Social prescribing is a non-pharmacological approach to supporting people’s health and wellbeing through facilitated engagement with meaningful activity such as the arts. It is considered a component of universal personalised care where patients are in control of their care package.
In Wales, it is a key policy area on the Welsh government agenda, part of the Wellbeing of Future Generations Act 2015 and discussed within the Cross-Party Group on Social Prescribing. The applications of ‘arts on prescription’ are complicated and often exclusive of communities they need to serve the most due to cultural differences between the arts and medicine, and a lack of systematised written evidence about how they work.
Particularly, when engaging older adults from diverse communities with experiences of social isolation and chronic conditions, there are additional complications such as digital literacy, access to technology, capacity to consent as well as cultural preferences.
Evaluative knowledge about what works and what doesn’t, currently resides in an oral and experiental form within creative practitioner and service user communities. Anthropological approaches are therefore highly suited to this particular form of knowledge documentation and translation.
This fellowship will enable dwelling in the ‘in-between’ spaces of the arts and health worlds tailored to older adults and offer insights to policy makers through participant observation and participatory action research. Research-derived knowledge will be communicated in accessible ways through the production of case studies, evidence reviews, blogs, podcasts and a short film.
Plan of Action
In this fellowship, I will start by engaging organisations in Wales that I have a working relationship with through my existing research, to begin a dialogue about their experiences of delivering arts and health activities that relate to social prescribing (SP), and identify any areas of improvement.
This will enable a deeper dialogue about their experiences on the ground and how that relates to policy discourse.
Between April and July 2022, I will engage five organisations that are part of the Health Arts Research People (HARP) programme - my current research and innovation programme - who work with older adults who experience social isolation and/or dementia.
The HARP programme is funded by the Arts Council of Wales and is delivered in partnership with Nesta, Y Lab at Cardiff University and the Wales Arts Health and Wellbeing Network. This means that there is already a pool of engaged professionals who will guide us in this enquiry and connect the researcher to relevant people their networks.
Phase 1: Social prescribing community engagement (April - June 2022)
I will work closely with five organisations working with older people with dementia and/or experiences of social isolation (Swansea Bay arts of prescription & music in hospital teams, Head 4 Arts, Impelo, Re-live and the Forget-me-not-chorus) to conduct detailed case studies of their experiences of engaging with creative social prescribing through various projects.
These organisations which have been playing a crucial role in supporting diverse communities throughout the pandemic and have a working knowledge of what works and what in the communities they engage in, the challenges for isolated and diverse populations, and methodological solutions.
They encompass diversity in settings (clinical, community, care homes), locations (urban and rural areas) and art forms (visual arts and singing). In this phase, I will interview key stakeholders, health and social care leaders, creative professionals and service users (n=20, 4 per organisation).
Phase 2: Equality, diversity and inclusion community engagement
Engaging diverse-led organisations (July - September 2022)
In this phase I will work closely with five diverse-led organisations that engage under-represented groups of older adults in arts and health activities, who might not identify as a social prescribing service (Sub-saharan African Panel, Disability Arts Cymru, Pride Cymru, Women Connect First and the British Deaf Association).
This is a deliberate choice in the research design in order to help identify whether SP schemes are inclusive and provide an equitable service. Similarly to phase 1, these are exemplary organisations in their approach to engagement.
Research engagement patterns will be guided by the organisations and will involve either individual in-depth interviews or focus groups with people who engage in creative activity.
Where appropriate and Covid-safe, time will be spent attending meetings, arts activities, rehearsals for performances and staged performances. Fieldnotes will be contextualised with ethnographic interviewing, short in-situ interviews with all participants involved.
Phase 3: Co-design and solution identification (October - December 2022)
During this phase, I will work closely with the Arts Council Wales to co-produce one online ‘summit’ meeting where all the engaged participants from phase 1 and 2 will come together to co-design solutions to key SP issues.
Due to the large number of participants, significant amount of time will be spent planning this meeting and ensuring all participants will be able to fully contribute. Up to four smaller co-design groups will work with specific issues through a series of facilitated Zoom meetings (up to three).
Phase 4: Dissemination and policy engagement (January - March 2023)
The dissemination phase will take place between December 2022 and February 2023.
In this phase we will engage:
- the UK-wide Social Prescribing Network,
- the Parliamentary Office for Science and Technology,
- the All-Party Parliamentary Group on Arts, Health and Wellbeing (Houses of Parliament),
- the Cross-party Group for Arts and Health (Welsh Assembly),
- and relevant Academic Health Science Networks and Clinical Commissioning Groups.
Planned Research Outputs
Each participating organisation has a unique story to tell, rooted in place- and people-based local culture.
Ten case studies will be produced for each of the participating organisation which will highlight their community arts and social prescribing journeys, the stumbling blocks and highlights.
These case studies will be co-produced with the organisations and care will be given to ensure that they are happy with the content and any sensitivities presented. Participants will have the option to opt for a de-identified case study.
Evidence notes will consist of brief two-page documents that summarise published research, relevant policy, research findings and recommendations from the codesign process. The following three topics have been selected, though they might slightly change throughout the course of this project.
1. Social prescribing experiences of professionals and older adults who experience social isolation
2. Social prescribing experiences of professionals older adults who experience dementia
3. Social prescribing and EDI: how do under-represented communities of older adults engage with SP and/or their own cultural traditions?
Based on our previously successful collaboration with Reality Theatre, the researchers and selected participants will contribute to the development of a short film on ageing and creativity which will communicate research findings in audiovisual ways. This will involve providing the director the case studies, commenting on the plot and advising on the script.
Project website, six blog posts, and five podcasts.
A dedicated project website will be hosted on the Y Lab website.
It will include links to publicly-facing documents, audiovisual outputs and information about relevant events.
We will also publish a bi-monthly blog on fellowship findings (6 total). We will also invite five stakeholders to take past in a podcast series where they will be interviewed by myself (5x20min podcasts).