De Viggiani, N., Daykin, N., Moriarty, Y. and Pilkington, P. and ...

SECONDARY RESEARCH OUTCOMES
As discussed previously, this project was developed during a change of government. Under the
coalition, a Big Society agenda was introduced as a political scheme to shift more services into the
community, and engage more actively with community, voluntary and third sector organisations –
hence the introduction of the Payment by Results system of commissioning and procurement. The
research has demonstrated that outcomes orientated interventions are difficult to implement and
evaluate where individual goals may vary, outcomes are individually focused, and the intervention
has to be adaptable to the context in which it is delivered. Moreover, small bespoke programmes
are rarely comparable, especially where there are so many context specific variables to account for.
A secondary objective of the research was to pilot conventional validated health, wellbeing and
social inclusion questionnaires with this population, partly to establish baseline scores across the
population but, moreover, to explore the feasibility of measuring these indicators with transient
and ‘hard-to-reach’ subgroups. Measurement of health and wellbeing outcomes has become a key
research agenda for arts and health programmes, particularly with the introduction of the ‘Payment
by Results’ culture to service commissioning.
Three survey tools were piloted pre-programme and at two time points post-programme to test
the reliability of these tools and provide baseline descriptive data. Despite limited scope to perform
statistical analysis with the data, piloting the three questionnaires with this population yielded
valuable insight into the acceptability of such techniques used to measure health and social
outcomes. Discussion of feasibility highlighted issues regarding survey design and administration.
Although each questionnaire was designed to measure positive and negative outcomes, none was
ideal for this population.
We would recommend development of a new measurement instrument that takes account of the
issues highlighted in this research. It should be appropriate and sensitive to different age groups,
levels of maturity, gender, and language and literacy skills. It is also important to consider the
context in which it is administered. These questionnaires were originally designed to be selfadministered
and were validated with the 16+ general population. With this population,
respondents more often than not required some level of one-to-one assistance from a researcher.
Moreover, the compulsory nature of the setting and the need to educate gatekeepers makes it all
the more challenging to recruit participants and administer questionnaires. Any new instrument
would need to undergo piloting with a non-intervention ‘control’ population to establish the
optimal conditions and support for its implementation.
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