¿What is Arts in Health? Key Concepts – Arts in Health International Foundation

Arts in health is a broad concept that refers to the use of the arts, culture, heritage and the humanities to contribute to the health and well-being of individuals and communities. It includes practices linked to visual arts, music, dance, theatre, literature, thought, contemporary creation and cultural participation, and can be developed in healthcare, social, educational, community and cultural contexts.

This approach is based on a central idea. The arts and culture can form part of strategies for health promotion, prevention, care, treatment, rehabilitation and support, provided that they are developed according to appropriate criteria of design, implementation, safety, quality and evaluation. In this sense, arts in health seeks to materialise the potential benefits of artistic and cultural participation in processes oriented towards health and well-being outcomes, in accordance with the available evidence and with the needs of the people and contexts in which they are applied.

Incorporating the arts into the tools available to address community health challenges requires a clear conceptual framework and methodologies capable of articulating artistic quality, healthcare knowledge, the participation of the intended participants and institutional responsibility. This framework must ensure that projects are designed on the basis of explicit objectives, reasoned foundations, appropriate indicators, monitoring mechanisms and evaluation tools that are coherent with the intervention.

To facilitate this application, Guillem d’Efak Fullana-Ferré, co-founder of the Arts in Health International Foundation, has elaborated an operational model based on five elements to define, design, implement and evaluate arts in health interventions. This model derives from accumulated experience in cross-sector projects involving cultural institutions, healthcare centres, universities, public administrations and community stakeholders, and offers a practical criterion for distinguishing a general artistic practice from a structured arts in health intervention.

The five elements are as follows.

Clearly defined health objective
The intervention must be based on an explicit health or well-being objective, formulated in a way that is understandable and coherent with the needs of the participants. This objective may relate to health promotion, prevention, mental health, quality of life, adherence, rehabilitation, healthy ageing, loneliness, pain, grief, recovery, support or other physical, emotional, cognitive, social or community dimensions.

Co-creation between health, arts and culture professionals
Arts in health interventions require genuine collaboration between diverse professional profiles. The design must integrate healthcare knowledge, artistic quality, cultural competencies, community sensitivity and knowledge of the context. This co-creation makes it possible to adapt the proposal to health needs, to the characteristics of the participants, to the spaces in which it takes place and to the resources available.

Active participation of the intended participants
Participants must occupy a central place in the intervention. Participation may take different forms depending on the project, such as artistic creation, guided aesthetic experience, movement, writing, conversation, listening, contemplation, narration or other forms of cultural engagement. The model emphasises meaningful, accessible and respectful participation, adapted to the capacities, preferences and circumstances of each group.

Rigorous evaluation suited to the project
Interventions must include evaluation mechanisms that make it possible to analyse the process, outcomes, safety, acceptability, quality of experience and implementation conditions. Evaluation may combine quantitative, qualitative and mixed methodologies, depending on the nature of the project and the objectives set. Its function is to generate evidence, improve practice, guide decisions and facilitate the transferability of learning.

Communication, dissemination and feedback
The results and learning generated by interventions must be communicated clearly and responsibly. This communication may include scientific publications, technical reports, dissemination materials, feedback sessions with participants, professional presentations or resources for other institutions. Dissemination helps to build knowledge, share methodologies, avoid duplication and strengthen the development of a field grounded in evidence, quality and public responsibility.

The model formulated by its author and adopted by the Arts in Health International Foundation as a reference framework provides a common basis for guiding arts in health projects in diverse settings. It also makes it possible to recognise the complexity of the field, since a rigorous intervention must attend simultaneously to health objectives, artistic quality, the relational dimension, participation, evaluation and the social return of the knowledge generated.

Health assets
Any factor or resource that enhances the capacity of individuals, communities and populations to maintain health and well-being. The conceptualisation of health assets follows the logic of making healthy options easier and more accessible, oriented towards well-being, healthy growth and healthy ageing.

Community health
The collective expression of the health of a defined community, determined by the interaction between the characteristics of individuals, families, the social, cultural and environmental context, as well as healthcare services and the influence of social, political and global factors. A community health intervention is defined as an action developed with and from the community through a participatory process.

Community assets model
A methodology for community health intervention that emphasises the development of policies and activities based on the capacities, skills and resources of people and disadvantaged neighbourhoods. This method aims to identify the map of assets or strengths of the community in order to discover individual, collective and environmental capacities, as well as the talents that already exist in the context.

Social prescribing
Social prescribing enables doctors, nurses and other healthcare professionals to refer patients to a range of non-clinical community services. This care approach is based on the recognition that people’s health is largely determined by a range of social, economic and environmental factors. Social prescribing seeks to address people’s needs holistically, supporting them to gain greater control over their own health. Social prescribing actions may involve a variety of activities typically provided by community organisations, including artistic activities, volunteering projects, group learning, gardening, cooking and a wide range of sports activities.

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