Evaluation of effectiveness of an art-based museum intervention in reducing loneliness among older adults (ArtGran): a quasi-experimental study

OBJECTIVES

Loneliness is a public health issue among older adults. We designed an intervention offering 10 sessions with diverse artistic methods (ArtGran). This study assessed the effectiveness of ArtGran in reducing loneliness and its negative effects on health in community-dwelling older adults in 2022 in Barcelona.

STUDY DESIGN

Quasi-experimental study, with an intervention group (IG) and a comparison group (CG).

METHODS

The sample included residents aged ≥70 years from 6 selected neighbourhoods of Barcelona. In each neighbourhood, an IG and a CG was formed with participants who reported loneliness and without special mobility needs. The participants were referred from primary care centres, social services, and community health centres. We included 138 participants (IG = 63, CG = 75). We collected data on loneliness, quality of life (QoL-5D), mood, and self-perceived health before and after the intervention through validated questionnaires. To assess the effect of the intervention, we built Poisson models with robust variance and linear regression models.

RESULTS

At the end of the intervention, participants in the IG were more likely than those in the CG to be able to perform their usual activities without problems (adjusted prevalence ratio [aPR] = 1.22; 95% confidence interval [CI]: 1.02-1.45). Compared with the CG, participants in the IG attending more than half of the sessions had lower levels of loneliness (aPR = 1.36; 95%CI: 1.07-1.73), a better ability to perform their usual activities (aPR [95%CI] = 1.24 [1.05-1.48]), and higher happiness scores (β = 0.73; P = 0.01).

CONCLUSIONS

The effectiveness of the intervention was more pronounced when participants had high attendance. Our results suggest that high attendance of the ArtGran program was helpful in shielding older individuals from loneliness, fostering positive moods, and preserving their functional status.

Art engagement and psychological well-being among community-dwelling older adults in Japan: an observational cross-sectional study

OBJECTIVES

Art engagement, which includes individual art activities and museum and gallery visits, potentially contributes to improving psychological well-being. However, there is insufficient evidence of its effects on the older population, and few reports are from Asia, including Japan. This study examined the association between art engagement and psychological well-being among older adults in Japan.

STUDY DESIGN

An observational cross-sectional study design was used.

METHODS

Community-dwelling older adults aged ≥60 years were recruited from the visitors to public facilities (including community centres, sports centres and cultural centres) in Aichi, Japan, in 2022, and completed questionnaires. The psychological well-being assessment included five domains according to Seligman's PERMA framework: Positive emotion, Engagement, Relationship, Meaning and Accomplishment. Regarding art engagement, the frequencies of active art engagement (e.g. activities by individuals and participation in groups, such as music and painting) and receptive art engagement (e.g. visiting museums, galleries and the theatres) were assessed.

RESULTS

A total of 522 participants were included in the analysis (mean age = 74.1 years; 78.0% females). Results from the multivariable linear regression analysis, which adjusted for demographic and socio-economic factors, revealed that higher frequencies of active art engagement were significantly associated with higher scores in all five PERMA domain scores. Higher frequencies of receptive art engagement were significantly associated with higher levels of Positive emotion, Engagement and Meaning domain scores, but were only marginally associated with the Accomplishment domain and were not associated with the Relationships domain.

CONCLUSIONS

This study indicates that art engagement has the potential to enhance psychological well-being among older adults. National and local government strategies to increase accessibility to art and cultural activities for older adults are recommended.

Development of a complex arts-based intervention for patients with end-stage kidney disease whilst receiving haemodialysis

BACKGROUND

Patients with end-stage kidney disease who receive haemodialysis experience a protracted treatment regimen that can result in an increased risk of depression and anxiety. Arts-based interventions could address this unique issue; however, no arts-based interventions have been developed for delivery within a haemodialysis unit and evaluation within a randomised controlled trials (RCTs).

AIM

To develop a complex arts-based intervention for patients with end-stage kidney disease whilst receiving haemodialysis.

METHODS

The development process utilised the Arts in Health framework (Fancourt, 2017). The framework was addressed through the establishment of an interdisciplinary advisory group, collaboration and consultation with stakeholders, a scoping and realist review, shadowing of artists-in-residence, personal arts practice and logic modelling.

RESULTS

The intervention involved six 1-h long, one-to-one facilitated sessions focused on creative writing and visual art. Patients could choose between art form and self-select a subject matter. The sessions had a primary focus on skill development and were delivered using principles derived from the psychological theory of flow.

CONCLUSION

The Arts in Health framework provided an appropriate and pragmatic approach to intervention development. Complex arts-based interventions can be developed for the purpose of evaluation within a trial framework. This intervention was designed to strike a balance between standardised components, and a person-centred approach necessary to address existential boredom.

Art boxes supporting parents and infants to share creative interactions at home: an art-based response to improve well-being during COVID-19 restrictions

OBJECTIVES

This article seeks to demonstrate the impact of distributing boxes of art resources and guided activities for vulnerable parents and infants to do together at home.

STUDY DESIGN

Designed in conjunction with the local arts centre and the psychology team at the University of Dundee, the art boxes were a response to planned face-to-face art interventions with families being cancelled due to COVID-19 restrictions. The aim of the art boxes is to encourage parents to make art together with their infants, fostering connection through playful, creative shared experiences. This research is currently being expanded to reach out to new families through referrals from health visitors, family nurses, and charity partners.

METHODS

Data is being collected on how the art boxes are experienced by families using a mixed-methods approach. Families complete feedback cards (online, or using the stamped addressed card included in the box) rating their experience on quantitative scales and providing open comments. Visual data are gathered through parents sharing images with us on social media. An initial sample of 10 participants has been interviewed using semistructured interviews, allowing more in-depth qualitative understanding of their experiences. These preliminary findings are discussed here.

RESULTS

The thematic analysis of initial interviews provided a rich picture of the disconnection families experienced during lockdown, why art boxes may be beneficial to parental well-being, and the mechanisms by which the boxes may help to develop connections for the parent and infant together.

CONCLUSIONS

Preliminary findings show parents reporting feeling more confident and undertaking new activities which they plan to continue. This was of particular importance during lockdown where parents report opportunities for different experiences being more limited. Parent's describe positive playful interactions and reported improvements to their own well-being from doing creative activities together with their child. Analysis of these initial interviews gives a framework of barriers and supports to connection which highlights how art boxes can facilitate connectedness between dyads with the potential to strengthen attachments.

A mixed-methods feasibility study of an arts-based intervention for patients receiving maintenance haemodialysis

Background

Haemodialysis can negatively impact quality of life and mental health. Arts-based interventions used successfully in other settings to improve health and well-being, could help address the impact of haemodialysis. This study aimed to evaluate the feasibility and acceptability of conducting a randomised controlled trial (RCT) of an arts-based intervention for patients receiving haemodialysis.

Methods

A parallel convergent mixed-methods design was used, including a pilot cluster RCT and qualitative process evaluation.

Phase 1 evaluated recruitment and retention rates through a pilot cluster RCT at a single haemodialysis unit in Northern Ireland. Participants included patients who received haemodialysis for ESKD, were over the age of 18 and had the capacity to consent. These participants were randomised to the intervention or control group according to their haemodialysis shift. The intervention involved six one-hour, one-to-one facilitated arts sessions during haemodialysis.

Phase 2 explored intervention and trial acceptability through a qualitative process evaluation using semi-structured interviews based on the RE-AIM framework. Participants included 13 patients who participated in phase 1 of the study, including 9 participants from the experimental group and four participants from the control group, and nine healthcare professionals who were present on the unit during implementation.

Results

Out of 122 outpatient haemodialysis patients, 94 were assessed as eligible for participation. Twenty-four participants were randomised, meaning 80% of the target sample size was recruited and the attrition rate at 3 months was 12.5% (n = 3). Participants viewed the arts as more accessible and enjoyable than anticipated following implementation. All participants who started the intervention (n = 11) completed the full six sessions. Qualitative benefits of the intervention suggest improvements in mental well-being. Patient choice and facilitation were important factors for successful implementation.

Conclusion

An arts-based intervention for patients receiving haemodialysis is acceptable for both patients and healthcare professionals, and a definitive trial is feasible. The intervention may help improve mental-wellbeing in patients receiving haemodialysis, but this requires further investigation in a definitive trial.

Trial registration

The trial was prospectively registered on clinicaltrials.gov on 14/8/2018, registration number NCT03629496.

Creative interventions for symptoms of postnatal depression: A process evaluation of implementation

BACKGROUND

This article is a process evaluation of a three-arm randomised controlled trial (RCT) comparing the effects of creative interventions on symptoms of postnatal depression (PND) in new mothers.

METHODS

Analyses of quantitative evaluation data from 91 participants and qualitative interviews and focus groups with 80 participants and 3 members of staff.

RESULTS

Key assumptions of the RCT, including how the delivery of the intervention was achieved and what the intervention involved, are explored. Data suggest that the intervention was delivered as planned with a high level of fidelity. Key uncertainties surrounding the project, in particular unanticipated challenges that had to be overcome during the RCT, are also discussed and simple recommendations for improvement are made.

CONCLUSION

This process evaluation aims to illuminate the outcome and mechanisms data from the RCT and enable organisations or individuals to ascertain the feasibility of establishing their own creative classes for women with symptoms of PND.

Towards a caring practice: reflections on the processes and components of arts-health practice

Background: Many arts and health studies have focused on evaluating the impact of participatory arts activities, but few have considered the processes and components shaping the wellbeing outcomes of the participants. This paper uses a relational approach to health to explore the elements at play in participatory arts.Methods: The study uses an action-research case study of a 12-week visual art programme in a nursing home with 10 participants. Data collected were analysed and interpreted using grounded theory to obtain general themes and to facilitate focused analysis.Results: The study identifies the participants, wellbeing outcomes, the environment and the quality of activities as key concerns of arts-health practice. It also reflects on the link between caring and arts-health practice to highlight several caring attributes that promote a caring arts-health practice.Conclusions: The study findings provide a practice framework that can guide decision making and action to foster a caring arts-health practice.

The biological impact of listening to music in clinical and nonclinical settings: A systematic review

This systematic review explored the evidence base on the impact of listening to music on biological response in both clinical and nonclinical settings. Human studies exploring the effects of listening to recorded music on biological markers were included. Studies had to involve a non-music control condition. Keyword searches were carried out of five major databases (Cochrane/Wiley, PsycINFO, PubMed, Sage, and Science Direct) and bias was assessed using the Cochrane Risk of Bias Tool for Randomized Studies (RoB 2.0). Forty-four studies assessing the biological impact of music listening were identified: 27 in clinical settings and 17 in nonclinical settings. Eighty-two percent had examined the effects of short-term listening interventions, while the remainder had looked at longitudinal interventions. Thirteen of 33 biomarkers tested were reported to change in response to listening to music. The most commonly analyzed biomarker was the stress hormone cortisol, with half of clinical studies demonstrating a stress-reducing effect of music listening. Blood glucose was also found repeatedly to reduce in response to music listening. Many of the other biomarkers analyzed are also part of biological stress pathways, which suggests that the primary way by which music listening affects us biologically is via modulations of stress response. Effects were shown irrespective of genre, self-selection of the music, or duration of listening, although a majority did use classical music. The evidence base for understanding biological responses to music is still developing, but there is support for the application of listening to music, especially within clinical settings for stress reduction.