The Singapore Art-Health Study
Condition: Art; Wellness, Psychological; Frailty; Quality of Life
MeSH terms: Frailty
Study type: Interventional

Summary: 
      The goal of the Singapore Art-Health RCT is to examine the effect of a standardized 12-week
      museum -based participatory art program on health condition, well-being, and quality of life
      in older community dweller, one that adheres to the Montreal Art-Health framework with
      culturally specific modifications that are fitting to the local Singaporean context.

      Participants will be randomized into an intervention group of a passive control group.
      Participants in the intervention group will be invited to participate in the 12-week
      Singapore Art-Health Intervention held at the National Gallery Singapore. All participants
      will be invited to complete four online psychometric assessments. Participants in the
      intervention group will be invited to completed an additional post-intervention survey and a
      feasibility focus group.
    

Detailed description: 
      Background: Population aging continues to be global health challenge. The prevalence of
      longstanding age-related conditions such as worsening physical, social, and mental health is
      expected to increase exponentially with a rapidly ageing population. The practice of
      participatory art in various settings has been found to be effective in the promotion,
      prevention and management of health and wellbeing conditions across the life span. However,
      its effect on health condition among the older population, particularly in the Asian context
      remains to be investigated. In Montreal, findings from a pilot study provided strong evidence
      to show that a 12-week, standardized "Art-Health" participatory art program had
      multidimensional positive effects on the health outcomes of older community dwelling
      participants including improvements in wellbeing, quality of life, and frail condition.

      Current Proposal: The current research will adopt and modify the Montreal Art-Health
      participatory art framework with local cultural specificity (i.e. The Singapore Art-Health
      Intervention), and tests its effectiveness in healthy and wellness promotion among a sample
      of Singaporean older adults via a randomized control trial.

      Research Design: The study adopts a participatory action research paradigm and a single-site,
      open-label Randomized Control Trial (RCT) design to develop and examine the effect of a
      standardized 12-week museum-based participatory art activity on health condition, wellbeing,
      and quality of life in older community dwellers.

      Sampling and Randomization: Allowing for an attrition rate of 5% at follow-up, a target
      sample of 110 provides 90% power to detect an effect size of 0.55 (based on the results of
      the pilot study) between the intervention group and the control group at 5% level of
      significance (two-tailed test). Participants will be randomized into an intervention group of
      a passive control group. Participants in the intervention group will be invited to
      participate in the 12-week Singapore A-Health Intervention held at the National Gallery
      Singapore.

      Intervention Design: The Singapore Art-Health Intervention will span 12 weeks, with each
      weekly session lasting for two hours. The program is designed to impart basic art
      appreciation skill (formal analysis in art) and art making techniques to participants through
      engagement with the collection at the museum.

      Outcome measures and Data Analysis: All participants will be invited to complete four online
      psychometric assessments. Participants in the intervention group will be invited to completed
      an additional post-intervention survey and a feasibility focus group. For the quantitative
      data, between and within comparisons of outcomes will be conducted by mixed model analysis of
      variance (ANOVA), repeated measures ANOVA, and pairwise t-tests with Bonferroni correction.
      The focus group discussions will be analyzed using thematic analysis with a grounded theory
      approach to provide insights to the participant's experience and impact of the Singapore
      Art-Health Intervention.

      Importance of Research: The current research will develop and test the effectiveness of a
      culturally-specific Art-Health participatory art program on health and wellness promotion
      among a sample of Singaporean older adults. Working collaboratively with the National Gallery
      Singapore in program development and implementation will serve to ensure program
      sustainability upon research completion. This collaboration will also foster practice and
      knowledge transfer to accelerate creative ageing in the local society. Moreover, the findings
      will contribute to an international RCT for evaluating a standardized participatory art
      framework to address the impact of population ageing. It will be a potential breakthrough in
      the development of an efficient art and museum program for older adults locally and
      internationally.
    

Intervention name(s): Singapore A-Health Intervention
Intervention type(s): Behavioral
Intervention description(s): The Singapore A-Health Intervention spanned 12 weeks, with each weekly session lasting for two hours. The program is structured around three thematic domains of the past, present, and future. In each thematic domain consisting of four weeks, participants were tasked with creating an artwork related to the theme and incorporating the learned art techniques. The structure of each thematic domain follows the same structure: the first week involved a 45-minute docent-led gallery tour on three selected pieces of artworks, followed by a 75-minute artist-led brainstorming session where participants were introduced to the techniques and discuss ideas on the artwork to be created. The subsequent three sessions involved further guidance from the artist and a scaffolded delivery of art techniques for participants to incorporate their learning to their artwork. At the end of each domain, there was a showcase where participants present their artwork.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Intervention group participants will be invited to engaged in a 12-week participatory art program at the gallery. Participants in the control condition will not offered any art-based activities. All participants were advised not to participate in concurrent health art-based interventions during the research period.
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Prevention
Keywords: Art; Museum; Quality of Life; Frailty