Impact Thinking

Developed by the International Arts + Mind Lab at Johns Hopkins University, Impact Thinking is a translational research approach to enhance human potential in health, wellbeing and learning through the arts.

Table of Contents

Overview

For 20 years, the neuroaesthetics field has studied the neurobiology of the arts and its specific impact on brain development and behavior. While there remains much to discover, we are beginning to learn more about how our brains process aesthetic experiences and the basic mechanisms that underlie these behaviors, paving the way for better use of aesthetics in health, wellbeing and learning.

Still, the neuroaesthetics field is diverse and diffuse. Drawing from disciplines as varied as neuroscience, cognitive science, psychology, psychiatry, public health, anthropology, humanities, architecture, music and education, it is perhaps unsurprising that neuroaesthetics research has yet to find its common core.

While there is much compelling research to point to, a growing body of disconnected studies has left few high-quality data sets, standardized measures or implementation protocols from which to build. Small sample sizes and a reliance on observational data have limited researchers’ ability to make claims about the effectiveness of arts-based interventions or influence evidence-based practice broadly. A separation of research and practice keeps many potentially life-changing findings firmly in the academic realm and out of reach of the clinicians, practitioners and caretakers eager to apply them.

To make truly groundbreaking discoveries that translate into changes in policy and practice, researchers and practitioners across diverse disciplines need a common process for discovering, evaluating, refining, replicating and scaling successful neuroaesthetics interventions. Beyond a theoretical frame, this work needs an organizing mechanism that facilitates collaboration across disciplines and organizes key data sets, measures, findings and experts for the field

The Concept

One of IAM Lab’s first major contributions is Impact Thinking, a consensus framework that applies rigorous brain science research methods to arts, architecture and music interventions by engaging a broad and multidisciplinary team. Beginning with a problem identification workshop and collaborative discovery process and concluding with dissemination and scaling, Impact Thinking is designed to build open-source capacity and expertise and a research-to-practice pipeline for arts + mind research focused on impact. Impact Thinking was developed through collaboration with an interdisciplinary team of nearly three dozen scientists and practitioners.

Impact Thinking:

      • Creates a common language and translational framework for multidisciplinary work
      • Can be used to improve or evaluate existing programs / interventions as well as build and test new programs and interventions
      • Engages a broad, multidisciplinary team
      • Is designed to get research to practice faster and with more fidelity
      • Includes a strong focus on communication and dissemination throughout the research project

What makes Impact Thinking different and essential?

Impact Thinking makes the translational scientific process inclusive, relevant and actionable. It moves beyond studies that begin and end in a lab to solve real-world, urgent problems and pave a path for broad implementation. For example: How can playing music ease the symptoms of Parkinson’s disease? How can architecture and design reduce chronic stress in the workplace?

Impact Thinking is based on the fundamental values of collaboration, transparency and follow through and the belief that applied neuroaesthetics can change the world. Impact Thinking projects are initiated by an Impact Team of a brain scientist and a practitioner in an arts discipline. Each project is facilitated by a project coordinator and supported by advisors, dissemination experts and community stakeholders.

Impact Thinking:

      • Begins with an open and inclusive problem identification process, engaging a broad, interdisciplinary team in collaborative discovery that transcends academic literature
      • Pairs scientists and practitioners to conduct evaluations together
      • Is focused on impact in health, wellbeing and learning
      • Leads to dissemination beyond academic publishing–targeted to practitioners to spread and scale best practices
      • Builds a base of case studies, research and capacity to grow the field

Impact Thinking Framework

Impact Thinking Spiral

Step 1: Problem Identification

Problem identification brings together a representative group of stakeholders engaged in a given topic to workshop key issues in a field, project or program. Ideally, this group includes representatives of all potential stakeholders in the issue, which may include researchers, clinicians, practitioners and community members, as well as representatives from ancillary fields.

Questions may include:

  • Who is the target population? Who are the potential audiences?
  • What are their needs/problems?
  • What’s our audacious vision and goal?
  • What are we already measuring? What do we know? What could we measure?
  • What are our potential research questions, and what would that research look like?
  • Who else needs to weigh in?
  • What’s our budget? What are our primary cost drivers for research?
  • What is the problem we should solve?

Step 2: Collaborative Discovery

Phase two of Impact Thinking is a collaborative discovery process, defined by a widening purview to examine the identified problem from multiple angles and disciplinary perspectives. It includes traditional literature review, non-traditional practice scans, interviews with subject matter experts and documentation of potential outcome measures (behavioral and biological) based on indicators of the problem. Collaborative discovery values learning from both traditional academic sources and practical and applied sources. Most importantly, collaborative discovery reaches beyond the initial group of stakeholders and fields most closely related to the issue to engage a multidisciplinary team of advisers and dissemination experts. This phase concludes with a Discovery Report of findings and recommendations.

Step 3: Hypothesis Development

Based on the Discovery report, the Impact Team develops and tests the face validity of a number of hypothesized solutions, considering impacts at the individual, organizational, field and even societal levels. The hypothesized solution must be replicable and/or scalable with implications for a broad population.

Step 4: Research Design

The Impact Team reviews methodologies and assessments used in previous neuroaesthetics research with a goal of extending previous research or generating comparable data. Then, the team designs a truly collaborative research design with involvement from both brain scientists and practitioners. This may include occupational therapists, teachers, architects, program leaders, etc., as relevant.

Step 5: Research Implementation

The Impact Thinking model brings a variety of supports to the Impact Team during research implementation. The advisory team act as independent reviewers, which the project coordinator catalogs data in a standard format. The dissemination team observes and documents the research implementation to inform mid-course communications and lessons learned about the work for research and practice audiences. Throughout the research implementation, Impact Team members document their experiences, struggles and reflections to generate lessons learned for future teams.

Step 6: Analysis

Once the intervention and data collection are complete, the Impact Team conducts an initial analysis of data and shares findings with the advisory team. Depending on the findings, the Impact Team may decide that more data collection is necessary or move on to reporting and recommendations.

Step 7: Refine, Retest, Recommend

If initial analysis warrants, step seven includes refining and retesting the solution to increase understanding. Once complete, the Impact Team writes a report, drawing from its Discovery Report and Impact Thinking workbook to detail the process, methods, findings and recommendations for practitioners, researchers and policymakers. A stakeholder team is brought in to review and provide feedback.

Step 8: Dissemination and Scaling

As a research-to-practice approach, Impact Thinking includes a multi-faceted dissemination and scaling effort. Efforts must go beyond academic journals to practitioner and policymaker-focused media, events and networks, as informed by the advisory and dissemination teams. If the intervention is deemed successful, the Impact Team will assess and recommend opportunities for scaling the solution, which may include training/capacity building, replication and expansion.

Step 9: Evaluation

Once an intervention is up and running, the Impact Team will consider ways to evaluate efficacy over time, developing a standardized set of measures that capture impact based upon the problem or issue identified in Step 1. The Impact Team will also build processes and instruments to enable ongoing evaluation.

Impacting Thinking Projects

Guitar PD

In partnership with the Center for Music and Medicine at Johns Hopkins, this project brings together neurologists and musicians for a unique series of guitar lessons specifically designed for people with Parkinson’s disease. During an 18 week period, participants are randomly assigned to treatment and control groups and assessed at the outset and every six weeks on a variety of self-reported and performance-based measures. These include mood, social participation, cognition and arm and hand function.

Led by Co-Principal Investigators Dr. Alexander Pantelyat, M.D., and Dr. Serap Bastepe-Gray, M.D., Guitar PD builds on a growing base of research on music therapy for Parkinson’s disease.

Hypothesis: Moving hands, arms and fingers rhythmically on the guitar to make music will benefit arm and hand function and cognition in individuals with Parkinson’s disease.


Tailored Activity Program (TAP)

Senior woman listening to music with blue headphonesThe Tailored Activities Program (TAP) extends research on a Johns Hopkins Bayview Nursing program that has trained family members to lead tailored arts activities at home. This project adapts the therapeutic art activity to each individual with dementia in an outpatient day program (the Hopkins ElderPlus program). The project will gather pilot data on the potential biological underpinnings of the TAP intervention through analyses of saliva samples.

Hypothesis: A tailored arts activity program in an outpatient setting can reduce agitation and aggression in patients with dementia as measured by salivary cortisol and alpha amylase levels.

 


Kennedy Krieger Children’s Hospital Sensory CARE Room

This project brings together architects with a variety of medical and health professionals and key stakeholders ranging from neurologists to neuropsychologists, physical therapists, child life experts and parents to build a better hospital room for children who are waking up from a coma. A primary goal is to promote regular sleep/wake cycles by regulating light and sounds and minimizing background noise and other disruptions. This project also explores the role of personalized sensory inputs such as visual projections, scents, and sounds in reducing patient agitation.

Hypothesis: By creating a personalized and evidence-based sensory care room, we can improve the quality of sleep and reduce waking agitation among children with disorders of consciousness.


One Book Baltimore

Teens discuss selected book for One Book BaltimoreIn collaboration with Enoch Pratt Free Library, Baltimore City Public Schools, and T. Rowe Price Foundation, this project provides 12,000 copies of the same book to Baltimore City 7th and 8th graders to read and discuss over a semester. Drawing inspiration from bibliotherapy—the use of books as therapy to support mental health—the One Book project seeks to use reading and storytelling as a way of healing and growth for schoolchildren and their communities. One Book also provides students opportunities to have an open dialogue about their own experiences.

The selected book for 2019, Long Way Down by Jason Reynolds, deals with teenage gun violence. In 2020, IAM Lab assessed the students’ personal experiences, attitudes and responses to violence before and after participating in the One Book program using surveys and focus groups. We also provided feedback for implementation of the program in the following years based on surveys of librarians and school site leaders.  

For the 2020 school year, the selected book is We Speak for Ourselves by D. Watkins, which gives voice to stories from the row houses of Baltimore to the stoops of Brooklyn and “offers an in-depth analysis of inner-city hurdles and honors the stories therein.”  

Hypothesis: Reading and discussing a novel about violence, combined with opportunities to share responses via self-expressive activities and prompts, will increase youth dialogue about violence and peace, generate meaningful reflection regarding individual experiences, and provide youth with tools for discussing and coping with violence and conflict.


Sound Resonance

Woman singing at Sound Resonance concertThe ultimate goal of this project is to study the effect of music to reduce stress and enhance a state of calm for high-needs communities around the world including refugees and people in conflict areas. This pilot project in Cremona, Italy tests the effects of different types of music on audiences using biosensors to measure heart rate and body temperature as well as self-reporting of emotional response.

Hypothesis: Music can reduce stress and trauma and enhance a state of calm.

 

 


Virtual Reality-Based Art Therapy

Study participant creates art using Google Tiltbrush

Working together with Drexel University’s Dr. Girija Kaimal and Dr. Arun Ramakrishnan, this project combined art therapy with virtual reality (VR) to examine participant experiences of two virtual drawing tasks (spontaneous self-expression and rote tracing)—and the impact of an olfactory stimulus (calming fragrance blend)—on mood, stress, self-efficacy, anxiety, creative self-efficacy and wellbeing (satisfaction with life).

 

 

 


Child-Friendly Environment

To expand and improve the use of art and aesthetics in the service of patients, families and staff, IAM Lab evaluated the site plan of the Johns Hopkins Charlotte R. Bloomberg Children’s Center and provided research-based recommendations. Key recommendations included improvements to the natural environment, use of color washes, more cohesive visual themes, more room for common area interaction and improved wayfinding.


VetArtSpan

VetArtSpan performanceAs a Creative Forces Community Connections demonstration site, the Straz Center for Performing Arts in Tampa, Florida designed and implemented a suite of arts programming to increase community-based arts engagement opportunities for military service members and veterans, their families and caregivers, and the general public. 

IAM Lab partnered with Straz artist-in-residence and VetArtSpan Director Fred Johnson and colleague John Parks to conduct an evaluation of the pilot program, which included events, curriculum, multi-week programming and a variety of communications products (videos, podcasts, website). After reviewing qualitative data on the programs, IAM Lab made recommendations for strengthening and evaluating future programming.


One Mind – Music and the Brain

Music and the Brain is a groundbreaking think tank envisioned by One Mind President Brandon Staglin and established as part of the organization’s Applications for Serious Psychiatric Recovery (ASPIRe) initiative. Co-chaired by Susan Magsamen and Dr. Eric Nestler, M.D, Music and the Brain draws upon numerous studies demonstrating that performing or listening to music can positively affect mental health. 

Music and the Brain expands and complements the National Institutes of Health’s Sound Health initiative by consolidating and advancing the evidence related to music’s role in the prevention and treatment of severe mental illness. Led by IAM Lab’s Dr. Tasha Golden, the project’s first deliverable is a broad international scoping review of the literature regarding uses of music in the treatment of serious mental illness, including schizophrenia, major depressive disorder (MDD), generalized anxiety disorder (GAD), bipolar disorder and post-traumatic stress disorder (PTSD), to inform the development of more rigorous pilot studies of the same.