What Does the New Research Say?
Recent Arts Participation Studies Take Diverse Approaches and Provide New Evidence for Positive Impacts
For the past month, I have been deep in the research weeds, trying to get my bearings with respect to a growing body of scholarship concerning the impacts of arts participation by older adults. It has been exciting to discover the wide-ranging nature of the research, the range of definitions, methods, goals, and conclusions.
While the diversity of approaches has seemed confusing at times, it has broadened my understanding of creative aging as an inherently multidisciplinary field, one that requires multiple approaches to assessing outcomes for participants.
It has also been heartening to find such a rich array of scholars — psychologists, environmental researchers, public health specialists, gerontologists and many others — applying their analytical tools to the issue of arts participation impacts.
Whether they use focus groups to elicit the “lived experiences” of older adults in a particular arts program or whether they work across a national landscape to document the health benefits of participatory arts activities, scholars’ growing focus on arts and aging can only help illuminate and grow the field of creative aging.
In this second issue of the Creative Aging Resource Newsletter, I am asking:
What do we know about the impact of participation in creative aging programs for older adults?
Further, what do we know about current approaches to measuring that impact?
— Diantha Dow Schull, Curator, for Lifetime Arts
“An emerging body of research indicates that active arts engagement can enhance older adults’ health and experienced well-being, but scientific evidence is still fragmented.”
— Barbara Groot et al, authors of a nationwide participatory study in the Netherlands on the “Value of Active Arts Engagement on Health and Well-Being of Older Adults.” Published in the International Journal of Environmental Research and Public Health, August 2021.
As teaching artists or program administrators, funders or advocates we recognize the importance of having an evidence base to validate our work in creative aging. We know we must reach beyond observations and anecdotes to engage researchers who specialize in assessing and measuring program outcomes.
We need to know: what does current research say, what are the standards for this research, how is it being carried out; are there new research trends and if so are they based on metrics or participant reflections — or both?
A number of studies on the impacts of arts participation have been published in recent years, using methods ranging from meta-analyses of prior studies and quantitative surveys of national populations or sub-groups to studies that are more focused and nuanced. The research I will highlight below include:
A broad international scoping review of current research concerning the health benefits of arts participation by the World Health Organization (WHO),
National studies of arts participation in the Netherlands and the UK using both qualitative and quantitative research methods
Academic studies carried out by scholars in diverse fields, i.e. psychology or public health
Studies that examine impacts of participation in a particular local program or cluster of programs carried out by scholars for non-profits, philanthropies, or government agencies
A Fragmented Research Landscape
As confirmed by the Dutch researchers’ statement above: the scientific evidence on the value of arts participation by older adults is fragmented:
Passive vs. active participation
While some studies, particularly the largest, define “arts participation” as both passive and active, other studies concentrate on participatory arts activities only.
Arts therapies vs. community-based
Some studies include art therapy under the umbrella of arts participation, while others concentrate on community-based participatory activities.
Variation in research questions
Most studies have a distinct research focus, ranging from arts participation as a reflection of older adult community participation or social connectedness to the examination of arts participation in relation to specific aspects of mental health, cognitive health, or even spiritual well-being.
Discipline-focused research
To complicate the picture further, within the larger body of arts participation impact studies there are studies that examine engagement with particular artforms such as participation in theatrical productions or community choirs. These studies are illuminating but further work is needed to determine whether or not the findings are corroborated through similar studies in other art forms.
Limited cross-disciplinary visibility
Finally, there is the problem of visibility across research communities and disciplines. The most reliable arts impact studies, rigorous studies that have been peer-reviewed and published in professional journals, are usually known mainly within the researchers’ particular fields, i.e., psychology, gerontology, public health, etc. For a practitioner, an advocate or a researcher with a different (or broader) disciplinary perspective, there are few current information portals providing access to studies across disciplines and research methods.
Creative aging is enjoying a growing recognition by diverse scholars and institutions
Despite the fragmentation of research and the myriad forms that it takes, it is possible to gain valuable and actionable evidence from recent studies as well as insights into research approaches. Above all, the growth in arts participation impact studies is an important signal to all of us working on creative aging: it reflects the growing recognition by diverse scholars and institutions that creative aging is a topic worthy of rigorous inquiry. Whether the studies are community-based focus groups or national surveys, they are all important building blocks towards a broad body of evidence that will at some point cohere. Over time, the diverse approaches to assessing “arts participation” can only enrich the field as it evolves.
Recent research highlights
As a preview of this rich field of work I have selected several examples to highlight, each of which demonstrates a current assessment method or methods and provides new evidence for the impact of arts participation on older adults.
Please note that these studies are among only the most recent — none older than 2018. The Creative Aging Resource site includes numerous other examples worth perusing, including some older and foundational studies.
What is the evidence on the role of the arts in improving health and well-being? A scoping review. By Daisy Fancourt and Saoirse Finn. Published by the World Health Organization (WHO) as Health Evidence Network synthesis report 67. 2019.
There are numerous literature reviews on the arts and aging, but none as comprehensive or as current as this recent study produced by WHO. The breadth of the report underscores the growth of interest in arts and aging by diverse researchers, especially in Europe, and provides context for the specific studies mentioned below. The abstract offers a helpful summary of current research and it underlines the consistency of findings, across study types and disciplines, concerning the beneficial role of arts participation.Arts Engagement Trends in the United Kingdom and their Implications for Mental and Social Wellbeing: HEartS Survey. By Urszula Tymoszuk of the Centre for Performance Science and the Faculty of Medicine, Imperial College, London, et al. 2021.
This large survey of 5,300 adults in the UK during 2018-2019 examined the connections between arts engagement and social wellbeing using the HEartS Survey, a tool that aims for inclusivity while being shorter than many existing arts engagement measures. The study included both participatory arts and “receptive arts.” It focused on the mental and social wellbeing of participants vis a vis a wide array of arts, from performing arts to crafts, and grouped them in clusters depending on their degree of engagement. The study also contextualized the findings with other research through in-depth analysis of both content and methods. This study offers a model for other national surveys, particularly as it includes a detailed discussion of methodology and findings.Active and receptive arts participation and their association with mortality among adults in the United States: a longitudinal cohort study. By Kristin, M Story, Ziyi Yang, Dawn M Bravata. Published in Public Health, July 2021.
Epidemiological studies on the arts are not common in the United States, especially studies on active engagement by older adults. This national study addressed associations between arts participation and mortality, including both passive and active participation. It was based on data from the Health and Retirement Study, a longitudinal panel survey that is following representative Americans over age 50 into retirement. Data were collected biennially through in-person or phone interviews and online surveys with questions about changes in health, economics, and social structures. In the off years a mail survey was distributed relating to time use, including arts participation, and special topics questionnaires were sent to a random subsample of respondents and collected with core data. For this study project two cohort groups, referred to as the 2012 and 2014 cohorts, were selected for analysis. Researchers concluded that “Engagement in the arts was associated with lower risk of mortality even after risk adjustment, especially for adults aged ≥65 years.”Participation in life-review playback theater enhances mental health of community-dwelling older adults: A randomized controlled trial. By Shoshi Keisari, Yuval Palgi, Dani Yaniv, Anat Gesser-Edelsburg. Published in Psychology of Aesthetics, Creativity, and the Arts. 2020.
This article reports on a randomized control trial designed to assess the mental health effects of community-dwelling older adults’ participation in a 12-week playback theatre program. (Playback theatre is a form of improvisational theatre that “combines artistic expression with an exploration of life stories in a group creative process.” )
Before the program started, at its conclusion, and 3 months later, participants reported on aspects of mental health, such as personal growth, relationships with others, well-being, and meaning in life. The results showed significant improvements in positive health indices that stayed stable 3 months after the program ended, confirming that “participation in a structured short-term creative group playback theatre program induces a strong and persistent positive psychological effect in community-dwelling older adults.”
The study stands out as an example of a randomized control trial carried out with a relatively small group of participants that focused on their responses to a particular art form. It demonstrates that even the most rigorous methods for impact assessment can be applied in a smaller-scale situation.A Community Choir Intervention to Promote Well-Being Among Diverse Older Adults: Results From the Community of Voices Trial. By Julene K. Johnson (University of San Francisco) et al. Published in The Oxford Journals of Gerontology Series B: Psychological Sciences and Social Sciences. February 2020.
In the US and in Europe there are researchers examining the health impacts of participatory musical activities for older adults. Several cross-sectional studies have found that older adults who participate in choirs report greater well-being. However, these studies involved older adults who were predominantly white and from relatively high educational backgrounds.
Dr. Julene Johnson of the University of San Francisco, and Associate Director of the UCSF Institute for Health and Aging, specializes in developing “cost-effective and novel community-based” musical interventions to promote health and well-being for diverse older adults. She has worked with senior centers and other partners to develop a network of community choirs in San Francisco that engage racially diverse community members in regular choir participation.
Early studies of these interventions suggest that regular participation in local choirs can help older adults with varied backgrounds remain socially connected and active. (Johnson et al, 2015).
This article reports on a randomized control study of the effects of a Community of Voices choir intervention on the “health, well-being and health care costs of racial/ethnically diverse” adults 60 years and older. 65% of study participants were non-white. Researchers examined an array of outcomes including “physical, cognitive and psychosocial aspects of health.” Findings suggest intervention group members experienced significant reductions in loneliness and increased interest in life.The following two studies reflect a trend in the research community to engage arts program participants directly in expressing their own “lived experiences” through qualitative assessment methods such as focus groups or personal narratives.
Subjective experiences of participatory arts engagement of healthy older people and explorations of creative ageing. By Emily Bradfield of the University of Derby in the UK. Published in Public Health, the Journal of the Royal Society for Public Health, September 2021.
This is an important example of research that is qualitative rather than quantitative, that focuses on participants’ observations and voices. The article discusses findings from a “focus group study conducted to understand the subjective experiences of community-dwelling healthy older people engaging in a range of participatory arts activities.”
Dr. Bradfield’s study analysis includes the following:
”Findings suggest that participation in everyday creative experiences can lead to a sense of achievement and purpose, which provides support and structure in the construction of changing identity in later life. Participatory arts engagement is particularly instrumental during transitions of ageing. This study provides a conceptualisation of 'creative ageing' which challenges traditional ideas of 'participatory arts' and audience engagement by focusing on subjectivities of the participant voice.”
Dr. Bradfield is an advocate for qualitative studies that can “unpack the complexities of ‘participatory arts’ engagement and support a conceptualization of ‘creative ageing.’ Visit the Creative Aging Resource website for a discussion of another study she designed and conducted in 2020: Creative ageing: participation, connection & flourishing. A mixed-methods research study exploring experiences of participatory arts engagement in later life through a systematic review of literature and focus groups with older people. 2020.The Value of Active Arts Engagement on Health and Well-Being of Older Adults: A Nation-Wide Participatory Study. By Barbara Groot of Leyden Institute and nine colleagues at academic institutions in the Netherlands. Published in the International Journal of Environmental Research and Public Health. August 2021.
This national study in the Netherlands used both qualitative and quantitative methods to document the perceived value of arts engagement by those taking part in 18 arts-based programs for older adults. Like Dr. Bradfield’s study, this one is distinguished by its emphasis on capturing “people’s lived experiences of the value of active arts engagement.” Researchers used a participatory study design that included gathering mini-narratives from program participants about how their art experiences affected their feelings, sense of growth, and quality of social interactions.
Beyond these examples, there are numerous other studies that offer reference points, insights, and data that can be helpful to creative aging practitioners, advocates, and scholars. Some have already been added to the Creative Aging Resource, and I urge you to regularly check the entries there under Research & Studies or Reports. We will continually add new research examples to help subscribers keep up to date on the various assessments taking place in the US and beyond.
Above all, the growth arts participation impact studies is an important signal to all of us working on creative aging: it reflects the growing recognition by diverse scholars and institutions that creative aging is a topic worthy of rigorous inquiry. Whether the studies are community-based focus groups or national surveys, they are all important building blocks towards a broad body of evidence that will at some point cohere. Over time, the diverse approaches to assessing “arts participation” can only enrich the field as it evolves.
Armed with the emerging evidence, we are all empowered to call for such recognition, and translation of that recognition into policies, practices, and long-term program investments.