Social return on investment analysis of an art group for people with dementia

Abstract

BackgroundFunding bodies require interventions to show value for money before further investment is made. Although cost-effectiveness analysis is widely used in economic evaluation it might not capture the social value generated by certain interventions. Here, we describe Social Return on Investment (SROI) analysis of the Dementia and Imagination study. SROI is similar to cost–benefit analysis in that inputs and outputs are converted into a monetary value; however, SROI also attempts to capture the social value generated. Although SROI has been used in the education and non-profit sectors, it is still relatively unused for the evaluation of health and social care interventions, partly because the valuation of outputs can be subjective. MethodsThe intervention will be delivered between June, 2014, to May, 2015, and involves people with dementia attending weekly art sessions for 3 months. An uncontrolled, cohort study design is being used. There will be three settings: the community, residential care homes, and inpatient assessment units. Participants will be interviewed at baseline, 3 months, and 6 months. SROI analysis involves six steps: establishing scope and identifying stakeholders, mapping outcomes, evidencing and valuing outcomes, establishing impact, calculating the SROI, and reporting it as a ratio of £X of social value generated for every £1 invested. The primary indicator for participant wellbeing is the DEMQOL; staff attitudes will be measured with the Approaches to Dementia Questionnaire. Semi-structured interviews will be conducted with participants, families, and staff involved with the project to capture broader outcomes. FindingsWe identified three key stakeholders: participants, participants' families, and staff at residential units where the project is taking place. Our next challenge is to assign a monetary value to non-physical outcomes such as increased wellbeing, increased confidence in participants, and increased staff morale. InterpretationSROI is an attempt to move towards broader economic evaluation in interventions that aim to have a wider effect on wellbeing than on health alone. The non-controlled study design would be a limitation for traditional cost-effectiveness analysis; however, establishing the effect through considering attribution, displacement, and drop-off are key parts of SROI analysis and are used to minimise the risk of overinterpreting the effect of the intervention. FundingDementia and Imagination was funded as Dementia and imagination: connecting communities and developing well-being through socially engaged visual arts practice, grant ref AH/K00333X/1, by the AHRC and ESRC as a part of the Cross-Council Connected Communities Programme.