This paper outlines secondary analyses of observational data gathered from the art-based community project to examine the feasibility, acceptability, and influence of the workshops on the well-being and healthy behaviour of the children (Local ethics approval No. LRS/DP-22/23-34303). These workshops were delivered to non-randomised groups of Ukrainian children without control participants.

The community-art workshops, with a working title My World Workshop, took place from June to July 2022 and were organised by a team of volunteer artists in collaboration with the Children and War UK, founded and curated by the first author MW. These workshops were carried out in a community art studio in West London. The workshops involved a team of independent artists and volunteers comprising school educators from a London-based Ukrainian School, clinicians, and some higher education researchers.

The project consisted of five weekly, half-day workshop sessions, where children created or decorated art objects. These workshop sessions received input from different disciplines including art, health science, and pedagogy, and were critically informed by the Displacement Art movement (12) and object theory (13). The children's experience of displacement and exposure to war were not explicitly disclosed, but there was an anticipation that the art objects and their creation might reflect thoughts or insights that were related to experiences of geographical dislocation and forced migration (14) that might affect the children during the workshop. Therefore, each session was organised with Ukrainian-speaking trauma-specialist counsellors on site.

The sessions were curated with the recurring themes of “home”, and “hope”, selected in recognition of the children's displacement, while both honouring the memories of home and nurturing positive experiences and belonging in their new environment, in accordance with the community-art principle, displacement art, and object theory (12). As such, the sessions were built around art activities that combined mark-making and object-making that reflect on both themes. During the workshop sessions, children were presented with blank, symbolic tabula rasa objects, paper, clay, or fabric, to creatively mark-make upon, such that the objects brim with meaning. In addition to the individual work, some exercises included the making of communal art pieces to encourage the children to create their community and sense of collective agency.

Each session was focused on one art project: (a) Workshop 1: Decorating a Key invited each child to ornately gild a lucky house key, and to draw/write a secret wish on a paper tag tied to the key; (b) Workshop 2: Designing Own T-shirts gave children the opportunity to self-express on a white t-shirt serving as a blank canvas; which was accompanied by a group activity the Wish Catcher, where the children created and tied personal paper messages on a giant, communal mobile hoop, in keeping with Ukrainian folklore traditions of hanging strichka (ribbon) that marks celebratory feasts, symbolising fortune; (c) Workshop 3: Working with Clay taught the children the skill of making “huggable” pinch bowls inspired by the Japanese Wabi-Sabi technique that celebrates the human marks of the maker, transience, and imperfections (15); (d) Workshop 4: Make Your Own Bunting enabled the children to create their own decorative style for their rooms at home, using collage, sewing, and fabrics; and finally (e) Workshop 5: Percussion Music taught the children to decorate percussion instruments made from white plastic bottles filled with dried pulses. The finished instruments were used in a free-style jam session, led by a professional musician (Figure 1).

Participants were female and male pupils attending the St Mary's Ukrainian School in London. The pupils were initially screened using the Child Revised Impact of Events Scale (CRIES-8) by teachers, and 24 pupils with higher scores were invited to take part in the community art workshops. The inclusion criterion was refugee children aged from 4 to 14 years. The participants' parents provided written informed consent for their children's data to be used as part of this publication.

A range of validated and non-validated questionnaires and inventories were used during the project. Some measures were adapted and shortened from validated measures to reduce the burden on the children. The measures assessed the mental health and psychological well-being, socialisation, and enjoyment of the children, as well as the feasibility of the families attending the workshops. The measures were translated when a Ukrainian version was unavailable. Unless otherwise stated, all questionnaires were completed up to one week before and immediately after the completion of the 5-week workshops.

Prior planning of the workshops took place between April and June 2022 and consisted of meetings between MW, DO and representatives from the Ukrainian school and Children and War UK Charity, which helped formulate the workshops' objectives and required organisation. All members of the team received training on trauma provided by two qualified clinicians (DO, LT). The workshops were co-designed by artists, psychologists, and educational staff members, and underwent pre-piloting involving some Ukrainian families and the local community.

Each workshop started with a “welcome” and some refreshments for the children and their parents. Then the children were led to the art studio while their parents had the opportunity to socialise in an adjoining welcome room. Children were seated typically in small groups of 5–8 around workshop tables. They were introduced to the session and given a demonstration of the workshop activity in Ukrainian. Then they were given art supplies and encouraged to freely engage in creative expressions. Up to ten volunteers took part in each session to support the children's activities. Several were Ukrainian speaking and provided communication translations between the children and the English-speaking volunteers. Most activities were easily demonstrated visually. Each session was concluded with refreshments and children were encouraged to bring their artwork home with them. Data collection was conducted by Ukrainian-speaking volunteers under the supervision of the first author SL.

The influence of the workshops on trauma, mood, daily functioning, and sleep was explored by comparing these dependent variables before and after the workshop completion using a linear mixed model, with time as fixed effects, and compound symmetry covariance structure. Post-hoc explorations adding (1) age group (i.e., preschool [aged <5 years] and school age [≥5 years and over]) and time × age group or (2) sex and time × sex to investigate whether age or sex moderate the pre- to post-workshop changes, i.e., whether the main interaction effects of time × age or time × sex as indicated by F-statistics, were significant. As there were only few pre-school children with substantial missing data, we also carried out a sensitivity analyses including only school age children. Furthermore, the influence of each session on the dependent variable mood and motivational state of the participants was examined by comparing their ratings before and after each session using paired t-tests.

All the children's experience of friendship and their and their parents' views about the workshops were assessed by combining the percentage ratings of “somewhat” and “yes” on each item denoting their presence. Free-text answers from the families were translated into English from Ukrainian and grouped according to themes and described narratively. All quantitative analyses were conducted with IBM SPSS Statistics for Windows 27 (Armonk, NY).

Fifty-three pupils were screened using the CRIES-8 by teachers, and 24 pupils with the higher scores were invited to take part in the community art workshops. Of the 24 pupils invited, eight declined to participate. These spaces were allocated to other pupils on a first-come first-serve basis, resulting in a total of twenty-two participants in the workshops (9 females and 13 males) aged from 4 to 13 years (mean = 7.36; standard deviation = 2.53 years). The children and their parents fully completed the questionnaires on site. However, there was no mechanism to gather data from the families outside the sessions. Therefore, datasets were completely missing from the families when they missed a session.

Pre- and post-workshop ratings are presented in Table 2. Children self-reported impact of traumatic events score appeared lower at post- relative to pre-workshop period, although non-significantly, t(21.1) = 2.04, p = .054. This was driven by lower intrusive re-experiencing of traumatic events, t(20.1) = 2.51, p = .021 to the children post-workshops, but not by avoidance of reminders/feelings associated with the event, which did not differ significantly between pre- and post-workshops, t(20.8) = 1.30, p = .21. The children also reported significantly reduced negative emotion, t(10.1) = 3.50, p = .006. Parents reported the children to have significantly reduced negative emotion, t(16.2) = 2.19, p = .043, and sleep disturbance, t(9.69) = 2.96, p = .015. Finally, they also reported a weak but non-significant reduction of functional difficulties from pre- to post-workshops, t(10.4) = 1.999, p = .073 (Figures 3A,B).

Post-hoc analyses revealed no significant interaction between age group or sex and the pre- and post-workshop changes of the dependent variables, F_{age × time} (df = 16.6–25.6) ≤ 1.32; ps_{age × time} = .39–.95, and F_{sex × time} (df = 8.65–18.9) ≤ 1.31; ps_{sex × time} = .28–.70. Sensitivity analyses involving only school-age children revealed a pattern of diminishing workshop influence which remained significant only in the context of self-reported negative emotion, t(7.73) = 3.09, p = .015, and parent-reported sleep disturbance, t(8.81) = 2.80, p = .021, and non-significant for all other measures, i.e., parent-reported reduction of the children's negative emotion, t(12.7) = 1.99, p = .068 and functional difficulties from pre- to post-workshops, t(9.90) = 1.96, p = .079, and self-reported of trauma, t(18.0) = 1.62, p = .12, and intrusive trauma re-experiencing, t(16.6) = 1.99, p = .063, and avoidance, t(17.8) = 1.01, p = .33.

Children reported their mood and motivation scores increasing after compared to before the activities in Session 2 (n = 15), t(13) = 4.01, p = .001, and Session 4 (n = 13), t(12) = 2.60, p = .023. Their scores did not increase significantly in Session 3 (n = 16), t(15) = 1.97, p = .068 (Figure 3C) although the change of mean scores was in the expected direction.

Post-workshops, children reported that they liked spending time with others in the workshops (100%), that the workshops helped them make new friends (87%), feel less lonely (60%), talk more often/with more people during the week (67%), and feel more confident in new situations (87%) (see Figure 3D).