JMIR Publications

ABSTRACT

Background:

Children’s mental health is a critical public health priority, with approximately 8% of children under 10 experiencing mental, behavioral, or emotional disorders. Despite the evidence supporting early intervention, access to mental health services remains limited, particularly for socioeconomically disadvantaged populations. Arts-based interventions have emerged as promising approaches to support mental health and socioemotional development. However, significant gaps persist in understanding their efficacy, scalability, and long-term impact.

Objective:

This study aims to evaluate the effectiveness and cost-effectiveness of a community-based visual arts intervention on children’s self-concept, psychological adjustment, and health-related quality of life (HRQoL), in vulnerable communities.

Methods:

: This study is a cluster non-randomized controlled trial with children from socioeconomically disadvantaged neighborhoods. Children between 6 and 12 years old (n=169; 114 intervention, 55 waitlist control) will be recruited through schools and community projects. Allocation to intervention or waitlist control will be based on neighborhood/cluster membership. The intervention consists of one-hour weekly sessions of visual arts sessions over nine months, led by a professional artist, culminating in community art exhibitions. Assessments will be conducted at baseline (T1) and post-intervention (T2) using validated measures: the Strengths and Difficulties Questionnaire (SDQ) for psychological adjustment, the Self-Perception Profile for Children (SPPC) for self-concept, the Child Health Utility 9D (CHU9D) for HRQoL, as well as societal resource use and related costs. Quantitative data will be analyzed using regression models and intention-to-treat principles.

Results:

This study was funded in September 2023. Recruitment began in March 2024, ending in July 2025. As of April 2024, a total of 171 participants have been enrolled. Data collection was completed by July 2025, and analysis is expected to begin in April 2026. Results are anticipated to be published in September 2026.

Conclusions:

This project has the potential to enhance children’s self-concept, psychological adjustment, and HRQoL through participation in a community-based visual arts intervention. The study design, with assessments at pre and post time points, will provide valuable insights into the trajectories of psychosocial and quality-of-life outcomes in this population. In addition, the combination of psychosocial assessment and economic evaluation will generate important evidence on the cost-effectiveness of arts-based interventions, informing both educational and public health decision-making. Clinical Trial: NCT07165704 (https://clinicaltrials.gov/study/NCT07165704; registration date: 10/09/2025) (retrospectively registered).