Arts and health activities or programs in Georgia are predominantly non-systemic, which hinders their integration into the wider healthcare system. In response to this challenge, child psychologist Tamta Kamushadze (MA in Psychodiagnostics and Counseling) presented a report at the GIMPHA 2026 annual conference. Her presentation focused on developing a unified assessment framework through close cooperation with industry professionals, consolidating existing tools, and adapting new approaches.
What is an Assessment Framework and Why is it Important?
An assessment framework is a strategic guide that precisely defines how specific program activities lead to health-related outcomes. The creation of the framework is based on several fundamental factors. It establishes a common language among field professionals, ensures consistency and quality, enables progress measurement, promotes the development of the discipline, and optimizes resource allocation.
The long-term goal of the project is to integrate, evaluate, and legitimize arts and health practices within the healthcare, social, and cultural sectors of Georgia. This process relies on several key milestones, such as promoting learning and development, ensuring accountability to participants and the community, and guiding decisions regarding program commissioning and funding. Furthermore, the project aims to inform policy development and share reliable evidence with the healthcare, culture, social protection sectors, and the general public.
In this context, it is important to distinguish between the concepts of evaluation/assessment and research. Evaluation is a structured process of data collection and analysis that determines a program’s effectiveness, value, operational challenges, and overall success. Research, on the other hand, aims to generate broader, new knowledge that will later be applied on a larger scale.
Theory of Change and the Logical Model
The Theory of Change explains how a program should achieve its desired results. Its practical expression is the logical model, which reflects the cause-and-effect relationship between various components. The first stage is Resources (Inputs), meaning the foundation required for the activity, such as funding, staff working hours, and materials. This is followed by Outputs, which reflect the direct achievements of the project, such as the number of sessions conducted. Intermediate Outcomes are short-term, necessary conditions for achieving the main goals, which include participant satisfaction. The Outcomes themselves involve specific changes that the project aims to achieve, such as improvements in well-being or social relationships. The final step is Impact, which implies long-term and large-scale social changes, including stigma reduction and raising awareness.
A clear example of these connections is the installation of a music system in a surgical reception area. The project’s Resource consists of the funding to purchase the audio system and staff for monitoring. The Output is the availability of music in the reception area and specially selected playlists. At the Intermediate Outcome stage, patients enjoy choosing music, redirect their attention, and share this experience with family members. All this leads to the final Outcome, which manifests in calmer patients and a better hospital experience. The long-term Impact is a better understanding of the role of music in clinical settings and the improvement of the overall hospital environment.
Types and Methods of Assessment
Three types of assessment are used for comprehensive monitoring: Formative Assessment is carried out at the initial stage and assesses the suitability of the program; Process Assessment runs parallel to the activity and examines operational challenges; and Outcome Assessment determines whether the activity had the desired impact on the participants.
To achieve diversity of information, four main assessment methods are utilized:
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Quantitative method: Focuses on explanation and objectivity, relying on numerical data. Tools include self-assessment, adapted, or third-party standardized questionnaires.
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Qualitative method: Explores subjective experience and relies on narratives instead of numbers, using tools such as structured or semi-structured interviews, focus groups, and participant diaries.
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Participatory method: Focuses on co-creation, putting the participant at the center of the process, and uses creative tools, including the joint development of questionnaires and interview frameworks.
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Economic method: Focuses on costs and monetary value, aiming to demonstrate the economic benefits of the program.
Direct observation in a natural or specially arranged environment is also an important approach, carried out through semi-structured forms, checklists, and evaluation matrices.
Assessment Areas and Indicators in Practice
Before starting an assessment, it is necessary to define the purpose of the program, the need for evaluation, and the stakeholders involved, as expectations and indicators vary depending on the specific practice.
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Arts in Healthcare: Involves artists and medical institutions, where indicators focus on experience, well-being, and communication.
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Arts Therapies: Require licensed therapists and clinical services, and its indicators measure psychosocial, rehabilitative, or psychotherapeutic outcomes.
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Arts-based Public Health: Implemented by public health agencies and community institutions, where the main indicators are stigma reduction, prevention, and community resilience.
The general assessment system combines several main areas: Coverage and accessibility measure registered participants and attendance; Implementation and compliance with standards focus on sessions conducted and supervision. In the area of participant experience, safety, trust, and creative freedom are evaluated, while mental state is measured in the direction of well-being and quality of life. When studying social relations, attention is paid to the sense of belonging and reduction of isolation, and during the assessment of physical and psychological aspects, motor functions, sleep quality, and stress response are observed.
Model Structure: The Hardware Store Metaphor
To better understand the structure of the assessment, the metaphor of a hardware store and a shed is used. The Hardware Store represents the wide range of possibilities and alternatives that you consider when looking for the best approach to build an assessment model. The Shed itself, or the Framework, represents the main, unifying structure where methods are gathered. This framework can be tailored to specific needs or have a standard, universal structure.
Inside this structure, there is a Toolkit, which brings together and organizes various methods needed for evaluation. The tools themselves, or Measures (Tools), are individual, specific means, such as a well-being questionnaire or supervision records, which collect information about an individual indicator. Ultimately, which toolkit a researcher chooses depends entirely on who the target group is and exactly what questions they want answered.
