In the past few decades, there has been a surge of international interest in the role of the arts and culture in healthcare, public health and health promotion, on an individual and community level. However, the vast majority of research studies have focused on the effects of targeted, time-limited arts interventions on particular patient groups. Yet, much of the arts and cultural engagement across the UK is not confined to specific interventions but involves a more general, ubiquitous participation that can be harder to measure through experimental studies. A select number of public health studies have found associations between cultural participation (including attending concerts, museums and galleries) and self-reported health, as well as inverse associations between cultural participation and mortality risk. However, important questions remain, and to date, there have been no large-scale public health studies examining the impact of the arts in the UK. This project is led by the Centre for Performance Science, an internationally distinctive partnership of the Royal College of Music and Imperial College London, with an extensive track record in arts, health and social research. It explores the effect of (i) activities that involve actively 'doing' (e.g. music, dance, art, photography and drama) and (ii) activities that require physical attendance (e.g. attending concerts, monuments, museums, galleries, cinemas, heritage archives and theatre); (iii) 'home-based' activities (e.g. listening to the radio, watching TV, reading, storytelling, using arts-based apps, digital arts experiences, online music co-production). Our research questions identify the impact of the arts and culture on individual, social and economic measures of health and wellbeing, as well as explore how associations vary between different socioeconomic, geographical and ethnic populations within the UK. To explore these questions, the project is organised into four work packages. Work package 1 will involve assessing existing data including undertaking a meta-analysis of previous studies and exploring a UK cohort study that includes some questions on the arts. However, recognising the limited data currently available, work packages 2 and 3 are based on a large-scale national survey to be carried out during our study. Open to all adults in the UK, the survey will target the general population as well as participants diagnosed with one of four major health conditions facing the UK: mental health, cancer, cardiovascular disease and chronic respiratory diseases. These conditions have all previously been researched in smaller arts-in-health intervention studies but not at a public health level, and their inclusion will facilitate understanding of the relationships between culture and the individual, social and economic facets of health and wellbeing. A total of 25,000 participants will be recruited to complete an anonymous online questionnaire consisting of demographic questions, validated psychological scales and economic metrics, assessments of arts and cultural participation and self-reporting of health. Work package 2 will explore the questions with a cross-sectional analysis of these data with nested case-control studies; work package 3 will monitor a sub-section of the sample as a cohort for the following year with 6-monthly updates to track longitudinal change in arts engagement. Recognising the complexity of cultural engagement and health, work package 4 will add context to the survey data, with a sub-sample of survey participants taking part in qualitative telephone interviews to explore motivations for, and experiences of, arts engagement across the UK and how this is reported to intersect with health behaviours, perceptions and outcomes. Through the extensive epidemiology methods proposed, an ambitious sample size and nested qualitative data, the findings promise to redefine the value of the arts and culture for public health in the UK.

There is a growing body of evidence which describes the social inclusion role of museums and the role that museums play in improving health and wellbeing, including previous research funded by the AHRC. This research has shown that engaging in museums provides: positive social experiences, leading to reduced social isolation; opportunities for learning and acquiring news skills; calming experiences, leading to decreased anxiety; increased positive emotions, such as optimism, hope and enjoyment; increased self-esteem and sense of identity; increased inspiration and opportunities for meaning making; positive distraction from clinical environments, including hospitals and care homes; and increased communication between families, carers and health professionals. Given the wide range of benefits it is not surprising that more and more museums and galleries are adapting their access programmes to consider the wider social, health and wellbeing benefits that museum encounters can bring about. From museum object handling to reminiscence sessions, through to interactive exhibitions, tours, talks and participatory arts and creative activities, museums offer a diverse range of opportunities for active engagement. With over 2500 museums in the UK alone, most of which are free, museums offer a largely untapped resource as places which can support public health. Museums, however, are very well placed to address issues such as social isolation, physical and mental ill-health and evidence suggests that museums can help to build social capital and resilience, and improve health and wellbeing. The Health and Social Care Act (2012) is bringing about considerable changes to the way health and social care services will be delivered in the future. A key part of these health reforms sees a shift towards 'prevention is better than cure', within a model which will require a multi-agency approach with an increased reliance on third sector organisations such as charities, voluntary and community organisations. Part of the reason for the health reforms is the realisation that individuals are living longer but with unhealthier lifestyles, with a significant increase in age- and lifestyle-related diseases, such as dementia and diabetes; this places added pressure on health services (including the NHS) and social services. It has also been shown that there is a 'social gradient' in relation to health, whereby individuals from poorer socio-economic backgrounds experience reduced health, wellbeing and social resilience. It is easy to see how museums could fit into this new era of health commissioning considering the benefits described above. One of the biggest challenges facing the museums sector is understanding how best to meet these needs; here lessons from arts-in-health could help inform the museums sector. Over the past few decades arts-in-health has gained considerable support, backed up by a robust evidence base. Many arts organisations have developed more formalised relationships with health and social care providers, offering schemes described as 'social prescribing'. Social prescribing links patients in primary care with local sources of support within the community. The proposed research seeks to test a novel 'Museums on Prescription' scheme (MoP). The research will link museums with health and social care providers, and third sector organisations such as AgeUK, and using lessons learnt from arts-based social prescribing schemes, will set up two MoPs, one in Central London and one regional MoP in Kent. By working closely with health/social care service users, and museum, health, social care and third sector professionals, the research will use a range of techniques, including quality of health measures, interviews and questionnaires, to develop a MoP model which can be adopted by the museums sector as a way to provide a novel public health intervention.

The 'MARCH' Network proposes that Assets for Resilient Communities lie at the heart of Mental Health (M-ARC-H) and is dedicated to advancing research into the impact of these assets in enhancing public mental health and wellbeing, preventing mental illness and supporting those living with mental health conditions. Specifically, it will advance our understanding of the impact of social, cultural and community assets including the arts, culture, heritage, libraries, parks, community gardens, allotments, leisure centres, volunteer associations, social clubs and community groups, of which there are an anticipated 1 million in the UK. The network will bring together a Disciplinary Expert Group of researchers with a Policy Group of major national policy bodies, a Patient Public Involvement Group of national mental health charities, and a Community Engagement Group of national organisations. Across three years, our network will unite research with policy and practice to tackle critical questions of research priorities, methods, and implementation in this field; understand and resolve barriers to mobilising community assets; and provide training and support to the next generation of researchers. Specifically, our network will address questions organised in two core work streams (WS): WS1. Cross-disciplinary research and challenges: (a) What evidence is there, from a cross-disciplinary perspective, for how and why community assets impact on public health and wellbeing and the lives of those living with mental health problems, and where are the gaps for future research? (b) How can we use a cross-disciplinary approach to provide meaningful data to different stakeholders and users? WS2. Equity of engagement and access innovation: (a) Who amongst the UK population, demographically and geographically, currently engages with these programmes and how does participation vary dependent on mental health? (b) What are the current barriers and enablers to engagement at an individual, organisational and policy level and how can we develop innovative approaches to enhance engagement, especially amongst the vulnerable? This research work will be complemented by a rich portfolio of impact, engagement and training activities (see 'Impact Summary'). This network aligns with strategic priorities of the AHRC and ESRC as well as having a secondary relevance to the priorities of the MRC (through its consideration of the role of community assets and social prescribing to support medical approaches to mental health), NERC (through its exploration of the impact of green spaces) and EPSRC (through its focus on the opportunities provided by technology for driving research forwards). It has also been designed in response to the Network Plus Research Agenda. In addition to the objectives already discussed in the prior Je-S section, it is responsive to many of the mental health challenges cited in the agenda. For example, the call specification noted that only 25% of people with mental health problems receive ongoing treatment. Whilst there are recognised economic and resource constraints with delivering sufficient mental health services, this Network proposes to focus on the role that existing community assets could play in providing support to a much wider range of people in the UK including those on waiting lists. As another example, the call specification raised that 70% of children and adolescents with mental health problems have not had appropriate interventions at an earlier age. This Network will involve working with policy makers and community organisations to see how research could help overcome barriers to access with the aim of engaging more young people and those who are hard to reach. Overall, the network will seek to understand and support future research into how community assets could be mobilised to encourage more resilient individuals and communities with a greater understanding of and capacity for self-management of mental health.