The goal of the Singapore Art-Health RCT is to examine the effect of a standardized 12-week museum -based participatory art program on health condition, well-being, and quality of life in older community dweller, one that adheres to the Montreal Art-Health framework with culturally specific modifications that are fitting to the local Singaporean context.

Participants will be randomized into an intervention group of a passive control group. Participants in the intervention group will be invited to participate in the 12-week Singapore Art-Health Intervention held at the National Gallery Singapore. All participants will be invited to complete four online psychometric assessments. Participants in the intervention group will be invited to completed an additional post-intervention survey and a feasibility focus group.

Background: Population aging continues to be global health challenge. The prevalence of longstanding age-related conditions such as worsening physical, social, and mental health is expected to increase exponentially with a rapidly ageing population. The practice of participatory art in various settings has been found to be effective in the promotion, prevention and management of health and wellbeing conditions across the life span. However, its effect on health condition among the older population, particularly in the Asian context remains to be investigated. In Montreal, findings from a pilot study provided strong evidence to show that a 12-week, standardized "Art-Health" participatory art program had multidimensional positive effects on the health outcomes of older community dwelling participants including improvements in wellbeing, quality of life, and frail condition.

Current Proposal: The current research will adopt and modify the Montreal Art-Health participatory art framework with local cultural specificity (i.e. The Singapore Art-Health Intervention), and tests its effectiveness in healthy and wellness promotion among a sample of Singaporean older adults via a randomized control trial.

Research Design: The study adopts a participatory action research paradigm and a single-site, open-label Randomized Control Trial (RCT) design to develop and examine the effect of a standardized 12-week museum-based participatory art activity on health condition, wellbeing, and quality of life in older community dwellers.

Sampling and Randomization: Allowing for an attrition rate of 5% at follow-up, a target sample of 110 provides 90% power to detect an effect size of 0.55 (based on the results of the pilot study) between the intervention group and the control group at 5% level of significance (two-tailed test). Participants will be randomized into an intervention group of a passive control group. Participants in the intervention group will be invited to participate in the 12-week Singapore A-Health Intervention held at the National Gallery Singapore.

Intervention Design: The Singapore Art-Health Intervention will span 12 weeks, with each weekly session lasting for two hours. The program is designed to impart basic art appreciation skill (formal analysis in art) and art making techniques to participants through engagement with the collection at the museum.

Outcome measures and Data Analysis: All participants will be invited to complete four online psychometric assessments. Participants in the intervention group will be invited to completed an additional post-intervention survey and a feasibility focus group. For the quantitative data, between and within comparisons of outcomes will be conducted by mixed model analysis of variance (ANOVA), repeated measures ANOVA, and pairwise t-tests with Bonferroni correction. The focus group discussions will be analyzed using thematic analysis with a grounded theory approach to provide insights to the participant's experience and impact of the Singapore Art-Health Intervention.

Importance of Research: The current research will develop and test the effectiveness of a culturally-specific Art-Health participatory art program on health and wellness promotion among a sample of Singaporean older adults. Working collaboratively with the National Gallery Singapore in program development and implementation will serve to ensure program sustainability upon research completion. This collaboration will also foster practice and knowledge transfer to accelerate creative ageing in the local society. Moreover, the findings will contribute to an international RCT for evaluating a standardized participatory art framework to address the impact of population ageing. It will be a potential breakthrough in the development of an efficient art and museum program for older adults locally and internationally.

Inclusion Criteria:

• individuals above the age of 60,
• fluent in English
• able to access the internet to complete the online psychometric assessments

Exclusion Criteria:

• unable to provide informed consent
• diagnosed with mental health conditions

There are currently no plans o make individual participant data (IPD) available to other researchers.

Simple randomization was administered by a dedicated research team member using an automated randomizer. Consenting participants were randomly assigned a number, where 1 = Intervention group, and 2 = Control group. Participants and other members of the research team were blinded to the randomization outcomes, and the outcome of the allocation was revealed after completion of the baseline assessment.