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Warran K, Burton A, Fancourt D. What are the active ingredients of 'arts in health' activities? Development of the INgredients iN ArTs in hEalth (INNATE) Framework. Wellcome Open Res 2022; 7:10. [PMID: 35600003 PMCID: PMC9106992 DOI: 10.12688/wellcomeopenres.17414.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 11/03/2023] Open
Abstract
Background: There is a scarcity of research concerning what it is about arts engagement that may activate causal mechanisms leading to effects on health and wellbeing: their active ingredients. Further, the limited studies that do exist have tended to be relevant to specific contexts and types of art forms. The aim of this study was to carry out a comprehensive mapping of potential active ingredients, construct a shared language, and propose a framework and toolkit to support the design, implementation, and evaluation of arts in health activities. Methods: Drawing upon Rapid Appraisal techniques and collaborating with 64 participants working in arts in health, we engaged in a three-phase process: 1) scoping review to inform the development of an initial framework; 2) consultation on the initial framework; and 3) analysis and construction of the INNATE framework. Results: The study identified 139 potential active ingredients within the overarching categories of project, people, and contexts. Project components relate directly to the content of the arts activity itself, intrinsic to what the activity is. The people category denotes how people interact through engagement with the activity and who is involved in this interaction, including activity facilitation. Contexts relates to the activity setting comprising the aggregate of place(s), things, and surroundings. Aligning with complexity science, ingredients may interconnect or feed into one another to prompt mechanisms, and may not be experienced as distinct by participants. Conclusions: Our mapping exercise is the most extensive to date. In relation to arts in health activities, the INNATE framework can support with: design and implementation, such as co-producing an intervention to meet the needs of a particular population; evaluation, such as facilitating the comparison of different interventions and their efficacy; and replication, scalability, and sustainability through enabling detailed reporting and articulation of what an arts in health activity entails.
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Affiliation(s)
- Katey Warran
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Alexandra Burton
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Daisy Fancourt
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
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Warran K, Burton A, Fancourt D. What are the active ingredients of ‘arts in health’ activities? Development of the INgredients iN ArTs in hEalth (INNATE) Framework. Wellcome Open Res 2022; 7:10. [PMID: 35600003 PMCID: PMC9106992 DOI: 10.12688/wellcomeopenres.17414.2] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 01/02/2023] Open
Abstract
Background: There is a scarcity of research concerning what it is about arts engagement that may activate causal mechanisms leading to effects on health and wellbeing: their active ingredients. Further, the limited studies that do exist have tended to be relevant to specific contexts and types of art forms. The aim of this study was to carry out a comprehensive mapping of potential active ingredients, construct a shared language, and propose a framework and toolkit to support the design, implementation, and evaluation of arts in health activities. Methods: Drawing upon Rapid Appraisal techniques and collaborating with 64 participants working in arts in health, we engaged in a three-phase process: 1) scoping review to inform the development of an initial framework; 2) consultation on the initial framework; and 3) analysis and construction of the INNATE framework. Results: The study identified 139 potential active ingredients within the overarching categories of
project, people, and
contexts.
Project components relate directly to the content of the arts activity itself, intrinsic to what the activity is. The
people category denotes how people interact through engagement with the activity and who is involved in this interaction, including activity facilitation.
Contexts relates to the activity setting comprising the aggregate of place(s), things, and surroundings. Aligning with complexity science, ingredients may interconnect or feed into one another to prompt mechanisms, and may not be experienced as distinct by participants. Conclusions: Our mapping exercise is the most extensive to date. In relation to arts in health activities, the INNATE framework can support with: design and implementation, such as co-producing an intervention to meet the needs of a particular population; evaluation, such as facilitating the comparison of different interventions and their efficacy; and replication, scalability, and sustainability through enabling detailed reporting and articulation of what an arts in health activity entails.
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Affiliation(s)
- Katey Warran
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Alexandra Burton
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Daisy Fancourt
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
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Miklos M, Jahnsen R, Nyquist A, Hanisch H, Girdler S. "Here we are together, at home you are alone" - social interactions and personal engagement during a group-based rehabilitation program for young adults with disability. Disabil Rehabil 2021; 44:1631-1641. [PMID: 34000938 DOI: 10.1080/09638288.2021.1921060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Young adults with disabilities often report feeling alone in their experience of disability. Group-based rehabilitation programs provide opportunities to participate in learning processes and share experiences of living with a disability. The aim of this study was to explore and interpret social interactions and personal processes of engagement and development of young adults with disabilities during a rehabilitation program. METHODS Fifty-four young adults attending a group-based rehabilitation program at Beitostølen Healthsports Center (BHC) participated in the study. A grounded theory methodology employing ethnographic data enabled an in-depth exploration of the social processes occurring during the rehabilitation stay. RESULTS The social environment was important to personal processes during the stay. Fundamental to the social processes was a culture defined by opportunities, competence, and involvement of the young adults that promoted feelings of safety and the freedom to challenge themselves. Being with peers with disabilities enabled a sense of community underpinned by a shared understanding. Peers fostered motivation to actively engage in the participation processes, built courage and promoted self-reflection. CONCLUSION This article contributes to the understanding of the dynamic interactions between social contextual structures and interrelations, and personal processes of engagement and developmental experiences during a group-based rehabilitation program.IMPLICATIONs FOR REHABILITATIONRehabilitation in context of a peer-group was highly valued and made a unique contribution to the rehabilitation experience.Being in a group with peers sharing the experience of disability resulted in a safe learning environment, improving participants' motivation, encouraging them to engage in challenging activities and social interactions.The informal interactions and shared experience of living with a disability promoted self-reflection and improved self-understanding.Being with peers sharing the experience of disability provided opportunities for role modelling and mentoring, inspiring participants as to what might be possible.
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Affiliation(s)
- Mette Miklos
- Department of Research, Beitostølen Healtsport Centre, Beitostølen, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Reidun Jahnsen
- Department of Research, Beitostølen Healtsport Centre, Beitostølen, Norway.,Department of Neurosciences of Children, Oslo University Hospital, Oslo, Norway.,Institute of Health and Society, University of Oslo, CHARM, Oslo, Norway
| | - Astrid Nyquist
- Department of Research, Beitostølen Healtsport Centre, Beitostølen, Norway
| | - Halvor Hanisch
- Work Research Institute, Oslo Metropolitan University, VID Specialized University, Oslo, Norway
| | - Sonya Girdler
- School of Allied Health, Curtin University, Perth, Australia.,Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
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King G, Kingsnorth S, Morrison A, Gorter JW, DeFinney A, Kehl B. Parents' perceptions of the foundational and emergent benefits of residential immersive life skills programs for youth with disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 110:103857. [PMID: 33453694 DOI: 10.1016/j.ridd.2021.103857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 12/08/2020] [Accepted: 01/06/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE To examine parents' views of the benefits of residential immersive life skills programs for youth with disabilities. METHOD Three- and 12-month post-session interviews were held with ten parents of youth with disabilities who had attended one of three residential immersive life skills programs in one of three years of data collection. A deductive thematic analysis was conducted to describe the types of benefits reported by parents. RESULTS Parents discussed foundational benefits that were common to youth and more individualized emergent benefits. The foundational benefits included acquisition of life skills, greater awareness of future possibilities, and enhancements to self-confidence. The emergent benefits included greater comfort in new situations, and changes in motivation and initiative, maturity and responsibility, and community involvement. CONCLUSIONS Parents reported diverse benefits from involvement in these youth transition programs. In the eyes of parents, these programs prepared youth for transition to adult roles by enhancing awareness of life possibilities, amplifying existing capacities, and accelerating growth in adaptability, motivation, and maturity, as well as community involvement. The findings indicate the utility of RILS programs, and can be used to explain the diverse effects of these programs to parents and youth contemplating enrollment.
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Affiliation(s)
- Gillian King
- Bloorview Research Institute, Toronto, Canada; Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada; Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.
| | - Shauna Kingsnorth
- Bloorview Research Institute, Toronto, Canada; Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada; Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Andrea Morrison
- Children's Developmental Rehabilitation Program, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Jan Willem Gorter
- CanChild and Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Andrea DeFinney
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Barbara Kehl
- ErinoakKids Centre for Treatment and Development, Mississauga, Ontario, Canada
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King G, McPherson AC, Kingsnorth S, Gorter JW, Avery L, Rudzik A. Opportunities, experiences, and outcomes of residential immersive life skills programs for youth with disabilities. Disabil Rehabil 2020; 43:2758-2768. [PMID: 31994942 DOI: 10.1080/09638288.2020.1716864] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To examine the opportunities, experiences, and outcomes of a transition program for youth with disabilities. METHODS Over three years, in a prospective study, 29 youth (17 males) attending residential immersive life skills programs reported on their experiences in 55 activity settings in which opportunities were also rated using standardized measures. Youth completed outcome measures of self-determination and self-efficacy pre-and post-intervention, and 3 and 12 months later. The alignment of opportunities and experiences was examined, as well as effects of experiences on outcomes. RESULTS Opportunities were significantly correlated with experiences for males only. There were significant pre-post changes in autonomy (all youth) and self-efficacy (males only). Social and personal growth experiences predicted pre-post changes in autonomy, and experiences of psychological engagement (all youth) and choice and control (males only) predicted changes in psychological empowerment. CONCLUSIONS The findings highlight the importance of designing transition programs to provide experiences of social interaction, personal growth, choice, and psychological engagement in order to enhance autonomy and empowerment. Further investigation is needed on how gender influences youth experiences. Context-mechanism-outcome linkages offer a useful frame to examine opportunities, experiences, and outcomes, and reveal multiple pathways to changes in youths' self-determination brought about by program involvement.Implications for rehabilitationResidential immersive life skills (RILS) programs enhance the autonomy and empowerment of youth with disabilities.The findings show the value of RILS programs and other complex interventions that provide youth of transition age with a rich variety of opportunities and capacity-enhancing experiences.It is important to intentionally design opportunities for social interaction, personal growth, choice, and psychological engagement.It is important to ensure youth are engaged with program content, and feel a sense of social belonging, choice, and personal growth, because these experiences were found to be related to changes in youths' autonomy and empowerment.Gender differences in program experiences and outcomes were found, which is an important and overlooked area of research.
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Affiliation(s)
- Gillian King
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Amy C McPherson
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Shauna Kingsnorth
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Jan Willem Gorter
- Department of Pediatrics, CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada
| | - Lisa Avery
- Kinesiology and Health Sciences, York University, Toronto, Canada
| | - Alanna Rudzik
- Department of Anthropology, The State University of New York, Albany, NY, USA
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Kingsnorth S, Rudzik AEF, King G, McPherson AC. Residential immersive life skills programs for youth with disabilities: a case study of youth developmental trajectories of personal growth and caregiver perspectives. BMC Pediatr 2019; 19:413. [PMID: 31690279 PMCID: PMC6833162 DOI: 10.1186/s12887-019-1793-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 10/17/2019] [Indexed: 12/02/2022] Open
Abstract
Background Professional support in pediatric and rehabilitation care environments has been recommended as a means to build youth competence in life skills during their transition to adulthood. Life skills are the essential psychosocial competencies and interpersonal skills needed to manage one’s life. Residential immersive life skills (RILS) programs offer youth with physical disabilities enriched learning environments to acquire these skills. This study explored trajectories of personal growth in life skills and positive psychological outcomes among youth participating in a RILS program and related caregiver perspectives. Method Delivered by a multidisciplinary healthcare team, The Independence Program is an intensive summer program housed in a college residence that provides realistic experiences of living away from home for small groups of youth between 17 and 21 years of age who have congenital and/or acquired physical disabilities. Using a longitudinal case study and qualitative descriptive design, four youth and their parents/guardians participated in semi-structured interviews prior to, and then 1 month, and 3 to 4 months after the program. A conventional content analysis yielded chronological narratives for each youth and caregiver dyad of their experiences, perceptions and outcomes over time. These narratives were further summarized using a ‘line of development’ perspective to describe individual developmental trajectories of personal growth. Results All four of the youth returned from the program with positive reports about the new life skills acquired and new behaviours they engaged in. These positive reports generally continued post-program, albeit with differing trajectories unique to each youth and varying levels of congruence with their caregivers’ readiness to support, accommodate and facilitate these changes. Caregivers differed in their capacity to shift in their parenting role to support consolidation of youth life skill competencies following program participation. Conclusions RILS programs can be transformative. Varied youth trajectories identified significant personal growth through enhanced self-determination, self-efficacy and self-advocacy. Congruence in youth and caregiver perceptions of post-program changes was an important transactional factor. Professional support addressing caregiver needs may be beneficial to facilitate developmentally appropriate shifts in parenting roles. This shift is central to a model of shared management whereby adolescents take on greater responsibility for their own care and life choices.
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Affiliation(s)
- Shauna Kingsnorth
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, Ontario, M4G 1R8, Canada. .,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada. .,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.
| | - Alanna E F Rudzik
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, Ontario, M4G 1R8, Canada.,Department of Anthropology, SUNY Oneonta, Oneonta, NY, USA
| | - Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, Ontario, M4G 1R8, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Amy C McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, Ontario, M4G 1R8, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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King G, McPherson A, Mosleh D, Hartman L, Rapley J, Pinto M. Program opportunities of residential immersive life skills programs for youth with disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 83:233-246. [PMID: 30290364 DOI: 10.1016/j.ridd.2018.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 06/21/2018] [Accepted: 09/19/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE Residential immersive life skills programs provide youth with the skills and outlooks needed to adopt new roles in life. Observed program opportunities and service providers' perceptions of opportunities were examined to determine program fidelity. Service providers' views of how the programs work were also examined. METHOD 107 activity settings were observed across two summers at three programs, with opportunities assessed using the Measure of Environmental Qualities of Activity Settings (MEQAS-48). Activity settings were classified by session format (instructional versus experiential) and activity type (active physical, skill-based, self-improvement). Qualitative interviews were held with seven service providers. RESULTS Service providers indicated the importance of life-preparatory learning opportunities for social interaction, choice, and skill development, which aligned with high observed MEQAS-48 opportunities for social interaction, choice in experiential session formats, and personal growth. Providers individualized program delivery to provide youth with personally meaningful and challenging experiences. Providers also discussed emergent, transformational outcomes, including enhanced awareness of strengths, enhanced confidence in skills, identity development, and greater awareness of future life possibilities. CONCLUSIONS The study provided evidence of program fidelity, along with robust evidence for program opportunities as an active ingredient that may be transferable to the design and delivery of other transition-support programs.
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Affiliation(s)
- Gillian King
- Bloorview Research Institute, Toronto, Canada; Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada; Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.
| | - Amy McPherson
- Bloorview Research Institute, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Donya Mosleh
- Bloorview Research Institute, Toronto, Canada; Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Laura Hartman
- Bloorview Research Institute, Toronto, Canada; Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada; Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | | | - Madhu Pinto
- Bloorview Research Institute, Toronto, Canada
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