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Arts-basedapproachestoKTinhealthpolicydevelopment SusanCox,PhDW.MauriceYoungCentreforAppliedEthicsSchoolofPopulationandPublicHealthUniversityofBritishColumbiaVancouver,BritishColumbia

Creativityandinnovationinknowledgetranslation

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It might work out well…

Or it might not…

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Learningobjectives

•  Exploretherangeofarts-basedapproachestoKT•  Identifychallengesandopportunitiesrelatedto

usingarts-basedapproachesinhealthpolicydevelopment

•  ConsiderexamplesofKTprojectsutilizinglivetheatre,foundpoetryandvisualmethodstoinformhealthpolicydevelopment

• Reflectonethicalandmethodologicalissuesarisingfromexamples

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Arts-based Research !  Providessetofinterdisciplinarymethodological

tools&practicesusedmainlybyqualitativeresearchersbutnowmorewidely

!  Canbeincorporatedinallphasesofresearchfromdatacollectiontoanalysisanddissemination

!  Posesrangeofnewresearchquestions&topics!  Expandsdiversityofaudiencesforresearch!  Enhancesemotional&intellectualengagement

Rangeofarts-basedapproaches

• Visual:collaborativemuralmaking,digitalstorytelling,PhotoVoice,bodymapping;multimediaexhibitions

• Performative:livetheatre,ethnodrama,dance,singing,music-making

• Literary:foundpoetry,storytelling,graphicnovels,comics

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"The7,024thPatient"isanartexhibitionthatincludespoetryandimagestodisseminateresearchfindingsfromastudyaboutpatients'experiencesofheartsurgeryandrecovery.PROJECTTEAM:Dr.JenniferLapum,Dr.GideonCohen,Dr.TerrenceYau,Dr.KathrynChurch,LindaLiu(imageretrievedfrom:http://the7024thpatient.com/events/)

Contact!Unloadisaplayco-developedbyveteranstellingthestoryofsoldiersastheytransitionbacktolifeinCanada.ThistheatreprojectispartoftheMan/Art/ActioninitiativeawardedtotheVeteransTransitionNetwork(VTN)bytheMovemberFoundation.ProjectLead:GeorgeBelliveau,UBCFacultyofEducation(Imageretrievedfrom:http://educ.ubc.ca/contactunload-in-vancouver/)

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Climate for arts-based approaches

•  OriginalemphasisonusesofABHRforknowledgetranslation&exchange

•  IncreasingfocusonuseofABHRasinnovative&transformationalmodeofdoingresearch

•  CanadianInstitutesofHealthResearchreviewofABHRfunding2009-2014(Boydelletal)revealsmillionsinfundingtoresearchusingphoto-elicitation,film,theatreanddance

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Somefactorsinfluencingmethodologicalinnovation

• Rapidlychangingsocio-technicalcontextsandnormsforhowwecommunicate

•  Theoreticalshiftsthatargueforafocusonmuchmorethanjustthe‘text’(e.g.,riseofsensoryethnography)

• Heighteneddesireonpartofresearcherstobemoreflexibleandcreative

• Needtocaptureearofpolicy-makersorengagedisenfranchisedpopulationsandcommunities

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Examples of arts-based approaches to KT

•  Theatreasaninnovativeapproachtopublicengagementindevelopmentofhealthpolicyonassistedreproduction

•  Multimediaperformancepieceaboutexperiencesofhumansubjectsinhealthresearchasamethodofsharingfindingswithkeystakeholderstoinfluencepolicychange

•  Useoffoundpoetryonreproductivetourismasameansofpromptingpolicy-relatedquestionsandenhancingawarenessofissues

Susan M. Cox & Jeffrey Nisker, Co-PI’s Magdalena Kazubowksi-Houston, Postdoctoral Fellow Hubert Doucet, Collaborator

Research Assistants

Natasha Damiano Margaret Dorazio-Migliore Celine Durand Isabelle Ganache Isabelle Gareau Heather Greenwood Holly Longstaff Marc Toppings

Theatre as an Innovative Tool for Public Engagement

in Health Policy Development Projectfundedby:

CanadianInstitutesforHealthResearch&HealthCanada(2005-2008)

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Ruins of Ephesus: Greco-Roman theatre seating 25,000

•  Provide Canadians with opportunity to learn about, debate and discuss complex issues arising from new reproductive and genetic technologies

•  Provide Health Canada with results of process so that multiple and diverse perspectives can be used to inform policy on PGD, prenatal testing & genomics

Objectives of public engagement:

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•  fieldnotes and in-theatre observation (during 16 performances)

•  demographics and audience feedback forms (70% response rate)

•  moderated post-performance large audience discussions (N = 373)

•  post-performance focus groups (N = 65 in 12 groups)

Documenting the process

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“My overwhelming feeling from the play is I’m in constant conflict. When I watched the play, I just found it amazing how the play brought that out. And when you look at policy, the tricky thing is THAT. How do you put THAT complexity and THAT conflict, which results from these types of issues, into a policy?” (Woman, Health Care Professional, LAD T9)

Complexity

•  Power of story in co–construction of knowledge (versus provision of information)

•  Actors and audience members are mutually responsive (i.e., not passive) participants

•  Performance creates empathy and stimulates imagination yet allows for multiple interpretations

•  Shared experience of play becomes basis for dialogue, discussion and intervention

Whatmakeslivetheatreaneffectivemeansofpublicengagement?

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Challenges•  Creatingaprocess:conceptualizinghowtodo

theatreforpublicengagement•  Constraints:needfor‘balanced’perspective•  Budgetaryissuesandcompetingpriorities:

qualityofproductionvsassessingengagement•  Evaluation:absenceofsuitablestandards•  Ethicalissues:aroundidentifiabilityofcitizen

voices,emotionallyvolatilesituation,accessibilityforpersonsw/disability

•  Implementation:blackholeatHealthCanada

Centering the Human Subject in Health Research CIHRFundedProject(2005-2012)SusanM.Cox(PI)MichaelMcDonald(Co-PI)AnneTownsend,PatKaufertandJoeKaufert(Co-Investigators)Whataretheexperiencesofhumansubjectsinhealthresearch?

ThePsychograph(antiquephrenologymachine,circaearly1900s)

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CentringtheHumanSubject.TheatricalperformancesattheArts-BasedMethodsInHealthResearchdisseminationevent,November19th&20th,2009.LeadingPlaywriterandDirector:GrahamW.Lea

(Visualartcreatedby:DonalODonoghue)

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Challenges•  Difficultiesofnegotiatingappropriateformsof

interdisciplinarycollaborationbetweenresearchersandartists

•  Methodologicalaspectsof‘creating’theperformance&weavingtogetherallthepieces

•  Differingprioritiesofresearchersaroundaccuracyinportrayingfindingsandartistsinaestheticsofperformance

•  Variedaudienceresponseandclinician/researcherconcernsabout‘lackofbalance’

Listening deeply: Understanding experiences of

reproductive tourism through poetic inquiry

SusanCox,HeatherWalmsley,CarlLeggoUniversityofBritishColumbia

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TheOdds(HeatherWalmsley)

WediddonorIVF:15matureeggs;8fertilized.Byday3,downto1embryo.Wetransferredthatone.Ican’thelpfeeldisappointed.WehopedtohavesomethingTofreeze.Justincase.Butthatwasnottobe

Whytheother7Didn'tmakeit?Theuniverse,Givingmethemiddlefinger.IreallythoughtTakingmycrappyeggsOutoftheequationWouldbethemagicbullet.Foronce,theoddsinmyfavor

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Challenges•  Issuesofvoiceandmethodological

uncertaintyof‘creating’poemsthatadequatelyrepresentparticipantexperiencesandperspectives

•  Taskbecomesoneofraisingtroublingquestionsbutbeingunabletoprovideanswers

•  Toleranceforambivalenceandambiguityinpolicycontext

Cautionary notes•  Startsmallandkeepitsimple.Thesekindsof

interdisciplinarycollaborationsarelabourintensiveandcomplex!

•  Aimforearlyinvolvementofartistsinconceptualizationofarts-basedapproach;can’tjustaddonattheendofaproject

•  Bepreparedforunforseenchallenges,differingparadigmsandcompetingpriorities

•  Audienceimpactscanbeunpredictableanddifficulttoassess;noacceptedstandardsforevaluation

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Referencesfromexamples•  Cox,SusanM,MagdalenaKazubowski-HoustonandJeffNisker.

(2009).GeneticsonStage:TheatreandPublicEngagementinHealthPolicyDevelopment.SocialScienceandMedicine,68:1472-80.

•  Lafrenière,Darquise,SusanM.Cox,GeorgeBelliveau,andGrahamLea.(2013)Arts-basedknowledgedisseminationmethodsinhealthresearch:Performinganddisplayingthehumansubject.JournalofAppliedArtsandHealth,3(3),253-257.

•  Walmsley,Heather,SusanM.CoxandCarlLeggo.(2015).Listeningdeeply:Understandingexperiencesofreproductivetourismthroughpoeticinquiry.CreativeApproachestoResearch8(3):15-43.

•  Cox,SusanM,DarquiseLafrenière,PamelaBrett-Maclean,KateCollie,NancyCooley,JanetDunbrack,andGerriFrager.(2010).Tippingtheiceberg?ThestateofartsandhealthinCanada.Arts&Health:AnInternationalJournal,2:2:109–124.

ResourcesBooks•  StephenCliftandPaulCamic,Eds.(2016)OxfordTextbookofCreative

Arts,Health,andWellbeing:InternationalPerspectivesonPractice,Policy,andResearch.OxfordUniversityPress.

•  DaisyFancourt(2016)ArtsinHealth:DesigningandResearchingInterventions,OxfordUniversityPress.

•  GaryKnowlesandArdraColeEds.(2008)TheHandbookoftheArtsinQualitativeResearch:Perspectives,Methodologies,ExamplesandIssues.SAGEPublishing.

•  PatriciaLeavy(2015)MethodMeetsArt:Arts-BasedResearchPractice.GuildfordPress.

Journals•  ArtsandHealth:AnInternationalJournalforResearch,Policyand

Practice•  Art/ResearchInternational:ATransdisciplinaryJournal

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Authors: Susan Cox, Sarah Drew, Marilys Guillemin, Catherine Howell, Deborah Warr, Jenny Waycott (alphabetical order)

Guidelines for: •  Visual researchers •  Ethics committees

Visual Research Collaboratory http://vrc.org.au/

Thank you! I welcome your comments and questions. Email: susan.cox@ubc.ca