Abstract
BackgroundThere 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.MethodsData 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.ResultsIndividuals 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.ConclusionsFindings 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.
Highlights
There is a large literature on the health benefits of engagement with the arts
Capabilities The pattern of reporting for capabilities, opportunities and motivations is shown in Table 2. 84.7% of individuals with depression, 86.3% of individuals with anxiety and 77.5% of individuals with no mental health problems reported that they would be more likely to engage in arts activities if they had greater psychological capabilities
Individuals with depression had a 65% higher odds of reporting psychological capabilities as a factor that would enhance engagement than individuals with no mental health problems, and individuals with anxiety had a 74% higher odds (Table 3). 21.5% of the association for depression and 36.5% of the association for anxiety was explained by factors such as personality and socio-economic status (SES) and, especially for people with depression, how frequently they engaged in physical activities
Summary
There are well-recognised challenges in ensuring equity of engagement with these activities It remains unclear whether individuals with poor mental health experience more barriers to participation. As engagement with the arts is a form of human behaviour, understanding what influences engagement can be facilitated by application of theories and models of behaviour change. There have, been efforts within the behavioural and social sciences to synthesise theories into a minimum set of constructs representing key influences on behaviour One such integrated theoretical model is COM-B, which posits that in order for a desired behaviour to occur, individuals must have the capability (i.e. knowledge and skills) to engage, opportunity (in their social and physical environment), and motivation (both reflective and automatic) [9]
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