Abstract
BackgroundOlder adults are the fastest growing segment of the United States population. There is an immediate need to identify novel, cost-effective community-based approaches that promote health and well-being for older adults, particularly those from diverse racial/ethnic and socioeconomic backgrounds. Because choral singing is multi-modal (requires cognitive, physical, and psychosocial engagement), it has the potential to improve health outcomes across several dimensions to help older adults remain active and independent. The purpose of this study is to examine the effect of a community choir program (Community of Voices) on health and well-being and to examine its costs and cost-effectiveness in a large sample of diverse, community-dwelling older adults.Method/designIn this cluster randomized controlled trial, diverse adults age 60 and older were enrolled at Administration on Aging-supported senior centers and completed baseline assessments. The senior centers were randomly assigned to either start the choir immediately (intervention group) or wait 6 months to start (control). Community of Voices is a culturally tailored choir program delivered at the senior centers by professional music conductors that reflects three components of engagement (cognitive, physical, and psychosocial). We describe the nature of the study including the cluster randomized trial study design, sampling frame, sample size calculation, methods of recruitment and assessment, and primary and secondary outcomes.DiscussionThe study involves conducting a randomized trial of an intervention as delivered in “real-world” settings. The choir program was designed using a novel translational approach that integrated evidence-based research on the benefits of singing for older adults, community best practices related to community choirs for older adults, and the perspective of the participating communities. The practicality and relatively low cost of the choir intervention means it can be incorporated into a variety of community settings and adapted to diverse cultures and languages. If successful, this program will be a practical and acceptable community-based approach for promoting health and well-being of older adults.Trial registrationClinicalTrials.gov NCT01869179 registered 9 January 2013.
Highlights
Older adults are the fastest growing segment of the United States population
The choir program was designed using a novel translational approach that integrated evidence-based research on the benefits of singing for older adults, community best practices related to community choirs for older adults, and the perspective of the participating communities
The program was designed using a translational research approach [33] that incorporated information from evidence-based research on the benefits of singing for older adults, community best practices related to community choirs for older adults, input from experts in delivering choral programs in community settings, and the perspective of senior center directors
Summary
Our study and the choir intervention are unique in several ways. First, we involved several community-based organizations in the design of both the study and intervention. Any one choir can be multi-cultural in composition; the music can potentially be used to increase awareness of different cultural traditions and cross racial/ethnic barriers If successful, this trial will add to possible interventions that can help eliminate or reduce some health disparities among older adults. The study is an example of a novel translational approach to address health disparities in which multiple inputs were integrated to create an intervention (evidence-based research, best practices, and the perspective of the communities in which the intervention is to be offered) This translational approach enabled a rigorous scientific design (randomized controlled trial) to be applied to an intervention delivered in existing community settings.
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