Abstract
Background:There is a scarcity of research concerning what it is about arts engagement thatmay activatecausal mechanisms leading toeffects onhealth and wellbeing: their active ingredients. Further, the limited studies that do exist have tended to be relevant to specific contexts and types of art forms. The aim of this study was to carry out a comprehensive mappingof potentialactive ingredients,construct a shared language,and proposea frameworkand toolkitto support the design, implementation, and evaluation of artsinhealthactivities. Methods:Drawing upon Rapid Appraisal techniques and collaborating with 64 participants working in arts in health,we engaged ina three-phase process: 1)scoping review to inform the development of an initial framework; 2) consultation on the initial framework; and 3) analysisand construction of the INNATE framework. Results:The study identified139potential active ingredients within the overarching categories of project,people, and contexts. Projectcomponents relate directly to the content of the arts activity itself, intrinsic towhatthe activity is. The peoplecategory denotes how people interact through engagement with the activity and who is involved in this interaction, including activity facilitation. Contextsrelates to the activitysettingcomprising the aggregate of place(s), things, and surroundings.Aligning with complexity science, ingredients may interconnect or feed into one another to prompt mechanisms, and may not be experienced as distinct by participants. Conclusions:Our mapping exercise is the most extensive to date. In relation to artsinhealth activities, the INNATE framework can support with:designandimplementation, such asco-producing an intervention to meet the needs ofa particular population;evaluation,such as facilitating the comparison ofdifferent interventions and their efficacy; andreplication, scalability, andsustainabilitythrough enabling detailed reporting and articulation of what anartsinhealth activity entails.
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