Clive Parkinson

The state of arts and health in England

This paper provides an overview of the current state of the arts and health field in England, through an examination of practice, research and policy developments. Five features of arts and health practice are identified: the scale of the sector, regional variations, mapping of arts and health initiatives, recent conferences and symposia, and the role of key agencies supporting arts and health initiatives. Eight areas of arts and health research activity are considered: retrospective qualitative evaluations, prospective evaluations with some quantitative assessments, experimental research on arts and health initiatives, economic evaluations of arts interventions, systematic reviews of arts and health research, theory development to underpin research efforts, and the establishment of dedicated arts and health research centres and research programmes. The final section considers three 2007 arts and health publications from the Department of Health and Arts Council England. There has been disappointment that the policy recommendations in these documents have not been acted upon. At the time of writing, however, there are some signs of renewed efforts to encourage national leadership from the Department of Health.

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

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.

Inequalities, the arts and public health: Towards an international conversation

This paper considers how participatory arts informed by thinking in public health can play a significant part internationally in addressing inequalities in health. It looks beyond national overviews of arts and health to consider what would make for meaningful international practice, citing recent initiatives of national networks in English-speaking countries and examples of influential developments in South America and the European Union. In the context of public health thinking on inequalities and social justice, the paper posits what would make for good practice and appropriate research that impacts on policy. As the arts and health movement gathers momentum, the paper urges the arts to describe their potency in the policy-making arena in the most compelling ways to articulate their social, economic and cultural values. In the process, it identifies the reflexive consideration of participatory practice – involving people routinely marginalised from decision-making processes – as a possible avenue into this work.

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

Introduction Dementia and Imagination is a multidisciplinary research collaboration bringing together arts and science to address current evidence limitations around the benefits of visual art activities in dementia care. The research questions ask: Can art improve quality of life and well-being? If it does make a difference, how does it do this—and why? Does it have wider social and community benefits? Methods and analysis This mixed-methods study recruits participants from residential care homes, National Health Service (NHS) wards and communities in England and Wales. A visual art intervention is developed and delivered as 1×2-hour weekly group session for 3 months in care and community settings to N=100 people living with dementia. Quantitative and qualitative data are collected at 3 time points to examine the impact on their quality of life, and the perceptions of those who care for them (N=100 family and professional carers). Repeated-measures systematic observations of well-being are obtained during the intervention (intervention vs control condition). The health economics component conducts a social return on investment evaluation of the intervention. Qualitative data are collected at 3 time points (n=35 carers/staff and n=35 people living with dementia) to explore changes in social connectedness. Self-reported outcomes of the intervention delivery are obtained (n=100). Focus groups with intervention participants (n=40) explore perceptions of impact. Social network analysis of quantitative and qualitative data from arts and healthcare professionals (N=100) examines changes in perceptions and practice. Ethics and dissemination The study is approved by North Wales Research Ethics Committee—West. A range of activities will share the research findings, including international and national academic conferences, quarterly newsletters and the project website. Public engagement projects will target a broad range of stakeholders. Policy and practice summaries will be developed. The visual art intervention protocol will be developed as a freely available practitioners guide.

The impact of a visual arts program on quality of life, communication, and well-being of people living with dementia: a mixed-methods longitudinal investigation

ABSTRACTBackground:Research reviews highlight methodological limitations and gaps in the evidence base for the arts in dementia care. In response, we developed a 12-week visual art program and evaluated the impact on people living with dementia through a mixed-methods longitudinal investigation. METHODS One hundred and twenty-five people living with mild to severe dementia were recruited across three research settings in England and Wales (residential care homes, a county hospital, and community venues). Quantitative and qualitative data on quality of life (QoL), communication and perceptions of the program were obtained through interviews and self-reports with participants and their carers. Eight domains of well-being were measured using a standardized observation tool, and data compared to an alternative activity with no art. RESULTS Across all sites, scores for the well-being domains of interest, attention, pleasure, self-esteem, negative affect, and sadness were significantly better in the art program than the alternative condition. Proxy-reported QoL significantly improved between baseline and 3-month follow-up, but no improvements in QoL were reported by the participants with dementia. This was contrasted by their qualitative accounts, which described a stimulating experience important for social connectedness, well-being, and inner-strength. Communication deteriorated between baseline and follow-up in the hospital setting, but improved in the residential care setting. CONCLUSIONS The findings highlight the potential for creative aging within dementia care, the benefits of art activities and the influence of the environment. We encourage dementia care providers and arts and cultural services to work toward embedding art activities within routine care provision.

Carrying out research across the arts and humanities and social sciences: Developing the methodology for Dementia and Imagination

ABSTRACT This paper analyses how the methodological approach for a major Arts and Humanities Research Council and Economic and Social Research Council-funded project entitled Dementia and Imagination 1 was formulated. This multidisciplinary project brings together the arts and humanities with the social sciences with their different epistemological philosophies and subsequent understandings of research methods. The main objective was to determine how visual arts activities may change, sustain and catalyse community cultures, beliefs, attitudes and behaviours to create dementia-friendly communities. This project involves 6 different UK universities, 14 researchers, 10 formal partners, 7 project artists, 3 research artists and a large number of civil society organisations. The analysis presents a series of themes that have been identified as influencing the approach taken to develop methods which aimed to speak to different audiences in the social sciences, arts and humanities, policy/practice and public domains. It is concluded that a research project of this type needs to embrace a wide variety of epistemological positions if it is to successfully achieve its objectives. This paper contributes to knowledge about how the methodology of large-scale multidisciplinary projects may be constructed which will be of value to those building research consortia across different universities and between universities and community partners.

Weapons of Mass Happiness: Social Justice and Health Equity in the Context of the Arts

There is a paradigm shift taking place in the way public health, social care and well-being are understood. The arts have a powerful part to play in this process, but for artists, there are challenges to remaining authentic to practice in the face of limited fiscal resources, access to the arts for marginalised people, and a culture of competition. This chapter explores the ways in which art and artists can empower new ways of thinking, being and doing. From jazz and blues to twenty-first-century dementia care, this chapter examines the power of the arts, its manipulation by those with power and calls for a reimagining of the arts and health agenda through a lens of social justice.