Supporting healthy communities through arts programs

There are some evaluations, critical descriptions of programs and systematic reviews on the benefits to Aboriginal and Torres Strait Islander communities from participation in arts programs. These include: improved physical and mental health and wellbeing; increased social inclusion and cohesion; some improvements in school retention and attitudes towards learning; increased validation of, and connection to, culture; improved social and cognitive skills; and some evidence of crime reduction.The effects of arts programs can be powerful and transformative. However, these effects tend to be indirect.For example, using these programs to reduce juvenile anti-social behaviour largely work through diversion: providing alternative safe opportunities to risk taking, maintenance of social status, as well as opportunities to build healthy relationships with Elders and links with culture.Art forms such as song, dance and painting, coupled with ceremony, are integral to cultural continuity and cultural maintenance in Indigenous Australian communities.

• The effects of arts programs can be powerful and transformative.However, these effects tend to be indirect.
For example, using these programs to reduce juvenile anti-social behaviour largely work through diversion: providing alternative safe opportunities to risk taking, maintenance of social status, as well as opportunities to build healthy relationships with Elders and links with culture.
• Art forms such as song, dance and painting, coupled with ceremony, are integral to cultural continuity and cultural maintenance in Indigenous Australian communities.

What works
In the absence of strong evaluation evidence, below is a list of principles of 'what works' and 'what doesn't work' to assist with program design and implementation: • Where no activity was previously made available, offering some type of art program to fill that void should be given priority over selectivity regarding which type of program to implement.
• Providing a quality artistic experience heightens engagement in the arts activity.
• Arts programs require long-term, sustained and regular contact between arts professionals and participants to allow time to consolidate new skills and benefits that flow from involvement in the program.
• Linking arts programs with other services (for example, health services or counselling) and opportunities (for example, jobs or more relevant educational programs) improves the uptake of other services required to improve health and wellbeing outcomes, or behavioural change.
• Keeping participants' costs to a minimum ensures broad access to programs, as well as sustainability after external funding ceases.
• Scheduling activities at appropriate times enhances engagement-for example, for young people: after school, weekends and during school holidays when they are most likely to have large amounts of unsupervised free time.
• Creating a safe place through arts activities, where trust has been built, allows for community members to work through challenges and potential community and personal change without fear of retribution or being stigmatised.
• Using local languages, where these are still strong, and linking programs to Country facilitates deeper engagement and allows local values and wisdom to be incorporated into programs.
• Facilitating successful and positive risk taking provides an alternative to inappropriate risks.
• Ensuring stable funding and staffing is crucial to developing sustainable programs.
• Involving the community in the planning and implementation of programs promotes cultural appropriateness, engagement and sustainability.

What doesn't work
• Expensive activities, or those that do not engender broad community interest, can increase social exclusion.
• Programs that are not developed in conjunction with the target community are less likely to be successful.
• Expecting too much from an arts program, such as expecting it to directly eliminate substance abuse or anti-social behaviour, is unrealistic.That is, the program needs to be linked to other services and programs to maximise positive outcomes.

What we don't know
• Because many of the positive effects of participating in arts activities are indirect and long-term, categorically stating causal links is not generally feasible.Therefore, it is important that policy makers and researchers continue to refine indirect measures, as well as building a body of documented and evaluated programs that demonstrate effectiveness through these indirect measures.A solid program logic (that is, the logic or reasoning upon which the program is based) may assist with this.
• Longitudinal studies of program outcomes would help to capture and assess the magnitude of those benefits of arts programs that appear to take longer to form than the average program funding cycle would allow.
• There is very limited literature on ways to deal with gender, financial and other barriers to participation in the arts.

Introduction
The purpose of this paper is to review the available evidence of a range of arts programs in relation to their effects on supporting and building healthy communities.Healthy communities refers to communities in which people have the physical and mental health and wellbeing needed to conduct their daily lives.
This paper considers the role of the arts in supporting healthy communities.It should be read in conjunction with Resource Sheet no. 26, which explores the role of sporting and recreational programs in supporting health communities.The literature indicates remarkably similar groups of benefits between, arts, sports and recreation programs.Therefore, it is important that any new program considers integrating all three areas to cater for varying preferences of community members for any single type of activity.
This paper is based upon the synthesis of findings from over 30 studies, covering all geographic areas from inner city to remote regions, and all age ranges from preschool children to the elderly.Approximately two-thirds of these studies are Australian, with some international studies used to add depth.Approximately half the studies examined programs run in Indigenous communities in Australia and Indigenous communities in the United States, Canada and New Zealand, with additional evidence from other ethnic minority (that is, immigrant) and ethnic majority contexts.The research synthesised in this paper uses a range of research methods to develop this research evidence: predominantly descriptions and critical assessments of programs, as well as evaluations and systematic literature reviews.
These programs are often conceptualised as sites where cognitive and social competency can develop (that is, skills such as cooperation and conflict resolution, communication, problem solving, delayed gratification and self-discipline) (Palmer 2010).The development of these skills can, in turn, lead to a change in self-concept and self-esteem.

Definitions of arts
The term the arts can be defined and delineated in a range of ways.For the purposes of this paper, the following terms will be used: performing arts (for example, music, dance, drama, theatre and circus), visual arts (for example, painting, drawing, sculpture, photography and filmmaking) and literary arts (for example, storytelling).The arts also include any traditional or non-traditional crafts such as weaving, sewing, jewellery making and so on.

A note regarding cultural heritage
Cultural heritage and its maintenance is a common thread that weaves its way through the literature on Indigenous arts, with these activities and cultural heritage being interrelated yet distinct.In addition to the activities described above, it can also include developing group or individual histories, community archives (using photos, stories and film), spear making and other traditional activities (Higgins 2005).
The maintenance and promotion of cultural heritage is vitally important for building healthy individual and collective cultural identities, and it will be drawn out of the evidence presented where appropriate.However, it should be noted that in the context of supporting healthy communities, the maintenance of cultural heritage is but one of many program outcomes that are reviewed here, and a fuller treatment of a range of specific heritage issues cannot be covered within the scope and length of this paper.

Why are arts activities important in Indigenous communities?
The overall importance of the arts The arts play an important role in any culture, society or local community.There is a large body of evidence, both in community arts and in arts therapies (that is, the use of arts as platforms for therapeutic treatment of physical or mental health issues), which demonstrates the links between these activities and improved physical and mental wellbeing (for example, Barraket 2005), as well as with improved social cohesion and inclusion.This section explores the reasons why the arts are important for supporting healthy communities: firstly looking at communities more broadly, before focusing specifically on why they are important activities in Indigenous communities.
Arts programs for young people often provide a vehicle for improving educational engagement, academic achievement and job-readiness, reduce anti-social behaviour, and provide avenues for more positive types of risk taking (Barraket 2005).Some degree of risk taking is a normal part of adolescent and teenage behaviour.However, where risk taking leads to harm (of self or others), it is not generally considered healthy or normal.
The enjoyment (or 'fun') generated by active or passive participation in these activities is both intrinsically beneficial and a powerful 'hook' for engaging communities in programs with other social or personal development objectives (Barraket 2005).

The role of arts activities specifically in Indigenous communities
Indigenous participation in arts activities is relatively high.For example, a recent report for Arts Victoria noted that 31% of Indigenous people in Victoria participated in some form of artistic activity (NCCRS 2012).These high participation rates mean that arts activities are an important part of Indigenous daily life.
There are additional reasons why arts programs play an important role specifically in the lives of Indigenous peoples and are a cost-effective means for supporting healthy communities.These include: • The arts have an integral role in the maintenance and transmission of Indigenous culture and in maintaining links to Country (Colquhoun & Dockery 2012;Lawrence 2007).One study summed this up as follows: If Descarte were a western desert man he would not have said 'Cogito ergo sum' ('I think therefore I am'), rather he would have said 'canto ergo sum' ('I sing therefore I am') (Bill Richards, cited in Palmer 2010:112).
The arts are especially important, given the disruption to cultural continuity experienced in most Indigenous communities (Bromfield & Burchill 2005;Colquhoun & Dockery 2012;Phipps & Slater 2010).
• In remote communities, there is often limited infrastructure and programming to provide leisure and other pursuits, at times leading to engagement in unhealthy or negative activities (SA CSI 2007).This is particularly acute among youth, but also a frequent complaint of adults (Allain 2011;Cooper et al. 2012).The evidence suggests that providing locally relevant arts programs can be useful in building a sense of purpose, hope and belonging in these communities (Cooper et al. 2012;Stojanovski 2010).
• Participation in these activities is also seen as a protective factor against substance abuse, self-harm and other negative behaviours (Colquhoun & Dockery 2012).

Some caveats to the evidence base
It should be noted that there are two caveats in the literature to the effects of participating in arts activities.
Firstly, not everyone is interested in the arts, so having only one option may limit the involvement of those not interested, or not skilled, thereby contributing to increased social exclusion.Therefore, ideally a range of activities, including arts, sports and recreational pastimes, is recommended to allow everyone to participate fully in ways that are most effective in engaging them (Barraket 2005).Secondly, it should also be noted that direct causal claims about benefits are problematic because such benefits are often diffuse and long-term and therefore difficult to measure (Mulligan & Smith 2006;Stokes 2003).Measurements of outcomes and impacts therefore tend to be via indirect means or proxy measures, such as improved attendance and retention at school, or reduced ambulance and police call-outs.
Although this means program acquittals based solely on quantitative data become largely meaningless (Allain 2011), the lack of statistical measures or data does not equal a lack of benefits.Thus, in implementing the programs described here, it should be noted that program benefits cannot be manipulated for short-term gain, so it is imperative that a longer term view of benefits be adopted (Allain 2011;Mulligan & Smith 2006).

What are the benefits of participating in arts programs?
This section provides an overview of the literature on the benefits of participation in arts programs to Indigenous communities and individuals.Several broad areas of benefit emerge in the literature-improvements in health and wellbeing, cultural maintenance and transmission, countering boredom, reducing crime and anti-social behaviour, increasing civic engagement and social inclusion, and economic development.

Health and holistic wellbeing
Although not specifically an Indigenous study, Barraket's systematic review describes the health benefits of arts participation.It acts as a 'powerful vehicle for community education around public health issues…' and can promote health networks and enhance access to health services…' (Barraket 2005:8).Hayward et al.'s (2009) study of a program using hip hop to promote health messages among Indigenous youth in Western Australia suggested that young people responded well to the format used to communicate health messages and also retained these messages several months later.
The benefits of these programs become even more apparent in improving mental health and wellbeing.Several authors reported improved mental health, and even a reduction in self-harming behaviours, following community arts programs (Allain 2011;Barraket 2005;Frazier et al. 2007;HoRSCATSIA 2011).Some of the specific benefits include reductions in harmful behaviours (Barraket 2005) and the experience of emotional healing through outward artistic expression of negative life circumstances (Allain 2011).A recent study that examined arts programs designed for therapeutic use demonstrated a range of benefits flowing from participation (see Van Lith et al. 2009).Figure 1 sums up the variety of benefits the authors observed in participants in these programs (Van Lith et al. 2009).

Utilising art as a partner in recovery
Becoming a practicing artist  • increased resilience (Hunter 2012).

Cultural maintenance and transmission
Traditional festivals celebrating Indigenous culture (both traditional forms and contemporary manifestations) and opening community-run art galleries to display and sell Indigenous arts products can all contribute to a sense of cultural validation (Cooper et  This is particularly important in Indigenous communities that have experienced disruptions to cultural continuity through forced removal of children or forced relocations.Palmer (2010) documented the 're-charging' effect community arts programs had on seniors when they had the opportunity to transmit cultural knowledge to young people, and Allain (2011) noted that traditional visual arts could help to increase a sense of connection to Country.

Reduction of anti-social behaviour and crime
Arts programs occasionally aim to reduce crime and anti-social behaviour indirectly through the provision of alternative, healthy activities (Allard et al. 2007;Allard 2010;Barraket 2005;HoRSCATSIA 2011).One study cited instances of reduced substance abuse through the opening of a local Indigenous art gallery: through participation in arts activities, local community members felt empowered to begin tackling community issues, which included providing direct personal support to other artists who were trying to cease taking drugs (Cooper et al. 2012).Local police and ambulance services in this study likewise reported reduced call-outs to violent incidents and injuries since the gallery was opened.Although causal statements should be interpreted with caution, these service providers did suggest these reduced call-outs were directly linked to the presence of the gallery (Cooper et al. 2012).

Improved learning and outcomes
There are multiple examples of the successful use of music or theatre activities to re-engage students who have disengaged from school and studies-for example, to improve attendance, retention at school and academic achievement (HoRSCATSIA 2011;Palmer 2010;Stokes 2003).Arts participation can also improve young people's engagement with their peers (Stokes 2003), which is an important intermediary to increased engagement with school.
Participation in these programs has also been shown to improve a range of cognitive and social skills.These include: • self-discipline (Palmer 2010) • goal setting and delayed gratification (Palmer 2010) • cooperation and conflict resolution (Cooper et

Increased social inclusion
Provided due attention is given to ensuring equal access to and affordability of programs, participation in arts programs is regularly demonstrated to increase social inclusion and decrease exclusion.Activities must be appropriate and implemented effectively (Barraket 2005;Mulligan & Smith 2006).(Principles for appropriate selection and implementation are detailed in the conclusion section).Indigenous festivals can act as 'fulcrums for social … cohesion' (Cameron & MacDougall 2000:4), while art galleries can act as a place for social reconciliation in a fractured community (Cooper et al. 2012).

Increased civic participation
Participation in Indigenous arts organisations have been shown to open up opportunities for development of leadership and governance, as well as increasing access and involvement in networks of local community service providers (Cooper et al. 2012).

Economic development-career pathways and tourism
Participation in arts programs can lead to economic development through direct training in specific job skills (for example, performing arts, painting, arts administration and teaching) or indirectly by encouraging increased tourism (Higgins 2005;Pope & Doyle 2006).The latter is particularly salient in remote communities where an art gallery can motivate tourists to stop in a town rather than merely driving through (Cooper et al. 2012).

How do arts programs support healthy Indigenous communities?
The studies reviewed here suggest that there is a range of mechanisms through which arts programs support healthy communities and assist communities in remedying negative behaviours.As noted above, the benefits of these programs and activities are often realised indirectly and cannot be manipulated, so the development of a given program will not necessarily automatically result in a particular personal or social outcome.Several themes emerged in the literature around these mechanisms, which are detailed below.

Fun and enjoyment as an engagement tool
Participating in arts programs is enjoyable for the majority of people.This makes these activities useful for engaging people in programs that aim to build other skills or promote health goals, such as increasing life expectancy, which of themselves are of less intrinsic interest (Barraket 2005).Pleasure is also an important mechanism by which these activities help to improve mental health and wellbeing (Allain 2011).

Building social, cognitive and emotional skills
Arts programs not only teach artistic skills, but can also be used to teach a range of other cognitive social skills that are important for personal and community functioning in everyday life.For example, group activities can be sites for learning to communicate more clearly, relate to different people, build networks (that is, social capital), contribute ideas, and learn pro-social values (Barraket 2005;Stokes 2003).Both group and individual activities can assist in learning to solve problems and prioritise tasks or issues needing to be dealt with (Stokes 2003).
In addition, arts programs can support skills development in the following ways: 1. Context-based learning situated in a community of practice: Learning new cognitive, social and other skills through participation in the arts takes place through context-based learning-that is, learning skills that are relevant to needs here and now (Fogarty & Schwab 2012).The use of traditional stories, song and visual representations of culture (Bromfield & Burchill 2005) allows Indigenous people to link new skills and foreign concepts directly with existing knowledge constructs: Research in education has repeatedly shown that [an Indigenous] student's ability to 'scaffold' new information on top of an existing knowledge base is a precursor to improved educational attainment (Fogarty & Schwab 2012 citing McRae et al. 2000).
Furthermore, they take place in a community of practice-that is, a group of people conducting the same activities at varied skill levels, which supports the learning process (Light 2010).
2. Facilitation of intergenerational learning, sharing and communication builds understanding, shared social values and empathy, and aids in cultural transmission: Cooper et al. (2012) and Palmer (2010) conducted evaluations of arts projects-an art gallery and a performing arts project-and both found that these activities provided an opportunity for senior community members to practice not only their traditional arts but also to pass them on to younger generations.This built greater understanding and cohesion between generations, as well as increasing a sense of shared heritage.This contributed to greater social cohesion in the target communities (Cooper et al. 2012;Palmer 2010).Barraket's review of the social impact of the arts has also found that by participating in community arts projects, people develop a sense of shared values, which can contribute to reduced crime (Barraket 2005).

Fostering intercultural exchange can help to build greater social cohesion:
The evidence shows that festivals and other arts events (particularly those that conduct performance tours) can foster intercultural exchange.This can occur between different Indigenous groups (

Box 1: Ngapartji Ngapartji
Ngapartji Ngapartji is a multi-arts program that was run by Big hART (a community cultural development organisation) in the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands of Central Australia (Palmer 2010).The program aimed to: draw out and showcase traditional stories and high-quality art; provide opportunities within communities for increased social interaction, as well as encouraging interaction between Anangu and non-Anangu; build literacy development by promoting use of local languages; and experiment with novel approaches to crime prevention (p.10).
The program employed a range of professional artists-musicians, dancers, theatre specialists, photographers and other visual artists-to run arts workshops in remote communities.These workshops led to the creation of a range of stage performances, as well as an on-line language course in Pitjantjatjara (the 'Ninti' site), short films (including language lessons and music clips), musical recordings and CDs, a project website, a documentary to be screened on the ABC and 'Memory Basket' resources pack for project participants, organizations and other interested groups (p.11) The stage shows were taken on tour across remote communities, as well as regional and major urban centres.During the course of rehearsing, developing and performing these productions, young Indigenous people were given opportunities to learn traditional artistic and other knowledge from Elders, thereby building greater intergenerational understanding and empathy, as well as developing self-discipline, resilience and pride in their culture.There is also some evidence that the program contributed to crime reduction by providing a positive focus to divert former offenders from inappropriate activities.For example: X [a young female with a criminal history] was absolutely amazing and dedicated, worked really well as part of a team of professional performers, contributed many creative ideas to the process, responded really proactively to feedback, criticism, encouragement, and was a delightful addition to the team for her sense of humor and energy.She excelled in her performative role, receiving heaps of positive feedback for her work as shadow-maker, singing and playing the car-part instruments with me and a bit of dancing (p.26).
The presence of a famous Indigenous actor in the stage shows provided positive role models to young people in remote communities, and 'was appreciated by scores of young people and children' (p.25).
The literacy project involved collecting sound recordings, photographs and other cultural information to develop an online Pitjanjatjara language course.By building links to their mother tongue, literacy was enhanced, thereby providing improved links to other Western-based learning at school.For example, one young person involved in filmmaking and media activities subsequently enrolled in a Certificate III media course (p.25).
Several courageous young people used filmmaking to challenge difficult social issues such as petrol sniffing, relaying positive messages and attempting to promote messages intended to alter sniffing behaviour (p.25).

Facilities as community hubs
Arts facilities can act as community hubs, which encourage interaction between the generations, different clans, or the Indigenous and non-Indigenous populations.Several studies noted that, in this way, participation in the arts activities generated at these sites can indirectly help to build social cohesion, inclusiveness and support (for example, Cooper et al. 2012:44).

Box 2: Regional arts centres
The Wirnda Barna Artists art gallery was established in the Upper Murchison region of Western Australia in 2007.In a context of 'normalised racism, social marginalisation of Aboriginal people and few local employment opportunities' (Cooper et al. 2012:8), Wirnda Barna provides a space for established Indigenous artists to meet daily, to paint and to display and sell their work.These senior artists also train and mentor young emerging artists.Equipment is subsidised by the gallery, allowing those on low incomes to paint with higher quality paints and canvases than they might otherwise access.
Cooper et al.'s 2012 evaluation of this project showed that, through the daily interactions, the gallery has facilitated enhanced intergenerational relationships and understanding, the resolution of long-standing family feuds through unhurried dialogue.Furthermore, painting improved the self-image of many Aboriginals by giving them a prized social label (that is, Indigenous artist), and has helped to improve the economic situation of some artists through the sale of paintings.There has been an increase of tourists stopping in the town to visit the art gallery (p.58), and use other commercial services-thereby contributing in part to economic development beyond the Indigenous community.The evaluation '…found that the project had achieved diverse positive social welfare, personal, social, community as well as health and well-being outcomes' (p.8).

Empowerment
Arts programs can contribute to empowering people to live happy, fulfilling lives.Two particular pathways for empowerment were identified in the studies.These were: • Taking control in civic spaces: Cooper et al. (2012) found that by learning to run an art gallery, local Indigenous people were empowered not only to take ownership and control of their organisation, but also to participate in broader civic spaces, such as networks of community service providers.
• Changed self-concept: Williams & Taylor (2004) worked with female prisoners who had also survived sexual assault and showed that 'Interventions such as art, storytelling, music therapy, and group support can foster identity and self-concept change as final outcomes congruent with the goal of empowerment'.

Self-expression
Self-expression facilitated through the arts can improve one's mood and foster the development of identity: • Improving or lifting one's mood: There is now a well-established body of evidence demonstrating the power of arts activities in lifting a person's mood.This becomes one mechanism for improving mental health, building a sense of hope and for increasing the desire to participate more fully in the life of one's community (Allain 2011;Mulligan & Smith 2006;Williams & Taylor 2004).

Box 3: Aurukun Art in Health Initiative
The Creative Recovery arts and mental health project in Aurukun involved weekly, 3-hour visual arts workshops at the local art centre, with the aim of improving social and emotional wellbeing (Allain 2011).The initial workshop attracted five older female participants who were keen to paint about their life stories and current challenges 'in a safe and secure environment' (p.43).Momentum was built over several intensive workshops and the group became self-supporting, with members …committing to [the] process, [and] finding release and meaning' (p.43).At the time of the project, a linguist happened to be in the community.Her presence enabled the facilitation of discussions about 'the participants' images and stories in their own language, providing a multi-layered involvement (p.43-4).
Allain observed that: The creative process provide[d] a deep sense of healing as participants access [ed] what is important to them, making more sense of their own life (p.44).
At an exhibition of the participants' works in Brisbane in March 2010, '…each one was transformed by the experience' (p.43).The exhibition generated a deep sense of pride in representing their community, '…proud of their culture and its power' (p.43).As a result of participating in the project, many older people expressed a desire to return to Country, with some actually being able to make the journey to remote homelands.In this way, the project had the added cultural benefit of reconnecting participants with Country.
• The arts can foster self-expression of emotion and identity: The arts in particular are useful for developing skills in self-expression and identity-building (Allain 2011;Mulligan & Smith 2006).This provides a space in which personal and community issues can be challenged and processed, and where positive changes can be explored (Palmer 2010;Williams & Taylor 2004).The studies reviewed here showed cases where the arts were used to develop 'new 'narratives of meaning'' (Mulligan & Smith 2006:8-9), to 'galvanise [individuals and communities] into action' (Barraket 2005:8) and to resolve family feuds (Cooper et al. 2012).Evaluations and program descriptions routinely talk about arts programs building a sense of hope in the community (for example, Palmer 2010) and being sites for emotional and spiritual healing (Allain 2011).

Box 4: Festivals
Phipps and Slater evaluated several Indigenous festivals across Australia, ranging from very small local initiatives through to long-running international festivals such as Garma in Arnhem Land.These festivals typically showcase both traditional and contemporary artistic and sporting achievements.The evaluation demonstrated that: festivals support communities in their efforts to maintain and renew themselves through the celebration of culture…Culture has to be the starting point in any serious efforts to address Indigenous disadvantage with Indigenous people (p.8).
Festivals are specifically of benefit in building 'community wellbeing, resilience and capacity' (p.9).
The Dreaming Festival at Woodford (Queensland) is run over three days and four nights, featuring multiple art forms, ceremonies, comedy, a youth program and forum (p.48) and offering opportunities for mentoring of emerging artists.
Phipps and Slater's (2010) evaluation showed that this festival 'is a space for performing, discussing and negotiating contemporary culture and identity, and provides much needed social space for affirming Indigenous visions and aspirations' (p.48).The 'positive visibility' of Indigenous cultures at the festival supported 'the development of positive and coherent youth identity, which enables young people to live a life of value and meaning' (p.50).It also inspired hope, facilitated intergenerational and intercultural exchange, and contributed to economic development through the sales of paintings and other art works.

Role models and mentoring
By working alongside accomplished artists and senior community members, positive role modelling and mentoring often occurs.The South Australian Commissioner for Social Inclusion suggests that young people are actually looking for positive models to emulate (SA CSI 2007).
Indigenous Australian cultures tend to have observational learning styles, which is facilitated in arts programs in a highly effective manner (Palmer 2010).Young people are able to observe, and then emulate, behaviours to which they aspire.For example, one community archive project used stories and photography to reconnect teenagers with their heritage.The evaluation noted that: Family members would talk about the relationships people had with each other through the images they witnessed, which is an interesting way of using images to look at what happened in the past.The archive is very positive: it reinforces the concepts of the family group and the way communities are structured, as they are able to look at photos of different people and places-to look at what the place looked like 50 years ago (Burchill et al. 2005:33).

Diversion from inappropriate behaviour
Participating in artistic or cultural activities can be a prime mechanism for preventing boredom and a sense of having no purpose, which are both often precursors to engaging in destructive, anti-social or illegal activities (Barraket 2005;Delfabbro & Day 2003).Likewise, in the case of youth, it reduces the amount of unsupervised free time they have, which reduces their capacity to engage in negative or risky behaviours (Morris et al. 2003a), while promoting positive behaviours and even some social or employment opportunities (Frazier et al. 2007).

Box 5: Mt Theo Petrol Sniffing Program
The Mt Theo Petrol Sniffing Program illustrated this clearly (Stojanovski 2010).Although youth were moved away from the Yuendumu township to outstations to participate in learning traditional bush skills, they were able to cease sniffing.However, when they returned to town, they often re-engaged with petrol sniffing, largely due to the lack of other constructive activities.A group of young Warlpiris noticed this pattern and decided to rectify the lack of constructive activities in Yuendumu by starting their own arts and other recreational activities.With other meaningful, fulfilling and enjoyable alternatives, the majority of former sniffers were able to consolidate the changes made on the outstation.
The South Australian Commissioner for Social Inclusion's interviews with delinquent youth documents that they actually repeatedly call for increased arts and sporting activities, so that they do not turn to crime for something to do (SA CSO 2007).
By building greater social interaction and greater understanding of other groups in the community (for example, age or ethnic groups), arts activities can help to reduce the fear of crime in the community, as well as building empathy, which may help to prevent would-be criminals from engaging in wrongdoing (HoRSCATSIA 2011; Palmer 2010).A particularly powerful medium for this is storytelling.One arts organisation's (Big hART) philosophy captures this idea neatly: It's harder to hurt someone if you've heard their story (Palmer 2010:47).
Some arts projects have found a way to move beyond reducing crime through diversion to challenging the thorny social issues that facilitate the development of criminal behaviours (Palmer 2010:25).By discussing and performing dramatic or musical pieces about petrol sniffing, for example, members of one community were able to begin discussing and dealing with the issue: In this work they relayed positive and powerful messages about the need to challenge and change certain kinds of behaviour.In this way they moved well beyond crime diversionary work, tackling head on themes of care and responsibility for others (Palmer 2010:25).

Principles for implementing effective arts programs in Indigenous communities
The above evidence demonstrates clearly the potential beneficial impacts and outcomes from arts programs in Indigenous communities.The literature reviewed here provides a range of principles that should be considered and incorporated in the development and implementation of a locally relevant and effective arts program.
These have been grouped under several themes that emerged.A diagram summarising these principles is also provided (see Figure 2).

Involve community -Indigenous languages -Collaboration and group ownership -Whole-of-community approach
Working with at-risk young people -Mix of at-risk and not-at-risk youth -Successful and healthy risk taking -Opportunities to develop and exhibit leadership -Strong relationships with schools

Program design
• Where no activity is previously made available, offering some type of art program to fill that void should be given priority over selectivity regarding which type of program to implement-that is, the evidence suggests that there is no single art activity that produces a given outcome.However, given that different activities appeal to people of different ages and genders, there is ultimately a need to provide a range of activities (Morris et al. 2003a(Morris et al. , 2003b)).
• The quality of an arts experience is just as important as the end product.These types of programs produce benefits through process, so it is more important to develop a positive process than a refined end product (Allain 2011;Barraket 2005;Palmer 2010).To facilitate positive personal and social changes, it is also of crucial importance to create a safe place to explore new ideas and experiment with change (MacDowell et al. 2009).
• Link arts programs to other services and opportunities: A given arts program in itself may not be sufficient to achieve improved health and social outcomes.• Sustainable programs are crucial to maximise long-term outcomes.Sustainability requires stable staffing and adequate resources, both in terms of finance and equipment (Cooper et al. 2012;MacDowell et al. 2009;Palmer 2010).Long-term funding is crucial to set up programs and build momentum, because trust often needs to be built first (Cooper et al. 2012).Finally, for a program to become truly sustainable in the long term, it needs to be run by the community (Cairnduff 2001;Pope & Doyle 2006).
• Have senior community members who are willing and able to transmit cultural knowledge to young people (Higgins 2005).One study highlighted that senior Indigenous community members want the absolute best for their young people, even though at times they are at a loss as to how to reach them (Palmer 2010).
• The quality of relationships in program design and implementation matters.Where a program increases social exclusion or where service providers do not consult representatives from across the community, there is the potential for arts programs to drive a wedge into a community (Barraket 2005).It is important therefore to involve the community in planning and delivering a program.The artist's commitment is vitally important in building a successful and engaging program, as is their relationship with the community (Stokes 2003).It is also vitally important that the artist running a program has consistent, regular contact with the community to maintain momentum (Palmer 2010).
• Keep costs to a minimum to ensure participation is feasible for those on low incomes (SA CSI 2007).Many Indigenous communities are among the most socioeconomically disadvantaged in Australia, so expensive activities or those requiring a lot of specialist equipment may normally be beyond their reach.
• Evaluation is important and requires funding (MacDowall et al. 2009).To be truly meaningful in assessing the effectiveness of these activities in which process is as important as end product, outcomes should be evaluated, as well as processes and outputs (Barraket 2005).

Areas for further research
Further study in the following two areas would help to improve our knowledge of how the benefits of arts programs help to support healthy Indigenous communities: • Although evidence suggests that attempting to prove causality between arts programs and positive community outcomes is largely a futile exercise, continuing to build a body of evaluation would provide additional evidence around the nature of these benefits and the mechanisms by which they are produced.
• Longitudinal studies of program outcomes would help to capture and assess the magnitude of those benefits that appear to take longer to form than the average program funding cycle would allow.

Conclusion
There is a wealth of evidence demonstrating the beneficial effects of participation in arts for supporting healthy Aboriginal and Torres Strait Islander communities.These activities provide a safe place for people to learn new skills, explore and deal with both personal and community trauma and dysfunction, and build social networks.This paper has outlined a range of successful practices, as well as some broad principles for effectively implementing an arts program.It should be noted that, although adhering to these principles is likely to result in effective programs, causal links between an arts program and specific outcomes are almost impossible to demonstrate.Therefore, care should be taken to design specific programs in consultation with the community in which they will be implemented to ensure relevance and the best possible uptake of the program.
Table A1 contains a list of selected research and evaluations that were the key pieces of evidence used in this Resource Sheet.The major components are summarised in the Assessed collection.
Therefore, links to other services (for example, health or employment services) or to other education or vocational development opportunities are important to capitalise on the outcomes of a program.Linkages between arts programs and multiple local community service agencies-where other needed services can be accessed-appear to have the most positive effects (Barraket 2005:8; Fogarty & Schwab 2012; Pope & Doyle 2006).

Table A1 : Assessed collection items for Supporting healthy communities through arts programs
TableA2contains a list of Closing the Gap Clearinghouse issues papers and resource sheets related to this resource sheet.To view the publications, visit <http://www.aihw.gov.au/closingthegap/publications/>.