Arts and culture engagement for health: a Danish population-based study.

OBJECTIVES: Global health challenges are complex and new approaches are pivotal. Engagement in arts and cultural activities is commonplace across different cultures, and research shows associations with benefits for health and wellbeing. Using the arts for health promotion and prevention of illness has increased worldwide. STUDY DESIGN: A population-based study. METHODS: Data were obtained from the Danish Health and Wellbeing Survey in 2019. A self-administered questionnaire was sent to 14,000 randomly selected adults (aged ≥15 years). The questionnaire included items on self-rated health and frequency of participation in various cultural activities (concerts or musical events; participation in a choir, band, or orchestra; theatre show or other performing arts; cinema; art museum or exhibition; library). A cultural participation index was calculated based on the six questions on cultural activities. Logistic regression models were fitted to examine the associations between the index and good self-rated health, adjusting for relevant covariates. RESULTS: In total, 6629 individuals completed the questionnaire (47.4%). The most frequent activity, used at least once a month, was visiting a library. A strong association between the cultural participation index and self-reported health was observed. A one-point-higher index score was associated with a 10% higher likelihood of having good self-reported health (adjusted odds ratio: 1.10; 95% confidence interval: 1.08-1.12). CONCLUSIONS: This study supports the understanding that engagement in arts and cultural activities is beneficial for self-rated good health. Individuals with higher frequency of arts and culture engagement were more likely to report good health than those with lower engagement.

Arts and culture engagement and mortality: A population-based prospective cohort study.

AIMS: The aim of this study was to investigate associations between having visited the theatre/cinema and an arts exhibition during the past year and all-cause, cardiovascular disease (CVD), cancer and other-cause mortality. METHODS: The 2008 public health postal survey in Scania, Sweden, was distributed to a stratified random sample of the adult population (18-80 years old). The participation rate was 54.1%, and 25,420 participants were included in the present study. The baseline 2008 survey data were linked to cause-of-death register data to create a prospective cohort with 8.3-year follow-up. Associations between visit to the theatre/cinema, visit to an arts exhibition and mortality were investigated in survival (Cox) regression models. RESULTS: Just over a quarter (26.5%) had visited both the theatre/cinema and an arts exhibition during the past year, 36.6% only the theatre/cinema, 4.9% only an arts exhibition and 32% neither of the two. Not visiting the theatre/cinema during the past year was associated with higher all-cause and CVD mortality. Not visiting an arts exhibition was associated with higher all-cause and other-cause mortality. The combination of having visited neither the theatre/cinema nor an arts exhibition during the past year was associated with higher all-cause, CVD and other-cause mortality. CONCLUSIONS: There is an association between attending arts and culture activities and a reduced risk of CVD and other-cause mortality but not cancer mortality, although model imperfections are possible.

Engagement with arts and culture activities in the Danish general population: Longitudinal associations with new onset or persistent depression and mental wellbeing.

OBJECTIVES: International literature suggests that arts and culture activities may benefit mental health, however, such survey studies conducted in the Danish population are scarce. Further, studies have investigated the associated risk for incident depression, but not for persistent depression. The objective of the current prospective study was to assess associations of engagement in arts and culture activities with incident/persistent depression and also mental wellbeing among Danish adults in the general population. DESIGN: Observational prospective study. METHODS: Data stem from a Danish nationally representative panel study of 5000 adults (aged 15+ years) conducted in 2019 and 2020, which was linked to Danish register data. An exposure variable was constructed for frequency of attending concerts, theatres, museums, and cinemas. Validated scales were used to assess the presence of depression (PHQ-8) and levels of mental wellbeing (SWEMWBS). Binary logistic regression analyses were conducted to assess the risk of incident depression (among participants free of depression at baseline), as well as the risk of persistent depression (among participants with depression at baseline), while multinomial logistic regression was used to assess odds for moderate and high mental wellbeing (low as base outcome) while adjusting for baseline values. RESULT: In terms of incident depression, quarterly engagement in arts and culture activities (compared to never) was associated with an OR of .43 (95%CI .23-.80), while 8 times or more was associated with an OR of .53 (.29-.97). In terms of persistent depression, quarterly engagement was associated with an OR of .30 (.10-.90), while 8 times per year or more was associated with an OR of .26 (.07-.92). Similar to the patterns for incident/persistent depression, associations with moderate mental wellbeing showed higher odds for quarterly engagement and 8 times per year or more. Quarterly engagement was also associated with higher odds for high mental wellbeing but did not reach statistical significance. CONCLUSIONS: The results support the involvement of the cultural and creative sectors in health strategies. Mental health promotion initiatives as well as arts and culture sectors may encourage the general public to engage in arts and culture activities with frequencies of at least once per quarter.

Swedish primary healthcare practitioners' perspectives on the impact of arts on prescription for patients and the wider society: a qualitative interview study.

BACKGROUND: There is growing evidence that participating in arts activities are beneficial for mental health and wellbeing. Many patients attending primary care services have mental ill-health or social issues that healthcare practitioners currently do not have adequate ways of supporting. This study set out to explore the perspectives of primary healthcare practitioners on Arts on Prescription (AoP) as an additional referral pathway. METHODS: A qualitative exploratory descriptive approach within an interpretive framework using semi-structured interviews was used to explore healthcare practitioners' perspectives and experiences of AoP programmes in Sweden. Ten interviews were conducted with healthcare practitioners in primary care. Data were analysed using an inductive thematic approach. RESULTS: The healthcare practitioners interviewed, recognised the need for more holistic approaches to care for those with mental health issues. They perceived that AoP is beneficial for patients in terms of motivation, creating routines, providing social interactions, and increasing self-esteem. In addition, AoP was felt to have the potential to impact upon current service provision and wider society. However, whilst the opportunity to refer patients to AoP in conjunction with conventional treatments was valued, participants reported that time pressures on practitioners and the continuing dominance of the medical model of care were barriers to wider acceptance amongst practitioners at the present time. CONCLUSIONS: AoP enabled primary healthcare practitioners to offer an additional pathway for patients that is an adjunct to the traditional care pathway. However, the programmes tend to be project-based and often time limited. For programmes to be sustainable and be included as part of a wider range of interventions available to healthcare practitioners' suitable levels of funding would be required.

Music Activities and Mental Health Recovery: Service Users' Perspectives Presented in the CHIME Framework.

Internationally, mental health service developments are increasingly informed by the principles of recovery, and the availability of arts and creative activities are becoming more common as part of provision. Mental health service users' experiences, reflecting on the complex nature of using music participation in recovery are, however, limited. This essay considers literature that explores how music can support mental health service users in a recovery process. We have selected studies that include a broad spectrum of music activities, as well as literature considering various concepts about recovery. The conceptual recovery framework CHIME, that includes five important components in the recovery process, is used as the backdrop for exploring music activities as a contribution to recovery-oriented practice and services in mental health care. Eleven key components are identified in which music can support the recovery process: Feelings of equality; Social and emotional wellbeing; Tolerance; Hope and social agency; Triggering encounters; Redefining and reframing; A social practice; Moments of flow and peak experiences; Moments of meaning; Continuity; and Potentials instead of limitations. This essay concludes that the experiential knowledge of music activities from service users' perspectives is essential knowledge when developing and using music activities in mental health recovery services. While this essay acknowledges that music activities can also produce unintended negative outcomes, the focus is on the positive contributions of music to mental health recovery processes.

An Arts on Prescription Programme: Perspectives of the Cultural Institutions.

Research on Arts on Prescription (AoP) programmes are on the increase and the participants' positive mental health outcomes are well-documented. However, there is insufficient research that considers the participating cultural institutions' perspectives. A qualitative focus group interview was conducted with the participating culture institutions in an AoP project in Denmark. Representatives from seven cultural institutions participated in the interview. The data was transcribed and analysed using Braun and Clark's (Qual Res Psychol 3(77):77-101. https://doi.org/10.1191/1478088706qp063oa , 2006) thematic approach. The cultural institutions were positive about the interdisciplinary collaboration with the Center for Mental Health and benefited from working with groups of people with mental health problems. They considered the collaboration to have encouraged skills development by working with groups that they did not regularly engaged with. If cultural institutions are to engage with the mental health wellbeing agenda then policy-driven initiatives can support collaborations that involve groups of people with mental health problems.

Interdisciplinary arts and health practice with an institutional logics perspective.

Background: Investigating the interdisciplinary relationships between stakeholders engaged in arts and health practice in the UK and Denmark, specifically with regard to institutional logics theory. The identified stakeholders: health professionals, museum educators and mental health service users. Method: Semi-structured interviews were conducted with 30 participants: health professionals, museum educators and service users. Data were collected in Denmark and the UK. A thematic approach was used to analyse the data and theoretical lenses of sociological theories, and institutional logics explored the findings. Results: The interdisciplinary work in arts and health is complex, given the different disciplines and institutions involved. Findings illustrate that institutional logics play a vital and ambiguous part in arts and health practice and that this presents a challenge for interdisciplinary working in the field. Conclusions: Awareness of the complexity of multiple logics in the arts and health field; recognising the differences between disciplines and institutions could benefit from research and practice.

[Participation in art and cultural activities has a positive effect on somatic illnesses].

The increasing international research into the use of arts and cultural activities in clinical contexts documents a number of beneficial effects in relation to many illness and diagnoses. A systematic review has identified a large number of studies documenting that art, culture and creative activities can have a positive effect on both mental and physical health. In this article, selected results are presented with the purpose of drawing attention to the possibilities for non-pharmacological methods, which are increasingly available, also in Denmark.

Arts on prescription in Scandinavia: a review of current practice and future possibilities.

AIMS: This article reviews current practice relating to arts and culture on prescription in Sweden, Norway, Denmark and in the United Kingdom. It considers future possibilities and also each of the Scandinavian countries from a culture and health policy and research perspective. The United Kingdom perhaps leads the field of Arts on Prescription practice, and subsequent research is described in order to help identify what the Scandinavian countries might learn from the UK research. METHOD: The method adopted for the literature search was a rapid review which included peer-reviewed and grey literature in English and the respective languages of Scandinavia. RESULTS: The discussion considers the evidence to support social prescription and the potential obstacles of the implementation of Arts on Prescription in Scandinavian countries. CONCLUSION: The article concludes that of the Scandinavian countries, Sweden is ahead in terms of Arts on Prescription and has embraced the use of culture for health benefits on a different scale compared to Norway and Denmark. Denmark, in particular, is behind in recognising ways in which art and culture can benefit patients and for wider public health promotion. All three countries may benefit from the evidence provided by UK researchers.

[Art participation enhances well-being].

This article provides a brief overview of different approaches and benefits of art participation from an international research perspective and looks at developments in art and health care in the Nordic countries. Three examples include a medical programme, an NHS trust and a museum (all in the UK) illustrating various approaches to art and health care benefitting health-care professionals and medical students as well as patients.

Beyond the borders: The use of art participation for the promotion of health and well-being in Britain and Denmark.

BACKGROUND: This article compares British and Danish promotion of well-being through participation in art activity to empower the individual. It examines the influence of national, social and political contexts on art and health community projects by comparing practice and project outcomes. METHOD: Based on two case studies, the article draws on specific evidence in Britain and Denmark. The approach taken is one of the psychosocial inquiries allowing reflection on practice including participants' testimonies. RESULTS: The two cases showed comparable problems with restricted resources, funding and organisational limitations to service delivery. The British case study shows a bottom-up approach in contrast to the Danish case study where the approach is top-down. Although the benefits from participation in art activities in the two countries were influenced by a complex set of different interacting factors, outcomes were typically similarly positive: finding identity, feeling a sense of well-being and increased self-confidence. CONCLUSION: In terms of practice, policy and research and in the recognition of value of art participation, the comparison demonstrates how different stories, contexts and institutions engage in different ways to facilitate and enable service users as well as generating different challenges; recognising the benefits of developing best practice guidelines in art practice in health settings.