Arts-Based Intervention Interview Guide

1. Abstract

The Arts-Based Intervention Interview Guide (Chandler, Catanzaro, & Siette, 2024) is a specialized qualitative evaluation instrument developed to assess participants' cognitive, emotional, and behavioral responses to an interactive arts-based public health exhibit focused on dementia risk reduction. Formulated by an interdisciplinary team at Western Sydney University, the guide comprises 10 semi-structured, open-ended items grounded in the theoretical framework of the Health Belief Model (HBM). Designed for administration with adult community cohorts spanning young adulthood to older age (18–84 years), the instrument interrogates four core experiential domains: primary perceptual shifts regarding dementia etiology and prevention, motivation and self-efficacy to implement brain-healthy lifestyle modifications, appraisal of aesthetic and multimodal exhibition elements, and critical recommendations for structural optimization and public health scaling. Because it functions as an open-ended qualitative interview protocol rather than a psychometric rating scale, traditional quantitative indices of reliability (such as Cronbach’s alpha) and factor analysis (such as exploratory or confirmatory factor modeling) are non-applicable. Instead, the instrument demonstrates high qualitative trustworthiness, established through rigorous content validation, deductive thematic coding consistency, and epistemological alignment with contemporary public health behavioral frameworks.

2. Keywords

Arts-Based Intervention Interview Guide, dementia risk reduction, Health Belief Model, qualitative interview schedule, public health communication, arts in health, lifestyle modification, brain health literacy, deductive thematic analysis, Western Sydney University, health behavior change, neurodegenerative disease prevention.

3. Authors

The Arts-Based Intervention Interview Guide was conceived and authored by an interdisciplinary research team affiliated with Western Sydney University, Australia:

• Connor R. A. Chandler – MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, Australia. Specializes in behavioral health, translational neuroscience, and dementia prevention methodologies.
• Michelle Catanzaro – Design, School of Humanities and Communication Arts, Western Sydney University, Penrith, NSW, Australia. Focuses on visual communication, participatory design, social impact design, and public health installations.
• Joyce Siette (Corresponding Author) – MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, Australia. Research group leader in health systems, aging, dementia epidemiology, and community health interventions.
  ORCID: 0000-0001-9568-5847 | Correspondence: [email protected]

4. Purpose

Dementia represents one of the most critical global public health challenges of the twenty-first century, with projections estimating that more than 150 million individuals worldwide will be living with neurodegenerative disorders by 2050. Evidence synthesized by the Lancet Commission on Dementia Prevention, Intervention, and Care (Livingston et al., 2020) indicates that up to 40% of dementia cases globally can be prevented or significantly delayed by modifying twelve specific life-course risk factors. These factors encompass physical inactivity, low cognitive stimulation, smoking, midlife hypertension, obesity, diabetes, depression, hearing impairment, excessive alcohol consumption, traumatic brain injury, infrequent social contact, and air pollution. Despite robust epidemiological consensus, public awareness regarding the modifiability of dementia risk remains remarkably deficient across broad demographic strata. Widespread fatalistic attitudes persist, with many individuals erroneously viewing dementia as an inevitable biological consequence of chronological aging rather than a multifaceted pathological process responsive to primary and secondary preventative strategies.

Conventional health communication modalities—such as informational brochures, clinical pamphlets, and didactic lectures—frequently fail to stimulate sustained lifestyle alterations. These traditional methods struggle to transcend health literacy barriers, provoke deep affective engagement, or counteract cognitive avoidance triggered by the terror of neurodegenerative decline. In response, public health researchers have increasingly embraced arts-based interventions as dynamic, participatory, and non-stigmatizing media capable of translating complex epidemiological evidence into emotionally resonant experiential narratives. The Arts-Based Intervention Interview Guide was designed precisely to capture, interrogate, and evaluate how individuals experience such installations, exploring whether aesthetic encounters can overcome cognitive dissonance, alter fatalistic beliefs, and ignite personal agency toward sustained behavioral change.

From an applied perspective, the purpose of this interview guide is twofold:

• Evaluation of Public Health Interventions: It equips program evaluators, health psychologists, and visual communicators with a standardized qualitative mechanism to evaluate audience immersion, comprehension, emotional engagement, and dissatisfaction across physical and digital art exhibits.
• Mechanistic Investigation of Health Behavior Change: It systematically explores the psychological mechanisms that translate aesthetic and visual stimuli into actionable cognitive modifications. By collecting detailed narrative responses, the guide clarifies how perceived risk, self-efficacy, and environmental cues interact to foster intentions regarding exercise, dietary modification, cognitive engagement, and social connection.

In clinical, community, and academic research settings, the guide offers a structured yet adaptable framework to assess public health interventions before large-scale regional or national rollouts. It enables researchers to identify which demographic cohorts (e.g., emerging adults versus middle-aged or older individuals) respond favorably to specific artistic modalities (e.g., interactive physical installations versus augmented or virtual reality environments) and pinpoint educational gaps that require refined programmatic scaffolding.

5. Psychological Construct

The primary psychological construct evaluated by the instrument is Arts-Based Dementia Risk Reduction Attitudes and Behavioral Intentions. Rather than treating attitude as an isolated, static cognitive trait, this construct captures the dynamic, multifaceted psychological shifts that occur when an individual encounters evidence-based neurocognitive health information mediated through creative, sensory, and interactive artistic installations. This overarching construct encompasses four principal theoretical dimensions:

1. Cognitive Perceptual Shift (Reconceptualization of Dementia)

This dimension examines the structural restructuring of an individual's mental model of dementia. Historically, societal attitudes toward dementia have been dominated by therapeutic nihilism and biological fatalism. The cognitive perceptual shift reflects the transition from viewing dementia as an unalterable, genetically predetermined certainty to recognizing it as a preventable or delayable condition governed by modifiable biological, vascular, and lifestyle vectors. This dimension gauges improvements in health literacy, the dispelling of cultural myths, and the assimilation of neuroscience data into personal illness representations.

2. Motivational Activation and Self-Efficacy for Lifestyle Modification

Grounded in social cognitive paradigms, this dimension assesses the degree to which artistic engagement elevates an individual’s perceived self-efficacy to execute lifestyle behaviors known to mitigate neurodegenerative risk. It moves beyond passive knowledge acquisition to capture motivational readiness—specifically intentions to initiate and sustain physical exercise, improve nutritional patterns (such as adopting Mediterranean or MIND diets), pursue continuous cognitive stimulation, monitor cardiovascular health, and foster social connectivity. The construct evaluates the psychological justification individuals formulate to bridge the intention-behavior gap.

3. Aesthetic-Affective Engagement and Resonance

This dimension targets the affective processing uniquely stimulated by arts-based public health interventions. Arts in health paradigms propose that aesthetic experiences activate emotional pathways distinct from traditional clinical education. Emotional resonance, aesthetic appreciation, narrative transportation, and sensory immersion can neutralize defensive denial mechanisms, diminish existential anxiety surrounding cognitive decline, and cultivate an empathic connection to brain health. This facet assesses how participants process visual, spatial, and tactile stimuli, and whether the emotional tone of the exhibit promotes empowerment rather than debilitating fear.

4. Contextual Receptivity, Modality Preference, and Environmental Cues

This dimension interrogates the environmental and technological contingencies of health communication. It assesses how delivery modalities—such as physical museum galleries, pop-up community installations, online portals, augmented reality (AR), and immersive virtual reality (VR)—differentiate cognitive assimilation and behavioral motivation. Furthermore, it probes the contextual barriers (e.g., socioeconomic constraints, age-related preferences, physical accessibility) that modulate an individual's capacity to translate exhibition insights into habitual daily routines.

6. Theoretical Framework

The Arts-Based Intervention Interview Guide is theoretically anchored in the Health Belief Model (HBM), originally articulated by Rosenstock (1974) and substantially refined by Becker and Janz (1985). The HBM remains one of the most widely applied conceptual frameworks in health psychology for explaining and predicting preventative health behaviors. Chandler, Catanzaro, and Siette (2024) deductively mapped their qualitative inquiry directly onto the foundational components of the HBM to determine how an arts-based installation systematically activates the cognitive precursors of behavioral change.

Health Belief Model Core Constructs ←→ Arts-Based Exhibition Mechanics ←→ Interview Guide Operationalization

The theoretical architecture incorporates six core HBM constructs, synthesized with contemporary neuroaesthetics and transformative learning theory:

• Perceived Susceptibility: An individual's subjective assessment of their personal risk of developing dementia. The interview guide investigates whether the exhibit effectively personalized risk without inducing fatalism, allowing participants across age brackets (including young adults who typically perceive themselves as immune) to recognize their current lifestyle as functionally linked to future brain health.
• Perceived Severity: The individual’s evaluation of the clinical, social, and psychological consequences of cognitive impairment. The installation leverages artistic visualizations to communicate the biological realities of neurodegeneration, which the interview schedule evaluates by examining alterations in how participants understand the broader implications of dementia.
• Perceived Benefits: The cognitive calculation of the efficacy of preventative actions in reducing the threat of disease. The guide directly explores whether attendees internalized the message that physical activity, dietary adjustments, and social engagement confer protective cognitive reserve.
• Perceived Barriers: The tangible, psychological, economic, or temporal costs associated with adopting new lifestyle patterns. The interview prompts explicitly probe for unsatisfactory exhibit elements, lifestyle resistance, and generational impediments that prevent individuals from executing protective behaviors.
• Cues to Action: The internal or external triggers necessary to prompt the actual execution of health behaviors. In this theoretical model, the arts-based exhibit operates as an intensive, multisensory “cue to action.” The interview guide evaluates how visual art, tactile installations, and interactive media function as psychological precipitants that disrupt routine inertia.
• Self-Efficacy: Added to the HBM by Rosenstock and colleagues in 1988, self-efficacy refers to the conviction that one can successfully execute the behavior required to produce the desired outcomes. Items in the guide specifically investigate whether attendees feel motivated and personally capable of modifying their lifestyle, prompting them to articulate actionable strategies.

Furthermore, the instrument incorporates tenets of Transformative Learning Theory (Mezirow, 1991) and John Dewey’s pragmatist aesthetics (Art as Experience, 1934). Under this dual framing, artistic encounters create a “disorienting dilemma”—in this case, challenging the entrenched societal belief that dementia is entirely uncontrollable. By engaging both analytical cognition and sensory-affective pathways, the arts-based intervention dismantles cognitive resistance, enabling participants to reconstruct their health beliefs through reflective discourse captured during the semi-structured interview.

7. Validity

Because the Arts-Based Intervention Interview Guide is a qualitative evaluation instrument rather than a standardized quantitative psychometric test, classical psychometric validity paradigms (e.g., numerical convergent, discriminant, and criterion-related correlation coefficients) are not directly applicable. Instead, the scientific integrity and validity of the instrument must be evaluated using the foundational criteria for qualitative rigor established by Lincoln and Guba (1985): credibility, transferability, dependability, and confirmability.

Content and Face Validity

The content validity of the 10 items was established through interdisciplinary expert consensus. The authorial team encompassed specialists in cognitive neuroscience, behavioral gerontology, dementia epidemiology, and visual communication design. The items were purposefully drafted to map directly onto the theoretical domains of the Health Belief Model, ensuring that all key behavioral predictors (susceptibility, benefits, barriers, self-efficacy, and cues to action) were systematically represented. Face validity was confirmed during pilot testing, where adult community members verified that the open-ended questions were unambiguous, non-threatening, accessible across varying levels of educational attainment, and directly reflective of their exhibition experience.

Credibility (Internal Validity)

Credibility was maintained through methodological strategies implemented during the primary study by Chandler et al. (2024):

• Prolonged Engagement and Immediate Debriefing: Interviews were conducted immediately following participants' exposure to the interactive exhibition, ensuring that affective impressions, sensory details, and cognitive evaluations were fresh in working memory, thereby minimizing retrospective recall bias.
• Triangulation: Narrative interview data were triangulated against observational field notes documenting how participants physically interacted with exhibit stations, as well as descriptive demographic metrics spanning diverse age cohorts (18 to 84 years).
• Peer Debriefing: The coding framework and qualitative derivations were continuously audited by co-investigators who did not conduct the primary interviews, mitigating individual interviewer bias.

Transferability (External Validity)

Transferability was established through “thick description” of the exhibition context, the physical setting in Australia, and the comprehensive demographic profile of the participants. While qualitative research does not claim statistical generalizability, the alignment of the interview items with the global Health Belief Model enables other public health researchers to adapt the guide to diverse cultural contexts, varying arts interventions, and international community settings targeting dementia literacy.

Confirmability and Deductive Thematic Alignment

Confirmability was secured through an explicit audit trail linking participant quotes directly to the 10 interview prompts and their corresponding HBM constructs. The authors utilized a structured deductive thematic analysis approach (Braun & Clarke, 2006, 2019), confirming that the interview questions systematically elicited data directly addressing the target construct (arts-based dementia risk reduction attitudes) without researcher contamination.

8. Reliability

In quantitative psychometrics, reliability refers to the consistency, stability, and repeatability of numerical measurements, typically quantified via Cronbach's alpha, McDonald's omega, split-half correlations, or test-retest reliability coefficients. In qualitative inquiry, these mathematical indices cannot be computed for open-ended, semi-structured protocols where individual verbal elaboration is deliberately encouraged. Consequently, the Arts-Based Intervention Interview Guide has no reported quantitative reliability coefficients.

Within qualitative research paradigms, the analog to reliability is dependability (Lincoln & Guba, 1985), which assesses whether the findings are consistent and repeatable given the same context, participants, and theoretical framework. The dependability of the guide was supported through the following operational protocols:

• Standardized Semi-Structured Administration: All 10 items were administered using a consistent question sequence and standardized exploratory probing prompts, ensuring that every participant was exposed to the same structural interview framework regardless of the individual interviewer.
• Audio Recording and Verbatim Transcription: All qualitative interviews were digitally recorded and transcribed verbatim, eliminating paraphrasing errors, interviewer selective memory, or subjective data reduction during the interview session.
• Inter-Coder Consistency: Qualitative coding dependability was reinforced through independent parallel coding. Multiple researchers independently coded a subset of transcripts using a deductive codebook derived from the HBM. Discrepancies in code assignments and thematic definitions were resolved through structured consensus discussions until complete agreement was reached, ensuring an exceptionally high level of thematic consistency across data synthesis.
• Reflexivity Audit: The research team maintained reflexive journals documenting potential preconceptions regarding arts-based health messaging, ensuring that thematic interpretations were grounded strictly in the participants’ own statements.

9. Factor Analysis

To date, no formal factor analysis (exploratory factor analysis [EFA] or confirmatory factor analysis [CFA]) has been conducted on the Arts-Based Intervention Interview Guide. Because the tool comprises 10 qualitative, open-ended interview prompts that elicit unstructured narrative discourse rather than parameterized ordinal responses (such as 5-point or 7-point Likert ratings), quantitative covariance matrices, eigenvalue decomposition, and factor loading models cannot be mathematically derived.

In qualitative methodology, the functional equivalent to factor structure is the Thematic Framework / Coding Taxonomy. In the foundational study by Chandler, Catanzaro, and Siette (2024), the operational conceptual structure was evaluated through deductive thematic analysis. The thematic structure identified from the 10 items maps systematically into four overarching conceptual clusters, demonstrating strong thematic structural validity:

Should future researchers seek to adapt this qualitative guide into a quantitative psychometric scale, these 10 items would provide the theoretical blueprint for generating a 4-factor Likert-type instrument, which could then be subjected to EFA and CFA with maximum likelihood or robust weighted least squares estimation to mathematically establish structural dimensionality.

10. Instrument / Measurement Tool

The complete technical profile and administration parameters of the Arts-Based Intervention Interview Guide are detailed below:

• Tool Name: Arts-Based Intervention Interview Guide
• Alternative Name / Abbreviation: Chandler et al. Arts-Based Interview Protocol
• Authors: Connor R. A. Chandler, Michelle Catanzaro, and Joyce Siette (2024)
• Affiliation: MARCS Institute for Brain, Behaviour and Development, Western Sydney University
• Methodological Format: Qualitative Semi-Structured Interview Schedule
• Number of Items: 10 open-ended items
• Administration Mode: Face-to-face, individual, semi-structured verbal interview (adaptable to digital audio/video conferencing platforms or focus groups)
• Target Population: General community adults aged 18 to 84 years who have attended an interactive dementia awareness or brain health art exhibit
• Estimated Administration Time: Approximately 20 to 45 minutes, depending on participant narrative depth and depth of follow-up probing
• Response Type: Qualitative, open-ended narrative verbal responses
• Response Scale: and Administration
• Required Materials: Digital audio recording device, printed interview protocol for interviewer, quiet interview setting adjacent to or within the exhibition venue, transcription software
• Interviewer Qualifications: Qualitative health researchers, behavioral scientists, or trained research assistants experienced in semi-structured interviewing, neutral conversational probing, and qualitative active listening techniques
• Scoring and Analytic Procedures: The guide produces non-numerical textual transcriptions. Data are analyzed using qualitative data analysis software (e.g., NVivo, MAXQDA) utilizing deductive thematic analysis aligned with the Health Belief Model or inductive thematic analysis (Braun & Clarke, 2006) to extract primary experiential themes, perceived behavioral barriers, and programmatic feedback

11. Permissions & Fee and Test Year

The Arts-Based Intervention Interview Guide was developed and published in 2024 as an integral component of an empirical investigation appearing in the peer-reviewed journal Archives of Gerontology and Geriatrics (Volume 123, Article 105440).

• Publication Year: 2024
• Copyright & Intellectual Property: Copyright © 2024 Elsevier B.V. and the authors. The article and its associated interview protocols are published under academic access frameworks.
• Usage Permissions: The 10 interview prompts are fully available in the public academic domain through the published manuscript. Researchers, educators, non-profit healthcare organizations, and public health practitioners may utilize, replicate, and adapt the interview guide for non-commercial research, academic, and program evaluation purposes, provided appropriate academic citation is attributed to Chandler, Catanzaro, and Siette (2024).
• Fee: There are no licensing fees, royalties, or costs associated with the academic or non-commercial application of this interview schedule.
• Correspondence and Adaptation Requests: Researchers seeking collaboration or advice on contextual modifications of the guide may contact the senior author, Dr. Joyce Siette, via email at [email protected].

12. References

Below is the academic bibliography supporting the theoretical, methodological, and psychometric foundations of the Arts-Based Intervention Interview Guide:

Becker, M. H., & Janz, N. K. (1985). The Health Belief Model: A decade later. Health Education Quarterly, 11(1), 1–47. https://doi.org/10.1177/109019818401100101

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa

Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health, 11(4), 589–597. https://doi.org/10.1080/2159676X.2019.1628806

Chandler, C. R. A., Catanzaro, M., & Siette, J. (2024). “I know now that it's something that you can do something about”: Deductive thematic analysis of experiences at an arts-based dementia risk reduction exhibit. Archives of Gerontology and Geriatrics, 123, 105440. https://doi.org/10.1016/j.archger.2024.105440

Dewey, J. (1934). Art as experience. Minton, Balch & Company.

Fancourt, D., & Finn, S. (2019). What is the evidence on the role of the arts in improving health and well-being? A scoping review (Health Evidence Network synthesis report 67). World Health Organization. Regional Office for Europe. https://iris.who.int/handle/10665/329834

Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. SAGE Publications. https://doi.org/10.1016/0147-1767(85)90062-8

Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., Costafreda, S. G., Dias, A., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Ogunniyi, A., … Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), 413–446. https://doi.org/10.1016/S0140-6736(20)30367-6

Mezirow, J. (1991). Transformative dimensions of adult learning. Jossey-Bass.

Rosenstock, I. M. (1974). Historical origins of the Health Belief Model. Health Education Monographs, 2(4), 328–335. https://doi.org/10.1177/109019817400200403

Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1988). Social learning theory and the Health Belief Model. Health Education Quarterly, 15(2), 175–183. https://doi.org/10.1177/109019818801500203

13. Items of the Scale