on addressing loneliness, social isolation, well-being, and connectedness, as well as related concepts, which are not yet considered jointly in one study. Following PRISMA, we search: EBSCOHost (CINAHL Complete; eBook Collection; E-Journals; MEDLINE Full Text; Open Dissertations; PsycARTICLES; PsycINFO); Web of Science Core Collection; and UK National Institute for Health and Care Excellence. Excluding systematic reviews and articles without impact evaluations, we review 51 studies. Several studies do not distinguish between core concepts and/or provide information on the measures used to assess outcomes; exactly one peer-reviewed study presents a randomised controlled trial. If we wish to know the potential of social prescribing to lead to universal financially sustainable healthcare, we urge researchers and practitioners to standardise definitions and metrics, and to explore conceptual linkages between social prescribing and system/community outcomes.