Is laughter the best medicine?

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Is laughter the best medicine?

Organization type: 
$100,000 - $250,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

Project under the partnership between Operation Red Nose (group of professional clowns who work in pediatric services in Portuguese hospitals) and the Institute of Education - University of Minho. It aims to assess the impact of the work of Hospital Clowns with children / adolescents, families and health professionals.

About Project

Problem: What problem is this project trying to address?

(I) The absence of systematic studies and multidisciplinary assessment of the potential impact of physical, emotional, psychological, sociological, and also financial assistance from the Clown Doctors (CD), (ii) the persistence of myths by the Portuguese society around the figure of CD and their work, (iii) the "divorce" that sometimes exists between academia, civil society, the Business world and the health sector, (iv) the resistance existing in the health sector concerning the recognition of the potential for other areas of knowledge and intervention in promoting physical and psychological well-being (and subsequent recovery) of patients in hospitals, in addition to medical action, framed in a more holistic care.

Solution: What is the proposed solution? Please be specific!

In recent years, groups of Hospital Clowns (HC) have expanded in several countries and its importance has been recognized by society, especially by those who witness their work directly. The observation of the practice allows us to recognize the benefits of their intervention in child, family and health professionals. But they lack their own indicators and development methodologies that would allow them to established, more objectively, the impact of their action. Although some investments have been made, it’s an area still under development. Among the variety of studies, there are the qualitative methods, focusing on specific dimensions of the HC, but usually the samples are of limited size. Despite the richness and depth allowed, difficulties remain in terms of reliability of collected data, as well as its generalization and / or comparison between different universes. In the draft I propose here (3 years), the work of HC is dimensioned in its physical aspect, as well as emotional, psychological, sociological and economic, using a multidisciplinary team of researchers that aims at a holistic reading of the phenomena under study, one of the innovative elements of the project. Plus (i) the construction of a rubric and analysis that serve other groups of HC ("methodological Kit"), (ii) sharing of results in scientific publications and Congresses involving different actors of the field (associations of clowns researchers and health and management professionals), (iii) creation of synergies between NGOs, academia and the health sector, which may enhance other partnerships.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

The Project is still in the embryonic stage, and the protocol between the Red Nose Operation (ONV) and University of Minho (UM) is of April 2010. Since then, we have been making efforts to set up a team of researchers, the literature review, identification of assessment tools, consulting with researchers in the area, and fundraising. The completion of several studies to be developed within this project is, however, dependent on the launch activities of the Hospital Clowns (HC) in the specific context of the Hospital de Braga (HB) in October 2010. HB represents one of the main contexts where research will take place, however, for reasons of thickening of the samples and the guarantee of scientific strength of the Project, some 11 hospitals in Portugal, targeted by the intervention of HC may also be considered. Regarding the potential social impact of this project, we hope, through the validation of HC’s work, to contribute to (i) the Movement for the Humanization of Hospitals, (ii) the dignity and credibility of the HC as a professional group, (iii ) ensure the continuity of ONV as a non-profit association, (iv) the development and dissemination of a solid body of research and knowledge into a new area of social relief, (v) provision of research methodologies and knowledge that can serve other groups of Hospital Clowns, (vi) the profitability of the knowledge and tools built in the specific context of health and their transfer to other environments.
About You
Institute of Education - University of Minho
Section 1: You
First Name


Last Name


Website URL

Institute of Education - University of Minho


, BA

Section 2: Your Organization
Organization Name

Institute of Education - University of Minho

Organization Phone


Organization Address

Campus de Gualtar, 4710 Braga

Organization Country

, BA

Your idea
Country and state your work focuses on
Do you have a patent for this idea?


- Conducting three doctoral theses and five master's theses (from 2011 to 2013) evaluating the work of Clown Doctors (CD) and their impact on (i) children, (ii) relatives, (iii) health professionals. Some of the areas of knowledge involved: Psychology, Arts, Medicine, Sociology, Business Administration;
- Conducting International Seminar (2nd semester of 2013) bringing together different actors in this field (clown associations, academics / researchers, health professionals, managers);
- Public presentation (in national and international congresses, in the media) about the results of the studies;
- Publications of main evidence collected over the three years of the Project in scientific journals;
- Construction and validation of a "methodological kit" to make available to other researchers and other Clown Hospital groups.


- Promotion of the main findings within the ONV, also their practices to improve and maximize their potential to act;
- Publication and dissemination of the Proceedings of the International Seminar (in 2013);
- Establishing partnerships - local and international - with other researchers in the area, in close collaboration with Clown Doctors Association;
- Publication and dissemination of the "methodological kit";
- Increased funding for ONV and similar associations;
Creation of synergies between academia, the Health Sector, Businesses and Civil Society;
- Erection of a more extensive body of knowledge about the Clown Doctor identity enabling - through training devices - continuous improvement of these professionals;
- Long term: transfer and adapt knowledge and tools built in the specific context of Health for other social settings where the potential for intervention by the clown may be of service to other target groups (eg elderly, prisoners, youth at risk, etc.).

What will it take for your project to be successful over the next three years? Please address each year separately, if possible.

The feasibility of this project depends on:
- Funding for three years, the fees of two doctoral theses - about $ 6,000 / year;
- Funding for three years, the research grant for a PhD student (approximately $ 12,000 / year)
- Close partnership between the ONV, University of Minho, Braga Hospital towards the feasibility of different studies. Contributions / responsibilities of each partner:
- ONV - Marketing Project with the media, access to its team of professionals (the observation of their practices, training, collecting data on their perceptions about the work in the hospital) and collection of funds in order to finance the project (eg. fees from two doctoral theses, acquisition of books, travel researchers for data collection, training and participation in national and international conferences, purchase of management and analysis softwares, supplies, purchase of assessment tools);
- Hospital de Braga (sample access, availability of human and physical resources for data collection and analysis: rooms for conducting interviews and collecting questionnaires, scientific advice for the collection and interpretation of some of the biometric indicators to be used, providing health professionals to collect data)
- University of Minho - Provision of physical resources, human and material (eg. meeting spaces in the research group, assignment of spaces and facilities for holding the international seminar, support in the handling of any technological tool associated with the collection and processing of data and communication between the different elements of the research group), the scientific advice level of research methodology and data analysis; orientation of doctoral dissertations and master's degree.

What would prevent your project from being a success?

The success of the project is largely dependent on the partnership between the ONV, University of Minho (UM) and Hospital de Braga (HB). The failure by either partner could compromise its viability. Obstacles / threats identified:
ONV - not attracting sufficient funding to support the expenditure-based Project which could endanger the start-up, maintenance and / or completion of some studies (eg. insufficient funds to pay for tuition doctoral theses or running costs of the Project). Difficult access to ONV professionals (insufficient observation of their practices, not sharing the same perceptions, processes, trainings and reflections).
HB - Difficult access to populations as a sample to be taken: health professionals and users of Pediatric Services (children, adolescents and their families). This access may be prohibited by the institution and its actors (eg. administration, physicians, nurses and / or nursing assistants) who could not provide data more directly related to their practices (eg. occupational stress, perceptions of impact, financial data) or not cooperate in the collection of data and / or the viability of the conditions of access to other targets of the studies (eg. space available, distributing questionnaires, collecting biometric data, access to the wards).

How many people will your project serve annually?


What is the average monthly household income in your target community, in US Dollars?

Less than $50

Does your project seek to have an impact on public policy?

What stage is your project in?

Operating for less than a year

In what country?

, BA

Is your initiative connected to an established organization?


If yes, provide organization name.

Operação Nariz Vermelho

How long has this organization been operating?

More than 5 years

Does your organization have a Board of Directors or an Advisory Board?


Does your organization have any non-monetary partnerships with NGOs?


Does your organization have any non-monetary partnerships with businesses?


Does your organization have any non-monetary partnerships with government?

Please tell us more about how these partnerships are critical to the success of your innovation.

The Project is an initiative of ONV that in October 2009, asked the IE-A their scientific and technical leadership. Looking to begin the collaboration in October 2010, ONV saw in this partnership an opportunity of achievement. In April 2010 a cooperation protocol was signed between ONV and IE-A, under which it established the following tasks: ONV - "follow and support the implementation of the project by allocating the necessary human resources and fundraising efforts in developing financial resources; IE - "mobilize the technical and scientific skills necessary for monitor the implementation of the project (...) through the development of a scientific study to assess the impact of the Clown Doctor with hospitalized children, their families and health professionals".

What are the three most important actions needed to grow your initiative or organization?

One of the key actions for ensuring the sustainability of this project over its 3-year is related to fundraising efforts. At present, the promotion and dissemination of the Project in the media (radio, television and print - see sample press ... ) and the quotation of the Project on Social Stock Exchange (BVS - see viewNoticia.php? cod = 52 ) emerges as major sources of funding. BVS, created in Portugal in November 2009, reproduces the concept of the Stock Exchange and aims to bring together civil society organizations - with assistance in various areas of social support - and potential social investors (donors). Through the purchase of social shares (minimum investment - € 10 equivalent to 10 shares), these investors - companies or citizens - can financially support these organizations and their projects. Supported by BVS, this project is one of their primary means of funding. A further decisive action to support the project relates to the publication and periodic dissemination by BVS, both in the media, of the intermediate and final results of the studies that are being developed. Other partnerships were established with other Clowns Hospital associations, researchers and institutions of higher education. Such partnerships are essential supports to the definition of methodologies, tools and access to outstanding results to the Project. These may yield results in future national and international consortia of research that may enhance the assertion of this new field of investigation and intervention of Clowns Hospital.

The Story
What was the defining moment that led you to this innovation?

As previously stated, this innovative solution resulted from the agreement between the ONV and University of Minho, in April 2010.

Tell us about the social innovator behind this idea.

Susana Caires - Ph.D. in Psychology, specialized in Educational Psychology from the University of Minho in 2004. Between 1996 and 2009 she was a lecturer in the Department of Psychology, University of Minho, most recently carried over to the Educational Institute of the same university, where she is an Assistant Professor. She is Deputy Director of the Department of Educational Psychology and Special Education. As a teacher, she’s linked to post-graduate training of teachers, kindergarten teachers, Psychologists and Speech Therapists Masters in Early Intervention, Education, Specific Learning Disabilities, Curriculum Development and Educational Innovation and Psychosocial Intervention on Children, Youth and Families. With regard to research, more recently she has dedicated herself to the themes of family, parenting, hospitalization in pediatric settings and quality in the field of Occupational Health and Stress.

How did you first hear about Changemakers?

Through another organization or company

If through another, please provide the name of the organization or company

Family Coaching