Assessing Outcomes of Three Different Museum-based Social Prescription Programs in Autistic Adults

This study will evaluate a museum-based social prescribing program for autistic adults with average-range intellectual functioning. Social prescribing is a person-centered approach that connects individuals with nonmedical community resources to support health, well-being, and social participation. Although social prescribing has been applied to people with chronic medical and psychiatric conditions, its effectiveness for autistic adults has not been well established. This study is being conducted through collaboration between the Department of Psychiatry at National Taiwan University Hospital and the National Taiwan Museum.

Approximately 90 autistic adults will be recruited through the outpatient services of National Taiwan University Hospital. After clinical referral and completion of baseline assessments, participants will select one of three museum participation programs, with a target enrollment of approximately 30 participants per group. Because participants choose their preferred program, assignment is nonrandomized.

The three programs are:

• **Independent Museum Visit:** Participants will visit the National Taiwan Museum once at a time of their choosing.
• **Guided Museum Program:** Participants will attend five structured group sessions, with approximately 10-15 participants per group. Each session will last approximately 90 minutes and will include a museum-guided introduction, a question-and-answer period, independent exploration of selected exhibits, and a facilitated group discussion.
• **Museum Visit With a Friend:** Participants will invite a friend or companion to visit the museum with them.

The guided program will use permanent museum exhibitions as prompts for social interaction, reflection, and discussion. Proposed themes include stereotypes and personal identity, relationships between people and nature, ideals and realities of living environments, human evolution and the future, and personal attitudes toward money and financial planning. During the discussion period, participants will share observations or photographs from the exhibits, listen to other participants, provide feedback, and express their own perspectives.

Quantitative assessments will be administered before participation and, for selected measures, after completion of the assigned museum program. Baseline assessments will characterize autism-related traits, social responsiveness, sensory processing, sensory sensitivity, attitudes toward social touch, emotional functioning, loneliness, anxiety, depression, and social interaction anxiety. Post-program assessments will focus on changes in emotional functioning, loneliness, anxiety, depression, and social interaction anxiety, as well as satisfaction with the museum experience.

Participants who complete their selected program may also be invited to take part in a focus group lasting approximately 30-60 minutes. The discussion will explore perceived benefits, difficulties, satisfaction, and recommendations for improving the program. Focus groups will be audio- and video-recorded and transcribed for qualitative analysis.

Quantitative analyses will examine within-participant changes in emotional intelligence, loneliness, anxiety, depression, and social interaction anxiety. Differences among the three participation programs will also be evaluated, including differences in activity satisfaction and changes from baseline. Exploratory analyses will examine whether baseline autism-related, social, and sensory characteristics are associated with program response. Qualitative data will be summarized thematically to identify perceived benefits and areas requiring improvement.

All research records will be identified by study code rather than participant name. Paper records will be stored in locked cabinets, and electronic files, including audio and video recordings, will be stored on password-protected computers. Study data will be retained for 20 years and then destroyed according to institutional procedures.

Inclusion criteria

• Meet the diagnostic criteria for autism spectrum disorder.
• Have intellectual functioning within the normal range.
• Be willing and able to participate in the study procedures.
• Be willing to attend the relevant museum activities and group discussions, when applicable.
• Agree to audio and video recording during relevant study activities.

Exclusion criteria

• Are unwilling to complete the required assessments.
• Have a serious physical or psychiatric condition that limits their physical stamina, emotional capacity, or ability to understand and complete the study procedures.
• Refuse audio or video recording.