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The health benefits of arts, cultural and community engagement A short guide for link workers

  • Marie Polley Consultancy Limited; Meaningful Measures Ltd; Visiting Reader UEL; Social Presribing Network
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This is a guide written for link workers and professionals in similar positions translating evidence on the benefit of supporting people to engage with arts and cultural community assets. It highlights research informed barriers, enablers and make suggestions on how link workers can use their role to overcome some of these barriers.
The health benefits of arts,
cultural and community
Dr Marie Polley
Abby Sabey
A short guide for link workers
This report was produced by Marie Polley Consultancy Ltd in collaboration with researchers
from the Department of Behavioural Science and Health at University College London. We
are particularly grateful to the ESRC for funding this work through the WELLCOMM project
How to cite this report:
Polley M and Sabey A (2022). The health benefits of arts, cultural and community
engagement - A short guide for link workers. Marie Polley Consultancy Ltd, England.
Main contact
Questions or comments about the guide can be directed to:
About the authors:
Dr Marie Polley BSc, PhD, is Director of Marie Polley Consultancy Ltd and works as a
freelance research consultant. Marie is a biomedical scientist and has a PhD in molecular
biology of how cancer develops. In 2015, Marie co-founded the Social Prescribing Network,
which has led a social movement around the use of non-medical activities to support people’s
wider determinants of health and provide additional routes of support to traditional
pharmaceutical prescribing. Social Prescribing has now been adopted by the NHS in England
and is being taken up internationally. Marie led the team to write the first national guidance
for social prescribing, the first economic overview of social prescribing on health service
usage and recently mapped all outcomes associated with social prescribing to support
discussion on inclusive ways of researching and evaluating this growing field. Marie is also
Co-Founder and Co-Director of Meaningful Measures Ltd.
Abigail Sabey is a Freelance Research Associate of Marie Polley Consultancy Ltd and
is also a senior lecturer in research methods at the University of the West of England where
she teaches on the MSc in Public Health. She has extensive experience of teaching research
and evidence-based practice to health and social care professionals at the University of the
West of England, combined with a background in health services and medical education
research, using both quantitative and qualitative methods. She currently leads a training
programme for NIHR ARC West to promote research and evaluation skills for the workforce
in health and social care.
Table of Contents
WHO IS THIS GUIDE FOR? ............................................................................................................. 3
WHAT ARE COMMUNITY ASSETS? ................................................................................................ 3
WHATS THE SCIENTIFIC EVIDENCE? ............................................................................................ 5
ARTS, CULTURE AND MENTAL HEALTH: RECENT EVIDENCE FROM THE UK ................................... 7
WHAT CAN I DO AS A LINK WORKER? ......................................................................................... 12
REFERENCES ............................................................................................................................. 17
Who is this guide for?
This guide is for link workers and serves as an introduction to scientific research on how
people can manage and improve their health by engaging in arts and cultural activities.
Link workers can use this guide to encourage their clients to take part in activities offered by
their communities. The research summarised in the following pages provides evidence for
how engaging in the arts and culture can improve both physical and mental health. It also
explains why many people may be prevented from taking part in such activities and how link
workers can help their clients overcome some of these difficulties. We hope this guide will
enable link workers to open up conversations on how arts and cultural assets can be powerful
tools for health.
What are community assets?
Community assets are resources within your community. They include individuals with
specific skills and knowledge, as well as community and voluntary associations, public and
private organisations, and physical environments. For example, libraries, writing groups,
archives, gardens, exercise classes, sporting events, volunteering and charitable groups,
youth services, trade unions, and religious groups are all community assets.
What is arts and cultural engagement?
Engagement in arts and culture encompasses the many ways that individuals take part in
arts and cultural activities. People do so passively (e.g., watching a performance in-person
or on TV) or actively (e.g., drawing, singing, writing, performing, or dancing). The terminology
around arts, culture and community engagement is often mixed and matched, so we have
provided examples below.
Performing arts (music or theatre), visual arts (painting, drawing,
sculpture), design, crafts, writing or reading groups and digital or
electronic arts.
Historic buildings such as monuments and castles, museums,
galleries, theatres, public or private buildings, historic parks, historic
places of worship, archaeological sites, landscapes, and spaces.
Theatres, concerts, opera, museums, galleries, *heritage sites, and
informal events and activities that reflect local culture.
Volunteers are also a community asset. Volunteering can be done
formally or informally and often involves social action.
*One example of ‘mixing and matching’ is between cultural assets and heritage. The heritage
sector specifically applies to historic buildings, landscapes and spaces and is part of our wider
‘cultural’ assets. Sometimes, however, heritage is listed separately from culture. Similarly,
the arts are listed as their own categories, but could also fit under the category of cultural
assets or vice versa.
What’s the scientific evidence?
The World Health Organisation commissioned a team of researchers at University College
London, led by Dr Daisy Fancourt, to review evidence from around the world on the benefits
of the arts and culture on health1. The studies covered a diverse range of arts activities
delivered in a variety of settings, ranging from the home and community to healthcare
People of all ages who engaged in the arts reported benefits to both their physical and mental
health. Sometimes studies looked at managing and treating health conditions. Other times
the research looked at the role of arts in preventing the onset of conditions or the worsening
of existing conditions (see examples below). Generally, evidence shows that more benefit is
derived when a person actively participates in a community asset. For example, drawing,
singing, writing, performing, or dancing might have more effect than being a passive recipient
of similar cultural assets. There are always exceptions to this rule though! This may be
useful to bear in mind when you are suggesting local community engagement activities to
your clients.
To help to prevent illness
and promote health, the
arts can
To help to manage and treat
health conditions, the arts
support child development
help those who are experiencing both mild to
severe mental illness
impact the social determinants of health
such as social cohesion
support care for people in hospital with acute
encourage health-promoting behaviours
such as a healthy lifestyle
assist with the management of chronic
conditions such as cancer, diabetes and heart
help prevent ill health through enhancing
wellbeing and mental health, as well as
reducing risk of cognitive decline and
help to support people with
neurodevelopmental and neurological
conditions e.g. autism, cerebral palsy, stroke,
support caregiving by professionals and
informal carers.
support end of life care.
A different review of research specifically investigating the benefits of the heritage sector also
showed positive impacts on people who engaged with this sector and their communities2.
As a link worker, you will be meeting people with a diverse range of physical and mental
conditions so the list above may help you when thinking about who of your clients could
benefit from engaging with art-based assets in your community.
Arts, culture and mental health: Recent
evidence from the UK
Dr Fancourt and her team have recently analysed data from 108,000 people to understand
the impact of engaging with community arts and cultural activities on mental health.
There were some really interesting findings that may help you justify why engaging in arts
and cultural activities are helpful to people.
Mental distress, mental health functioning and how satisfied a person was with their
life all improved when people engaged with arts or cultural activities in their
communities3,4. There were significant improvements seen particularly if people
attended an activity more than once a week3.
Even attending a cultural event once or twice a year still improved people’s level of
satisfaction with their lives3 and improved their physical and social functioning as well
as their general health5.
Taking part in reading for pleasure as well as arts and crafts activities during the
pandemic helped people reduce their depression and anxiety symptoms as well as
improve their life satisfaction6. These were all things people tended to do at home, so
not all activities offered to your clients need to be activities in the community.
Participatory music engagement was a powerful tool for people who find it hard to
express emotional aspects of their life. Participants reported improvements in
confidence, self-worth, sense of purpose and emotional wellbeing. It was also helpful
for providing diversion and distraction and for making social connections7.
Participatory music engagement could be very supportive and relevant for people with
ongoing or acute mental health challenges.
Volunteering was associated with lower levels of mental distress and higher levels of
quality of life, with greater effects found amongst people who were born before 1945
or were part of the Baby Boomer generation8.
How does the level of engagement change
across different groups?
Dr Fancourt and her team have started to identify different patterns of engagement in arts
and cultural activities across the UK. Some of these patterns may seem obvious or
predictable to you. Nevertheless, if you know some of your clients are less likely to engage
or may need more motivation and support, you can tailor your conversation accordingly.
Who was less likely to engage in arts, culture and community
People with poor mental health, who were lonely or lived alone9
People with low levels of happiness10
People in the North of England had lower engagement that people in the South of
‘Industrious communities’ engage less than those in ‘cosmopolitan student’
People living in areas of greater deprivation14
Non-White people were less likely to engage in cultural activities12
Asian and Asian British people were less likely to engage in arts-based activities12
Children from ethnic minority backgrounds were less likely to visit an archive, museum
or heritage site outside of school compared to children from White backgrounds13
People living in multicultural areas had lower levels of engagement 11
Who was more likely to engage in arts, culture and
community activities?
Among school-age children, girls are more likely to engage in the arts
outside of school than boys13.
Children in rural areas are more likely to engage in arts, crafts and design
activities outside of school13.
Among school-age children, arts engagement outside school is more
likely among those whose parents engaged in arts activities either
recently or as children themselves13.
Arts and cultural activities, and performing arts in particular, are more
likely to be taken up by women than men12.
Cultural activities are more likely to be taken up by older people12.
Cultural engagement is more likely among those in rural settings
compared to urban areas11.
During the Covid-19 pandemic, neighbourhood volunteering was more
likely among older people and females, but this may not reflect
volunteering more widely8.
During the Covid-19 pandemic, online and digital arts activities were
popular among people with a disability or mental health condition, which
may suggest new patterns of engagement in the future if more arts
activities are transitioned to online platforms.
What do we know about the enablers and
barriers associated with engagement?
As social prescribing schemes become more widespread in the UK, research is revealing
information that helps us understand what barriers may prevent engagement and what
factors enable engagement in arts, culture and community assets. As a link worker, you can
help break down barriers and reinforce enablers where possible.
Socioeconomic status
Socioeconomic status is a measure of a person's social and economic status in relation to
others. It relates to income, education and occupation. You may be aware that a low
socioeconomic status means a person is more likely to experience inequalities and these can
have a negative effect on their health. As link workers you no doubt become very aware of
someone’s socioeconomic status as your conversations progress and barriers become
Low socioeconomic status affects how people engage in arts activities9,11,12,14. People who
live in social housing, have a low level of education or a low grade of employment are less
likely to engage in arts activities15,12. This might be because people may not be able to afford
to attend activities, or they may not have time to attend, or they may never have been
provided with the opportunity to engage, so the idea is very foreign9,10. Patterns of
engagement may also reflect a lack of cultural resonance in available arts and cultural
activities for non-White groups12 for instance. In areas of high deprivation, link workers have
found it hard to motivate patients with complex social issues16.
Supporting healthcare professionals to refer into social
prescribing schemes
Researchers17 have found that GPs are keen to use new pathways such as social prescribing
to support patients’ unmet needs and to de-medicalise social problems17. GPs who are
already using social prescribing found it rewarding and liked to get regular informal feedback
from link workers17. Up until now, however, GPs and other health professionals haven’t had
any education on the benefits of non-medical interventions. Therefore, their own beliefs and
lack of knowledge about the benefits of engaging in arts, culture and community activities
can be a barrier17.
Wider issues
Since social prescribing was rolled out, funding for the Voluntary, Community and Social
Enterprise (VCSE) sector has been precarious17,19, which affects the availability of projects
in local areas. As a link worker, until this stabilises you need to know what organisations are
still operating.
What can I do as a link worker?
Key considerations when talking with your clients
Introduce the topic of arts and cultural activities if your clients haven’t mentioned it
Gently and sympathetically explain the benefits of engagement and what is available
locally. This can be instrumental in helping a person give something a go.
Remember that people living in areas of high deprivation and people with low
socioeconomic status are less likely to have engaged in arts and cultural activities
before, but they are likely to benefit the most from these activities.
For people with low socioeconomic status the accessibility of activities is extremely
important to explore.
You can help a person to feel less pressured about having the capability to engage
in the arts by focusing on how they will feel while engaging in the arts.
Emphasise that a health professional has referred your client to you to show that it is
socially acceptable and encouraged to take part in arts and cultural activities to
support health.
Start by suggesting a home-based activity such as reading or arts and crafts,
particularly as these support anxiety and depression6.
Support your clients in attending a community activity or accompany them so that
they can get the additional benefit of social interaction.
Show your client a short video clip of someone sharing their experience of benefitting
from an arts or cultural activity.
Think about how you could tailor your conversation based on the groups of people
who are more or less likely to engage in different arts and cultural activities. Some
activities may be more likely to be taken up over others.
Keep on top of which organisations are providing activities especially whilst funding
for the VCSE sector is precarious.
Key considerations when talking with healthcare professionals
Be aware that many healthcare professionals don’t know about the scientific evidence that
has been collected on the benefits of engaging in arts, cultural and community activities.
Neither was this topic covered in the medical curriculums of GPs who are working with you
at the moment.
Provide them this summary document and refer them to the publications in the reference
section below if they would like further reading. They can also sign up to the Social
Prescribing Network which circulates research evidence for social prescribing each month.
Offer GPs informal updates on patients, as they don’t often hear how patients are getting on
after they have referred them to social prescribing link workers. This is a great incentive for
GPs to continue referring to you as link workers.
Check out what currently exists in your local community
Part of a link worker’s role is to keep abreast of what activities are available in the local area.
It is understood, however, that the amount of time in which link workers have to do this varies
For many people the cultural appropriateness of a community activity can be a ‘make or
break’ situation. So, it is important to offer culturally appropriate activities to people where
possible, particularly for your non-White clients and patients. As more organisations are
starting to open up and offer both in-person and online activities again, there may be more
choice for your clients. The bottom line is that non-White clients and patients should be
offered an activity that speaks to their culture as this will increase the likelihood that they will
try it out.
The importance of opening up the conversation
We hope that by reading this document you are more aware of how people can benefit from
community engagement in the arts and cultural sector. Many of your clients, patients, and
colleagues may not be aware of this compelling evidence. We live in a society where the arts
and culture have been seen as ‘soft and woolly’ while medical approaches have ruled.
Some of your clients and patients may not even consider engaging in a community arts or
cultural activity as it may not have been part of their experience growing up. Yet from the
evidence it is clear that their health could really benefit from it. By even opening up the
conversation you are making a valuable step to increasing a person’s awareness of the
benefit of arts and cultural engagement.
This is especially the case for people with lower socioeconomic status and for the non-White
population. What has been accessible or meaningful for the White population may mean little
to a non-White population. As a link worker you have the opportunity to overcome a hidden
barrier. You can start the conversation, explore clients’ feelings about engaging in the arts,
explain the known benefits and then help to find something that could be most appropriate to
them as an individual. It’s also important to remember that people in more deprived areas
may benefit the most from community cultural engagement4,10. Even if these groups of people
don’t engage currently, they stand to gain the most.
Did you know that if parents engage in arts activities, their children are more likely to engage
and therefore benefit? Especially in terms of their mental health? This could be another
motivating fact to tell your clients.
Also, online activities can also be helpful for people who are unable to leave the house much.
Research during the pandemic has shown that the provision of online activities was really
helpful for people with physical conditions or with disabilities. So understanding how the
activities are provided, whether in-person or digitally, and tailoring this to your client can
increase the proportion of your clients and patients who could benefit15.
The other aspect to consider is which activities have a cost and which are free. You are no
doubt seeing a rise in the number of your clients who are needing to use foodbanks and are
having financial difficulties. Therefore being able to offer free activities is more important than
The power of support and encouragement
Finally, an important part of your role is encouragement. As link workers you know that
your clients and patients are more likely to engage in any activity as their mental health
improves, and engaging with arts and cultural activities will improve their mental health.
One research study specifically identified that clients with anxiety and depression were
more likely to engage in an activity if they felt supported and encouraged to do so, if they
knew other people that were in the group, and if it was socially acceptable to do this type of
So when opening up the conversation, try to offer a short explanation in a very open way:
“We have talked about your loneliness [or isolation /depression
/mental health etc.]. Did you know that research now shows that
you may really benefit from trying some activities such as [add
in the community groups and activities that are locally available
in the arts and cultural sector]?”
“You mentioned that you were feeling depressed [or
anxious/low in mood]. Have you thought of doing any activities
at home? In a research study, people who read for pleasure or
did some sort of arts and crafts activity at home found it helped
their anxiety and depression?
Can you think of other ways to open up the conversation? Showing empathy and respect
for your clients, as well as awareness of their situations, will go a long way.
We hope that the research summarised in this guide will help you to introduce more of your
clients to the health benefits of arts and cultural engagement. If you want to find out more
about the research and evaluation that is happening in this area, you can look at the
following websites:
Social Prescribing Network - Here you will find an open access google sheet archive of
reports in social prescribing. The monthly social prescribing newsletter will keep you up to
date with social prescribing news, reports and events.
Culture Health and Wellbeing Alliance - The Culture, Health and Wellbeing Alliance CIC
(CHWA) is a national, free-to-join membership organisation supporting everyone who
believes that culture and creativity can transform our health and wellbeing.
National Academy for Social Prescribing, Thriving Communities - Thriving Communities is a
new national support programme for voluntary, community, faith and social enterprise
groups, supporting communities impacted by COVID19 in England, working alongside
social prescribing link workers.
Happy Social Prescribing!
(1) Fancourt D, Finn S. What is the evidence on the role of the arts in improving health and well-being? A scoping review. Copenhagen: WHO
Regional Office for Europe; 2019 (Health Evidence Network (HEN) synthesis report 67).
(2) Pennington A, Jones R, Bagnall A-M, South J, Corcoran R (2019) The impact of historic places and assets on community wellbeing - a
scoping review. London: What Works Centre for Wellbeing
(3) Wang, S., Mak, H.W. & Fancourt, D. Arts, mental distress, mental health functioning & life satisfaction: fixed-effects analyses of a nationally-
representative panel study. BMC Public Health 20, 208 (2020).
(4) Mak, H.W., Coulter, R. & Fancourt, D. (2021). Associations between community cultural engagement and life satisfaction, mental distress
and mental health functioning using data from the UK Household Longitudinal Study (UKHLS): are associations moderated by area
deprivation? BMJ Open. doi:10.1136/ bmjopen-2020-045512
(5) Elsden, E., Bu, F., Fancourt, D. & Mak, H.W. (under review). Frequency of leisure activity engagement and health functioning using SF-36
over a 4-year period: a population-based study amongst middle-aged adults. Social Science & Medicine.
(6) Bu, F., Steptoe, A., Mak, H., & Fancourt, D. (2021). Time use and mental health in UK adults during an 11-week COVID-19 lockdown: A
panel analysis. The British Journal of Psychiatry, 219(4), 551-556. doi:10.1192/bjp.2021.44
(7) Perkins, R., Mason-Bertrand, A., Fancourt, D., Baxter, L., & Williamon, A. (2020). How Participatory Music Engagement Supports Mental
Well-being: A Meta-Ethnography. Qualitative Health Research, 30(12), 19241940.
(8) Mak, H., & Fancourt, D. (2021). Predictors of engaging in voluntary work during the COVID-19 pandemic: analyses of data from 31,890
adults in the UK. Perspectives in Public Health.
(9) Fancourt D, Mak HW (2020) What barriers do people experience to engaging in the arts? Structural equation modelling of the relationship
between individual characteristics and capabilities, opportunities, and motivations to engage. PLoS ONE 15(3): e0230487.
(10) Fancourt, D., & Baxter, L. (2020). Differential participation in community cultural activities amongst those with poor mental health: Analyses
of the UK Taking Part Survey. Social Science & Medicine,261; 113221.
(11) Mak HW, Coulter R, Fancourt D. Does arts and cultural engagement vary geographically? Evidence from the UK household longitudinal
study. Public Health. 2020 Aug;185:119-126. DOI: 10.1016/j.puhe.2020.04.029. PMID: 32619767; PMCID: PMC7456771.
(12) World Health Organization. Regional Office for Europe, Mak HW, Coulter R & Fancourt D. (2020). Patterns of social inequality in arts and
cultural participation: findings from a nationally representative sample of adults living in the United Kingdom of Great Britain and Northern
Ireland. Public Health Panorama, 6 (1), 55 - 68. World Health Organization. Regional Office for Europe. License: CC BY-NC-SA 3.0 IGO
(13) Mak HW, Fancourt D (2021) Do socio-demographic factors predict children’s engagement in arts and culture? Comparisons of in-school and
out-of-school participation in the Taking Part Survey. PLoS ONE 16(2): e0246936.
(14) Mak HW, Coulter R, Fancourt D. Associations between neighbourhood deprivation and engagement in arts, culture and heritage: evidence
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34530782; PMCID: PMC8444412.
(15) Bu F, Mak HW, Bone JK, Fancourt D. Longitudinal changes in home-based arts engagement during and following the first national lockdown
due to the COVID-19 pandemic in the United Kingdom. medRxiv; 2021. DOI: 10.1101/2021.05.14.21257233.
(16) Fixsen, A., Seers, H., Polley, M. et al. Applying critical systems thinking to social prescribing: a relational model of stakeholder “buy-in”. BMC
Health Serv Res 20, 580 (2020).
(17) Aughterson, H., Baxter, L. & Fancourt, D. Social prescribing for individuals with mental health problems: a qualitative study of barriers and
enablers experienced by general practitioners. BMC Fam Pract 21, 194 (2020).
(18) Fancourt, D., Baxter, L. & Lorencatto, F. Barriers and enablers to engagement in participatory arts activities amongst individuals with
depression and anxiety: quantitative analyses using a behaviour change framework. BMC Public Health 20, 272 (2020).
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ResearchGate has not been able to resolve any citations for this publication.
Full-text available
Rationale Leisure activities have wide-ranging benefits for physical and mental health. However, previous studies have often focused on “leisure” as a homogeneous group of activities. This study was therefore designed to take a prospective and comparative approach exploring different types of leisure activities, as well as investigating whether frequency of engagement is associated with strength of benefits. Method Data from the 1970 British Cohort Study Waves 9 (age 42) and 10 (age 46) were analysed ( N = 5,639). Eight domains derived from the SF-36 health survey questionnaire were used to measure health functioning (general health, vitality, bodily pain, social functioning, physical functioning, mental health, role limitations due to emotional, and role limitations due to physical problems). Leisure activities included physical activity, culture engagement, arts participation, volunteering or community engagement, and literature activities. Both ordinary least squares and logistic regressions were applied. Results Physical activity was associated with greater levels of physical functioning, general health, and vitality at higher frequencies, while cultural engagement was associated with social functioning and physical functioning when engaged in several times a year. Arts participation and literature activities had a general negative association with health functioning. Engagements in volunteering/community groups showed varying associations with health functioning (both positive and negative) depending on the levels of engagements. Conclusion This research suggests that the types of leisure activities and levels of engagement can have differential associations with health amongst middle-aged adults. This may be helpful for public health initiatives and programmes such as social prescribing schemes when formulating programmes, especially regarding ‘dosage’ of engagement. Further, the overall benefits of high engagement frequency suggest that increasing leisure engagement could play an important role in supporting improving health and wellbeing at a population level.
Full-text available
Background Previous research has shown the benefits of arts and cultural engagement for physical, mental and social wellbeing. This engagement is socially and geographically patterned. Yet it remains unclear whether place-based attributes are associated with engagement behaviour independent of individual factors. Therefore, the aim of this cross-sectional study was to robustly disentangle associations between geographical deprivation and arts engagement from the individual socio-demographic factors that tend to correlate with residential locations. Methods Two different samples drawn from two representative surveys of adults living in England were compared – Understanding Society Wave 2 (2010/12) ( N = 14,782) and Taking Part survey (2010/11) ( N = 4575). Propensity score matching (PSM) was applied to investigate the association between neighbourhood deprivation (20% most deprived vs 20% least deprived) and arts engagement (arts participation, cultural attendance and museums and heritage engagement). Results Higher levels of neighbourhood deprivation were associated with lower arts, culture and heritage engagement independent of individuals’ demographic backgrounds, socio-economic characteristics and regional locations. When exploring subcategories of deprivation, similar results were obtained across deprivation domains. Results were also consistent when using more distinct categories of deprivation (i.e. 10% most deprived vs 10% least deprived) and when comparing people living in the 20% most deprived neighbourhoods with those living in the 40% medium-deprived areas. Conclusion This study is the first to apply a robust PSM technique to examine the association between neighbourhood deprivation and arts engagement using two nationally-representative samples. Results show that neighbourhood deprivation may act as a barrier that could prevent people from engaging in the arts, which in turn may exacerbate social and health inequalities. This highlights the importance of place-based schemes that focus on increasing individual motivation and capacity to engage in arts and cultural activities, especially in areas of high deprivation.
Full-text available
Objectives The association between community cultural engagement and mental health and well-being is well established. However, little is known about whether such associations are influenced by area characteristics. This study therefore examined whether the association between engagement in community cultural assets (attendance at cultural events, visiting museums and heritage sites) and subsequent well-being (life satisfaction, mental distress and mental health functioning) is moderated by neighbourhood deprivation. Design Data were drawn from Understanding Society: The UK Household Longitudinal Study waves 2 and 5. Participating households’ addresses were geocoded into statistical neighbourhood zones categorised according to their level of area deprivation. Setting General population. Participants UK general adult population, with a total sample of 14 783. Main outcome measures Life satisfaction was measured with a seven-point scale (1: completely unsatisfied to 7: completely satisfied). Mental distress was measured using the General Health Questionnaire 12. Mental health functioning was measured using 12-item Short Form Health Survey (SF-12). Results Using Ordinary Least Squares (OLS) regression, we found that engagement in cultural assets was consistently and positively associated with subsequent life satisfaction and mental health functioning and negatively associated with mental distress. Importantly, such associations were independent of individuals’ demographic background, socioeconomic characteristics and regional location. The results also show that relationships between engagement in community cultural assets and well-being were stronger in more deprived areas. Conclusions This study shows that engagement in community cultural assets is associated with better well-being, with some evidence that individuals in areas of high deprivation potentially may benefit more from these engagements. Given that causal mechanisms were not tested, causal claims cannot be generated from the results. However, the results suggest that place-based funding schemes that involve investment in areas of higher deprivation to improve engagement rates should be explored further to see if they can help promote better well-being among residents.
Full-text available
Aims: This study aimed to examine potential heterogeneity in longitudinal changes in home-based arts engagement during the first national lockdown and following gradual easing of restrictions in the UK. Further, it sought to explore factors that were associated with patterns of longitudinal changes in home-based arts engagement. Methods: Data were from the UCL COVID-19 Social Study. The analytical sample consisted of 29,147 adults in the UK who were followed up for 22 weeks from 21st March to 21st August 2020. Data were analysed using growth mixture models. Results: Our analyses identified five classes of growth trajectories. There were two stable classes showing little change in arts engagement over time (64.4% in total), two classes showing initial increases in arts engagement followed by declines as restrictions were eased (29.8%), and one class showing slight declines during strict lockdown followed by an increase in arts engagement after the easing of restrictions (5.9%). A range of factors were found to be associated with class membership of these arts engagement trajectories, such as age, gender, education, income, employment status, and health. Conclusions: There is substantial heterogeneity in longitudinal changes in home-based arts engagement. For participants whose engagement changed over time, growth trajectories of arts engagement were related to changes in lockdown measures. These findings suggest that some individuals may have drawn on the arts when they needed them the most, such as during the strict lockdown period, even if they usually had lower levels of arts engagement before the pandemic. Overall, our results indicate the importance of promoting arts engagement during pandemics and periods of lockdown as part of public health campaigns.
Full-text available
Background There is currently major concern about the impact of the global COVID-19 outbreak on mental health. But it remains unclear how individual behaviours could exacerbate or protect against adverse changes in mental health. Aims To examine the associations between specific activities (or time use) and mental health and well-being among people during the COVID-19 pandemic. Method Data were from the UCL COVID-19 Social Study, a panel study collecting data weekly during the COVID-19 pandemic. The analytical sample consisted of 55 204 adults living in the UK who were followed up for the 11-week strict lockdown period from 21 March to 31 May 2020. Data were analysed using fixed-effects and Arellano–Bond models. Results Changes in time spent on a range of activities were associated with changes in mental health and well-being. After controlling for bidirectionality, behaviours involving outdoor activities such as gardening and exercising predicted subsequent improvements in mental health and well-being, whereas increased time spent following news about COVID-19 predicted declines in mental health and well-being. Conclusions These results are relevant to the formulation of guidance for people obliged to spend extended periods in isolation during health emergencies and may help the public to maintain well-being during future lockdowns and pandemics.
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Aims As the COVID-19 pandemic has grown internationally, there has been an increased need for volunteers. This study aimed to identify the predictors of volunteering including demographic backgrounds, socio-economic characteristics, personality, and psychosocial factors. Methods Data were analysed from 31,890 adults in the UK COVID-19 Social Study run by the University College London – a longitudinal study focusing on the psychological and social experiences of adults living in the UK during the COVID-19 pandemic. Tetrachoric factor analysis was applied to identify latent categories of voluntary work. Multivariate logistic regression was used to identity predictors for volunteering and change in volunteering behaviours since before the COVID-19 pandemic. Results Three types of volunteering during the pandemic were identified as follows: formal volunteering, social action volunteering, and neighbourhood volunteering. Regression analysis showed that the pattern of voluntary work was structured by demographic backgrounds, socio-economic factors, personality, and psychosocial factors. Conclusion The predictors of volunteering during the pandemic may be slightly different from other non-emergency period.
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There is evidence on the health, social and developmental benefits of arts and cultural participation for young people. While there is a known social gradient across adult arts participation where socially advantaged individuals are more likely to engage in the arts, it remains unclear whether socio-economic factors also affect child participation either in school or out of school. This study analysed cross-sectional data from 1,986 children aged 11–15 in the Taking Part Survey interviewed from 2015–2018. It focused on three aspects of children‘s participation: (i) performing arts activities, (i) arts, crafts and design activities, and (iii) cultural and heritage engagement. Results show a social gradient across all three activities for out-of-school engagement, but not for in-school engagement. Arts and cultural activities provided by schools are therefore important to ensuring universal access to the arts amongst young people.
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Background: There is growing evidence for the use of social prescribing as a means to improve the mental health of patients. However, there are gaps in understanding the barriers and enablers faced by General Practitioners (GPs) when engaging in social prescribing for patients with mental health problems. Methods: This study uses a qualitative approach involving one-to-one interviews with GPs from across the UK. The COM-B model was used to elucidate barriers and enablers, and the Theoretical Domains Framework (TDF) and a Behaviour Change Theory and Techniques tool was used to identify interventions that could address these. Results: GPs recognised the utility of social prescribing in addressing the high levels of psychosocial need they saw in their patient population, and expressed the need to de-medicalise certain patient problems. GPs were driven by a desire to help patients, and so they benefited from regular positive feedback to reinforce the value of their social prescribing referrals. They also discussed the importance of developing more robust evidence on social prescribing, but acknowledged the challenges of conducting rigorous research in community settings. GPs lacked the capacity, and formal training, to effectively engage with community groups for patients with mental health problems. Link workers, when available to GPs, were of fundamental importance in bridging the gap between the GP and community. The formation of trusting relationships was crucial at different points of the social prescribing pathway, with patients needing to trust GPs in order for them to agree to see a link worker or attend a community activity, and GPs requiring a range of strong inter-personal skills in order to gain patients' trust and motivate them. Conclusion: This study elucidates the barriers and enablers to social prescribing for patients with mental health problems, from the perspectives of GPs. Recommended interventions include a more systematic feedback structure for GPs and more formal training around social prescribing and developing the relevant inter-personal skills. This study provides insight for GPs and other practice staff, commissioners, managers, providers and community groups, to help design and deliver future social prescribing services.
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Participatory music engagement has the capacity to support well-being. Yet, there is little research that has scrutinized the processes through which music has an effect. In this meta-ethnography [PROSPERO CRD42019130164], we conducted a systematic search of 19 electronic databases and a critical appraisal to identify 46 qualitative studies reporting on participants’ subjective views of how participatory music engagement supports their mental well-being. Synthesis of first-order and second-order interpretations using thematic coding resulted in four third-order pathways that account for how participatory music engagement supports mental well-being: managing and expressing emotions, facilitating self-development, providing respite, and facilitating connections. Our interpretation suggests that people benefit from participatory music engagement by engaging with specific and multiple processes that meet their individual needs and circumstances. These findings inform research directions within the field of music and well-being, as well as guiding the development and delivery of future music interventions.
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Rationale: There is a growing literature on the benefits of arts and cultural engagement for mental health. However, whether poor mental health is a barrier to engaging in cultural activities remains unclear. Objective: To identify whether there are differential participation rates in community cultural activities amongst those with differing levels of mental health (specifically, feelings of anxiety and happiness) and identify potential explanatory factors. Method: We analysed data from 7241 participants in the Taking Part survey; a random face-to-face household survey conducted in England (2016-2017). Cultural engagement was measured using a four-factor variable of cultural participation derived from assessing annual attendance at 21 receptive cultural activities. Mental health was measured using two of the Office for National Statistics measures of subjective wellbeing: happiness and anxious feelings. Analyses were adjusted for demographic, socio-economic, geographic and behavioural factors. Results: There was no difference in participation amongst individuals experiencing high levels of anxious feelings, but individuals experiencing low levels of happiness were less likely to engage in 'popular' cultural activities (e.g., live music events/cinema), 'high art' cultural activities (e.g., opera/ballet), and crafts and literary cultural events (e.g., exhibitions/book fairs). Education and socio-economic status largely explained differences, but for 'high art' and 'popular' activities, differences persisted independent of all explanatory factors tested. There was no difference in participation in global cultural activities (e.g., festivals). Conclusions: Using behaviour change theory, our findings suggest that lower levels of physical and social opportunity and psychological capability may reduce levels of cultural participation amongst individuals with low levels of happiness, but other physical and perceived barriers still remain to be explored.