Creating Change: A collaborative action inquiry approach for integrating creativity and community assets into ICS responses to Health Disparities

In a context where health systems are under increasing strain and the social drivers of health disparities are increasingly being recognised, there is a growing acknowledgement of the value of non-medical responses such as creative, physical and nature-based activities in supporting health and wellbeing. Evidence reveals that one third of GP appointments are for issues that are not medical and many tangible health problems arise as a result of social drivers (for example, loneliness, anxieties around finances or housing, depression about body image or being unemployed). The potential for developing the wider use of creative and community-based approaches to address health disparities is therefore substantial. West Yorkshire is leading the way in developing the use of non-medical interventions to promote health and well-being. For example, the award-winning charity Creative Minds has developed an innovative approach to providing creative and outdoor activities through a network of over 120 community providers; and West Yorkshire is one of the National Centre for Creative Health pilots. However, creative and community providers rely on short term funding and are not fully integrated into the health care system with the result that provision can be ad hoc and unsustainable. This project will build on leading edge developments across West Yorkshire in progressing the creative health agenda by bringing together key stakeholders (health trusts, local authorities, creative/cultural practitioners, community providers and people with lived experience) to innovate thinking in order to better integrate creative and community-based responses into health improvement strategies and systems to address health disparities. The project will encompass a truly coproductive approach centred around the use of collaborative action inquiry as a participatory process of learning for change in four iterative phases. It will build on stories from people with lived experience to provide a deeper understanding of the social drivers and complexities of health problems in communities, as well as learning from the challenges and achievements of partners in practice. These will be complemented by a rapid review of evidence about different collaborative models for community health provision which together will inform coproduction of an initial programme theory in a cross-ICS collaborative action inquiry workshop. The initial programme theory will be used to focus community mapping of creative provision and partnerships and further coproduction in consultation workshops with community groups and people with lived experience in phase 2. This will be followed by a further cycle of collaborative action inquiry with key stakeholders to refine the programme theory about how to integrate community assets into responses to health disparities and work up into a logic model, principles and guidance. These will then be tested in 5 action research case studies which will involve setting up community asset hubs, one in each of the ICS local authority areas to further refine the cross-ICS consortium model for integrating community assets. The final phase will involve a third stakeholder action inquiry workshop to respond to learning from the action research case studies and further refine and finalise the programme theory for the consortium and develop plans for scaling up, embedding and sustaining the integration of community assets into health improvement systems research. The new University of Huddersfield Health Innovation Campus and Wellbeing Academy will provide a context for hosting these developments and undertaking the research and development functions needed to support, sustain and further develop health improvement initiatives. We have support from all the key health and local authority players along with creative community providers and people with lived experience and wider community representatives who will be actively involved throughout the project.