Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
Centre for Behaviour Change, University College London, London, UK.
BMC Public Health. 2020 Feb 27;20(1):272. doi: 10.1186/s12889-020-8337-1.
There is a large literature on the health benefits of engagement with the arts. However, there are also well-recognised challenges in ensuring equity of engagement with these activities. Specifically, it remains unclear whether individuals with poor mental health experience more barriers to participation. This study used a behaviour change framework to explore barriers to engagement in participatory arts activities amongst people with either depression or anxiety.
Data were drawn from a large citizen science experiment focused on participation in creative activities. Participants who reported engaging infrequently in performing arts, visual arts, design and crafts, literature-related activities, and online, digital and electronic arts were included and categorised into no mental health problems (n = 1851), depression but not anxiety (n = 873) and anxiety but not depression (n = 808). Barriers and enablers to engagement were measured using an 18-item scale based on the COM-B Self-Evaluation Questionnaire, with subscales assessing psychological and physical capabilities, social and physical opportunities, and automatic and reflective motivations. Logistic regression analyses were used to identify whether individuals with either depression or anxiety reported greater barriers across any of the six domains than individuals without any mental health problems. Where differences were found, we calculated the percentage of protective association explained by various demographic, socio-economic, social, physical or geographical factors.
Individuals with depression and anxiety felt they would be more likely to engage in arts activities if they had greater psychological and physical capabilities, more social opportunities, and stronger automatic and reflective motivations to engage. However, they did not feel that more physical opportunities would affect their engagement. Covariates explained only 8-37% of the difference in response amongst those with and without anxiety and depression.
Findings suggest that for individuals with poor mental health, there are certain barriers to participation that are not felt as strongly by those without any mental health problems. Mapping the behaviour change domains to potential interventions, activities that focus on increasing perceived capabilities, providing social opportunities, and reinforcing both automatic and reflective motivations to engage has the potential to help to redress the imbalance in arts participation amongst those with poor mental health.
关于参与艺术活动对健康的益处，已有大量文献记载。然而，确保公平参与这些活动也面临着公认的挑战。具体而言，人们仍不清楚心理健康状况不佳的个体在参与这些活动时是否会遇到更多障碍。本研究使用行为改变框架，探讨了抑郁或焦虑个体参与参与性艺术活动时所面临的障碍。
数据来自一项专注于创意活动参与的大型公民科学实验。研究纳入了报告偶尔参与表演艺术、视觉艺术、设计和手工艺、文学相关活动以及在线、数字和电子艺术活动的人群，并根据是否存在心理健康问题（无心理健康问题者 1851 人，抑郁但无焦虑者 873 人，焦虑但无抑郁者 808 人）进行了分类。使用基于 COM-B 自我评估问卷的 18 项量表来衡量参与的障碍和促进因素，该量表的子量表评估了心理和生理能力、社会和物理机会以及自动和反射动机。使用逻辑回归分析来确定抑郁或焦虑个体在任何六个领域报告的障碍是否多于无任何心理健康问题的个体。如果存在差异，我们计算了各种人口统计学、社会经济、社会、身体或地理因素解释的保护相关性的百分比。
抑郁和焦虑个体认为，如果他们具有更强的心理和生理能力、更多的社会机会以及更强的自动和反射动机来参与，他们更有可能参与艺术活动。然而，他们认为更多的物理机会不会影响他们的参与。协变量仅解释了焦虑和抑郁患者与无焦虑和抑郁患者之间反应差异的 8-37%。
研究结果表明，对于心理健康状况不佳的个体而言，他们在参与方面存在某些障碍，而这些障碍并不像那些没有任何心理健康问题的个体那样强烈。将行为改变领域映射到潜在干预措施上，重点关注增强感知能力、提供社会机会以及加强自动和反射动机，有可能有助于纠正心理健康状况不佳的个体在艺术参与方面的不平衡。
