A review of evaluation in community-based art for health activity in the UK, J Angus

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Content: Health Development Agency A review of evaluation in community-based art for health activity in the UK John Angus
Copies of this publication can be downloaded free of charge from the HDA website (www.hda-online.org.uk) Health Development Agency Holborn Gate 330 High Holborn London WC1V 7BA Email: [email protected] ISBN 1-84279-118-4 © Health Development Agency 2002 About the HDA The Health Development Agency (HDA) is an NHS special health authority, established to support and enhance national efforts to improve health in England, with a particular focus on reducing health inequalities. In partnership with others, it gathers evidence of what works, advises on putting health into practice, and develops the skills of all those working to improve people's health.
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A review of evaluation in community based art for health activity in the UK
Acknowledgements
The Health Development Agency (HDA) commissioned this report from the Centre for Arts and Humanities in Health and Medicine (CAHHM) at the University of Durham in 2001. The report's author, John Angus, is a research associate of CAHHM, a member of Pioneer Projects (Celebratory Arts) Ltd and has worked as an artist in the art for health field.
The Health Development Agency The Health Development Agency (HDA) is an NHS special health authority, established to support and enhance national efforts to improve health in England, with a particular focus on reducing health inequalities. In partnership with others, the HDA's role is to:
CAHHM was set up in 2000 by Sir Kenneth Calman, vice chancellor of the University of Durham and a former government Chief Medical Officer. CAHHM intends to meet the groundswell of interest from many areas of social policy and academic disciplines in the importance of the arts as a force for improving the health and wellbeing of communities and individuals. CAHHM's ultimate aims are to influence change in the way we learn, work and communicate in healthcare, and to build trusting creative partnerships between medical and health professionals, artists and the public. Thanks are due to Dr Jane Meyrick, who undertook revisions and amendments to the text, adding an executive summary and `map' of the art for health field (Appendix 6). Also involved in the production of this report were Dr Jane Macnaughton, director, CAHHM, and Mike White, director of projects, CAHHM.
· Gather evidence of what works · Advise on good practice · Support all those working to improve the public's health. How? The HDA works with key statutory and non-statutory organisations at national, regional and local level to develop and maintain: · An accessible evidence base · Guidance on how to translate evidence into practice · The skills of those working to improve the public's health · The standards and tools to measure the results · Resources to help those working locally. . Why?
CAHHM wishes to thank all the organisations listed in the appendixes of this report that sent in documentation to inform this study. Special thanks go to the National Network for Arts in Health for access to its archive and assistance in identifying organisations to approach.
· To improve the health of people in England · To tackle growing inequalities in health · To fill the gaps in our knowledge about what works · To ensure every penny spent on public health is money well spent.
CAHHM 14/15 Old Elvet, Durham City DH1 3HP Tel: 0191 374 7231 Email: [email protected] www.dur.ac.uk/cahhm
A review of evaluation in community based art for health activity in the UK
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Contents
Acknowledgements
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Summary
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1 Introduction
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2 The aims of community-based art for health projects
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3 Stated aims/theoretical models
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4 Non-stated/broader aims and implicit theoretical models
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4.1 Theoretical concept of health
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4.2 Communication/community/participation
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4.3 Personal development
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4.4 Staff development
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4.5 Specific health needs
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4.6 Art
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4.7 General aspects
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5 Evaluation
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5.1 Ethnographic approaches
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5.2 Other approaches
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5.3 Evaluation of particular aspects
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5.4 Appropriate methods
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5.5 Guidance on evaluation and promising practice
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6 Conclusions
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Appendix 1 ­ The sample
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Appendix 2 ­ Request letter
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Appendix 3 ­ Documents reviewed
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Appendix 4 ­ Analysis
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Appendix 5 ­ Stated aims and outcomes summary list
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Appendix 6 ­ Map of the art for health field
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A review of evaluation in community based art for health activity in the UK
Summary
Background This report was commissioned by the Health Development Agency (HDA) from the Centre for Arts and Humanities in Health and Medicine (CAHHM) as a first step to improve evaluation practice in the field of communitybased art for health activity. It was felt that some feedback and reflection on the diversity of implicit models of health and wellbeing, models of evaluation, practice and reporting in the field would be helpful. This report provides an overview of available documentation of work in this field and summarises the information on evaluation contained in them with some critical appraisal. It does not, however, attempt to describe an ideal evaluation. Special attention is given to both the stated aims of projects and to the more general aims of practitioners. Scope This report provides a review of over 150 recent documents describing 64 separate projects on community-based art for health activity in the UK, a field that has expanded rapidly since 1996. The range of projects included 34 in community settings, 13 in community-based health organisations, five in care homes and 14 in hospitals. The majority of projects were based in England with about three-quarters located in the north and one quarter in the south; a small number were located in Wales and Ireland. Projects with a specific target issue/population included 18 on young people, five on older people, four on mental health, two on young and older people, three on disability and one on learning disability. Conclusions · The majority of people working in community-based art for health appear to recognise that it is important to evaluate their activity. · Many are attempting to evaluate, but they are struggling to find appropriate methods, and the evaluation they carry out is frequently inadequate.
· Many projects do not have clearly stated aims. · Projects address various aspects of health and wellbeing, but very few explicitly aim to have a direct effect on health. · Art for health appears to be working in the context of medicine and the health service, and so it may be assumed that it has similar aims. However, it is often trying to do something quite different to medicine. · It is therefore inappropriate to assume that art for health should use medical models of health and wellbeing, measurement and assessment. Recommendations To be able to seek the evidence of the effect of community-based art for health, it is first necessary to be clear about what effect is intended. · Community-based art for health work needs to show its effectiveness in addressing a range of issues around health, wellbeing and their wider determinants. · To achieve this, evaluation practice in the field of community-based art for health activity needs to be improved. · Evaluation practice needs to be based on explicit models of health and wellbeing, stated aims and rationale for how these will be achieved through the work. · The variety of types of work carried out in communitybased art for health should be made more explicit in order to more clearly distinguish the different aims/intentions this encompasses in addition to the even wider variety in the whole of the art for health field (see Appendix 6). · Key agencies around community-based art for health practice should support consensus building on models for practice and appropriate evaluation. This should include access to training, sharing of good practice, funded networking and materials to support improved practice.
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1 Introduction
This report provides a review of documents written about community-based art for health activity in the UK from 1993 to 2001. The study was carried out by a researcher for the Centre for Arts and Humanities in Health Medicine (CAHHM) which is based at the University of Durham. It was commissioned by the Health Development Agency (HDA). The report is intended to provide background information and context for a national advisory forum on the evaluation of community-based art for health which CAHHM is undertaking to develop. It therefore focuses on the actual evaluation which is carried out by projects and the comments on evaluation requirements found in the documents reviewed. As evaluation methodology must be appropriate for the aims of any activity, special attention has been given to both the stated aims of projects and also to the more general aims of practitioners in this field.
The table in Appendix 3 provides a list of the documents reviewed and numbers them in alphabetical order by organisation. Documents referred to in the text are indicated by this number in brackets, eg (97). One document includes five organisations and so is referred to by all five numbers (30, 94, 125, 148, 156). Appendix 3 also classifies the documents in a variety of ways. An analysis of these classifications is provided in Appendix 4.
This report has covered a total of 157 documents which range from 150-page reports to single sheet publicity flyers. They include detailed project reports, Research Reports, conference papers, strategy documents, annual reports, newsletters, published articles, information sheets, publicity materials, project proposals, lists of projects and practitioners in an area, notes and letters. Most of these documents were produced between 1999 and 2001, but some earlier reports are included that date back to 1993. The sample is described in Appendix 1.
The total of 157 documents included 63 reports that provide details of a specific project. The following discussion focuses on these 63 reports, but it is also informed by careful and thorough consideration of the information and ideas presented in all the documents.
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A review of evaluation in community-based art for health activity in the UK
2 The aims of community-based art for health projects
Community-based art for health is a very new activity and has expanded rapidly in the past five years. It involves the use of art to address health and wellbeing, but its aims are diverse and not entirely clear (see Appendix 6 for a broad map of the types of work often encompassed under the title). As with any new field of activity, the boundaries of community-based art for health are not defined but it is a much more diverse area than sometimes thought. It is not a unified field: it is still emerging and includes a wide variety of activities that share some characteristics (eg involve art and address health and wellbeing, or work in a health context), but have quite different intentions. There is a variety of approaches, and a variety of projects, including participative arts, therapeutic arts, health promotion, community development, environmental enhancement, exhibitions and performances, staff development, etc. Some projects involve many different stakeholders. The people and agencies who initiate and deliver these various approaches and projects have different backgrounds, assumptions, skills and intentions. The wide range of aims, and their individual lack of clarity, is due to the diversity of both the field and the stakeholders involved. Tom Smith (136, p7) states that:
He continues (p11): `If the field is understood as having various and complementary dimensions it will have two important benefits: 1) it will relieve unnecessary and potentially destructive tensions within the field as it searches to define itself and 2) it will help those in the health service interested in arts based techniques to understand the range of interventions and the potential impact of each.' People who have participated in community-based art for health projects are already convinced of its impact and value, but more objective evidence of its effects is needed. The reports reviewed here reveal a widespread recognition by practitioners that it is necessary to evaluate their activity. It seems clear, however, that no single evaluation method can be suitable and appropriate to assess all the different approaches and aims. A variety of methods is required to match the wide range of aims. A few projects address quite specific aspects of health in a defined and quantifiable way, and so it is fairly easy to find appropriate methods to evaluate them. But the vast majority of work in the field has a variety of aims which are often intangible, and so they are difficult to assess.
`... there is no clear statement on its use or benefits ... and: `Approaches from a variety of perspectives and with different origins have come to be seen as part of a single approach ... They are better thought of as different approaches within a broad field.'
Whatever method of evaluation is adopted, practitioners can only collect appropriate data and evidence if they are clear about their aims. There is a call for evidence of the effect of community-based art for health, but to be able to seek that evidence it is first necessary to clarify what effect is intended.
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3 Stated aims/theoretical models
To be able to evaluate effectively it is first necessary to know what art for health projects aim to achieve and how.
that, just because this work is in a health context, practitioners are trying to improve individual health and wellbeing.
This review has found that projects in this field have a very wide range of stated aims, many of which might indirectly lead to effects on individual health and wellbeing, but that practitioners do not actually state that they aim to improve health and wellbeing. A summary list of the stated aims and suggested additional outcomes is given in Appendix 5. The most common aims can be grouped under the following headings: · Raising awareness of health issues and encouraging people to take responsibility for their health · Personal development · Aesthetic improvement of buildings and environments · Acquisition of art and craft skills · Social activity and participation · Staff development for health professionals · Health needs assessment · Communication between consumers and the health and social care agencies · Cross-sector partnership working. Many projects address several of these groups of aims. The use of the term `art for health' communicates an apparent assumption that projects are intended to improve or enhance health and wellbeing and that evaluations should therefore collect evidence of such improvement and individual health gain. Those in government, the NHS and arts funding organisations who are requesting evidence for the effect of art for health activity seem to expect this. But it should not be assumed
In fact it is particularly notable that hardly any project reports state explicitly that their aim is to affect health and wellbeing. The only ones that do so are three projects which include the phrase `to enhance health' in their aim. These projects are included in one report (30, 94, 125, 148, 156) that summarises five projects in total. In some cases it is clearly stated that improvement in health is not intended. The absence of explicitly stated aims to improve health and wellbeing is perhaps surprising in a field commonly referred to as `art for health'. It may be suggested that practitioners assume that the intention is to improve health and wellbeing and so do not feel that it is necessary to state that as an aim. It may be an omission which is simply due to not wishing to `state the obvious'. Alternatively, it may be that practitioners accept that it would be unrealistic to aim to improve health and wellbeing directly. Perhaps they have recognised and accepted that they should aim at indirect or intermediate steps towards improving health and wellbeing. However, it may be that most art for health practitioners actually do not aim to improve health, but rather aim to address a variety of aspects of health and wellbeing which have previously not been thought to be important. Certainly, the aims of most projects in this review are psychological, social and even spiritual, rather than physical. It seems reasonable that art would be more likely to be able to affect the mind rather than the body
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(psyche rather than soma). The aims are not for direct effects on health but for factors that might precipitate or facilitate such effects. One of the commonest types of aim is for personal development, particularly raising selfesteem and self-confidence. It may be that practitioners assume that these aims are intermediate indicators for, or steps towards, improvement in health and wellbeing. But there is little evidence that this is the assumption, as reports do not provide discussion of the issue. Health and art may be considered as the two ends of the range of aims. At one end are projects that aim to enhance health and wellbeing through involvement with art. In these projects the art is to some degree being used, or is at the service of, health improvement. At the other end are projects that aim to produce or present `pure' art and to broaden the audience for art. At this end the aim is not to affect health and wellbeing, but to produce and present art in a new context, which in this case is a health context. In many projects the aims are provision of interesting and stimulating activities, development of art skills and staff development. Some projects do address specific aspects of health, particularly mental health and physical disability. However, there are a few projects that have physical aims. These tend to be quite specific, such as reducing falls in older people and aiding breathing for children with asthma.
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4 Non-stated/broader aims and implicit theoretical models
The range of aims is expanded further if we move from an examination of the explicitly stated aims for projects to consider some of the general discussion presented in the reports. This discussion is found not only in project reports but also in a variety of conference, research and strategy papers. The writers provide thoughts and ideas both about their particular part of art for health and about the whole field that are often passionate and illuminating. The aims and purposes that are discussed can be loosely grouped under the following headings, but there is frequent overlap between them. 4.1 Theoretical concept of health
human worth, communication, autonomy, responsibility, self-direction and control, participation in the making of political decisions, cultural and spiritual needs and celebration. It also appears to be assumed that there are multiple determinants of health including environmental, economic, social and psychological factors. A research report on art for health (121) recommends use of the concept of `Social Capital'. It suggests that many of the aims of art for health projects such as increased self-esteem, participation and social connectedness will build social capital, and that this will lead to enhanced individual health. Some other relevant concepts that are suggested include `salutogenesis' and `sense of coherence' (151), and `foundation for achievement' (54).
The concept or model of `health' employed is crucial to an understanding of the aims of art for health. It also affects and informs the methods of evaluation that are appropriate. Unfortunately, these reports do not clearly state what model of health the art for health practitioners adopt. There is negligible explicit mention of concepts of health in the project reports, but the range and types of aims of the projects imply the use of a broad concept of health and wellbeing. Some of the more discursive reports do provide discussion of these issues (4, 23, 43, 116, 117, 121, 136, 138, 151, 153). They particularly point out the inappropriateness of the medical or health service model for this work because it sees health in negative terms as the absence of illness. A positive and holistic concept seems to be generally assumed by arts for health practitioners and is occasionally stated (38, 136). It is implied that important issues for health and wellbeing include personal and social identity,
Nicola Gardner provides a clear statement of the position of art for health activity as an approach to health and wellbeing (43, Sec. 4.1): `... the modern approach to medicine ... treats parts of the person or the disease, but all too often can overlook the whole. Illness and the places where we treat these, hospitals and clinics, are alienating as they physically set us apart from our families, friends and communities in separate buildings. The routines of health care are controlled by health professionals, reinforcing the sense of alienation and loss of control for the patient and carer. The arts have an important role in bringing a sense of ownership, participation and familiarity; and in reminding and helping us look at the entire person's needs.' Projects often appear to be attempting to reveal and explore issues around health and wellbeing which may have been ignored. As a result, art for health activity may be shifting and expanding both cultural and institutional understanding of `health'.
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A review of evaluation in community-based art for health activity in the UK
4.2 Communication/community/ participation
particularly effective in team building and providing insight and understanding into other team members' roles.
A large proportion of the documents emphasise the participatory and social aspects of art for health, the engagement in art activity to encourage conversation and communication, and also to `make special and celebratory' (eg 4, 23, 28, 30, 35, 38, 39, 43, 48, 54, 73, 94, 97, 121, 125, 126, 134, 135, 148, 153, 156). Participation, creating community, communication, conversation and listening are each frequently given as ends or aims in themselves. There seems to be a widespread assumption that social activity and inclusion in social networks are important for health and wellbeing. It is not clear whether there is any justification or evidence for this assumption.
Art is also being considered as part of doctors' training to improve communication skills with patients. One GP claims (153) that at present the medical schools train medics to be unemotional. Some projects (30) illustrate that artists can play a key role in creating a broader partnership in healthcare. Involvement of artists in the primary healthcare and health promotion teams can bring skills of creativity and lateral thinking to the practice. It is often said that health professionals tend to focus on physical aspects of health but, through addressing emotions, artists can help to provide a more holistic and integrated response to people's needs.
4.3 Personal development
4.5 Specific health needs
There is a widespread emphasis on the use of art for personal development through the discovery of creativity and social connectedness leading to increased confidence, self-esteem and empowerment. Many of the reports reviewed here seem to suggest that art can stimulate thought and provoke an individual response. This assists people to question their boundaries, explore issues, voice aspirations, identify needs and facilitate learning. As a consequence people may be enabled to make informed choices and become able to take control of, and responsibility for, their own lives and the factors affecting their health and wellbeing. There appears to be a political intention behind many community-based art for health projects to raise the consciousness and awareness of the effects of social inequality on health, promote wellbeing and empower communities to address these issues. There is also an apparent assumption that if individuals are enabled to express emotions they will be able to build the skills and strength necessary to promote wellbeing, deal with depression and anxiety, and prevent ill health.
Some work addresses particular health needs. One dance project (65) is working with neurologists to explore the effects that movement plays in Young Children's neurological development. Some projects address the needs of physically disabled people (37, 83, 104, 105) and others deal with mental illness (14, 39, 77, 92). In both there is an assumption that art can break down barriers and challenge prejudices. Also, some of these projects are providing an alternative to clinical care, which allows for personal, social and artistic growth. 4.6 Art Many reports emphasise that the quality of art produced is most important and state that it is the experience of quality which is effective and which generates hope. They affirm that mystery and magic are required rather than social work.
4.4 Staff development Some writers (eg 106, 108, 109, 111) promote involvement in Art Activities for the staff development of health professionals. They assert that by generating creativity, innovation and increased effectiveness, art activity is
There is much concern about the integrity of the art practice. The research on community-based projects by SHM Productions for the Health Education Authority (121, pp48-49) found that: `... attempts to make the content of activities overtly educational, didactic, social or health-related, met with
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general disapproval. This suggests that attempts to link arts projects too specifically to social or educational "messages" are likely to be unsuccessful, whereas attempts to capitalise on perceived notions of the value of "arts for art's sake" have a better chance of building strong communities of participants, and achieving benefits in terms of increased social capital, albeit via more indirect means.' Sue Roberts (22, p20) says that an arts project: `... needs to be absolutely crystal clear about its artistic purpose and integrity ... [or] it will become a health project which just happens to use the arts, rather than arts development in a health setting.' Another report (73, p43) states: `If the art is just seen as an add-on activity for keeping people amused or the place pretty, it will lose its effect.' There is a real concern that using art to deliver particular health requirements will simply result in bad art. This will not do anyone any good. It is important that art should not be subsumed by the requirements of health promotion or the medical profession. If art is to have an effect it must maintain its integrity, and its special power and effect must be asserted. A distinction can be made between art and the intentions of artists in community-based projects and art in hospitals. Art in hospitals generally brings established works into hospitals and displays them as a gallery would. Community-based work is grown from and reflects the experience of community members. Some of the artists involved emphasise that they are facilitating and nurturing art, and that any therapeutic or health improvement result is merely a spin-off. But many artists attempt to develop a role for the artist as responsible citizen, and so perhaps to produce a different kind of art. The term `art for health' itself carries implicit assumptions about the aim of the work and the role of art. The term can imply art that is at the service of health. The use of different conjunctions between `art' and `health' alter the implications, eg `art and health', `art into health', `art in health'. Tom Smith (136) recommends use of `art/health' to avoid the different assumptions that may lie behind these phrases.
An alternative would be clearer recognition of the differences between the types of work practised across the whole field of art for health (see Appendix 6). It is interesting that medical staff tend to assume that art for health contexts should be `safe' and have a calming effect. Some art can have this effect but art is also effective in stimulating thought, activity and dealing with difficult emotions. One project (46) was a touring exhibition by an artist suffering from cancer who had produced paintings in which he attempted to communicate his feelings about his experience. Staff in many hospitals did not want to show the exhibition stating that they felt `the pictures were not suitable for a hospital environment', and they `did not want patients to be upset' and `did not want patients challenged and confronted'. But the response from cancer patients seemed to be the reverse: `... the overwhelming evidence ... is that patients ... do not want to be isolated and marginalised with their fear and loss. They want to share and learn from the experience of others, and they want to be exposed to, and have access to, material of this nature.' 4.7 General aspects The Common Knowledge project (135) questions whether art/health is about promoting health, a healthy activity in itself, a means or an end, a useful vehicle to explore health, or all of these. Angela Everitt (30, 94, 125, 148, 156) suggests that the key concepts in community-based art for health are creativity, conversation, play, congenial space and emotional literacy. One writer (47, p1) says: `This project was founded on the belief that creative work with a professional artist ... has the potential to reach the parts that other things cannot.' But various writers point out that it is important to recognise that `the arts cannot do everything' and that it is necessary to be clear about what art for health can and cannot achieve. Bill McDonnell (49) points out: `As a culture we are too solution orientated. We need to accept that we don't have to have all the answers.'
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5 Evaluation
In addition to reviewing project reports to determine their aims, they were also examined to discover whether any evaluation was carried out and, if so, what methods were employed. Consistent information on other aspects of evaluations such as when they were planned, who carried them out and the intentions behind them was not contained in the reports and so no conclusions about these could be drawn. Out of the 64 projects, 54 include some evaluation and 48 state aims. Out of the 42 organisations, 36 include evaluation in their reports.
to maximise learning and generate reflection and informed debate. Most reports indicate that practitioners feel the aims of evaluation work are rather intangible and so are difficult to quantify. Numbers are collected wherever it is felt to be appropriate and straightforward, such as recording the number of attendees, but most information collected is qualitative. The information collected is from a wide variety of sources, including:
It is clear from these numbers that most of the organisations producing project reports are attempting to carry out evaluation of their work. Many of the project reports and other documents in the survey, including some covering letters, provide comment on, and discussion of, evaluation. It is clear that nearly all practitioners recognise its importance. However, in most cases the evaluation actually carried out is rather basic, unstructured, poorly thought out, provides limited information and often does not really assess the project's aims. Many of the report writers recognise these inadequacies and they comment on their uncertainty about how to carry out evaluation, what the most appropriate procedures are, and what types of evaluation will be acceptable to others. Some reports include comment on the reasons for adopting a particular approach. 5.1 Ethnographic approaches Most evaluators adopt an ethnographic or critical social science approach. It is often pluralistic, in that everything which may be relevant is collected. The best involve participative and reflective practice which attempts
· Participant observation and field notes by evaluators/artists steering group members/funders, etc · Interviews by evaluators/community researchers/other professional workers with all stakeholders including workers/steering group members/participants/ funders/advisors etc · Discussions with all stakeholders · Verbal feedback sessions · De-briefing sessions · Evaluation meetings · Focus groups · Verbal or written comments by all stakeholders and participants · Personal memoranda of reflections and remarks · Diaries by workers · Project stories written by users · Project planning and evaluation books for which participants gathered and put together a wide variety of material, including pictures, tapestries and sketches · Project documentation ­ attendance registers/ day books/minutes of meetings/promotional materials/ proposals/funding applications/notes of events/ comment books/scrapbooks · Videos of activities · Photographs
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· Audio tape · Artworks produced · Evidence of high standards · Awards · Reports in media · Accredited courses · Research on relevant documentation and local statistics.
Questionnaires and evaluation sheets are prevalent in school-based projects, and are particularly used by touring theatre companies. Full details of these questionnaires are provided in some cases. It is evident that the intention is primarily to provide information for the company about delivery and there is little, if any, attempt to assess effectiveness in achieving aims.
In most projects only a few of these types of information are collected and in many of the reports there is negligible information about the procedure used. There is also little attempt at analysis. A few projects, however, collect a wide selection of information and are very thorough and structured. One report (30, 94, 125, 148, 156) uses log frame planning, a technique which provides a structure or framework through which that practice may be understood, analysed, communicated and debated. In another (98), the analysis and interpretation consists of reducing the data by simplifying, abstracting and pulling out themes, noting patterns, commonalities and differences in the data. In these well thought-out examples there is an independent evaluator who facilitates, guides, and oversees the evaluation and who equips the artists and practitioners to collect the information. There is a commitment to sharing of knowledge and understandings. There is also an emphasis on the involvement of all stakeholders and that all their multiple perspectives are articulated and recognised. 5.2 Other approaches
Some projects do attempt to collect more quantitative measurements. There is a range from simple to complex approaches. One project involving arts on prescription (20) was evaluated by professionals who had a medical background, using a questionnaire before and after a series of sessions. They employed a standardised questionnaire (General Health Questionnaire) and added specially devised questions. This was intended to provide information on contacts with GPs and other health professionals in a three-month period, and to assess selfconcept, anxiety, depression, somatic complaints, social functioning, social relationships, activities, interests and hobbies. A statistical test was applied to the difference between scores on the questionnaire before and after the sessions. The evaluation of a project in a health action zone (40) collected qualitative data but also attempted to collect quantitative information through use of `a validated and standardised assessment tool', Frydenberg and Lewis's Adolescent Coping Scale. This was administered near the beginning of the project and a few days after the final performance.
Although most reports adopt an ethnographic approach, a variety of other methods are also used. A number of projects refer to the collection of comments through evaluation sheets or forms which are given out to participants or members of the audience. The content of the forms is not usually explained but they seem to produce very basic data which primarily concern delivery rather than achievement of aims. Many of the projects use questionnaires and one used an opinion survey. These are often employed without any comment on their appropriateness or effectiveness, but some reports state quite clearly that although they used or tried to use questionnaires they were found to be unsatisfactory and inappropriate.
One project (reported in 21) took an ethological approach in which observations were recorded in a highly structured way, employing scoring categories that were as unambiguous as possible and required relatively little interpretation by the observer. It produced a behavioural record and sought (and checked) to ensure high interjudge reliability. In one case (reported in 21) the effectiveness of music therapy was assessed against a set of specified goals. Each participant was assigned to a different treatment or non-treatment, so providing a simple randomised controlled trial. A project on the effect of singing (45) used technology to measure electrical activity in the brain via electrodes fitted to the head and a display on a specially designed computer graph. A dance project (65)
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is working with neurologists and attempting to show that particular movement patterns actively promote neurological organisation and development in young children. Assessment sheets are used to provide an individual child's `movement play profile' by observation and assessment of various components on 5 or 10 point scales or percentages.
5.3.3 Professional training The success of a project also depends on the skills and abilities of the artists involved. There is little reference to assessment of the skills required to do this work or to the need for training. Where it is mentioned the recommendation is that training is best achieved through practice with an experienced mentor, rather than through formal courses of study.
5.3 Evaluation of particular aspects Most evaluation work focuses on outcomes and results of a project, but some included other aspects. 5.3.1 Process and practice Although reports emphasise that the process is as important as the result in art for health work, evaluation tends to focus on the outcomes. The questionnaires used in school-based projects focus on practical aspects of delivery, but they also provide some information on the extent of audience engagement. Many reports provide some comments on the involvement of participants but the evaluation focus is on results. This relative absence of process evaluation seems surprising given the emphasis on participation. The practitioners seem not to be really evaluating the claimed strengths of their work. The lack of attention given to process evaluation might indicate that practitioners recognise the need for evaluation, but see the purpose of this as being primarily to satisfy outsiders who focus on results. A guide on evaluation may need to address this issue. 5.3.2 Project management The effective management of projects is obviously very important and some reports recognise the need for it to be included in evaluation. Community-based art for health projects often involve a wide range of partners including community groups, statutory bodies, voluntary sector, specialist agencies, schools and local committees. Reports regularly comment it is absolutely crucial for the successful development of a project that a steering group is formed. They recommend that this group should spend a lot of time discussing the project and the reasons for each partner's involvement. The steering group should generate a shared understanding of what the partners are collectively seeking to achieve, and ensure that all aims and objectives are jointly negotiated and agreed so that everyone's needs are met. Several reports describe the tension, confusion and misunderstanding which result if this careful planning is not carried out (eg 40, 136).
5.3.4 Art therapy Art therapy works in a medical context with individual clients or patients and so seems to be doing something different from community-based art for health. However, there is clearly some overlap between the two areas. Art therapy may be able to provide a useful contribution to the delivery and practice of art for health. The reports by arts therapists (29, 76) express concern about art for health projects that ask people to explore complex emotional issues. They wish to ensure that any issues arising can be adequately supported and followed up if necessary. This support is as important for workers as it is for participants. Art for health workers may become deeply involved in people's lives around times of great stress, distress and disturbance and are bound to be affected by these experiences. It is important that they look after themselves. Art therapy's code of practice obliges each therapist to spend regular amounts of time reflecting on practice with other practitioners. Art for health workers could benefit from using this model as one of the safety features of a project. It may be important to include this procedure in training and evaluation. 5.4 Appropriate methods The documents reviewed suggested that practitioners feel that the aims of this work are rather intangible and so are difficult to quantify. There are projects that attempt to produce quantitative information (eg 20, 46, 65), and several reports comment that both qualitative and quantitative information should be collected. The latter point out that a balance can be struck between the two, and that a valuable synergy may emerge from the combination (eg 4, 21, 22, 30, 40, 48, 94, 98, 121, 125, 148, 151, 156). However, it seems to be widely felt that it is inappropriate, and even dangerous, to try to reduce evaluation of the complex quality of life issues addressed by art for health to some kind of star rating
A review of evaluation in community-based art for health activity in the UK
11
scheme (eg 21, 22, 30, 48, 64, 78, 94, 125, 148, 156). The changes sought by art for health projects are not of the kind that may be easily quantified or monitored in a highly structured way. It is felt that an over-emphasis on a quantitative approach, and on investigations which match the criteria of scientific experiments, may limit the attention paid to variables which are a central focus of this humanistic practice (eg 21, 22, 35, 48, 64, 81, 97, 153). There is extensive concern that the work itself could be affected or even led by the requirements of evaluation (eg 12, 21, 64, 87). Many report writers are familiar with doing evaluation, but they draw attention to the differences in requirements of various stakeholders; eg the arts funders, statutory funders and medical funders all have different requirements. Many writers and practitioners are particularly concerned that there seems to be a need and a pressure for the evaluation methodology employed to be acceptable to the medical profession (eg 21, 47, 64, 81, 153). Many report writers express deep misgivings and worries that their work will be compromised, or even negated, by such demands. They are concerned that attempts to meet these requirements are liable to destroy the very things that are addressed (eg 12, 21, 64, 87, 97). These are very real and important concerns and must be taken into account in any consideration of appropriate methods for evaluation. Projects must be evaluated against their own aims, and evaluation methods used that are appropriate to assess whether or not those aims are achieved.
There are several project reports in this review whose approaches could be adapted and modified to suit the needs of many individual projects. In particular the reports by Angela Everitt (30, 94, 125, 148, 156), Janet Henderson (98), Tom Smith (136) and Ruth Hecht (28) can be recommended. Ruth Hecht was working as a member of a health promotion team but succeeds in maintaining some of the necessary distance and objectivity. Her report is a model of clarity. Tom Smith's report is written part way through a large project and does not provide details on evaluation practice, but the approach is thoughtful and inclusive, so the final project report can be expected to provide a valuable example. Janet Henderson's report is short and is on a comparatively small project, but is very clear and provides very useful guidance on evaluation and project management. Angela Everitt's report on five art for health organisations provides a structure which could be adapted to most purposes. It emphasises the inclusion of all stakeholders' diverse assumptions and requirements, and provides a method to help them all to be open and explicit about these. This review has included her interim report (30, 94, 125, 148, 156), but unfortunately her final report was completed too for inclusion. The interim report provides the most useful guidance to evaluation of any report covered in this review.
5.5 Guidance on evaluation and promising practice It is clear that many practitioners are struggling with evaluation and recognise that they need support and guidance. It is highly likely that they would welcome such guidance enthusiastically, and with considerable relief. On the other hand there are some organisations that provide no discussion or comment about the methods they have used, so it is not known whether they have considered their effectiveness or appropriateness. They seem to proceed with evaluation confidently while apparently being unaware that it is of rather limited value. Some of these practitioners could also benefit from guidance. 12
A review of evaluation in community-based art for health activity in the UK
6 Conclusions
This review has found that the majority of practitioners in community-based art for health recognise that it is important to evaluate their activity. Many are attempting to do so, but they are struggling to find appropriate methods, and the evaluation they carry out is frequently inadequate.
be regarded as indicators for, or intermediate steps towards, improving individual health and wellbeing. The intended effects may not be direct `health benefits' or `impacts on individual health gain' in a conventional sense, but they can generally be seen as related to a broad conception of health and wellbeing.
A common shortcoming is a failure to state and agree clear aims for a project. Whatever method of evaluation is adopted, practitioners can only collect appropriate data and evidence if they are clear about their aims. As stated earlier, there is a call for evidence of the effect of community-based art for health, but to be able to seek the evidence it is first necessary to be clear about what effect is intended. The people in government, the NHS and the arts funding organisations who are requesting evidence often appear to expect effects on individual health or `health benefits' in a conventional medical sense. However, the reports reviewed indicate that these may not be the effects which art for health projects aim to deliver. It should not be assumed that just because this work is carried out in a health context it is necessarily aimed at directly improving individual health. Art for health practitioners might not be aiming to improve health, but they may be addressing aspects of health and wellbeing which medicine does not, and which have previously not been emphasised. In the reports reviewed, the aims and potential outcomes, both stated and implied, are very diverse. This diversity is found across the whole field but often also within individual projects. Very few projects state that their aim is to improve health, while several state explicitly that they do not aim to improve health. Nevertheless, the majority of projects aim to produce effects which may be understood as indirectly affecting health or as directly affecting holistic health and wellbeing. These effects may
The concept or model of `health' employed is crucial to both an evaluation and an understanding of art for health. While practitioners seem to hold a holistic and expansive view of health, many outsiders, including sympathetic outsiders, tend to assume a concept of individual health as understood in conventional medicine. As a result there is a potential mismatch between the expectations of outsiders about what the effects of art for health might be, and the effects actually intended by practitioners. These possible differences in conception must be clarified and stated to avoid misunderstanding about the aims. Practitioners are not establishing a rationale for why their work is expected to have any effect, and what these effects might be. If they want to demonstrate effects of this work on health and wellbeing they need to provide a rationale for why these effects are expected. Art for health practitioners need to set aims which are achievable by engagement with art and they need to be able to justify the use of art as the best way to achieve these particular aims. It is important to be clear about what art can and cannot achieve. Many of those projects that do state aims are not carrying out evaluations in a manner that can determine whether those aims are achieved. They have recognised the need for evaluation, but the methods they are using do not provide the information required.
A review of evaluation in community-based art for health activity in the UK
13
Practitioners are not evaluating the claimed strengths of their work. For example, it is often claimed that involvement in the process of this work is very important, but evaluation rarely addresses this aspect. Most evaluation only examines outcomes. It appears that evaluation is being carried out in an attempt to meet other stakeholders' requirements rather than to demonstrate the potential strengths of the work. There is widespread uncertainty about what evaluation methods to use and what methods will be acceptable to other stakeholders. There is also concern that a requirement for quantitative evaluation will affect and damage the delivery of the work. In particular there is concern about the requirements of medical practice. Art for health appears to be working in the context of medicine and the health service, and so it may be assumed that it has similar aims. But it is trying to do something quite different to medicine. It is therefore inappropriate to attempt to meet the expectations of the medical world, or to assume art for health should use medical methods of measurement and assessment. Community-based art for health needs to step outside the medical domain and its domination of health and wellbeing. It may have more in common with public health and health promotion than it does with medicine. Most art for health practitioners are passionate about, and committed to, their work. They are skilled professionals who understand the effects and potential of this activity. It is essential that they confidently assert their vision, knowledge and expertise, rather than being solely at the service of other stakeholders and attempting to meet their assumptions and fulfil their requirements. The practitioners are the people who can best set the agenda for art and health. They need to be quite clear about what they aim to achieve and the rationale for engaging art in this process.
lifting spirits, stimulating thought, challenging ideas, and providing new views of the world. In doing these things, all art indirectly contributes to wellbeing and health in the holistic sense. Many art for health practitioners seem to want to engage art directly to affect health and wellbeing. If art for health work is intended to contribute to the achievement of aspects of holistic health that are not covered by medicine, that difference should be stated. Most art for health projects apparently do not aim to directly improve individual health, but they do address a wide variety of issues which may be important with respect to health and wellbeing. Projects often appear to be attempting to reveal and explore issues around health and wellbeing which have been ignored. Art for health activity may be shifting and expanding both cultural and institutional understanding of `health' and drawing out aspects of health which have previously not been thought to be important. If so, it is important for practitioners and supporters to articulate and explore these ideas and their implications. Art for health needs to assert the value of its own strengths, intentions and effects. Art for health might be able to contribute to the health and wellbeing of the population, not only in the way that art already does, but in a direct and structured way, embedded in a new and broader approach to health and wellbeing. However, it will not have the opportunity to make that contribution effectively unless it provides evidence for its special effects. To be able to provide such evidence, practitioners first need to clarify what the aims and rationale of art for health are, and what its special effects can be. It is essential for them to set objectives which are specific, clear, realistic and achievable, and to describe and assess the effects in terms which are appropriate to the activity.
Many practitioners emphasise that the quality of the art produced is most important, otherwise it will not do anyone any good. There is a tension between the production of good quality art and the production of a particular effect. If art is to have any effect it must maintain its own integrity.
Arts for health practitioners must assert their aims and the potential effects clearly and confidently, and not be intimidated or diverted by the demands and assumptions of other stakeholders.
The art should be allowed to be judged on its own terms, to do what it is best at doing. Art does a variety of things including expressing emotions, enhancing environments,
14
A review of evaluation in community-based art for health activity in the UK
Appendix 1 ­ The sample
This review has covered a total of 157 documents which range from 150 page reports to single sheet publicity flyers. They include detailed reports of projects, research reports, conference papers, strategy documents, annual reports, newsletters, published articles, information sheets, publicity materials, project proposals, lists of projects and practitioners in an area, notes and letters. These documents have been produced since 1993, but are mainly from 2000-2001. The documents were obtained from four sources. These were a request letter, the files of CAHHM, the National Network for the Arts in Health (NNAH) and the researcher. The letter (reproduced on p17) requesting reports on community-based art and health projects was sent in July 2001 to 109 members of NNAH. These organisations were selected by CAHHM from the total membership of NNAH on the basis that they were known or thought to be community-based or to include a community aspect. All documents received until early December 2001 were included in the review; 45 organisations responded, sending 90 documents. Although the letter explained that this request was for support with a survey of evaluation, it asked for any documents produced by that organisation. The request for any available documents was intended to allow some assessment of whether or not organisations carried out any evaluation at all, but this assessment is obviously biased as organisations will be more likely to respond if they have evaluation to report. The documents from CAHHM were selected and supplied by that organisation. The reports from NNAH were obtained largely on one visit by the researcher to the organisation's office and a quick search through its files with a focus on community-based projects.
It is probable that more documents could have been obtained through more active and repetitive requests and research. Responses may depend on organisations having a paid administrator who has the spare capacity to respond to such non-essential requests, which many organisations do not have. Some organisations that are known to be carrying out interesting work in the field and so would have been expected to respond, did not do so. This review could have adopted an approach of actively seeking out reports from these organisations, but that procedure would be biasing the sample towards those which are more likely to be doing evaluation. Instead it was decided to accept the sample as simply representing those organisations which were sufficiently motivated to reply. It was decided that the sample obtained would be sufficient and that this review may be regarded as providing a satisfactory and representative snapshot of recent and current activity in community-based arts and health in the UK. The table in Appendix 2 provides a list of the documents reviewed and numbers them in alphabetical order of the organisation. Documents referred to in the text are indicated by this number in brackets, eg (97). One document includes five organisations and so is referred to by all five numbers (30, 94, 125, 148, 156). The researcher was surprised and gratified by the number of documents available and the extent of activity in community-based arts and health. When he was researching a report six years ago, in 1996 (97), there was very limited activity and hardly any documentation. There has been an explosion of activity in the field in this short intervening period. Unfortunately, however, the increase in activity has not so far been matched by an increase in the effectiveness of evaluation. Some of the
A review of evaluation in community-based art for health activity in the UK
15
reports which were then available are still among the few which can be recommended as examples to follow for evaluation.
The result is that the 63 project reports under consideration have been treated as including 64 projects. These reports are from 42 organisations.
Appendix 3 also classifies the documents in a variety of ways. An analysis of these classifications is provided in Appendix 4.
The figures in the analysis have not been converted into percentages because these could suggest that they provide `measurements' of activity, eg the percentage of all community-based arts and health projects which are carrying out evaluation. It is felt that the sampling procedure would not justify such conclusions. As regards the responses to the request letter, it may be assumed that those organisations which have carried out evaluation are more likely to respond. As regards the documents from existing files, it is almost certain that these files have a much higher percentage of reports which include evaluation than would be found in a random sample of art and health projects. Therefore we may assume that the sample reviewed includes a higher percentage of projects that carry out evaluation than the percentage in all the art and health projects currently in progress.
Project reports The total of 157 documents included 63 reports which provide details of a specific project. The review focuses on these 63 reports, but it is also informed by careful and thorough consideration of the information and ideas presented in all the documents. It should be noted that regarding these 63 reports: · Some organisations submitted separate reports on each of several projects · Some reports are by one organisation but include many individual projects · One report includes projects by five organisations · One project submitted four reports. In the report which includes five organisations (30, 94, 125, 148, 156), three of these organisations are actually conducting numerous projects. If all these projects were listed separately, the total number of projects covered would be over 100. But as details are not provided on each separate project, these three organisations have been treated as each being one project. 16
A review of evaluation in community-based art for health activity in the UK
Appendix 2 ­ Request letter
Dear I am carrying out a national survey for the Centre for Arts and Humanities in Health and Medicine (CAHHM) on the use of evaluation in community-based art and health projects, and I am seeking your assistance. `Evaluation' in this case does not only mean carefully planned and structured research, but includes any reflection upon the activities involved in a project. For example, it could include participants' comments on any aspects of a project, artists' judgments about their own work, the objectives (however vague) of a project, number of people involved, number of agencies involved, changes produced by a project, and many other possibilities. The survey, which is being supported by the Health Development Agency, is seeking to gain a complete picture of the whole range of types of reflection which are applied to the process of delivery of art and health projects and their effects. I would be grateful, therefore, if you would send me any project reports which you have. Whether or not these reports include specific sections on evaluation/assessment/reflection, I would like to include them all in the survey. If you charge for your reports, or you require payment for photocopying, postage etc, you may enclose an invoice if the total is less than Ј5. If it is over this amount, please send a report summary and let us know how much you will require for the full version. This survey is being done in collaboration with the National Network for Arts in Health (NNAH). If you have already submitted material to them there is no need for you to do so again, but please let me know so that I can ensure that your work is included. The aim of this survey is firstly to provide an overview of the current practice of evaluation in art and health projects in community settings, and to find out if there is a need for a practical guide to appropriate methods. The longer term aim is to use the demonstration of the range of art and health activity and its effectiveness to help obtain increased funding for projects. If you would like further information about this survey please let me know. I look forward to hearing from you and receiving your reports. Yours sincerely John Angus CAHHM Researcher
A review of evaluation in community-based art for health activity in the UK
17
Appendix 3 ­ Documents reviewed
The table is arranged and numbered in alphabetical order by organisation. A document is referred to in the text as (XX), where XX is its number in the table.
One document describes evaluation of five organisations and so is referred to by all five numbers (30, 94, 125, 148, 156).
Key
Project* P ­ Project report PAR & PA ­ Project as annual report or article, so not detailed Pr ­ Proposal R ­ Research study Location C ­ Community HC ­ Community-based but in health organisation, eg GP surgery CH ­ Care homes H ­ Hospital
Health (Projects or organisations with a specific health sector focus) MH ­ Mental health LD ­ Learning disabilities D ­ Disabled O ­ Older people Y ­ Young people Theory E ­ Includes discussion of evaluation T ­ Includes theoretical ideas about art and health
Status I ­ Independent organisation A ­ Health authority led/initiated AI ­ Authority initiated ­ but delivered by independent organisation AT ­ Art therapy
Evaluation E ­ Evaluated EP ­ Evaluation planned A ­ Aims/objectives stated O ­ Outcomes stated (suggested/claimed) ­ different or additional to aims/objectives
Survey S ­ Organisation which responded to survey request SA ­ Additional reports from above
* The grounds for classification as a project report are difficult to define ­ some included give little detail, but enough to provide information about a specific activity and thoughts about it. Note: ­ Some organisations submitted separate reports on each of several projects ­ Some reports are by one organisation but include many projects.
18
A review of evaluation in community-based art for health activity in the UK
19
A review of evaluation in community-based art for health activity in the UK
Organisation
Place
Report title
Sub-title/description
Author
1 Action Space
London
Annual report 1998/9 `... bringing the visual and performing arts to Londoners with learning disabilities.'
2 all CHANGE 3 ARIA
London Glasgow
Flyer Arts on prescription
Community arts company ARIA ­ an action research initiative to promote the application of the arts to mental healthcare
Larry Butler
4 ARPAT 5 Art for Life Chard Hospital
Edinburgh
Action research proposal for the arts therapies in mental health
Taunton and Artist in residence Somerset folded colour leaflet
Proposal for 3 year project Artist in residence
6 Art for Life: Taunton Taunton
and Somerset NHS and
Trust Hospitals
Somerset
Sense of place/sense Artists' residencies of self
7 Art for Life:
Taunton and
arts programme for Somerset
NHS Trust and Take
Art ­ Somerset's
rural arts
development agency
Hospital arts programme
8 Art for Life:
Taunton and Artist in residence
Take Art ­
Somerset
Minehead
Community Hospital
9 Art Operation:
Maidstone Art Operation
Maidstone and
and
letter ­ arts
Tunbridge Wells NHS Tunbridge coordinator
Trust
Wells
Artist in residence Handwashing bus to visit schools
Date Project Locat. Status Health Theory Eval. Survey
1999 PA
C
I
LD
A
R
O
1999 Pr
EP
Pr
AT
T
EP
No
H
A
date
1999/ P
H
A
2000
15pp
O
SA
E
SA
O
S
1995/ P
H
A
1996
18pp
2001 Pr
C
A
Y
E SA A O S
20
Organisation
Place
Report title
Sub-title/description
Author
Date Project Locat. Status Health Theory Eval. Survey
10 Art Shape
Glos.
Action research
Project with the Summerfield
report:
Charitable Trust ­ in nursing
Inspirations ­ creative home
futures for older
people
Nov PA CH
I
O
E
2000 R
A
20pp
11 Art4Space
Information sheets
Three artists working with local communities
C
I
S
12 Artcare Salisbury District Hospital
Salisbury
Annual report 2001
Art project integrated as part Emma Ryder
of health trust
Richardson
2001 PA
H
A
R
HC
E
E
S
13 Artlink
West Yorkshire
Celebrating Sound Festival: report and evaluation forms
Residential event for people with learning disabilities
1998 P
C
I
LD
E
S
A
14 Artlink West Yorkshire
West
Annual report
Yorkshire 1998/99
Arts programmes for people with learning disabilities, and mental health service users
1999
HC
I
M
8pp
H
LD
15 Artlink and
Edinburgh Three issues of
Lothian Hospital Arts
FUSION
Consortium
Generating art within hospital settings
P
H
AI
T
A
S
16 Artlink Central
Stirling
Arts equals
Brochure
A
opportunities
17 Arts Consultancy
Newcastle NNAH questionnaire upon Tyne
Arts project in centre for cancer treatment (part of 3)
H?
?
EP
18 Arts in Healthcare Hastings Evaluation of staff
Project with hospital staff
Evelyn
2001 P
H
A
E
­ art in hospital
East Sussex participation projects
Carpenter:
21pp
A
project ­ Conquest
community
Hospital, Hastings
education
`Works of Art' Trust,
consultant
Hastings and Rother
NHS Trust
A review of evaluation in community-based art for health activity in the UK
A review of evaluation in community-based art for health activity in the UK
Organisation
Place
Report title
Sub-title/description
Author
Date Project Locat. Status Health Theory Eval. Survey
19 Arts on Prescription Stockport
Exercise on Prescription and Arts on Prescription
Referral by GP, voluntary sector or self
1997? P
HC
A
7pp
20 Arts on Prescription Stockport Arts on Prescription: Evaluation of above an evaluation
Prof Peter
1997 P
HC
A
Huxley and the
project team
E
E
T
A
O
21 Arts Therapists in UK Wales
A review of research relevant to outcome measurement in the art therapies
Research review report
Melanie Kliendients Neil Frude
1999 R 19pp +33pp
AT
E
O
T
22 Artservice
??
Arts in healthcare
Evaluation report
Sue Roberts
Only R
E
initiative:
for Northern Arts Board and
part of
T
evaluation report
Northern Regional Health
report:
Authority
pp16-
25
1993
9pp
23 Bolton Community Homes and Freedom in Dance
Bolton
Community dance project 2000/2001
Dance and exercise sessions with older people
June P
CH
I
O
E
2001
A
28pp
O
24 Bolton Health Promotion Service and activ8
Bolton
Tagged
Drama project with young people
No
P
C
AI
Y
O
date
2001?
2pp
25 Bolton Hospitals Arts Bolton
Annual report
Bolton Hospitals Arts Project
1999/
H
A
O
Project
Annual report
2000
26 Bradford Health Authority and Artlink West Yorkshire
Bradford NHS
Bradford Arts and
Conference
Health Day: Supporting
the development of
healthy living centres
1999
AI
S
12pp
21
22
Organisation
Place
Report title
Sub-title/description
Author
Date Project Locat. Status Health Theory Eval. Survey
27 Brainstorm Madcap
Birmingham Leaflet: developing community art for mental health
Community art for mental health
C
I
MH
S
28 Bristol Area Specialist Health Promotion Service
Bristol
I talk now
Health promotion and community arts projects
Ruth Hecht
1996 P
HC
A
28pp
E
E
T
A
O
29 British Association of UK
Art Therapy
Some notes for the National
Oct
Art Therapists
Network for Arts and Health
2000
(BAAT)
launch
AT
T
30 Bromley-by-Bow London Healthy Living Centre
Arts in Health National Evaluation Programme: interim report
Arts in Health National Evaluation Programme
Angela Everitt August P/R C
I
Ruth Hamilton 2000
34pp
E
E
T
A
O
31 Bromley-by-Bow London Art in Health
Windsor conference paper
?
1999?
T
Healthy Living Centre
15pp
32 Carnegie National UK Sports Development Centre, School of Leisure and Sport Studies, Leeds Metropolitan University
Letter and progress report to Common Knowledge
Research project on social inclusion for Dept of Culture, Media and Sport ­ 14 projects ­ inc CK (rep 93)
E
O
T
33 Chiltern Community Chiltern Arts
Paper on art and disability
Community arts healthcare projects
2000/1
C
AI
D
34 Clare Louise Edwards Ceiriog
Report on student
student project
Clare Louise
2001
H
S
Ward at project
Edwards
Chirk
Hospital
35 Commedia
UK
Use or Ornament
Francois
2000
Matarasso
E
E
T
36 Community Dance Wales
Leaflet
The National Forum for
O
Wales
Community Dance in Wales
A review of evaluation in community-based art for health activity in the UK
A review of evaluation in community-based art for health activity in the UK
Organisation
Place
Report title
Sub-title/description
Author
Date Project Locat. Status Health Theory Eval. Survey
37 Conquest Art
Surrey
No project reports
Enriching the lives of
2001
but sent:
physically disabled people
­ outline of intro talk
­ two small brochures
­ issue of magazine:
summer 2001
A
S
38 Copeland Borough Cumbria Council
Transfusion: evaluation report
Young people's health project
1999 P
C
A
Y
6pp &
16pp
E
S
A
39 Core Arts
London
Prospectus ­ colour brochure
Mental health/arts company
PA
C
I
M
R
H
A
S
O
40 Cornwall and Isles of Scilly HAZ
Cornwall `These voices' and Isles of Scilly
A case study evaluation of the arts and health project (phase 1)
Nick May
April P
C
AI
Y
E
E
S
2001
A
25pp
41 CragRats
Huddersfield React
Theatre in education
company
Report: `Sexual Health' touring theatre production
2000 P
C
I
Y
E
42 Dance 4 and Foundation For Community Dance
Leicester
Creative movement Conference report and the healthier older person
2000
O
E
22pp
43 Department of
UK
A report on the value Review ­
Nicola Gardner June R
A
E
O
Health Strategy and
and use of the visual unpublished draft report
2001
T
Planning Division
arts in healthcare
44 Disability Media Agency
Art of Disability ­ information
Individual artist
Steven Bloch
C
I
D
A
S
45 Dr Anand ­ GP
Newcastle Sing ­ and let your cares fade away
Article in `The Journal' on project at GP surgery
Rosie Waller
14/6/ PA HC I? 2000 2pp
E
E
T
A
O
46 East Sussex, Brighton Brighton The Emotional Cancer The Emotional Cancer Journey: Margaret Felton 1997 P
C
AI
and Hove NHS
and Hove Journey: Michele
Michele Angelo Petrone
18pp
East Sussex Angelo Petrone ­
exhibition report
E
S
A
O
23
24
Organisation
Place
Report title
Sub-title/description
Author
Date Project Locat. Status Health Theory Eval. Survey
47 Eden Arts ­ Eden District Council
Cumbria
Letter ­ arts officer project report
Artists' residencies in primary Sue Allan schools in areas worst affected by foot and mouth disease
2001 P
C
I
Y
approx
30pp
E
S
A
48 Equal Arts
Gateshead Creating Conversations: interim report
Gateshead Elderly Arts Project Angela Everitt 1994 P
CH
I
87pp
O
ET
E
A
O
49 Foxhill School
Sheffield Respect Project:
Respect Project in primary
Bill McDonnell 1999? P
C
I
Y
evaluation report
school
John Goodchild 17pp
E
SA
A
O
50 Gwent Healthcare Gwent
Various short
Artists in residence
1996
H
S
NHS Trust
documents
programme
51 Hastings and Rother Hastings NHS Trust
Art in hospital project
52 Healing Arts
Isle of
Isle of Wight
Wight
Healthcare NHS Trust
Letter
Art projects in hospital?
H
A
E
S
53 Health Education UK
An evaluation resource Guide for evaluation
Jane Meyrick
1999 R
E
Authority
for healthy living
Paige Sinkler
56pp
centres
54 Helen Chambers UK
The role of community artists in primary care health promotion: creating connections and compassion
MSc thesis
Helen Chambers 1995 R 120pp
ET
O
55 Helix Arts
Sunderland Institute for the Health Colour brochure of the Elderly: report
O
S
56 Hull and East Riding Hull and West End Children's West End Children's Unit Community Health East Riding Unit puppetry project puppetry project NHS Trust health promotion service
Nov P
HC AI
Y
2000
4pp
E
S
A review of evaluation in community-based art for health activity in the UK
25
A review of evaluation in community-based art for health activity in the UK
Organisation
Place
Report title
Sub-title/description
Author
57 Hull and East Riding Hull and St John's House Community Health East Riding Jabadao NHS Trust health promotion service
St John's House Jabadao Dance with children
58 Hull and East Riding Hull and Adolescent unit
Community Health East Riding graffiti and banner
NHS Trust health
making project
promotion service
Adolescent unit graffiti and banner making project
59 Hull and East Riding Hull and Adolescent Unit, West Adolescent Unit, West End
Community Health East Riding End Music and CD Music and CD making project
NHS Trust health
making project
promotion service
60 Hull and East Riding Hull and Speak Out Community Health East Riding Newsletters 1 and 2 NHS Trust health promotion service
Speak Out drama and health in six secondary schools
61 Hull and East Riding Hull and A celebration of arts
Community Health East Riding in health projects:
NHS Trust and Arts
brochure
Unit of Kingston
upon Hull City
Council
Pilot projects focused on the specialist children's services
62 I am ­ the inspired art movement London network
London
I am [email protected] Modern
Report on inaugural conference
63 J. Casson
Evidence-based
Dramatherapy
practice received from
Martin Gill via email
64 Jabadao
??
Dance and health
Windsor conference paper
J. Casson ??
Date Project Locat. Status Health Theory Eval. Survey
Oct P
HC AI
Y
2000
4pp
E
SA
Oct
P
HC
A
Y
2000
3pp
E
SA
Nov P
HC
A
Y
2000
4pp
E
SA
March P
C
A
Y
& April
2001
2pp
each
E
SA
A
2001? PA HC AI
Y
T
E
S
R
A
O
2000 Photos 12pp 2001 2pp 1999? 9pp
I
M
H
AT
T
S
E T
26
Organisation
Place
Report title
Sub-title/description
Author
Date Project Locat. Status Health Theory Eval. Survey
65 Jabadao
Building evidence on the value of movement play: short report
Movement play and evaluation research
P
E
EP
S
T
A
66 Joseph Rowntree Wales
Creative regeneration: To highlight effect of community Tim Dwelly
2001 P
C
I
E
Foundation
lessons from 10
arts in regeneration ­
64pp
A
community arts
10 projects in Wales
O
projects
eg Arts Care ­ mobile dark
room for special needs users
67 Kala Sangam
Bradford
NNAH questionnaire Craft work with Asian women re mental health
C
I
M
E
H
?
68 LIME
Four reports
S
on CD ROM
­ only able to open
three as `text-only'
(not DRIVWO~2.EXE)
69 LIME
Bolton
Seven short-term artist In seven locations within the
residencies
mental health directorate at
Bolton Hospitals NHS Trust
Sept P
H
AI
M
1999-
H
April
2000
36pp
E
S
A
A
O
70 LIME
Manchester
The arts and Ashworth Hospital: a report on a unique experiment
Project in high security hospital
Brian Chapman 9pp P
H
AI
M
H
A SA
71 LIME
Manchester The Emergency
Central Manchester
Starship
Healthcare NHS Trust
(CMHT) children's
accident and
emergency unit
Projects in children's accident and emergency unit
4pp P
H
EP SA
72 London Arts
London
The Art of Well-Being Partnership strategy for the arts and health sectors
2000
I
T
6pp
A review of evaluation in community-based art for health activity in the UK
A review of evaluation in community-based art for health activity in the UK
Organisation
Place
Report title
Sub-title/description
Author
Date Project Locat. Status Health Theory Eval. Survey
73 Look Ahead Housing London Association (LADA)
The Story of Art at Aldgate Hostel (draft report)
Aldgate Hostel for homeless people
Jean Horstman 1998 P
C
Julia Rowntree 59pp
74 Loud Mouth
Birmingham Trust Me
Educational Theatre
evaluation report
Company
(emailed report)
Theatre in health education
1999 P
C
38pp
75 Loud Mouth Educational Theatre Company
Working For Marcus ­ Theatre in health education Jan Norton
Oct P
C
an evaluation from
The Theatre
1999
three perspectives:
in Health
36pp
booking teacher,
Education Trust
teacher and student
(THE)
(emailed report)
for Walsall
Health Authority
76 Malcolm Learmouth UK and Karen Huckvale
Support for the Art in Comments on relation of art
Health from Art
therapy and art/health
Therapy
Malcolm Learmouth Karen Huckvale
77 MAPS
Stockport The MIND art project The MIND art project in
The MIND Art Project
in Stockport: an
Stockport
evaluation
Sarah Clarke
2000 P
C
Exec.
summ.
2pp
78 Medical Architecture University of Visual Art and
Plan for a study of relationship Susan Francis 2001 Pr
H
Research Unit
South Bank, Architecture in Acute between visual art and
(MARU)
London Hospitals
architecture in acute hospitals
79 Medicinema Guy's Hospital
London
Operational report on Medicinema cinema briefing note ­ hospital coordinator
P
H
80 Merseyside ACME Liverpool Note of report
To evaluate community arts
C
I
E
I
Y
I
Y
AT
E
T
I
M
H
E T A
E
E A O
E
S
E
SA
A
O
E ? ?
E
S
SA
81 Michael Baum
UK
Evidence-Based Art? Article Journal of the Royal Michael Baum
E
Society of Medicine
T
94: 306-307
27
28
Organisation
Place
Report title
Sub-title/description
Author
Date Project Locat. Status Health Theory Eval. Survey
82 music and dance Cornwall I want to go to
Education (MaDE)
Amberley
Report on a pilot music and Pat Hickman
1998 P
H
I
dance project
4pp
Stroke Rehabilitation Unit of
City Hospital, Cornwall
83 Music and Dance Cornwall Mines are closing,
Report on a music and dance Pat Hickman
1998 P
CH
I
Education (MaDE)
minds are opening project ­ home for people
3pp
with cerebral palsy
84 Music and Dance Cornwall Country Reminiscence: An intergenerational project in Pat Hickman
1999 P
C
I
Education (MaDE)
a rural community
three Cornish communities
Chris Morgan
12pp
natural history project
85 Music and Dance Cornwall MADD (music-arts- Project on children's ward in Pat Hickman
Sept P
H
I
Education (MaDE)
dance-drama) arts for Royal Cornwall Hospital.
Chris Morgan 2001
children in hospital May 2000-July 2001
16pp
evaluative report
86 Music and Dance Cornwall Rolling back the years: Report in unnamed publication Pat Hickman
No
P
C
I
Education (MaDE)
an intergenerational
date
arts and reminiscence
2pp
project in Cornwall
87 Music Network
Dublin
Music in healthcare project: evaluation report
Programme of performance Judith Wilkinson and participatory workshops
P
CH
I
88 Music Network
Dublin
Music in healthcare project: evaluation report Phase 2
Programme of performance Judith Wilkinson and participatory workshops
P
CH
I
89 Newcastle Healthy Newcastle Old Spice Report
City project
1997-1999
Action for Health ­ senior citizens in Newcastle (AFH-SCIN)
1999 PA
C
I
14pp R
90 North and East
North and Note
Devon Partnership East Devon
NHS Trust
Art therapy
O
O Y
Y
E
O Y
O
E
O
T
O AT
E
SA
A
E
SA
A
E
SA
A
O
E
SA
A
E
S
A
E
S
A
O
E
SA
A
A
O
A
S
A review of evaluation in community-based art for health activity in the UK
A review of evaluation in community-based art for health activity in the UK
Organisation
Place
Report title
Sub-title/description
Author
Date Project Locat. Status Health Theory Eval. Survey
91 North Staffordshire North Staffs Open Art Society Combined Healthcare NHS Trust
A review of arts activity in
Saul Hewish
2000? P
H
A
North Staffs Combined
Approx
Healthcare NHS Trust
150pp
E
E
A
O
92 North Tyneside Arts North
Studio: Arts and
Tyneside
Business
Article
North Tyneside Arts Studio: artists' studio for people recovering from mental illness
C
I
M
H
93 Oldham NHS Trust Oldham Letter ­ no reports
S
94 Pioneer Projects Looking Well
Yorkshire
Arts in Health National Arts in Health National
Evaluation
Evaluation Programme
Programme:
interim report
Angela Everitt August P/R C
I
Ruth Hamilton 2000
34pp
95 Pioneer Projects
Yorkshire NNAH questionnaire Looking Well community led arts-based project
C
I
96 Pioneer Projects
Yorkshire
Millennium Festival Fund ­ final report on project: Millennium Bugs
Completed questionnaire plus press cuttings
97 Pioneer Projects
North Yorks/ Lancs
An enquiry concerning possible methods for evaluating arts for health projects
Report on evaluation
John Angus
1999 R
C
I
79pp
98 Pioneer Projects
North
Evaluation of `Getting A project on community
(then: Celebratory Yorkshire Together'
participation through arts
Arts for Primary
Health Care)
North Yorkshire and
Airedale NHS Trust
Dr Janet Henderson
1996 P
C
AI
14pp
99 Pod Clare
Ceredigion Letter
Individual artist
C
I
100 Poems in the Waiting Room
Richmond Report 2000
Poems in the Waiting Room
Poetry pamphlets for waiting rooms
P
HC
I
E
E
T
A
O
E A SA
E
O
T
E
E
T
A
O
S A O
29
30
Organisation
Place
Report title
Sub-title/description
Author
Date Project Locat. Status Health Theory Eval. Survey
101 Project Ability
Glasgow
Space for Art: a creative strategy for 1999-2004 ­ booklet visual arts Prog 2000-01 ­ leaflet Art Workshops at Westlands Report 406: paintings by Japanese children
Visual arts company that specialises in creating sustainable opportunities for disabled people
P
C
I
D
A
S
102 Quantum Creative Newcastle NNAH questionnaire Art on prescription ­ painting
Health
upon Tyne
(part of 3)
C
I
EP
103 Robin Philipp
UK
A users' guide to the Draft report for discussion at Robin Philipp
Aug
E
practice and benefits Windsor II conference
1999
T
of arts in healthcare
130pp
and healthy living
104 Share Music
N Ireland Share Music 1999
Residential music courses for Terence Zeeman 1999 P
C
I
D
disabled
7pp
E
S
A
105 Share Music
N Ireland Share Music 2000
Residential music courses for Sandra Joyce
2000 P
C
I
D
disabled
8pp
E
SA
A
106 Sheffield University Sheffield Institute of General Practice
A Different Way of Being: reflective practice at the turn of the millennium
Windsor conference paper
Gillie Bolton
1999? 13pp
T
O
107 Sheffield University Sheffield Institute of General Practice
The Northern General Hospital Palliative Care Story: application for grant
Project proposal for writing in palliative care
Gillie Bolton T. W. Noble
Pr
H
AI
T
A
S
108 Sheffield University Sheffield Institute of General Practice
Reflections Through Course for healthcare the Looking-Glass: professionals the story of a course of Pub: Teaching in Higher writing as a reflective Education 4 (2): 193-211 practitioner
Gillie Bolton
1999 P
HC
18pp
E
O
S
T
109 Sheffield University Sheffield Don's Diary
Article on reflective practice Gillie Bolton
1999
SA
Inst. of Gen. Practice
TES 16 July 1999
A review of evaluation in community-based art for health activity in the UK
A review of evaluation in community-based art for health activity in the UK
Organisation
Place
Report title
Sub-title/description
Author
Date Project Locat. Status Health Theory Eval. Survey
110 Sheffield University Sheffield Institute of General Practice
Understanding Misunderstanding in Medical Consultation
Description of use of reflective practice writing with GPs. In: Medical Humanities: a practical intro. Kirklin and Richardson (eds): 89-108
Gillie Bolton
2001 PA HC 19pp
111 Sheffield University Sheffield Stories at Work:
Article re reflective practice Gillie Bolton
1999
Institute of General
reflective writing for writing in medical and
3pp
Practice
practitioners
nursing education.
Lancet 354: 241-43
112 Sheffield University Sheffield Stories at Work:
Critical writing for health
Gillie Bolton
1994 P
HC
Institute of General
fictional-critical
professionals' development
14pp
Practice
writing as a means British Educational Research
of professional
Journal 20 (1): 55-68
development
113 Sheffield University Sheffield On becoming our own Article on therapeutic writing Gillie Bolton
2000
Institute of General
shaman: creative
Context Feb 2000 pp18-20
p3
Practice
writing as therapy
114 Sheffield University Sheffield Writing as Therapy ­ Article about a `writing as
Gillie Bolton
2001
Institute of General
a Therapeutic Space: therapy' day school with
7pp
Practice
opening the box
group of counsellors
In: Counselling ­ the BACP
Counselling Reader
Vol 2 2001 pp106-112
115 Sheffield University UK Institute of General Practice
Keep Taking the
Project with six GPs
Gillie Bolton
2000 P
HC
I
Words: Therapeutic British Journal of General
2pp
Writing in General Practice Jan 2000 pp80-81.
Practice (also reported
in 104)
116 Sheffield University Institute of General Practice
Poetry as a key to
Article in: Medical Humanities. Gillie Bolton
2001
healthcare
Evans and Finlay (eds) BMJ
16pp
pp119-135
T
O SA
SA
E
E
SA
T
E
SA
SA
T
E
SA
O
T
O SA
31
32
Organisation
Place
Report title
Sub-title/description
Author
Date Project Locat. Status Health Theory Eval. Survey
117 Sheffield University Institute of General Practice
`Every poem breaks a Article
silence that had to be Feminist Review 62,
overcome'
pp118-133
The Therapeutic Power
of Poetry Writing
(also reported in 102)
Gillie Bolton
1999 PA HC
I
15pp
118 Sheffield University Institute of General Practice
Correspondence
Four letters Lancet Vol 357
Includes one
May
letter from Gillie 2001
Bolton
119 Sheffield University Institute of General Practice
`The Rime of the
In: Medicine and Literature: Gillie Bolton
2001
Ancient Mariner' by the doctor's companion to the
Samuel Taylor
classics. John Salinsky
Coleridge
Radcliffe Medical Press
pp207-220
120 SHM Productions UK for the Health Education Authority
Art For Health: summary bulletin
A review of community-based Produced
1999 R
arts projects and interventions by SHM
6pp
which impact on health and Productions for
wellbeing
the HEA
121 SHM Productions UK for the Health Education Authority
Art for Health: a review of arts-based projects and interventions which impact on health and wellbeing
One of a series on social capital for health research review of arts/health projects and evaluation
No R date ­ 1999? 80pp
122 Signposts
Sheffield
Sheffield Writing
Development Project
Writing Health 2000: completed form and report
Writing development project: writing workshops in three GP surgeries
4pp P
C
I
123 South Peterborough South Primary Care Trust Peterb'gh NHS
Letter
Replied ­ have no appropriate material
124 South Tees Hospitals Middlesb'gh NNAH questionnaire Artworks in hospital NHS Trust
H
A
T
E
SA
O
SA SA
E T
E
O
T
E
SA
A
S
EP
A review of evaluation in community-based art for health activity in the UK
A review of evaluation in community-based art for health activity in the UK
Organisation
Place
Report title
Sub-title/description
Author
Date Project Locat. Status Health Theory Eval. Survey
125 South Tyneside Arts South
Studio
Shields
Arts In Health National Evaluation Programme: interim report
Arts In Health National Evaluation Programme
Angela Everitt Aug P/R C
I
M
E
E
Ruth Hamilton 2000
H
T
A
34pp
O
126 Studio Upstairs
London Annual report
A working art studio within a therapeutic framework
1999 PA
C
I
M
T
A
12pp R
H
127 The Council for
UK
Music In Hospitals
Review 2000
Music in hospitals
2000 PA
H
I
R
A
S
O
128 The Royal Devon and Exeter
The Exeter Evaluation Evaluation research project of Peter Scher
1999 P
H
A
Exeter Healthcare
Exeter Health Care Arts ­
Peter Senior ­ 106pp
NHS Trust
artworks in hospital
Arts for Health
E
E
A
O
129 Theadora Children's Stoke on Feedback notes/points/ Clowns in hospital
Trust
Trent
form
H
I
Y
S
130 Trentham Mews
London
Jigsaw: putting people Annual report
2000 PA HC I?
A
Medical Centre
together in Trentham 1999-2000
19pp R
­ art projects at GP surgery
131 Trust Arts Project (TAP) and Lambeth Healthcare NHS Trust
Tyne and Wear
On Site/Off Site
Arts and Health Care: Collaborative project examining historic and contemporary issues on a healthcare estate
Photos P
HC
AI
M
A
1999
H
16pp
132 Tyne and Wear
Tyne and
Health Action Zone Wear
Common Knowledge
Framework summary of first Carnegie interview with CK Project Manager and Director
Common Knowledge SEE 93
July
C
AI
2001
E
O
133 Tyne and Wear
Tyne and
Health Action Zone Wear
Common Knowledge
First Phase Project Report 1998-2001 An `Arts In Health' Initiative for the Tyne and Wear Health Action Zone
Common Knowledge ­ art/health community projects
Tom Smith?
2001? P/R C
AI
16pp
E
E
A
33
34
Organisation
Place
Report title
Sub-title/description
Author
Date Project Locat. Status Health Theory Eval. Survey
134 Tyne and Wear
Tyne and
Health Action Zone Wear
Common Knowledge
Interim evaluation report ­ OHP summary
Common Knowledge 21? art/health community projects
Tom Smith
June P
C
AI
2001
10pp
E
E
A
135 Tyne and Wear
Tyne and
Health Action Zone Wear
Common Knowledge
Report on `A Six-Hour Common Knowledge
Coffee Break'
­ introductory conference
Tom Smith
Feb P
C
AI
2001
16pp
E
E
T
A
136 Tyne and Wear
Tyne and
Health Action Zone's Wear
Arts and Health
Project
Common Knowledge: Common Knowledge
interim evaluation
21? art/health community
report
projects
Tom Smith
Nov P
C
AI
2001
90pp
E
E
T
A
O
137 University of Umea Sweden Attendance at cultural Swedish interview survey of L. O. Bygren
1996 R
C
I
Dept of Social
events, reading books living conditions BMJ 313:
B. B. Konlaan
4pp
Medicine
or periodicals, and 1577-80
S-E. Johansson
making music or
singing in a choir as
determinants for
survival
E
O
T
138 Vital Arts and University of East London at Royal London Hospital
London
The patient doesn't end at the elbow: creativity lends a hand in occupational therapy
Proposal for a research project at the Upper Limb Occupational Therapy Dept
No Pr
H
AI OT
E
A
date
4pp
139 Walsall Community Walsall Male Art: art in
Project report ­ issues around
2000? P
C
AI
E
Arts (CAT)
men's health
men's health
27pp
A
140 Walsall Community Walsall Arts into Health:
Three year strategic
Kate Grant
2000
Arts Team
strategic framework development framework
24pp
and Walsall Health
December 2000
Authority
Solutions that fit
E
A
S
O
141 Walsall Community Walsall Arts Team
Arts into Health in the Borough of Walsall
Publicity leaflet
1999/ 2000? A3
E
A SA
O
142 Walsall Community Walsall
Critical Measures:
Evaluating arts into health ­
July
Arts Team
summary report of one one day conference
2001
day conference
E
SA
A review of evaluation in community-based art for health activity in the UK
A review of evaluation in community-based art for health activity in the UK
Organisation
Place
Report title
Sub-title/description
Author
Date Project Locat. Status Health Theory Eval. Survey
143 Walsall Community Arts Team East Walsall Health Action Zone
Walsall
`Young and Smoke Arts into PSHE project: Free' summary report school pupils years 7&9
Sept P
C
AI
Y
2001
26pp
E
SA
A
144 Walsall Community Walsall Arts Team Arts into PSHE
`How do I see Me?'
Arts and health consultation project ­ four primary schools
Oct- P
C
I
Y
Nov
2000
44pp
E
SA
A
145 Walsall Community Walsall Arts Team and Walsall Health Authority and Healthy Schools Scheme: Arts into PSHE
(Draft) documentation report on Walsall's Pilot `Transition' project
Arts into PSHE and healthy schools initiative project
May- P
C
AI
Y
July
2001
62pp
E
SA
A
O
146 Walsall Community Arts Team, Walsall MBC Health Action Zone
Walsall
Happenin' project report
Event involving young people in West Walsall
July P
C
AI
Y
T
E
SA
2001
A
16pp
O
147 Walsall Community Walsall Arts Team: Arts into PSHE
Arts into PSHE: newsletter 1
Brief descriptions of approx Arts into PSHE Jan
25 projects
coordinator
2001
8pp
C
I
Y
A SA
148 West End Health Resource Centre
Newcastle
Arts in Health National Evaluation Programme: interim report
Arts in Health National Evaluation Programme
Angela Everitt Aug P/R C
I?
Ruth Hamilton 2000
34pp
E
E
T
A
O
35
36
Organisation
Place
Report title
Sub-title/description
Author
Date Project Locat. Status Health Theory Eval. Survey
149 West Midlands Arts Board
150 West Yorkshire Playhouse
West Yorkshire
151 Withymoor Village Surgery
Dudley West Midlands
­ Letter ­ Arts and health projects in West Midlands: overview ­ Arts and health/ social exclusion: projects in West Midlands: list ­ Healthy living centres and the arts in West Midlands: list ­ Hospitals: contacts ­ Arts and mental health: contacts ­ Potential speakers: arts, health, community ­ Year of the Artist in West Midlands ­ Art/health projects
A Heydays B Connect C Spark D Spark ­ pilot E Activate
A case study of
Art projects at GP surgery
Withymoor Village
Surgery ­ a health hive
Keith Tones
1999 P/R HC I?
Jackie Green
130pp
S
S
E
E
T
A
O
A review of evaluation in community-based art for health activity in the UK
152 Withymoor Village Surgery
Dudley West Midlands
Withymoor Surgery ­ a health hive
Art projects at GP surgery
Malcolm Rigler 1997 20pp
HC I?
153 Withymoor Village Surgery
Dudley West Midlands
Art and health in Dudley
Windsor conference paper
Malcolm Rigler 1999? 18pp
154 Wolf and Water: arts company
Devon
Brochure ­ loose leaf Arts company ­ various
article 2pp
projects
No P
C
I
date
6pp
E
T
O
S
A review of evaluation in community-based art for health activity in the UK
Organisation
Place
Report title
Sub-title/description
Author
Date Project Locat. Status Health Theory Eval. Survey
155 Word Of Mouth
Cornwall Project description Proposal for three year project
No Pr
C
I
A
­ oral history
date
6pp
156 Wrekenton Lantern Project
Gateshead
Arts in Health National Evaluation Programme: interim report
Arts in Health National Evaluation Programme:
Angela Everitt Aug P/R C
I
Ruth Hamilton 2000
34pp
E
E
T
A
O
157 Wright Stuff Theatre Huddersfield A Shot in the Dark:
of Puppets ­
25 schools performance
supported by
workshop for young
CAHHM and Arts
people in school
Faculty Newcastle
re drug, alcohol and
University
tobacco use
Proposal for evaluation
To be Pr
C
I
Y
E
A
carried
out
2001-
2003
158 Y Touring Theatre London Company
Cracked 2001: an evaluation
Touring theatre production
2001 P
C
I
Y
E
S
A
159 Y Touring Theatre London
Theatre of Debate
Feasibility study
SA
Company
Stage 5
for work in art/health
160 Yorkshire and Humberside Arts
Yorkshire Serious Fun
Four community projects
Bill McDonell
No R
C
I
date
33pp
E
O
S
161 Yorkshire Arts
Letter plus five items
S
(49, 80, 96, 122, 162)
162 Yorkshire Arts
Arts in health contacts List
SA
37
Appendix 4 ­ Analysis
Analysis of table (Appendix 3)
The other 52 documents reviewed include:
Number of documents reviewed
Received from CAHHM
138
From survey request
90
From CAHHM files
48
From researcher's files
4
From NNAH's files
15
Total
157
Responses to survey request
Documents received
90
Organisations responding
45
Total number of organisations in survey (includes seven individuals)
104
Document types
From table, P = 60; P/R = 7 (5 of these are in one document); R = 10; PAR = 9; PA = 3; Pr = 9 (93 documents)
The qualification for classification of a document as a project report (P or P/R) is that it provides details about a specific activity. Annual reports and articles are not so detailed.
Project reports
63
Project annual reports
9
Project articles
3
Proposals
9
Research reports
13
Questionnaire responses Conference papers Conference reports Funding proposals Feasibility studies Strategy documents Publicity leaflets Information sheets Newsletters Letters, notes, and other personal communications Contacts lists Lists of art and health projects in a region Analysis of project reports The qualification for classification as a project report is that it provides details about an activity. Number of project reports 63 Note: ­ Some organisations submit separate reports on each of several projects ­ Some reports are by one organisation but include many individual projects ­ One project has four reports ­ One report includes projects by five organisations. Number of separate projects 64
38
A review of evaluation in community-based art for health activity in the UK
Note: Regarding the report which includes five organisations (30, 94, 125, 148, 156). Three of these organisations are actually conducting numerous projects; however as details are not provided on each separate project, these organisations have been treated as each being one project. Another report includes five projects. If all these projects were listed separately, the total number of projects covered would be over 100. Number of organisations with project reports 42 Several organisations have more than one project report
Health authority initiated
17
projects run by independent
organisations
local authority initiated and run 1
Health focus (where specific)
Learning disability
1
Disabled
3
Mental health
4
Young people
18
Old people
5
Young and old people
2
Evaluation
Note
Projects which include some 54
evaluation
Organisations which include 36
evaluation in project report
Projects which state aims
48
The figures in the analysis have not been converted into percentages because these could suggest that they provide `measurements' of activity, eg the percentage of community-based arts and health projects carrying out evaluation.
Location
Projects in community
34
Projects community-based
13
in health organisation
Projects in care homes
5
Projects in hospitals
14
Organisations running:
Projects in community
25
Projects community-based
6
in health organisation
Projects in care homes
4
Projects in hospitals
8
It is felt that the sampling procedure would not justify such conclusions. As regards the responses to the request letter, it may be assumed that those organisations which have carried out evaluation are more likely to respond. As regards the documents from existing files, it is almost certain that these files have a much higher percentage of reports which include evaluation than would be found in a random sample of arts and health projects. Therefore we may assume that the sample reviewed includes a higher percentage of projects that carry out evaluation than the percentage in all the arts and health projects currently in progress.
Status
Projects initiated and run by 30
independent organisations
Independent organisations
24
running projects
Projects run independently in 2
health organisations
Health authority initiated and 8
run projects
A review of evaluation in community-based art for health activity in the UK
39
Appendix 5 ­ Stated aims and outcomes summary list
Demonstrate/assess evaluate value/role of art for health Increase awareness/profile of art for health Provide access to art Introduce contemporary art to people Increase number of people experiencing the arts Support regional artists Develop art forms Generate art in (and in response to) new contexts Develop understanding/appreciation of art Produce art Ensure high quality Participate in art Encourage creativity Provide opportunities for creative activity Development of art skills Opportunities for learning Opportunities for employment Improve quality of life Improve wellbeing Lift the spirits Have fun Provide emotional experiences and inspiration Explore ideas Stimulate discussion Engage imagination Provide therapeutic activity Self-expression Self-determination Increase confidence Increase self-esteem Self-empowerment
Independence Pride Personal achievement Personal development Psychological rather than physical impact Sense of coherence Provide a safe/congenial environment Create welcoming, warm, relaxed and safe place Create environment of respect and support Participation Make new friends Talk/conversation/chat Foster emotional literacy Explore and share experiences, feelings, thoughts, emotions Develop communication skills Extend social interaction Increase sociability Reduce isolation Develop (sense of) community Develop social capital Combat social exclusion Work together Involve people Give people a voice Enable people to express their views Provide people with means to pursue their rights Inform people options available to improve their quality of life Enable (young) people to contribute Express views on health/social services Identify health needs Voice aspirations
40
A review of evaluation in community-based art for health activity in the UK
Change agencies' conceptions of involving people Health needs assessment Profile older people as respected, valued, and trusted members of society Enhance attitudes to older people Encourage interaction between generations Enhance relations between people from different ethnic groups Reduce stress/anxiety/depression Enhance health and wellbeing Promote health Raise awareness/understanding of health issues Raise awareness/understanding of social/environmental issues Challenge misconceptions Improve access to/communication of information Decrease fear of treatment Reduce health risk behaviours Encourage individuals to look after their own health Increase healthier lifestyles Provide alternative treatment to medication Discourage somatisation Allow people to express emotions Catharsis Allow people to mediate/take control of/take responsibility for their own treatment and healing Improve recovery rates Assist emotional and physical recovery Reduce relapses Reduce medication Reduce consultation time Reduce costs Reduce disease Support for recovery from mental illness Improve understanding of mental illness Reduce fear of and stigma of mental illness Break down prejudice Integration/inclusion Relief and rehabilitation of physically disabled Occupational therapy
Increase exercise Provide opportunities for gentle exercise for men and women with problems of weight, diabetes and high blood pressure Increase range of movement Improve muscle power Improve relaxation Improve sleeping Reduce falls and accidents in older people Reduce incidence of asthma attacks among children with asthma Assist and aid breathing for children with asthma Reduce current rate of teenage pregnancy Strengthen immune system Promote neurological development in young children Improve/enhance/humanise buildings/environment Make building more conducive to healing Assist healing Improve morale Staff/professional development for health care staff Team building Change care approaches/policies Suggest/develop new approaches Encourage holistic approach to health and care Support carers Communication Break down barriers between staff and patients Aid communication between GPs and patients Improve GPs' understanding of patients Collaboration/cooperation between sectors Alliance Joined-up working Partnership
A review of evaluation in community-based art for health activity in the UK
41
42
Appendix 6 ­ Map of the art for health field
A review of evaluation in community-based art for health activity in the UK
Built environment
Art in hospitals
Medical humanities
Art therapists
Community arts
Healthcare General
Passive audience
Active workshops
Doctors' Patient/Dr training communication
Art to treat
Art in Arts to reach community deprived healthcare groups
Hospitals
Primary care
Use of art and design in creation of healing healthcare environments
Use of visual and performing arts to improve experience of patients, staff, visitors in hospitals, promote healing
Use of literature, visual art, drama to broaden doctor training, promote empathy and communication
Use of various arts to treat labelled conditions, clinical aims
Use of arts as powerful tool to build communities. Use of arts to consult communities, give voice to more socially excluded groups (© HDA 2001)

J Angus

File: a-review-of-evaluation-in-community-based-art-for-health-activity.pdf
Title: art for health FINAL v3
Author: J Angus
Author: Marc Beishon
Published: Wed Oct 16 13:31:20 2002
Pages: 46
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