Social prescription in the US: A pilot evaluation of Mass Cultural Council's "CultureRx"

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.

Arts Engagement as a Health Behavior: An Opportunity to Address Mental Health Inequities

The significance of mental health inequities globally is illustrated by higher rates of anxiety and depression amongst racial and ethnic minority populations as well as individuals of lower socioeconomic status. The COVID-19 pandemic has further exacerbated these pre-existing mental health inequities. With rising mental health concerns, arts engagement offers an accessible, equitable opportunity to combat mental health inequities and impact upstream determinants of health. As the field of public health continues to shift its focus toward social ecological strategies, the social ecological model of health offers an approach that prioritizes social and structural determinants of health. To capture the impacts of arts engagement, this paper creates an applied social ecological model of health while aiming to advocate that engaging in the arts is a protective and rehabilitative behavior for mental health.

An Evidence-Based Framework for the Use of Arts and Culture in Public Health

OBJECTIVES

In recent years, increasing efforts have been made to apply arts- and culture-based strategies to public health concerns. Accumulating studies point to the value of these strategies for addressing social determinants of health in ways that center communities, cultures, and lived experiences. However, this work has lacked a common framework to support application and advancement. The objectives of this study were to examine knowledge, experience, and evidence related to the uses of arts and culture in public health in the United States and to develop a pilot version of an evidence-based framework to guide cross-sector development and research.

METHODS

Using a convergent mixed-methods design with sequential elements, this study drew upon findings from a national field survey, seven focus groups, eight structured working-group dialogues, and a five-day structured dialogue and writing process with 12 interdisciplinary thought leaders. Data were integrated to develop a pilot evidence-based framework.

RESULTS

The study identified six broad ways in which arts and culture can be used in public health and 59 specific outcomes that can be addressed through arts and cultural strategies. The framework identifies evidence supporting the effects of arts and culture on each outcome, along with mechanisms that may mediate or moderate these effects.

CONCLUSION

The pilot framework clearly links arts and culture practices with public health outcomes. In doing so, it provides both a resource for current practice and a model for the continued development of interdisciplinary tools that support health researchers and practitioners in utilizing arts and culture resources to advance community health and health equity.

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.

Arts and Culture: A Necessary Component to Address Unmet Social Needs and Advance Individual and Community Well-Being

U.S. healthcare institutions increasingly integrate screenings for social needs into standard care, and help meet those needs by referring patients to community-based resources. However, community arts/culture assets are not commonly included among those resources. Given growing evidence of the positive health impacts of arts/culture, and given that access to these benefits remains inequitable, this article argues for the integration of arts/culture resources into healthcare referral networks. It highlights two early models, the CultureRx initiative in Massachusetts and Creative Forces, both of which piloted this integration with promising results. It also offers suggestions for better utilizing local arts/culture assets, emphasizing that these existing community resources can and should be applied to advance whole-person strategies and better address social drivers of health.

Community-based social healthcare practices in China for healthy aging: a social prescription perspective analysis

Background

The global population is aging, and the number of people suffering from chronic diseases is increasing. In response to these trends, community-enhanced social healthcare practices are a novel paradigm of social prescribing that aims to improve both the community's and the individual's level of health by combining community involvement, organizational change, and individual-level practice.

Objective

The study examined the state of community-based social healthcare practices using the lens of social prescription in China with an eye on promoting healthy aging there.

Method

Thematic analysis approach was used in this investigation. A social prescription lens was used to conduct an open-ended theme study of China's community-based social healthcare practices for healthy aging. The research was conducted in Yiwu in Zhejiang Province, P. R. China. A sample of 24 "comprehensive evaluation team members (CETM)" was chosen using a purposive selection strategy.

Results

In the context of the social prescription, we analyzed social healthcare practices for healthy aging at the community level. All the comprehensive evaluation team members described community social healthcare practices under the paradigm of social prescription. After analyzing the community social healthcare practices under the paradigm of social prescription, six main themes (E-Social Prescription, Nature-based Social Prescription, Healthy Living Social Prescription, Culture-based Social Prescription, Health Screening Social Prescription, and Health Education Social Prescription) emerged for healthy aging at the community level.

Conclusion

Social prescribing links individuals to non-clinical services and activities, typically provided by the nonprofit and community sectors. Community-based social healthcare practices under social prescription can be an efficient and cost-effective way to assist patients with chronic diseases in managing their illnesses and enhancing their overall health and wellbeing.