Arts for Wellness (AFW): Arts-Based Social Prescribing During Inpatient Rehabilitation for Older Adults in Singapore
SPNAC
Enhancing Wellbeing in Seniors Through an Arts-Incorporated Social Prescribing Program in Rehabilitation and Community Settings: A Mixed-method Study
2 other identifiers
interventional
288
1 country
1
Brief Summary
This mixed-methods study examined whether Arts for Wellness (AFW), an artist-led arts programme introduced during inpatient rehabilitation, improves mental wellbeing among older adults in a Singapore community hospital, and explored how and for whom it works. Adults aged 50 years and above admitted to Outram Community Hospital for rehabilitation were randomly assigned (2:1) to AFW plus standard care or to standard care alone. AFW consisted of six group sessions (twice weekly for 3 weeks, 45-60 minutes each) in either dance or literary arts, delivered by trained National Arts Council artists. The art form was determined by which programme was running on the ward during the participant's admission, not by randomisation. After discharge, AFW participants were offered two virtual "Social Hour" sessions, a Take-Home Kit, and linkage to community arts programmes. The main question was whether AFW improves mental wellbeing (Warwick-Edinburgh Mental Well-being Scale, WEMWBS) 4 weeks after baseline compared with standard care. Secondary questions were whether it affects symptoms of depression and anxiety, health-related quality of life, patient satisfaction, and health-care utilisation, and whether any benefit is maintained up to 4 months later. Participants completed questionnaires at baseline, 4 weeks, 12 weeks, and about 20 weeks after baseline. A nested qualitative strand involved interviews with AFW participants and focus groups with artists, health-care professionals, and programme implementers to understand mechanisms, inclusion, and sustainability.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Aug 2025
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
July 30, 2025
CompletedStudy Start
First participant enrolled
August 1, 2025
CompletedPrimary Completion
Last participant's last visit for primary outcome
April 27, 2026
CompletedStudy Completion
Last participant's last visit for all outcomes
September 2, 2026
CompletedFirst Posted
Study publicly available on registry
October 1, 2026
CompletedOctober 1, 2026
September 1, 2026
9 months
July 30, 2025
September 24, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Change in Mental Wellbeing (Warwick-Edinburgh Mental Wellbeing Scale -WEMWBS)
14-item validated scale of positive mental wellbeing; total score range 14-70, higher scores indicate better wellbeing. Analysed as the adjusted mean difference between groups at T1 using a constrained longitudinal data analysis model adjusted for age, sex, and ethnicity.
Baseline (T0) and 4 weeks after baseline (T1; ±7 days)
Secondary Outcomes (8)
Mental wellbeing (WEMWBS) at later follow-up
12 weeks after baseline (T2; 8 weeks after T1) and approximately 20 weeks after baseline (T3; 4 months after T1); ±7 days
Symptoms of depression (Patient Health Questionnaire-9, PHQ-9)
Baseline, 4 weeks, 12 weeks, and approximately 20 weeks
Symptoms of anxiety (Generalized Anxiety Disorder-7, GAD-7)
Baseline, 4 weeks, 12 weeks, and approximately 20 weeks after baseline
Health-related quality of life: EQ-5D-5L utility index
Baseline, 4 weeks, 12 weeks, and
Health-related quality of life: EQ visual analogue scale (EQ VAS)
Baseline, 4 weeks, 12 weeks, and approximately 20 weeks after baseline
- +3 more secondary outcomes
Other Outcomes (1)
Attendance at AFW sessions and Social Hour (process measure)
During the 3-week intervention and up to 8 weeks after the final session
Study Arms (2)
Arts for Wellness (AFW) plus standard care
EXPERIMENTALStandard community hospital care plus six artist-led group arts sessions (45-60 minutes, twice weekly for 3 weeks) during the inpatient rehabilitation stay, in either dance or literary arts. Art form was determined by the programme running on the ward during the participant's admission and was not randomised. After discharge, participants were offered two virtual Social Hour sessions within 8 weeks of their final session, a Take-Home Kit specific to their art form, and linkage to community arts programmes such as those at Active Ageing Centres. Intervention(s) in this arm: Behavioral: Arts for Wellness - Dance; Behavioral: Arts for Wellness - Literary arts
Standard care
NO INTERVENTIONStandard community hospital care during inpatient rehabilitation, including routine social prescribing by Wellbeing Coordinators, usual discharge planning, and usual community referrals. No AFW sessions, Social Hour, or Take-Home Kit.
Interventions
: Structured dance programme ("Move to the Rhythm of Life") drawing on Malay dance principles and using culturally familiar objects (batik cloths, sarongs, fans, drums). Six group sessions of 45-60 minutes, twice weekly for 3 weeks, led by trained National Arts Council dance artists, tailored in real time to participants' physical ability, language, energy, and confidence. Followed after discharge by two virtual Social Hour sessions, a dance Take-Home Kit, and linkage to community arts programmes. Other Names: Move to the Rhythm of Life; arts-based social prescribing
Structured literary arts programme using modular storytelling prompts, reminiscence, character-building, and group expression. Six group sessions of 45-60 minutes, twice weekly for 3 weeks, led by trained National Arts Council literary arts facilitators, adapted in real time to participants' language, ability, and confidence (e.g. scribing for participants who cannot write). Followed after discharge by two virtual Social Hour sessions, a literary arts Take-Home Kit, and linkage to community arts programmes.
Eligibility Criteria
You may qualify if:
- Aged 50 years or older at recruitment
- Admitted to Outram Community Hospital for inpatient rehabilitation
- Willing and able to participate in an arts-based programme
- Able to converse in English, Mandarin, or Malay
- Able to provide informed consent
- Able to complete study questionnaires
You may not qualify if:
- Receiving palliative care
- Awaiting nursing home placement
- Qualitative strand:
- Patient interviewees (subgroup of trial intervention-group participants): attended at least four AFW sessions, purposively sampled for variation in art form, mobility, language, and engagement
- Artists (≥ 21 years old): National Arts Council artists who facilitated AFW sessions for at least one month
- Health-care professionals (≥ 21 years old): clinicians (e.g. Wellbeing Coordinators, physiotherapists, doctors) involved in referral to or implementation of AFW
- Programme implementers (≥ 21 years old): producers, operations, and administrative staff who supported AFW delivery, with at least three months of experience in social prescribing
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- SingHealth Community Hospitalslead
- National Arts Council, Singaporecollaborator
- National Arts Councilcollaborator
Study Sites (1)
Outram Community Hospital
Singapore, 168582, Singapore
Related Publications (2)
Jensen A, Stickley T, Torrissen W, Stigmar K. Arts on prescription in Scandinavia: a review of current practice and future possibilities. Perspect Public Health. 2017 Sep;137(5):268-274. doi: 10.1177/1757913916676853. Epub 2016 Nov 16.
PMID: 27852837BACKGROUNDLee KH, Low LL, Lu SY, Lee CE. Implementation of social prescribing: lessons learnt from contextualising an intervention in a community hospital in Singapore. Lancet Reg Health West Pac. 2022 Aug 17;35:100561. doi: 10.1016/j.lanwpc.2022.100561. eCollection 2023 Jun.
PMID: 37424685BACKGROUND
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- SUPPORTIVE CARE
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- A/Prof
Study Record Dates
First Submitted
July 30, 2025
First Posted
October 1, 2026
Study Start
August 1, 2025
Primary Completion
April 27, 2026
Study Completion
September 2, 2026
Last Updated
October 1, 2026
Record last verified: 2026-09
Data Sharing
- IPD Sharing
- Will share
- Shared Documents
- STUDY PROTOCOL, SAP, ICF
- Time Frame
- Beginning 3 months and ending 3 years after the publication
- Access Criteria
- Qualified researchers affiliated with academic, research, or health-care institutions, on submission and approval of a research proposal with a sound scientific rationale, an analysis plan, and documentation of ethics approval. Requests to the corresponding author; a data access agreement will be required.
De-identified individual participant data underlying the published results will be shared: demographic and baseline characteristics; WEMWBS, PHQ-9, GAD-7, EQ-5D-5L and EQ VAS scores at each timepoint; patient-reported experience measure responses; attendance; and health-care utilisation data where reported. Qualitative transcripts will not be deposited because of the risk of re-identification of participants in a single-site study; anonymised excerpts may be made available on reasonable request subject to ethics approval.