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Emerging Themes

Overview

As the Invest to Save evaluation draws to a close we have been reflecting on the process and analysing the information collected as it emerges. The data is still being analysed and the final results should be available in the Autumn, however we are keen to begin sharing what is coming up to promote discussion and response from those of you who are interested in developing or using research within the field.

The process overall has been one of participation through exploration of practice, questioning and dialogue; and this we believe has been instrumental in facilitating team and organisational learning and development. We realised from the outset that this project would not just be about measuring benefits of arts activities with existing tools, but would be about learning with projects what was happening in practice, how this was developing and what aspects should, or could be captured within evaluation and how we might best achieve that. This we feel, is a work in progress but overwhelmingly what has begun to emerge are some core areas for focus and development in terms of understanding activity, representing impact and facilitating development which we will begin to explore.

We are keen therefore to continue working within this methodology whilst analysing and reporting the findings and disseminating them. The sharing of findings from this evaluation for example will be one aspect of the interactive dissemination event we have planned for September. We are planning a stimulating focused event that will hopefully encourage engagement and interdisciplinary participation in discussion with both the findings from this study along with perspectives on what is happening in the field generally. This we hope will promote shared exploration of concepts emerging and underpin ongoing discussions around arts and health development.

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Study design

The study design has two core elements; a quantitative measure of eudaimonic well being and its relationship to health, mental health and job satisfaction, and a qualitative exploration of multiple perspectives on the arts and health field. The aim of taking this mixed methodological approach was to both measure impact and benefit of aspects of the work that projects found important and to furthermore explore with stakeholders, project teams and participants their perspectives on arts activities including views on impact, benefit, health and well being.

The focus for the study emerged out of an intensive consultation process that formed stage one of the process.

Stage (1)

At the outset of the project we wanted to form strong working relationships with the projects, to enable us to best explore their practice and build capacity for evaluation and project development. We also were looking to explore with each of them what aspects of their work they felt were valuable in terms of health and how we might capture that most effectively. This was tricky as often the projects had stakeholders from both the arts and health fields and each of these had differing underpinning values and goals for the practice as well as different ways of determining or measuring outcomes. What we wanted to do was to get to the heart of felt benefit, to encourage the project teams to engage with each other and discover and bring forward what was central to their practice.

For this 'journey into projects' we utilised appreciative inquiry this is an action research tool that provides a framework for positive exploration of what people are passionate about within their work, it encourages appreciation of strengths, successes and good practice. This process was very affirming for those involved and generated both a positive culture for evaluation and the capacity for reflection and development. The response to engaging in this process differed across projects, for some it evoked radical sometimes difficult transformation, for others it was a positive force for team building, practice review and planned change.

For the research team this way of working enabled us to enter projects and engage with all the stakeholders at a deeper level. We found that we were accepted into established teams in a critical friend type role, where we were privileged to learn and develop our own sense of what was happening, and share in forming an understanding of that work whilst being accepted to challenge aspects of it in a way that those within the teams perhaps did not feel able to do.

The results of the sharing and learning across projects from this consultation through inquiry process led us to developing the central focus for measurement of benefit within this study, which comes from the following question;

Does engagement with art and arts activities improve an individuals sense of eudaimonic well being, and does experiencing an increased sense of this form of well being have an impact on:

  • Health
  • Mental health
  • Job satisfaction

We are still analysing the questionnaire data associated with this, however what I would like to do at this stage is to share some emerging themes from the qualitative data as well as some useful aspects of the overall process that it might be helpful. Full details of both aspects of this process will be made available within the final report, highlights of which will be on this website.

Emerging qualitative themes

Emerging themes from stage one of the evaluation (consultation and mapping of practice) suggest that benefits achieved within projects arise as a result of their efforts to invest creatively in people and places, and it is this investment that builds the capacity and motivation within participants for positive changes around health and well being, as well as improving potential for job satisfaction for staff. Further more it is suggested that those 'positive changes' are brought about in response to the quality of the creative approach developed by projects and also the nature of the arts activities and emphasis placed on creative investment in health and community environments, which all combine to stimulate what is described as an active or eudaimonic form of well being within participants. It is suggested that this form of well being is not just about feeling good, or happy, it is achieved where people experience personal growth, challenge, raised self esteem and confidence and engage in purposeful experiences and relationships. Achieving eudaimonic well being is thought by practitioners to be linked to improved motivation and capacity for making healthy choices and changing unhealthy behaviours.

Primary emergent themes:

  • It is the nature of the arts and health approach in creating an environment conducive to growth and change that is most valuable.
  • This is described as being a creative space that generates an atmosphere where individuals have permission and support to innovate and respond…where there is a spirit of co-operation and appreciation.
  • Engagement with arts activities within this space generates experience of 'flow' conditions within and around those involved and this in turn leads to greater feelings of confidence, self-esteem, motivation and enhanced creativity.
  • This in turn promotes greater feelings of well being described as a particular active or 'eudaimonic' for of well being which when established in turn leads to enhanced potential for healthy behaviours or choices.

Reflecting on the process

  • The Appreciative Inquiry workshops from data collection stage 1 have proved to be very successful in engaging teams and focusing project aims and objectives.
  • Questionnaires have had a mixed response from projects. The mental health projects have found them lengthy and time consuming. Projects with older people in hospital have found the length of them difficult for vulnerable and sick patients. The other projects have reported that the questionnaires although lengthy have facilitated understanding and positive relationships with participants.
  • The research process overall including our ongoing involvement and dialogue with projects has proven to be instrumental in promoting developments and new projects as well as mediating difficult changes and transition in existing projects. Whilst being a worthwhile and useful process for the research team in terms of learning this has been at times time consuming and stressful.

Key recent Developments

  • As a result of the research process with Start in Salford it emerged that there was a need to raise awareness of the potential of arts activities with health professionals. The director of the organisation along with the research team met with a member of the improving working lives committee for Salford PCT to look at the potential of an arts project to meet both groups aims. An offshoot pilot project is planned to be evaluated by the team.
  • As a result of the research process with Alder Hey hospital. The research team have been approached to look at a continuing potential two year evaluation with the neurology department and FACT organisation to evaluate the impact of arts activities on staff, children and families and to explore the process of the arts organisation working within health care.
  • Pendle arts on prescription only had a small pilot scheme budget to be involved with the study, but the work done and the awareness raised with the PCT from doing interviews has led to the development of an arts and health forum, that will bring together key stakeholders in the region to advocate for arts and health practice and collaboration to explore commissioning of future projects and priorities for the work.

Amanda Kilroy
May 2007
a.kilroy@mmu.ac.uk


Notes

September Event
The Invest to Save: Arts in Health project team will be holding a dissemination event at the Lowry on September 19th 2007. Details of this day will be publicised in June 2007.

Definition of Eudaimonic Well-Being
It is suggested that this form of well being is not just about feeling good, or happy, it is achieved where people experience personal growth, challenge, raised self esteem and confidence and engage in purposeful experiences and relationships. Achieving eudaimonic well being is thought by practitioners to be linked to improved motivation and capacity for making healthy choices and changing unhealthy behaviours.

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