Culture on Prescription in Europe: Health promotion through cultural learning experiences

<< Background >>In 2019, the European Commission's Joint Research Centre found that more than 75 million European adults get together with family or friends at most once a month, and around 30 million European adults often feel lonely. The mortality risk of loneliness is comparable to that of obesity and smoking. Persistent loneliness is also associated with unhealthy behaviours, mental health problems and poor cognitive performance. Lonely people also report more pessimistic judgements and feel more threatened by life situations. They also face the potential double penalty of poorer health and being stigmatised as socially inept. The Social Prescribing scheme in the UK has shown that it can be effective for people who are lonely and feel isolated, and that it is associated with a range of positive health and well-being outcomes when used as an adjunct to medical treatment.In addition to addressing the needs of people suffering from loneliness, we saw a need for knowledge of social and cultural prescribing concepts, as well as educational concepts and tools to facilitate the introduction of such prescribing schemes.<< Objectives >>The main objective of the COPE project was to show that combining culture and health promotion can create new ways of adult education and reduce loneliness and social exclusion among vulnerable groups, such as older people living alone or people with mental health problems. The Culture on Prescription project aimed to contribute to the health and well-being of these people by encouraging their active participation in cultural activities, strengthening their social interaction and helping them to feel more resilient to the challenges of their daily lives. The project aimed to disseminate knowledge about a promising, tested and proven approach to tackling mental health problems, and to provide models that could be easily adapted in parts of Europe where practical experience of social prescribing programmes is still limited. It therefore aimed to provide practical support to facilitators in delivering low-threshold education to people experiencing or at risk of loneliness or social exclusion, and to guide policy-makers in adopting the Social and Cultural Prescribing approach.<< Implementation >>In order to achieve the above objectives, we began by gathering knowledge about the impact of social and cultural prescribing programmes and examples of good practice through desk research and interviews. The results were analysed, documented and published in a compendium designed to reach a wide audience. Based on the lessons learned, pilot training courses were prepared and conducted in five European locations with different cultural and organisational settings. Before and during the pilot courses, methods and tools were developed, tested and published. In five virtual exchange meetings, facilitators were supported and had the opportunity to share their experiences.In addition to the evaluation of the pilot courses, the impact on learners' well-being and feelings of loneliness was assessed. Based on the experience gained during the implementation of the pilot training and the results of an online survey among associations and decision makers, targeted recommendations for the promotion of cultural prescribing programmes in general and COPE courses in particular have been developed.<< Results >>Four key outputs have been produced in the languages of all participating countries. The compendium (PR1) provides an insight into social and cultural prescribing in Europe and identifies the benefits of these concepts in addressing loneliness and other mental health and social issues. It also presents current practice in each of the partner countries and beyond, as well as inspiring examples of good practice in health promotion through cultural learning. More detailed findings from the research phase in each country can be found in the national reports.The interactive learning platform (PR2) acts as a hub for knowledge transfer by publishing project results and helping COPE facilitators to develop their skills in designing, delivering and sustaining the courses. The training kit (PR3) facilitates the delivery of cultural courses for people affected by loneliness. The concept was tested and evaluated by participants and trainers. In addition, a facilitator preparation workshop concept, a video tutorial and the specific curricula used in the pilot courses are available.The 'Guidelines for decision-makers in communities and associations' (PR4) presents recommendations for implementing a Culture on Prescription programme. It also provides an overview of the key issues and findings for each partner country.