{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:04:20Z","timestamp":1789707860481,"version":"4.0.1"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study examined short-term changes in social connectedness and subjective vitality following culturally adapted, co-created immersive performances, and explored baseline-adjusted associations among cultural appropriateness, co-creation engagement, social connectedness, and vitality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single-group pre\u2013post field study was conducted across four communities in Guangdong, China. Data from 786 matched participants were analyzed using paired-samples tests and structural equation modeling with bootstrap estimation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Social connectedness was higher after participation than at baseline (3.48 vs. 3.27,\n                      <jats:italic>d<\/jats:italic>\n                      z\u202f=\u202f0.40,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), as was subjective vitality (4.57 vs. 4.20,\n                      <jats:italic>d<\/jats:italic>\n                      z\u202f=\u202f0.46,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Cultural appropriateness was positively associated with co-creation engagement (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f0.551), which was associated with social connectedness (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f0.355); social connectedness was associated with vitality (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f0.419). Significant indirect associations were observed through co-creation alone (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f0.068, 95% CI [0.037, 0.102]) and through co-creation and social connectedness (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f0.082, 95% CI [0.065, 0.100]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Participants reported higher immediate social connectedness and subjective vitality after the performances, while the structural findings were consistent with theory-informed indirect pathways. Given the study design, these associations should not be interpreted as evidence of causal mediation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1945573","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T04:37:36Z","timestamp":1789706256000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cultural appropriateness, co-creation, and subjective vitality: a pre\u2013post structural modeling study of immersive performances in rural Guangdong, China"],"prefix":"10.3389","volume":"14","author":[{"given":"Yuqi","family":"Shang","sequence":"first","affiliation":[{"name":"Zhujiang College, South China of Agricultural University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e013384","DOI":"10.1136\/bmjopen-2016-013384","article-title":"Social prescribing: less rhetoric and more reality. A systematic review of the evidence","volume":"7","author":"Bickerdike","year":"2017","journal-title":"BMJ Open"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1080\/17533015.2017.1334002","article-title":"Non-clinical community interventions: a systematised review of social prescribing schemes","volume":"10","author":"Chatterjee","year":"2018","journal-title":"Arts Health"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"l1285","DOI":"10.1136\/bmj.l1285","article-title":"Social prescribing","volume":"364","author":"Drinkwater","year":"2019","journal-title":"BMJ"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1111\/hsc.12839","article-title":"What approaches to social prescribing work, for whom, and in what circumstances? A realist review","volume":"28","author":"Husk","year":"2020","journal-title":"Health Soc Care Community"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/s12913-018-2893-4","article-title":"Facilitators and barriers of implementing and delivering social prescribing services: a systematic review","volume":"18","author":"Pescheny","year":"2018","journal-title":"BMC Health Serv Res"},{"key":"ref6","volume-title":"What is the Evidence on the role of the arts in Improving Health and well-Being? A Scoping Review World Health Organization Regional Office for Europe","author":"Fancourt","year":"2019"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1177\/1757913910384050","article-title":"Arts on prescription: a review of practice in the UK","volume":"130","author":"Bungay","year":"2010","journal-title":"Perspect Public Health"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1386\/jaah.1.1.19\/1","article-title":"Choral singing and psychological wellbeing: quantitative and qualitative findings from English choirs in a cross-national survey","volume":"1","author":"Clift","year":"2010","journal-title":"J Appl Arts Health"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1093\/geront\/46.6.726","article-title":"The impact of professionally conducted cultural programs on the physical health, mental health, and social functioning of older adults","volume":"46","author":"Cohen","year":"2006","journal-title":"The Gerontologist"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1177\/0305735611430081","article-title":"\u201cTo be heard\u201d: the social and mental health benefits of choir singing for disadvantaged adults","volume":"41","author":"Dingle","year":"2013","journal-title":"Psychol Music"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1192\/bjp.2018.267","article-title":"Cultural engagement and incident depression in older adults: evidence from the English longitudinal study of ageing","volume":"214","author":"Fancourt","year":"2019","journal-title":"Br J Psychiatry"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/17533015.2019.1567563","article-title":"The arts and the social determinants of health: findings from an inquiry conducted by the United Kingdom all-party parliamentary group on arts, health and wellbeing","volume":"12","author":"Gordon-Nesbitt","year":"2020","journal-title":"Arts Health"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1111\/hsc.12669","article-title":"Arts on prescription for community-dwelling older people with a range of health and wellness needs","volume":"27","author":"Poulos","year":"2019","journal-title":"Health Soc Care Community"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1177\/1757913917737563","article-title":"Effects of a museum-based social prescription intervention on quantitative measures of psychological wellbeing in older adults","volume":"138","author":"Thomson","year":"2018","journal-title":"Perspect Public Health"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"10","DOI":"10.12688\/wellcomeopenres.17414.2","article-title":"What are the active ingredients of \u201carts in health\u201d activities? Development of the INgredients iN ArTs in hEalth framework","volume":"7","author":"Warran","year":"2022","journal-title":"Wellcome Open Res"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1177\/1090198102251021","article-title":"Achieving cultural appropriateness in health promotion programs: targeted and tailored approaches","volume":"30","author":"Kreuter","year":"2003","journal-title":"Health Educ Behav"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"105780","DOI":"10.1016\/j.foodqual.2025.105780","article-title":"Promotion vs. prevention? The impacts of national cultural values and regulatory focus on near-expiry food across Malaysia and China","volume":"136","author":"Shu","year":"2026","journal-title":"Food Qual Prefer"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"101599","DOI":"10.1016\/j.ijgfs.2026.101599","article-title":"Culinary symbols in southern Han Chinese wedding foods: homophony, color, and numbers","volume":"45","author":"Shu","year":"2026","journal-title":"Int J Gastron Food Sci"},{"key":"ref19","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-137-01985-1","volume-title":"Immersive Theatres: Intimacy and Immediacy in Contemporary Performance","author":"Machon","year":"2013"},{"key":"ref20","doi-asserted-by":"crossref","DOI":"10.1057\/9781137010742","volume-title":"Audience Participation in Theatre: Aesthetics of the Invitation","author":"White","year":"2013"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.tourman.2017.09.012","article-title":"Co-created value: multidimensional scale and nomological network","volume":"65","author":"Busser","year":"2018","journal-title":"Tour Manag"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1080\/14719037.2015.1111927","article-title":"Co-production and the co-creation of value in public services: a suitable case for treatment?","volume":"18","author":"Osborne","year":"2016","journal-title":"Public Manag Rev"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.1080\/14719037.2014.930505","article-title":"A systematic review of co-creation and co-production: embarking on the social innovation journey","volume":"17","author":"Voorberg","year":"2015","journal-title":"Public Manag Rev"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1037\/0022-0167.42.2.232","article-title":"Measuring belongingness: the social connectedness and the social assurance scales","volume":"42","author":"Lee","year":"1995","journal-title":"J Couns Psychol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"e1000316","DOI":"10.1371\/journal.pmed.1000316","article-title":"Social relationships and mortality risk: a meta-analytic review","volume":"7","author":"Holt-Lunstad","year":"2010","journal-title":"PLoS Med"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"S54","DOI":"10.1177\/0022146510383501","article-title":"Social relationships and health: a flashpoint for health policy","volume":"51","author":"Umberson","year":"2010","journal-title":"J Health Soc Behav"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1177\/1088868314523839","article-title":"Depression and social identity: an integrative review","volume":"18","author":"Cruwys","year":"2014","journal-title":"Personal Soc Psychol Rev"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1002\/ejsp.2333","article-title":"Advancing the social identity approach to health and well-being: progressing the social cure research agenda","volume":"47","author":"Jetten","year":"2017","journal-title":"Eur J Soc Psychol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"150221","DOI":"10.1098\/rsos.150221","article-title":"The ice-breaker effect: singing mediates fast social bonding","volume":"2","author":"Pearce","year":"2015","journal-title":"R Soc Open Sci"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1096","DOI":"10.3389\/fpsyg.2014.01096","article-title":"Music and social bonding: \u201cself-other\u201d merging and neurohormonal mechanisms","volume":"5","author":"Tarr","year":"2014","journal-title":"Front Psychol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1111\/j.1467-6494.1997.tb00326.x","article-title":"On energy, personality, and health: subjective vitality as a dynamic reflection of well-being","volume":"65","author":"Ryan","year":"1997","journal-title":"J Pers"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e0211362","DOI":"10.1371\/journal.pone.0211362","article-title":"How do artistic creative activities regulate our emotions? Validation of the emotion regulation strategies for artistic creative activities scale (ERS-ACA)","volume":"14","author":"Fancourt","year":"2019","journal-title":"PLoS One"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1412306","DOI":"10.3389\/fpubh.2024.1412306","article-title":"The impact of arts on prescription on individual health and wellbeing: a systematic review with meta-analysis","volume":"12","author":"Jensen","year":"2024","journal-title":"Front Public Health"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1554882","DOI":"10.3389\/fpsyg.2025.1554882","article-title":"Social media sharing, psychological distress, and student well-being: a PLS-SEM and fsQCA analysis of Chinese college students","volume":"16","author":"Shu","year":"2025","journal-title":"Front Psychol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1177\/135910457000100301","article-title":"Back-translation for cross-cultural research","volume":"1","author":"Brislin","year":"1970","journal-title":"J Cross-Cult Psychol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1186\/s13012-017-0635-3","article-title":"Psychometric assessment of three newly developed implementation outcome measures","volume":"12","author":"Weiner","year":"2017","journal-title":"Implement Sci"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1177\/002224378101800104","article-title":"Evaluating structural equation models with unobservable variables and measurement error","volume":"18","author":"Fornell","year":"1981","journal-title":"J Mark Res"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1108\/EBR-11-2018-0203","article-title":"When to use and how to report the results of PLS-SEM","volume":"31","author":"Hair","year":"2019","journal-title":"Eur Bus Rev"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1007\/s11747-014-0403-8","article-title":"A new criterion for assessing discriminant validity in variance-based structural equation modeling","volume":"43","author":"Henseler","year":"2015","journal-title":"J Acad Mark Sci"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1080\/10705510701301834","article-title":"Sensitivity of goodness of fit indexes to lack of measurement invariance","volume":"14","author":"Chen","year":"2007","journal-title":"Struct Equ Model"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.dr.2016.06.004","article-title":"Measurement invariance conventions and reporting: the state of the art and future directions for psychological research","volume":"41","author":"Putnick","year":"2016","journal-title":"Dev Rev"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"863","DOI":"10.3389\/fpsyg.2013.00863","article-title":"Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs","volume":"4","author":"Lakens","year":"2013","journal-title":"Front Psychol"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1037\/0021-9010.88.5.879","article-title":"Common method biases in behavioral research: a critical review of the literature and recommended remedies","volume":"88","author":"Podsakoff","year":"2003","journal-title":"J Appl Psychol"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"558","DOI":"10.1037\/0021-843X.112.4.558","article-title":"Testing mediational models with longitudinal data: questions and tips in the use of structural equation modeling","volume":"112","author":"Cole","year":"2003","journal-title":"J Abnorm Psychol"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1080\/01973533.2015.1049349","article-title":"The mediation myth","volume":"37","author":"Kline","year":"2015","journal-title":"Basic Appl Soc Psych"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1037\/1082-989X.12.1.23","article-title":"Bias in cross-sectional analyses of longitudinal mediation","volume":"12","author":"Maxwell","year":"2007","journal-title":"Psychol Methods"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1080\/00273171.2011.606716","article-title":"Bias in cross-sectional analyses of longitudinal mediation: partial and complete mediation under an autoregressive model","volume":"46","author":"Maxwell","year":"2011","journal-title":"Multivar Behav Res"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1037\/met0000154","article-title":"Tutorial: the practical application of longitudinal structural equation mediation models in clinical trials","volume":"23","author":"Goldsmith","year":"2018","journal-title":"Psychol Methods"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"1254","DOI":"10.1177\/17456916221134573","article-title":"Adjusting for baseline measurements of the mediators and outcome as a first step toward eliminating confounding biases in mediation analysis","volume":"18","author":"Loh","year":"2023","journal-title":"Perspect Psychol Sci"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1027\/1614-2241.1.3.86","article-title":"Sufficient sample sizes for multilevel modeling","volume":"1","author":"Maas","year":"2005","journal-title":"Methodology"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"105950","DOI":"10.1016\/j.foodqual.2026.105950","article-title":"Instant health or long-term wellness? A lay belief perspective on AI vs. human recipe recommenders","volume":"143","author":"Shu","year":"2026","journal-title":"Food Qual Prefer"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1945573\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T04:37:53Z","timestamp":1789706273000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1945573\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,18]]},"references-count":51,"alternative-id":["10.3389\/fpubh.2026.1945573"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1945573","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,18]]},"article-number":"1945573"}}