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The effect of an artist in residence program on self-reported loneliness in senior citizens

Author: Catherine Richmond-Cullen

Richmond-Cullen, Catherine. “The Effect of an Artist in Residence Program on Self-Reported Loneliness in Senior Citizens.” Educational Gerontology, vol. 44, no. 7, July 2018, pp. 425–432. EBSCOhost, doi:10.1080/03601277.2018.1494369.

Introduction
The study, funded by the Pennsylvania Council on the Arts and the Pennsylvania Department of Aging, measured the effect that an artist in residence program (conducted by state-vetted professional teaching artists) had on self-reported loneliness in senior citizens. All participants were aged 60 years or older and participated in programming in state-funded senior community centers located in 14 sites throughout the Commonwealth of Pennsylvania. Artists offered 10 sessions in creating and critiquing art to senior citizens in their respective art forms including performing arts, visual arts, and multidisciplinary/interdisciplinary arts. Through pre and post-tests, changes in loneliness were measured using the Revised UCLA Loneliness Scale. The data revealed that there was a significant correlation between a self-reported decrease in feelings of loneliness and participation in a program conducted by professional artists.
The purpose of the study was to determine if artist in residence programs can positively impact the lives of senior citizens in the Commonwealth of Pennsylvania. The study measured the effect that artists in residence programs had on decreasing self-reported feelings of loneliness in older adults. It was proposed that findings from the study could influence the quality of programs provided by state-funded senior community centers in Pennsylvania and increase funding levels to senior community centers throughout the commonwealth. The project was supported and funded by the Pennsylvania Department of Aging and the Pennsylvania Council on the Arts (PCA) two agencies of the Office of the Governor in the Commonwealth of Pennsylvania. In the future, the state agencies may continue to collaborate to finance quality arts programs for seniors throughout Pennsylvania.
Creative aging
Pennsylvania has the fourth “oldest” population in the nation with 2.9 million individuals aged 60 years and older and more than 300,000 citizens aged 65 and older living in the commonwealth. It is estimated that by the year 2030 there will be more than 3.6 million Pennsylvanians ages 60 and older (Pennsylvania Department of Aging, [ 9] ). A program of the Pennsylvania Department of Aging that directly influences the quality of the lives of senior citizens is the creative aging initiative. This concept focuses on the role of the arts in enhancing the lives of older adults by providing quality arts programs and services through community organizations throughout the commonwealth (Pennsylvania Department of Aging, [ 9] ). As a result of the combined interest in creative aging and making the arts accessible to all Pennsylvanians, the PCA and the Pennsylvania Department of Aging collaborated to fund this state-level research project to determine the effect an artist in residence program had on senior citizens who utilize the services of state-supported senior community centers. This is the first time in the history of the Commonwealth of Pennsylvania that the two state agencies, under the auspices of the Office of the Governor, have collaborated to fund a research project in the arts.
Artists in residence
Artists in residence are professional artists who are experts in a given field of the arts. The artists are selected for the approved roster of teaching artists through a specific process in the Commonwealth of Pennsylvania. In order to apply to the PCA, Arts in Education Partnership program, the artist must be a full-time working artist and must demonstrate expertise in his or her chosen art form. The artist must provide documentation of professional performances or exhibitions which indicate that he or she is fully engaged in working as a professional artist. All artists in the program are required to attend professional development sessions in order to increase their knowledge and skills as teaching artists. The training is provided through either the PCA or through the PCA in Education Partners located throughout the Commonwealth.
Artists work in schools and community-based organizations for a specific number of days (10-120 or more) in the given setting. They guide participants to advance in their understanding and development of creative works of arts. Artists represent the following fields: preforming (theater, dance, music, puppetry, spoken word, etc., visual (painting, printmaking, ceramics, sculpture, etc.), media arts (film, television, video, computer-generated art, graphic design, etc.), poetry/creative writing and folk arts (basket weaving, knitting, traditional dance, etc.) . Artists encourage participants to learn historical and cultural understandings and techniques for critique of their own and others’ works. A final exhibition or performance is part of the programs artists conduct in school and community agencies. At times, printed materials are created to document the results of the program.
Arts in education partners of the PCA
The mission of the PCA is to foster the excellence, diversity, and vitality of the arts in Pennsylvania and to broaden the availability and appreciation of those arts throughout the state (Pennsylvania Council on the Arts, [ 8] ). In order to advance the mission, the Council decentralized grant allocations in arts programming and arts in education services throughout the commonwealth by establishing a network of partner agencies that covered all of the counties in Pennsylvania. According to literature published by the PCA, “the organization undertakes partnerships and initiatives to leverage opportunities, to seek solutions to challenges affecting the arts in the commonwealth, and to initiate programs that will serve a broad spectrum of artists, arts organizations and arts participants throughout the state” (Pennsylvania Council on the Arts, [ 8] ).
The artist in residence program of the PCA is managed through the arts education partner agencies throughout the commonwealth. Each agency is approved through a board of directors appointed by the Governor of Pennsylvania consisting of 19 members, represented by 15 private citizens and 4 members of the General Assembly. The Council is responsible for overseeing the finances and programs of the arts council. The Arts in Education Partnership organizations have worked as associate organizations of the PCA to provide grants, training, programs, and services throughout the 63 counties in the Commonwealth of Pennsylvania. The partner organizations work within assigned counties to offer arts programs and services to schools and community organizations. The arts partnership program which decentralized the finances and programs of the arts council has been in existence for more than 25 years. The organizations are required through a competitive grant process to apply for partnership status every year.
State-supported senior community centers
Senior community centers in Pennsylvania promote socialization, engagement, and a positive quality of life. They provide a nutritious meal, social activities, a range of informative programs, creative arts, exercise, volunteer opportunities, community services and other special events (Pennsylvania Department of Aging, [ 9] ). The state-supported senior community centers which were selected for this project are located throughout the Commonwealth of Pennsylvania. These sites were geographically selected as they were within the boundaries of the arts in education partners’ organizations of the PCA (See Table 1 for a list of the PCA Arts in Education Partners and Senior Centers).
List of PCA arts in education partners and senior centers.
Arts in education partner name:

Address:

Senior center partner
Allentown Art Museum

31 North Fifth St. Allentown, PA 18101-1605

Lehigh Valley Active Life
ArtsPath, Indiana University

1011 South Drive Indiana, Pa. 15705

Brookville Heritage House
Bradford County Regional Arts Council

601 Main St. Towanda, PA 18848-1613

Benton Senior Center
Cultural Alliance of York County

14 West Market St. York, PA 17401-1228

Northeastern Senior Center
Elk County Council on the Arts

237 Main St. Ridgway, PA 15853-1015

Coudersport Senior Center
Art Council of Erie, Inc.

23 W. 10th St. Suite 2 Erie, PA 16501-1423

Lifeworks Erie
Galaxy, the Arts in Education Program at Central Intermediate Unit 10

345 Link Rd. West Decatur, PA 16878-8351

Clearfield Senior Center
Jump Street

21 S. 3rd St. Suite 200 Harrisburg, PA 17101-2125

Jewish Community Center
Northeastern Educational Intermediate Unit #19

1200 Line St. Archbald, PA 18403-1918

Abington Senior Center
Perry County Council of the Arts

PO Box 354 Newport, PA 17074-0354

Huntingdon County Senior Center
Philadelphia Arts in Education Partnership

440 North Broad St. Philadelphia, PA 19130-4015

KleinLife Northeast Senior Center
Pittsburgh Filmmakers/Pittsburgh Center for the Arts

477 Melwood Ave. Pittsburgh, PA 15213-1135

Community Action Southwest
South Central PaARTners at Millersville University

The Ware Center Lancaster, PA 17603-3840

Elizabethtown Senior Center
Southern Alleghenies Museum of Art

112 Fransciscan Way PO Box 9 Loretto, PA 15940-0009

Ebensburg Senior Center
In this study, designated personnel of the Arts in Education Partner organizations (in most cases, the director of the arts partnership) selected volunteer artists who were interested in working with older adults. A total of 14 artists from the following disciplines participated in the program: performing arts, visual arts, folk arts, and interdisciplinary/multidisciplinary arts. The artists were financially compensated for working as artists in residence from a grant awarded to the Arts in Education Partner organizations from the Pennsylvania Department of Aging. No compensation was awarded to participants for involvement in the study (see Table 2 for a List of artists in residence participating in the study).
List of artists in residence participating in the study.
Arts in education partner

Senior center

Teaching artist

Discipline
Allentown Art Museum

Lehigh Valley Active Life

Lisa Faccioponti

Storyteller
ArtsPath, Indiana University

Punxsutawney Senior Center

P.J. Piccirillo

Literature
Bradford County Regional Arts Council

Highlands Care Center

Mary Knysh

Musician
Cultural Alliance of York County

Northeastern Senior Center, Mt. Wolf

Judeth Pekala Hawkins

Visual Arts
Elk County Council on the Arts

Coudersport Senior Center

Julie Mader

Visual Arts
Erie Arts & Culture

Lifeworks, Erie

Kelly Armor and Gyan Tamang

Folk Arts and Music
Galaxy, IU#10

Clearfield Senior Center

Michele Randal

Visual Arts
Jump Street

Jewish Community Center

Cheryl Kugler

Visual Arts
Northeastern Education Intermediate Unit 19

Abington Senior Center

Earl Lehman

Visual Arts
Perry County Council on the Arts

Huntingdon County Senior Center

Danza Antiqua

Dance
Philadelphia Arts in Education Partnership

KleinLife Northeast Senior Center

Kristen Balmer

Visual Art
Pittsburgh Filmmakers/PGH Center for the Arts

Community Action Southwest, Waynesburg

Maritza Mosquera

Interdisciplinary Arts
South Central PaARTners, Millersville University

Elizabethtown Senior Center

Julie and Barnaby Holmes

Theatre
Southern Alleghenies Museum of Art

Ebensburg Senior Center

Deb Bunnell

Multidisciplinary
Literature review
Research on the impact of arts participation on health outcomes for older adults has been published for more than 40 years. Due to the intervention of arts programs, both physical and mental health benefits have been reported in elderly participants in the studies. Studies on successful aging elucidate data which includes information on positive changes in both mental and physical abilities. Transformational experiences in older adults as a result of arts programs have been recorded through quantitative and qualitative studies. The research indicates changes in the following: ( 1) physical health (overall health, decrease in number of doctor visits, decrease in the use of prescription medications, decrease in numbers of falls), ( 2) mental health (increase in morale, decrease in depression and loneliness, and ( 3) social (increase in attendance and activities).
The Creative and Aging Study (Cohen et al., [ 1] ) is the landmark study in the field. Participants in the study were involved in intensive weekly participatory art programs. Specifically, health promotion, disease prevention and an impact on adults to maintain independence and reduce dependency were results of the long-term study. In this study, data on participants indicated a trend toward improvement in loneliness. According to the data, the intervention of arts programs affected health promotion and disease prevention (Cohen et al., [ 1] ). Another study measured growth in self-acceptance, positive relations with others and personal growth after the intervention of a theatre program (Noice, Noice, & Staines, [ 7] ). Additionally, recent research measured positive gerontology and reported that successful and productive aging can be facilitated with productive engagement. Although the study does not define productive activity as arts engagement, it suggests the more that seniors are involved in activities, the more positive their later years can be (Johnson & Mutchler, [ 6] ). Stephenson ([ 11] ) found that art making has a significant effect on older adults’ mental health and self-esteem and the most successful way to empower the healthy elder is for that person to seek further creative growth. Hodges, Keely & Grier ([ 4] ) found that elderly patients who were exposed to visual images as a catalyst for discussion were shown to open up to caretakers regarding past life experiences and feelings.
Hanna, Patterson, Rollins and Sherman ([ 3] ) conducted a study to frame an agenda for research on lifelong learning and individual well-being. The researchers found a strong connection between arts learning and improved cognitive development and an improvement in quality of life for older adults who engage in the arts and creative activities as compared to those who do not. Specific instances reported include higher overall physical health, fewer visits to the doctor, less medication use, fewer instances of falls, fewer use of health programs, and, as related to this study, higher morale and less loneliness than the control group in the study (The Arts and Human Development, [ 3] ). The national study contains subsets of research studies that provide evidence that arts learning is a positive addition to the lives of older adults.
Phillips, Reid-Arndt, and Pak ([ 10] ) reported that adults who are active participants in arts programming have been shown to improve in their respective of quality of life. Further investigation found that adults with strong networks are likely to stay out of nursing homes and have a higher quality of life compared to adults with less social connectedness (Jeffri, Raveis, & Miller, [ 5] ). Grenade and Boldy ([ 2] ) indicate that regardless of their living circumstances older people require access to services and supports that enable them to continue to develop and maintain their social connectedness.
The research center for Arts and Culture and the National Center for Creative Aging revealed that mental health variable such as morale, depression, and loneliness were affected after the intervention of the ART CART program. The program engaged professional artists in their aging years in community-based arts activities (Jeffri et al., [ 5] ).
This study was influenced by the positive findings in the literature. It is apparent that arts programming has a positive effect on the social and mental health of older adults.
Study sites and subjects
The sample selected for the study was geographically representative of the entire Commonwealth of Pennsylvania, as there was purposeful sampling utilized in the selection of the senior community centers across the commonwealth. Purposive sampling was conducted through consultation with the PCA in Education partner organizations which are located throughout the commonwealth. The PCA in Education Partnership directors were commissioned by the PCA to contact the director of a state-funded senior community center within the geographical region assigned to said partnership. The inclusion criteria for selection of senior community centers was the following: ( 1) they were state-supported senior community centers and ( 2) they were geographically located within the designated arts partner organization region. This ensured that there was representation of senior citizens living in rural, suburban, and urban regions throughout the Commonwealth of Pennsylvania.
Due to ambiguity with regard to the age at which individuals are considered to be seniors, the researcher utilized the criteria identified by the Pennsylvania Department of Aging as a requirement to receive senior community center services throughout Pennsylvania which is age 60 or older (Pennsylvania Department of Aging, [ 9] ). Inclusion criteria for the subjects was the following: ( 1) they attended a state-supported community center and agreed to participate in 10 sessions of an artist in residence program and ( 2) they were age 60 or older. The sample for the study consisted of 71 senior citizens, ages 60 and older, who attended the program in 14 sites across Pennsylvania. The participants consisted of 20 males, 50 females, and 1 transgender. Mixed races are represented in the sample. There were 63 Caucasians, 0 Hispanic, 3 African Americans, 2 Asians, 1 Native American, and 2 listed as other.
Data measures, collection, and analysis
The research question was: Is there a significant decrease in self-reported loneliness in senior citizens following participation in an artist in residence program? The Revised UCLA Scale of Loneliness was given as a pre and post-test. In the analysis of the data, a dependent paired-samples t-test was utilized to compare the mean self-reported loneliness scale between the two administrations of the instrument. A dependent paired-samples t-test was most appropriate for this purpose, as the same participants were measured on two occasions, once prior to participation in the artist in residence program and once following the final session of the artist in residence program. The null hypothesis asserted that there would be no change in self-reported loneliness as measured by the Revised UCLA Loneliness Scale following participation in an artist in residence program. The alternative hypotheses stated that there would be a decrease in self-reported loneliness as measured by the Revised UCLA Loneliness Scale following participation in an artist in residence program.
Approval for the data collection and analysis was obtained from the University of Scranton Institutional Review Board. Permission to conduct research was obtained in writing from each senior center involved in the study. The Revised UCLA Loneliness scale, a 20-item scale designed to measure one’s subjective feelings of loneliness and social isolation, was used for the pre and post-test assessments. The instrument is considered highly reliable in terms of internal consistency and test-retest reliability. Permission was granted from the author of the instrument to use the Revised UCLA Scale of Loneliness. A group of five volunteer directors from the PCA, Arts Education Partnership and the Arts in Education Director of the PCA completed the online CITI training program in order that research protocol could be followed at each of the sites involved in the study. The participants provided written consent to participate in the study, which included participating in the artist in residence program for a period of 10 session for 2 hours each. They also consented to participating in the pre and post-test assessments. Online meetings were held before the research began in order that the researcher could inform the volunteers about the chosen instruments, protocol for administration of the instruments, etc.
The artists who were part of the study were professional teaching artists chosen by the directors of the PCA partnership program. They were recruited by the partner directors because of their willingness to provide a 10 week artist in residence program in a senior community center. The artists were paid the required state rate for a 10 day artist in residence program. They were not involved in the pre or post-testing sessions and were required to recuse themselves from the room when the data were collected (see Table 2). The volunteer directors mailed the data to the researcher. Data were gathered from January to May 2018. Statistics were calculated using the Statistical Package for the Social Science version 24.
Results
Since the entire population of seniors across the Commonwealth of Pennsylvania could not be included in the research, due to financial constraints, time limitations, and the voluntary nature of the study, a sample was selected to represent that population. As such, the research findings could not be without error. The researcher therefore had to identify an acceptable level of error/chance, which is the alpha level. The researcher selected an alpha level of.05, as this is the most commonly selected level of error/chance in the field of Education. This means that the researcher is willing to accept up to and including 5% error/chance in the findings.
The level of significance, also known as the p value, indicates the probability of chance or error that were present in the findings. The level of significance was found to be.034 for a two-tailed test. As this test was one-tailed with a directional alternative hypothesis in favor of a decrease in self-reported loneliness among the participants, the level of significance was divided by 2. Therefore, the level of significance was found to be.017, or 1.7%. This means that the researcher can be 98.3% confident that the findings are real and due to the study rather than due to extraneous or confounding variables or chance. The test statistic value was found to be t = 2.160 with 70 degrees of freedom. The mean pre-test and post-test self-reported loneliness scores respectively were 39.61 and 38.23. The mean difference from pre-test and post-test was 1.380, which indicates that the participants’ self-reported loneliness decreased by 1.38 points following participation in the artist in residence program.
Limitations
In the initial stage of the study, 245 senior citizens across the Commonwealth of Pennsylvania were interested in participating in the study. Due to various reasons (illness, winter weather, transportation, etc.) many did not complete the 10 sessions with the artists. The final sample of 78 participants, all of whom attended all 10 sessions, although acceptable, was not as large as the original number of seniors who had a desire to participate in the study.
The researcher did not distinguish if there were any differences in results contingent on the type of artist who worked with the older adults. It is possible that a specific art form (dance, music, theatre, or visual arts) may have more influence on the decrease in self-reported loneliness.
Ten sessions may not be sufficient time for older adults to experience change in loneliness. Due to financial constraints, the program was limited to 10 sessions. It is possible that the data would elucidate a higher degree of change if there were more time spent in program. Additionally, the length of time between sessions varied throughout the study. Some senior community centers conducted the program weekly while others offered sessions bi-weekly. Winter weather influenced the schedule as well. This difference in how frequently the participants met with the artists may have influenced the results.
Discussion
The fact that older people experience feelings of loneliness and social isolation has been revealed in the research and in this study. In order that many senior citizens can feel less lonely or more connected in their communities many attend recreational programs in senior community centers. Much of the programming at state-funded senior community centers in Pennsylvania is activity-based but not considered to be the type of program discussed in this study. Although recreational activities in centers such as bingo, craft making, and sing alongs can be stimulating, they may not provide the cognitive and creative stimulation inherent in arts learning. The participants in this study indicated that they were less lonely after working with artists in the program. Because the arts inherently engage people in collaboration and cooperative processes, it is expected that if older adults frequent the state-funded senior community centers during an artist in residence program, they may develop important relationships and friendships that could have a positive effect on their emotional and social health.
Recommendations
Artist in residence programs offer opportunities for senior citizens to participate in quality arts courses of study in senior community centers. Rather than the more typical recreational offerings such as games and craft making, the artist in residence programs provide senior citizens a chance to engage with professional teaching artists who are experts in their art forms. High-quality programming that is cognitively challenging and stimulating should be offered to older adults who seek to improve their lives and engage with others at senior community centers.
The emotional health of senior citizens is important to their quality of life. When older adults to connect to and collaborate and cooperate with others while learning in and through the arts, their self-reported feelings of loneliness decrease. The results of this study should be taken into consideration when state agencies and local senior community centers are planning and financing programming for senior citizens who frequent the centers. Artists in residence programs can have an influence on the emotional well-being of participants.
Arts and culture are a critical part of the Commonwealth of Pennsylvania’s commitment to providing a vibrant and livable life that inspires all citizens. The significant number of artists, arts organizations, arts programs, and projects provide Pennsylvania citizens with opportunities to engage in and benefit from the arts as creators/artists, audiences, or participants (Pennsylvania Council on the Arts, [ 8] ).
State agencies in the Commonwealth of Pennsylvania have an opportunity to share resources in order to support their respective missions. The artist in residence program in Pennsylvania as described in this study can be easily replicated throughout Pennsylvania due to the established network of agencies ready to collaborate to ensure program success. Certainly, the model of state agencies collaborating to provide substantive programs for seniors can be developed in other states/regions/countries. It is suggested that pooling financial and other agency resources can only benefit senior citizens as programs become more enriching to their lives and interests.
Conclusion
The study found that there was a significant decrease in self-reported loneliness in senior citizens after participation in a 10 session artist in residence program. The self-reported loneliness score decreased by 1.38 points on the UCLA Loneliness Scale following participation in the artist in residence program. Decreased feelings of loneliness and social isolation can be the result of participation in artist in residence program in senior community centers.

DMU Timestamp: February 03, 2020 23:30





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