Strengthening Adoption of Arts/Health Practices through Research: A Five-Point Plan 


By Sunil Iyengar
graphic that says Measure for Measure. On the left side of the graphic, there are hatchmarks that suggest bar graphs

At an event last weekend, I spoke at the invitation of that rarest of entities—a coalition of brain scientists, foundations, and venture capitalists. This group, BrainMind, held a forum inspired by Susan Magsamen and Ivy Ross’s bestselling book, Your Brain on Art: How the Arts Transform Us.

Sessions at the forum covered such topics as the neurophysiology of one’s brain “on art,” the arts and physical and mental health, and the arts and learning—but the conversation also extended to the arts’ role in building community. 

The panel on which I spoke was at the tail-end of the event. I and the other panelists had been charged with discussing “the future of the arts” in these domains and “how we get there.”

Accordingly, as appropriate for a five-minute introduction, I had prepped a few slides listing examples of resources and accomplishments that the NEA has produced over the last few years, and which can help to strengthen an empirical understanding of the arts’ relationships to neuroscience, health, and well-being. (Whether it’s the agency’s research awards program, the NEA’s Creative Forces initiative with the U.S. Departments of Defense and Veterans Affairs, or the Sound Health Network—such assets have been covered previously in this blog.)

But I also had wanted to capitalize on the title of the panel session. My thinking was, I would use the “how we get there” clause to advance some ideas for navigating these cross-disciplinary concerns.

Thus, my last slide was titled (rather presumptuously) “A Roadmap to the Future.” I was even excited to present it. But then, when I got behind the podium, after I had been speaking for 4:30 minutes or so, the dreaded card from the session’s timekeeper was raised. I had to start wrapping up.

Because I couldn’t fully present these ideas on how to progress with building knowledge about the arts, neuroscience, and health, I figured I would avail of this forum (if you’ll indulge me, dear reader) to discuss that slide’s contents.

Here, then, they are. I hasten to observe that I do not see them as the only, or even most important, needs we have as a research community working on issues regarding the arts and health—but I do rate them as critical, based on more than a decade of inhabiting this space as a research funder. 

  1. Accomplish more purposive, meaningful integration of arts and culture throughout federal programs and funding opportunities. This is a critical function for a small but influential agency such as the Arts Endowment. As NEA Chair Jackson has noted, we can unlock other resources, within the federal government, for the benefit of artists and cultural providers; the same applies to researchers of arts and culture.  The caveat being that we are not, ultimately, benefiting only these professionals, but the greater public’s capacity for knowledge and understanding about the arts’ multidimensional impacts, and how they intersect with the intended outcomes of other federal agencies. 

    As a practical matter, this realization has led to the establishment of an Interagency Working Group on the Arts, Health, and Civic Infrastructure. Co-chaired by Chair Jackson and U.S. Department of Health and Human Services (HHS) Secretary Becerra, the group has met twice so far to begin discussing how best to embed the arts in other agencies’ strategies for achieving their disparate missions.

  2.  Elevate and circulate promising strategies and case studies promoting arts/health integration at the federal, state, and local levels.  Rather than merely urge collaboration between the cultural and health agencies within government, or shore up evidence of why this is important, we need to share vignettes of what the process looks like. It is necessary to comb through projects occurring within states and municipalities to harvest such examples. Here we can rely in part on our state and local arts agency partners, but working with other federal agencies should unearth additional stories and strategies. 

  3.  Cultivate research-practice partnerships in the arts and health. Last winter, the NEA co-hosted with the National Institutes of Health a research workshop, “Music as Medicine: The Science and Clinical Practice.” The workshop prompted many timely observations, including an awakening of interest among many biomedical and behavioral researchers that artists should be more closely involved in the generation of research questions and hypotheses and in the sense-making of research results. These lessons were distilled, with others, in a Lancet article that appeared shortly thereafter: “Music as medicine: quickening the tempo of progress.” But the idea of artists and culture-bearers playing a more central role in research processes is not new. A 2019 NEA report, stemming from a summit of the agency’s Research Lab awardees, documented some of these needs, and was titled, fittingly, Arts Research Partnerships in Practice

  4.  Standardize descriptions of program or therapy components, outcome measures, and reporting requirements. This one may be a little less obvious to non-researchers. But the staggering array of arts programs and interventions—and the diversity of art forms, and modes of arts participation—while attesting to the growth, dynamism, and endurance of the field, pose measurement problems nonetheless. In an attempt to generalize research results from any single study, we must attend to context-dependent factors that make a difference in outcomes. Ultimately, this means documenting process: collecting and analyzing data—qualitative no less than quantitative—about core elements of arts programs or therapies, so we better understand key similarities and differences in the mechanisms of action, and so we can ensure what researchers call “fidelity” when reproducing a specific program or therapy. 

    A related need is to achieve, if not consensus, then at least a shared vocabulary among different sub-fields within the arts and health, and broad agreement among research funders and journal editors about what types of data should be reported as part of a study’s results. Fortunately, these topics have attracted wider attention in recent years. At NIH, there is a Music-Based Intervention (MBI) Toolkit that clarifies common data elements and functional outcome areas related to MBIs that address aging-related disorders. In 2023, researchers at the University of Florida’s Center for the Arts in Medicine published a research article titled “Defining ‘Arts Participation’ for Public Health Research.” So the game is afoot.

  5.  Build capacity for large, multisite, prospective trials to test the effectiveness of arts/health programs and therapies. Although we never should treat the arts as a pharmaceutical (despite the preposition in the catchphrase “your brain on art”), subject to the same types of clinical studies as those interventions, it remains true that randomized, controlled trials and quasi-experimental approaches are valid models for exploring causal relationships between the arts and distinct outcome areas.  It also matters that policymakers in both health or education often require data that speak of a program’s or activity’s potential benefits—including cost benefits—compared to doing nothing or providing an alternative service. At a minimum, the pursuit of large prospective trials should animate researchers who wish to claim representativeness of their study populations, so the results can capture effect differences among demographic and socioeconomic subgroups. 

Despite my inability to complete presenting this slide at last weekend’s event, I was gratified to see audience members snapping photos of it, using their phones. I suppose that each of the five points could inspire a symposium of its own—but, for now, I hope they are considered among other long-term actions needed for research that can help bring arts/health strategies into the mainstream of public policy and professional care practices.

Sunil Iyengar directs the Office of Research & Analysis at the National Endowment for the Arts.

 

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