In an increasingly globalised world, patterns of human behaviour are changing, and so too are the strategies needed to ensure health and wellbeing. The complexities of human health behaviours are driven by evolving social, structural and corporate forces. Communities, as spaces where health knowledge, behaviours, and empowerment are able to be shaped (or to be challenged), are evolving thanks to increasingly global technology. In this evolving world, we are reckoning with the need to address the complexities of human health-related behaviours in creative and human ways.

 

The global community is coming to recognise – in a variety of ways and through various fields over time – that behaviour change for health is so much more than the availability of facts, data and evidence. Community engagement for health is one such strategy that enables collaboration and transformation of human health-related behaviours. Whilst the concept of community engagement has been a long-recognised strategy in health and development, it has often been limited by unclear conceptualisation and partial operationalisation; as such the value of true community engagement is only slowly being realised by mainstream health organisations. Beyond community engagement as a tool for health or empowerment, we are interested in its transformative impact on community wellbeing and empowerment. There is an increasing body of evidence to suggest that storytelling, and its engine of empathy, is key to positively changing behaviours, and for our purposes, health behaviours. At a deep neurological level, it has been shown that empathy, particularly when it is framed in a narrative or sensory frame, is more likely to elicit a learning opportunity which is acted on, deeply felt, and remembered than the mere presentation of fact. The arts is one such way to cultivate an environment of empathy and expression. The impact of arts and culture on health is also increasingly recognised; the arts may facilitate a less mechanistic and more meaningful human interaction within the health sciences and promote health through a variety of ways we are only starting to come to terms with. 

 

One of the challenges, as we see it, is to bring these rich fields – arts, community engagement and behaviour change – together and to learn from the existing, diverse fields of practice and enquiry, in order to come to a more complete understanding of human health and wellbeing. The report was drafted to help inform the WHO Draft Strategy for community engagement through the arts and humanities, which aims to use the arts and humanities to catalyse and support countries to engage communities and individuals at local, national and global levels on the key health issues of our time to improve all peoples’ health no matter where they live.Through this review, by mapping the current landscape and identifying limitations and gaps, we also hope to contribute to shaping a future research and practice agenda. 

 

We have structured this review into three parts. First, we start with the why. Part One, Why, provides a summary of the theory and concepts of behaviour change, community engagement and the arts and health movements, and suggests why arts and community engagement combined may be effective for changing human health-related behaviours, in order to frame the subsequent sections. In Part Two, Who, we undertake a global environmental scan of initiatives for community engagement in global health through the arts, including policy, funding, organisations, networks and academic bodies. In Part Three, What, we present a scoping ‘review of reviews’ plus narrative synthesis to present the evidence for what works in community engagement in global health through the arts. Finally, Part Four, How, we present our reflections on the current landscape and some preliminary suggestions about how we may proceed in the spirit of creativity and human wellbeing.