OddSocks at the Melbourne Fringe Festival: A methods paper for using an arts installation in promoting public health

T he arts, including the visual, literary, performing and environmental arts, create the means and the media for personal expression in the public domain.1 Multi-modal creative and expressive arts have been used as interventions in health care for some decades. The innovative and typically expansive ways of experiential learning and knowing, facilitated through interacting with the arts, have been articulated by Heron and Reason (1997) in their exploration of a participatory inquiry paradigm.2 As McNiff (1998) states, ‘Artistic knowing is different than intellectual knowing; this distinction is the basis of its creative value’ (p36).3 Installation art is a particular form of the visual arts and constructs an environment for active participant engagement. It can deliberately blur distinctions between art and life, introducing as a result new ways of experiencing familiar settings. Through this process, narrative and sensory experience merge,4 with the potential to deepen knowledge and encourage public discourse.5 Arts-based inquiry and interventions assume many useful forms, including health projects have also been undertaken. However, it has been reported that while many of these projects involved the use of art to improve health and well-being, the aims were diverse and not completely clear.9 OddSocks was conceived as a public health installation as a part of the annual Melbourne Fringe Festival, and serves as a specific example of how an arts-based approach can be developed as a vehicle for health promotion. The main aim of the installation was to promote an understanding that many health benefits are achieved by caring for the feet, an aspect of personal health which is often ignored. Our primary objectives were threefold: a) to raise awareness about the importance of foot health, b) to provide helpful self-management strategies and information about exercise and foot care, c) to provide referral to relevant health care professionals and services. These aims gave rise to several secondary objectives: i) to deliver health messages to the public in imaginative ways, ii) to involve health sciences students in engaging fieldwork beyond the classroom setting, iii) to allow Disparities Article Methods The basic OddSocks module is a transportable clothes line mounted in a concrete base, with socks attached to the clothes lines using conventional clothes pegs (Figure 1). Public liability insurance was provided by the University, and the data collection phases of the project granted ethical approval by the Faculty Ethics Committee. OddSocks was an unfunded project. Registered as an official 2007 Fringe Festival event, 10 it featured as part of the festival for 10 days (10 days for 10 toes). The full installation was situated at a central and highly visible city location outside St Paul’s Cathedral, Melbourne (Figure 2), and took place from 10 am to 7 pm, weather permitting. The complete installation consisted of three clothes lines covered in odd socks (i.e. unmatched) which were donated by the general public. It was attended by staff members and chaplaincy of the University, as well as podiatrists, a physiotherapist, and students from the Schools of Public Health and Podiatry. As such, many had either a broad or specific knowledge of foot health issues. It was understood that delivery of the public health messages and interaction with the public would be spontaneous; however, when uncertain, all were encouraged to provide referral to specialist services. Information was disseminated either via written material, or verbally from healthcare professionals on site. In keeping with the theme, pedometers, pamphlets and brochures were displayed in cloth peg-baskets within easy reach. Examples of topics included: foot health for children, exercise, diabetes, physiotherapy, podiatry, ‘walk 10,000 steps a day’ optimal exercise message and walkingtrail maps. Images of socks to colour in (Figure 3) and sock puppets were provided to encourage parents with children to participate; intriguingly, we found these items were popular with adults as well as children. In addition, the public were able to ask specific questions to the podiatrists on site. Those who stopped could self-select information, or seeks answers to specific concerns. Overall, members of the public were encouraged to engage with the installation in any way they preferred. A methodology was developed to gauge responses, including the recording of public reactions, as well as interactions between installation staff and the public. As part of this process, we undertook systematic counts of participant and non-participant passers by. A participant was considered to be a member of the public who stopped and interacted with the installation and health promotion materials in any way. A passer-by was considered to be an individual who passed in either direction on the same side of the street as the installation. Although we were aware that many people were discussing the installation without stopping, these were not included as active participants. Figure 1: The simplicity of participation aided interaction. Figure 2: Location and visibility is critical in installation art. Figure 3: Colouring in sock images was one form of Disparities The role of the arts in promoting public healt