1. Tracking momentary experience in the evaluation of arts on prescription services: A pilot study
Nicola J. Holt1, Julie Matthews2 & Barbara Disney2
1 Corresponding author, Department of Health and Life Sciences, UWE,
2 Bristol Arts on Referral Alliance,
Abstract/Description
Aim of project: Although there is increasing impetus to explore the use arts on prescription, as advocated by a recent All Party Enquiry on the Arts and Health (2017), there is a limited evidence base for its efficacy. Nevertheless, arts on prescription has been reported to have a significant impact on well-being (Crone et al., 2018) and reductions in social isolation and anxiety (Clayton & Potter, 2017). The current project sought to contribute to the evidence base by evaluating the efficacy of the Bristol Arts on Referral Alliance (BARA). BARA provides 13 art workshops across Bristol, and 6 follow-on groups, embedded within a larger social prescribing scheme. Drawing on the experience sampling method (Holt, 2018), the evaluation repeatedly assessed in-the-moment affect for each participant, over each course of art workshops, in order to test whether specific aspects of mood (hedonic tone, stress, excitement) are impacted by arts on prescription and whether this predicts longer-term wellbeing. Method(s) used: A mixed methods design was employed, including semi-structured interviews with participants and drawing on existing pre-post intervention evaluation frameworks to measure wellbeing, using the Warwick Edinburgh Wellbeing Scale (Crone et al., 2018). The mood of participants was tracked over time, before and after each art workshop, for the duration of each 12-week-long art course. Key Findings/Learning: Analysis of the data is currently underway. This consists of a thematic analysis of semi-structured interviews with arts on prescription participants. The quantitative analysis will compare pre- and post scores on wellbeing measures and will evaluate whether changes in different aspects of mood (following art making) predict any changes in overall wellbeing. Conclusions: Consideration will be given to whether the data supports previous evaluations of arts on prescription services. The efficacy of tracking mood within the research and evaluation of social prescribing schemes will be reflected upon.
Notes
Graph selected:Pre_post_mood=1 & No_sessions_attended >= 4 & term = 1
References
Clayton, G. & Potter, S. (2017). Arts on prescription: A creative and cost-effective approach to improving mental Health. In Stickley &S. Clift (Eds), Arts, Health and Wellbeing: A Theoretical Inquiry for Practice, Cambridge Scholars Publishing.
Crone, D. M., Sumner, R. C., Baker, C. M., Loughren, E. A., Hughes, S., & James, D. V. (2018). ‘Artlift’ arts-on-referral intervention in UK primary care: updated findings from an ongoing observational study. The European Journal of Public Health, 28(3),
Dolan, P., & Metcalfe, R. (2012). Measuring subjective wellbeing: Recommendations on measures for use by national governments. Journal of social policy, 41(2),
Holt, N. J. (2018). Using the experience-sampling method to examine the psychological mechanisms by which participatory art improves wellbeing. Perspectives in Public Health, 138 (1). pp
Ruch, W., Martínez-Martí, M. L., Heintz, S., & Brouwers, S. A. (2014). Short form of the Orientations to Happiness Questionnaire for the German-speaking countries. Swiss Journal of Psychology, 73(4),
Tennant, R., Fishwick, R., Platt, S., Joseph, S., & Stewart-Brown, S. (2006). Monitoring positive mental health in Scotland: validating the Affectometer 2 scale and developing the Warwick-Edinburgh Mental Well-being Scale for the UK, Edinburgh, NHS Health Scotland.
Wilhelm, P., & Schoebi, D. (2007). Assessing mood in daily life. European Journal of Psychological Assessment, 23(4),
Introduction
Although there is increasing impetus to explore the use arts on prescription, as advocated by a recent All Party Enquiry on the Arts and Health (2017), there is a limited evidence base for its efficacy.
Nevertheless, arts on prescription has been reported to have a significant impact on well-being (Crone et al., 2018) and reductions in social isolation and anxiety (Clayton & Potter, 2017).
The current project sought to contribute to the evidence base by evaluating the efficacy of the Bristol Arts on Referral Alliance (BARA). BARA provides 13 art workshops across Bristol, and 6 follow-on groups, embedded within a larger social prescribing scheme.
Drawing on the experience sampling method (Holt, 2018), the evaluation repeatedly assessed in-the-moment affect for each participant in order to test whether specific aspects of mood (hedonic tone, stress, energy) are impacted by arts on prescription.
Method
A mixed methods design was employed, including semi-structured interviews with participants, a pre-post intervention evaluation (drawing on Crone et al., 2018), and tracking the mood of participants over time. Due to nested data (repeated experience of multiple participants), it was planned to used multi-level modelling to analyse data.
Participants were drawn from three arts on prescription workshops and one follow-on group, each over three courses (12 courses in total). This poster presents data from the arts on prescription groups for two terms only (6 courses): 577 mood reports nested in 66 participants.
Materials: Warrick-Edinburgh Mental Wellbeing Scale, WEMWBS (Tennant et al., 2006); Short Form of the Orientations to Happiness Scale, SFOHS (Ruch et al., 2014), assessing hedonic, eudemonic and engaged happiness; a short mood scale developed by Wilhelm and Schoebi (2007) to repeatedly assess hedonic tone, energetic arousal and tense arousal (depicted above).
Procedure: Participants completed the WEWBS and SFOHS at the beginning and end of each course. Participants completed the mood scale before and after each art workshop.
Pre course WEWBS & Orientations to Happiness
Mood (pre-post art)
Post course WEWBS & Orientations to Happiness
Results 1: Mood scores pre and post art workshops
Multi-level modelling was used to examine whether completion of mood scales before and after each art workshop differentially predicted mood (controlling for time, group, artist, and number of sessions attended overall).
Post art making participants reported significantly improved:
Hedonic tone, feeling more content (F (1, 543) = , p < .001)
Energetic arousal, feeling more energetic (F (1, 549) = , p < .001)
Tense arousal, feeling calmer (F (1, 543) = , p < .001)
Results 2: Growth analysis
Multi-level modelling was used to examine individual change in mood over time, on arrival at each art workshop (controlling for group, artist, and number of sessions attended).
Over time, repeated attendance at the workshops was significantly associated with:
Reduced tense arousal (β = .12, t(186.38) = 2.32, p =.02)
But not:
Improved hedonic tone (β = .04, t(187.26) = .89, p =.37)
Increased energetic arousal (β = .07, t(200.08) = 1.37, p =.17)
Interim conclusions and future analyses
Tracking mood over time is an informative and novel tool in evaluation – assessing wellbeing in immediate experience (Dolan & Metcalfe, 2012)
Arts on prescription workshops appear to impact multiple dimensions of mood, increasing positive affect and decreasing negative affect.
Growth analyses suggest decreases in negative affect, only, over time.
Further research could evaluate curvilinear effects and track mood after leaving art workshops to further explore this effect.
Subsequent analyses will:
Evaluate pre-post data for wellbeing (WEMWBS) and happiness (SFOHS)
Use multi-level modelling to predict whether changes in mood following art workshops predict longer-term changes in wellbeing and happiness.
Res
Figure One: Mean scores on mood dimensions before and after art workshops.
Figure Two: Scatterplot showing the positive correlation between time and reduced tense arousal, with regression lines for individual participants (term one).
References
Clayton, G. & Potter, S. (2017). Arts on prescription: A creative and cost-effective approach to improving mental Health. In Stickley &S. Clift (Eds), Arts, Health and Wellbeing: A Theoretical Inquiry for Practice, pp Cambridge Scholars Publishing.
Crone, D. M., Sumner, R. C., Baker, C. M., Loughren, E. A., Hughes, S., & James, D. V. (2018). ‘Artlift’ arts-on-referral intervention in UK primary care: updated findings from an ongoing observational study. The European Journal of Public Health, 28(3),
Dolan, P., & Metcalfe, R. (2012). Measuring subjective wellbeing: Recommendations on measures for use by national governments. Journal of social policy, 41(2),
Holt, N. J. (2018). Using the experience-sampling method to examine the psychological mechanisms by which participatory art improves wellbeing. Perspectives in Public Health, 138 (1). pp
Ruch, W., Martínez-Martí, M. L., Heintz, S., & Brouwers, S. A. (2014). Short form of the Orientations to Happiness Questionnaire for the German-speaking countries. Swiss Journal of Psychology, 73(4),
Tennant, R., Fishwick, R., Platt, S., Joseph, S., & Stewart-Brown, S. (2006). Monitoring positive mental health in Scotland: validating the Affectometer 2 scale and developing the Warwick-Edinburgh Mental Well-being Scale for the UK, Edinburgh, NHS Health Scotland.
Wilhelm, P., & Schoebi, D. (2007). Assessing mood in daily life. European Journal of Psychological Assessment, 23(4),