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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].

The impact of participation in performing arts on adolescent health and behaviour: a systematic review of the literature

N Daykin, J Orme, D Evans, D Salmon, M McEachran, and S Brain.

Review published: 2008.

CRD summary

Having reviewed the effects of performing arts for improving health and well-being in young people in non-clinical settings, the authors concluded that there were some rigorous and innovative studies that supported such interventions. These conclusions may be appropriate, but it is difficult to be confident given the methodological shortcomings.

Authors' objectives

To review the effects of performing arts for health in young people in non-clinical settings.


Databases searched at July 2004: AMED, British Nursing Index, CINAHL, EMBASE, HMIC, ASSIA, British Humanities Index, British Education Index, CareData, ChildData, Cochrane Library, Community WISE, HealthPromis, Humanities Abstracts, IBSS, MEDLINE, National Research Register, PsycINFO, Science Citation Index, Social Sciences Citation Index, Arts and Humanities Citation Index, SIGLE, Sociological Abstracts, Index to Theses and Dissertations. Search terms were reported. Only English-language papers published during 1994 to 2004 were considered. Additional web searches were carried out using general research terms. References from included and additional key papers were followed up to identify any additional papers.

Study selection

The intervention of interest was performing arts interventions (music, drama or dance) delivered in mainstream schools or community settings outside of the normal curriculum to children/young people aged 11 to 18 years. Eligible designs for this review included controlled or uncontrolled studies that incorporated a pre- and post-test measurement of a performing arts intervention or a qualitative study that used recognised procedures for data collection. Both qualitative and quantitative papers were required to report outcomes or explore impacts relating to health and well-being as a result of the intervention.

All of the included studies were concerned with drama interventions, but the actual intervention duration varied from a one-off performance to weekly sessions with participants as either performers or observers. The populations varied from general to selected at-risk groups of children and young people between 11 and 18 years. Quantitative study designs included both non-controlled and controlled randomised methodologies. Qualitative studies used a mixture of approaches: grounded theory, ethnography and action research.

Studies were screened and selected by one reviewer; any uncertainty the paper was discussed with a second reviewer.

Assessment of study quality

The included studies were assessed using the CASP (Critical Appraisal Skills Programme) criteria for RCTs and qualitative research as appropriate. Critical appraisal was carried out by two researchers.

Data extraction

The authors did not state how the data were extracted for the review, nor how many reviewers performed the data extraction.

Methods of synthesis

A narrative synthesis was carried out and the results presented as a thematic overview for the following key areas: peer interaction; social skills and empowerment; knowledge, attitude and risk in relation to HIV/AIDS; sexual health; and alcohol, tobacco and illegal drug use.

Results of the review

This review included a total of 14 studies (n unclear). Nine quantitative studies were included: three randomised controlled trials (RCTs); three that used pre and post test measurements without a control group; and three were not described. One study used both qualitative and quantitative methods and was counted in both groups. Five purely qualitative studies were included, of which three met CASP methodological criteria.

Peer interaction, social skills and empowerment (seven studies): the quantitative studies found that drama interventions resulted in positive changes to reported behaviour among at-risk young people, with improvements in social skills and interactions as rated by teachers and parents (although effects on behaviour were mixed). The qualitative studies suggested that drama interventions could impact on the development of social skills and self-confidence, enhanced peer interaction and co-operation.

Knowledge, attitudes and risk behaviour in relation to HIV/AIDS (three studies): the authors reported finding evidence of changes in reported behaviour (such as condom use), but mixed evidence of drama interventions' impacts on knowledge and awareness.

Sexual health (two studies): there were no randomised studies in this area, but two studies reported improved sexual knowledge and changes in attitudes around contraception after a performing arts intervention.

Alcohol, tobacco and illegal drug use (two studies): the included studies reported drama interventions increased resistance toward drug use and significant improvements in knowledge about drugs.

Overall the qualitative studies provided information on factors affecting the impact of performing arts interventions. Further details are provided in the original paper.

Authors' conclusions

Overall there were some rigorous and innovative studies that support the use of performing arts interventions to improve the health and well-being of children/young people, although there is a need for further good-quality well-reported research.

CRD commentary

This review addressed a broad question with clearly specified inclusion criteria and detailed searches that were likely to have identified the relevant primary studies. The authors acknowledged the limitations placed on their review by limiting included studies to English-language publications, but did not justify the relatively tight publication date restriction of 10 years. Appropriate methods were used to reduce reviewer error and bias during the validity assessment and parts of the study selection process, but it was unclear if these methods were also used for data extraction. Validity was assessed, but did not seem to have been used within the narrative synthesis. Appropriate synthesis techniques appear to have been used, although the synthesis of qualitative and quantitative research is a new and developing area. Relatively little information on the results of the primary studies were reported, making it difficult to follow the analysis. Thematic summary did not label studies clearly as qualitative or quantitative. The authors' conclusions may be appropriate, but it is difficult to be confident given the methodological shortcomings.

Implications of the review for practice and research

Practice: the authors did not state any implications for practice.

Research: the authors recommended that future research should include rigorous quantitative and qualitative studies on the health impacts of performing arts interventions, particularly in relation to key areas such as public health, sexual health and knowledge, attitudes and risk behaviours.


Not stated.

Bibliographic details

Daykin N, Orme J, Evans D, Salmon D, McEachran M, Brain S. The impact of participation in performing arts on adolescent health and behaviour: a systematic review of the literature. Journal of Health Psychology 2008; 13(2): 251-264. [PubMed: 18375630]

Indexing Status

Subject indexing assigned by CRD


Adolescent; Adolescent Behavior; Dancing; Drama; Humans; Music; Self Concept; Sexually Transmitted Diseases /prevention & control; Social Behavior; Substance-Related Disorders /prevention & control



Database entry date


Record Status

This is a critical abstract of a systematic review that meets the criteria for inclusion on DARE. Each critical abstract contains a brief summary of the review methods, results and conclusions followed by a detailed critical assessment on the reliability of the review and the conclusions drawn.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2014 University of York.

PMID: 18375630

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