Abstract
There has been increasing interest in the potential of community-based organisations to contribute to people’s health and sustain the social and health care sector. In this context, community-based arts programmes have been promoted by policy makers to support vulnerable groups such as older adults. Despite a vast literature exploring the relationship between health, wellbeing and participation in the community, it remains unclear how best to evaluate complex phenomena such as community-based arts programmes that operate in fluid contextual conditions (e.g. hard-to-reach communities, with a diverse range of social, economic and health issues). Realist evaluation approaches are well suited to unravel how and why fluid and complex forms of engagement such as community-based arts programmes impact on health.This thesis aims to evaluate what works, for whom and how and under what circumstances in community-based arts programmes for older people’s health. This is done through a case-based evaluation of an arts project for older people called Crafts for Change, run by a third-sector organisation (Beaux Arts) operating in one of the most deprived urban areas of Glasgow.
This thesis is a mixed and multi-method realist evaluation conducted through three phases. First, a realist-informed scoping review is carried out to extract, from existing evidence, candidate explanatory models of how community-based arts interventions achieve their outcomes. Second, analysis of longitudinal ethnographic data explores through which resources and under what circumstances a community-based arts initiative such as Crafts for Change can support older users’ health. Data were collected through observant participation and conversational interviews with 52 individuals (including programme users, facilitators, managers from the organisation and community stakeholders), as well as a review of 18 project documents. Phase one and two leads to the advancement of three preliminary programme theories (i.e. if-then-because scenarios) in the form of Context-Mechanisms-Outcomes (i.e. CMOs). In phase three, these exploratory programme theories are tested and refined through analysis of: (a) longitudinal qualitative data (11 realist interviews, observant participation and interviews with 47 individuals including users and programme managers and stakeholders); (b) descriptive and inferential quantitative analysis of health-related and relational (i.e. social networks) repeated measures collected through intensive and longitudinal diary method and monitoring of physical activity of nine programme users.
Data analysis suggests that the health impacts of community-based arts programmes (i.e. physical activity, mental health and social well-being) are triggered by an array of mechanisms (i.e. competence, relatedness, motivation, self-efficacy, purpose and membership) that, in turn, are influenced by different contexts (every-day individuals’ life challenges, health and structural forms of deprivation). Crafts for Change shows that the outreach potential of community-based arts can be extensive when programmes are designed to be professionally and empathically led, drop-in, free-access, predominantly based on group projects and highly inclusive. However, such outreach also represents the moderating factor of the extent to which a community-based arts initiative can contribute to activate a series of generative mechanisms. This is due to the varied and unpredictable nature of the problems that older adults may carry in their lives when coming from a particularly disadvantaged background. Community-based arts may therefore be considered as an important social and health asset to tackle a range of local needs.
| Date of Award | 2020 |
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| Original language | English |
| Awarding Institution |
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| Supervisor | Olga Biosca Artinano (Supervisor), Simon Teasdale (Supervisor) & Dawn Skelton (Supervisor) |