Effectiveness and cost-effectiveness of community singing on the mental health related quality of life of the older population: a randomized controlled trial

Background: As the population ages, older people account for a greater proportion of the health and social care budget. While some research has been conducted on the use of music therapy for specific clinical populations, little rigorous research has been conducted looking at the value of community singing on the mental health-related quality of life of older people. Aims: To evaluate the effectiveness and cost-effectiveness of community group singing for a population of older people in England. Method: A pilot pragmatic individual randomized controlled trial comparing group singing versus usual activities in those aged 60 years or more. Results: 258 participants were recruited across 5 centres in East Kent. At 6 months post-randomisation significant differences were observed in terms of mental health related quality of life measured using the SF12, mean difference 2.35 (95% CI 0.06 to 4.76) in favour of group singing. In addition the intervention was found to be marginally more cost-effective than usual activities. At 3 months significant differences were observed in terms of mental health components of quality of life (4.77; 2.53 to 7.01) anxiety (-1.78; -2.5; -1.06) and depression (-1.52; -2.13 to -0.92). Conclusions: Community group singing appears to have a significant effect on mental health related quality of life, anxiety and depression and may be a useful intervention to maintain and enhance the mental health of the older population

Singing and COPD: a pilot randomized controlled trial of wellbeing and respiratory outcomes

Aims/objectives To test whether a ten-week regular weekly group singing programme, with guided home practice, leads to improvement in COPD-specific health status, as assessed by the COPD Assessment Test (CAT, primary outcome). To test whether the programme results in changes to health-related quality of life, mental health, breathlessness, lung function, functional exercise performance and breathing patterns (secondary outcomes). Rationale A number of randomized controlled trials (RCTs) exist which suggest that there are potential benefits to health and wellbeing of regular singing for people with COPD (Chronic Obstructive Pulmonary Disease). However, most rely on small samples, and findings across the different outcome measures are inconsistent, while interview studies tend to report consistent positive physical and psychological outcomes. Further research is therefore needed. Approach A single-blind, randomized controlled trial compared a structured, weekly group singing programme plus home practice between sessions over ten weeks, with a usual COPD treatment control. The sample was drawn from a local NHS population of people with COPD. Following baseline assessments, participants were allocated to a 10-week singing programme or a control. Findings Twenty-four individuals completed to follow-up. Measures at 12 weeks showed no significant differences between singing and control groups except for one item on the health status questionnaire (SF-36) which suggested the singers were less limited in their activities of daily living post-singing. Final follow-up, planned for 6 months post intervention, was aborted due to the COVID-19 pandemic. Discussion and conclusion The study failed to recruit to target. There remains a recruitment problem in RCTs of singing for COPD, resulting in inconclusive findings, which conflict with the positive qualitative evidence. A wide variety of research methods, as well as RCTs, are suggested to enable a better understanding of the impact of singing on COPD

Arts and creative activities for mental wellbeing during Covid-19 lockdown: report of a survey of university staff

Purpose: There is evidence that the recent Covid-19 pandemic has led to an increase in stress in the UK workforce. Research also suggests that engaging in arts and creative activities may alleviate stress. The purpose was to explore how this might relate to staff at Canterbury Christ Church University, and specifically: 1) to identify the overall extent of uptake and popularity of different arts activities; 2) to assess how this compares with pre-Covid levels of engagement and; 3) to identify how engagement with activities may serve to mitigate any adverse effects of the pandemic and beyond. Design: The two-stage design comprised an online questionnaire, followed by in-depth interviews with a sub-sample of respondents. Findings: 178 individuals responded to the questionnaire, and 12 individuals were interviewed. Receptive arts engagement featured more frequently than participatory arts. 46.6% respondents reported more engagement during lockdown than before. The most frequently reported benefits related to the ability to disengage from the negative concerns of lockdown. Interview data identified four themes: creativity for wellbeing; connecting and contributing; pandemic as opportunity; and reflecting the times. Originality: Little previous research has been conducted on the impacts of the arts specifically on university staff during Covid, particularly research including non-academic staff

Community singing groups for people with chronic obstructive pulmonary disease: participant perspectives

Aim Chronic obstructive pulmonary disease (COPD) is a major public health issue which is irreversible and progressive, but previous research suggests that singing may have beneficial effects. The aim of this study was to establish the views of participants with COPD taking part in a singing for better breathing programme. Methods This was a descriptive qualitative study nested within a single-cohort feasibility study which included measures of lung function and wellbeing. Participants (n=37) were interviewed following a community singing programme that ran over ten months in South East England. Results Findings support those from previous studies regarding the impact of singing on respiratory wellbeing. These included: the teaching on breath control, relaxation and the breathing exercises; singing as a means to deflect attention away from breathing problems, leading to increased activity levels; and the mutual support for respiratory problems. Beyond the impact on breathing, the singing was also seen as fun, and provided friendship and a ‘feel-good’ factor which led to motivation to participate in further activities. For some it was the highlight of the week, and singing together in a group was felt to be central to the benefits experienced. Findings are compared with the quantitative measures within the same study. Conclusions The majority of participants reported improvements in respiratory symptoms as well as mental and social wellbeing following the programme. The study contributes to the evidence base in supporting and highlighting the consistently positive experiences of a large sample of participants, despite variable outcomes in clinical measures

The effectiveness and cost-effectiveness of a participative community singing programme as a health promotion initiative for older people: protocol for a randomised controlled trial

Background The growth in numbers of older people represents a considerable cost to health and social care services in the United Kingdom. There is an acknowledged need to address issues of social exclusion and both the physicial and mental health of this age group. In recent years there has been much interest in the potential contribution of the arts to the health of communities and individuals. There is some evidence that participative singing may be of benefit to older people, however studies to date are limited in number and have lacked rigour. There is therefore a need to build on this knowledge base to provide more quantifiable evidence of both effectiveness and cost efffectness of singing as a health intervention of this population group. Methods The proposed study is a pragmatic randomised controlled trial with two parallel arms. The primary hypothesis is that singing groups for older people improve both physical and mental aspects of qualaity of life when compared to usual activities. Potential participants will be volunteers over 60 years living in the community and recruited through publicity. Eligible and consenting participants will be randomized to either a singing group or a control group. Singing groups will take part in a twelve week planned programme of singing and control groups will continue with usual activities. The primary outcome measure will be the York SF-12, a health related quality of life measure which will be administered at baseline, three and six months after baseline. The study will evaluate both effectiveness and cost-effectiveness. Discussion This study proposes to add to the exisiting body of evidence on the value of singing for older people by using a rigorous methodological design, which includes a power calucation, a standardised intervention and assessment of cost-effectiveness. It should be regarded as a stage in a progressive programme of studies in this area. If group singing is found to be effective and cost-effective it may offer an alternative means to maintaining the health of people in later life

Singing for Better Breathing: Findings from the Lambeth & Southwark Singing & COPD Project

Over the last eight years there has been a growth of interest in the potential value of participation in singing groups for people with chronic obstructive pulmonary disease (CODP) and other respiratory illnesses. This is shown by the increasing number of singing for breathing groups established across the UK over this period. The British Lung Foundation have taken a leading role in promoting this activity through their ‘Singing for Lung Health’ programme. A limited number of small-scale research studies have assessed the benefits of singing for people with COPD and other lung conditions. These include three randomised controlled trials, one in Brazil, and two conducted at the Royal Brompton Hospital in London. Further studies have been carried out in Canada, New Zealand, the UK and the USA. There is limited evidence that singing improves lung function and exercise capacity, but qualitative feedback from participants has been highly positive. Testimonies point to singing having substantial subjective benefits for physical, psychological and social wellbeing, and in enabling people with COPD to better manage their lung condition. The current study in Lambeth and Southwark, South London, was based on earlier research conducted in East Kent, UK. Morrison et al. (2013) established and evaluated a network of six community singing groups for people with COPD which ran over the course of ten months. Seventy-two people with COPD were followed up over this time and assessed using validated questionnaires, with St. George’s Respiratory Questionnaire (SGRQ) as the primary outcome measure. Spirometry was also used to assess lung function. Significant improvements were found on the total and impact scores from the SGRQ, and participants also improved in their lung function

Kent Academic Repository Full text document (pdf) Versions of research Citation for published version Link to record in KAR The effectiveness and cost-effectiveness of a participative community singing programme as a health promotion initiative for older

(2011) The effectiveness and cost-effectiveness of a participative community singing programme as a health promotion initiative for older people: protocol for a randomised controlled trial. BMC Public Health, 11 (142) Document Version The effectiveness and cost-effectiveness of a participative community singing programme as a health promotion initiative for older people: protocol for a randomised controlled trial The growth in numbers of older people represents a considerable cost to health and social care services in the United Kingdom. There is an acknowledged need to address issues of social exclusion and both the physical and mental health of this age group. In recent years there has been much interest in the potential contribution of the arts to the health of communities and individuals. There is some evidence that participative singing may be of benefit to older people, however studies to date are limited in number and have lacked rigour. There is therefore a need to build on this knowledge base to provide more quantifiable evidence of both effectiveness and cost effectiveness of singing as a health intervention for this population group

Singing for better breathing: findings from the Lambeth and Southwark singing and COPD project

Over the last eight years there has been a growth of interest in the potential value of participation in singing groups for people with chronic obstructive pulmonary disease (CODP) and other respiratory illnesses. This is shown by the increasing number of singing for breathing groups established across the UK over this period. The British Lung Foundation have taken a leading role in promoting this activity through their ‘Singing for Lung Health’ programme. A limited number of small-scale research studies have assessed the benefits of singing for people with COPD and other lung conditions. These include three randomised controlled trials, one in Brazil, and two conducted at the Royal Brompton Hospital in London. Further studies have been carried out in Canada, New Zealand, the UK and the USA. There is limited evidence that singing improves lung function and exercise capacity, but qualitative feedback from participants has been highly positive. Testimonies point to singing having substantial subjective benefits for physical, psychological and social wellbeing, and in enabling people with COPD to better manage their lung condition. The current study in Lambeth and Southwark, South London, was based on earlier research conducted in East Kent, UK. Morrison et al. (2013) established and evaluated a network of six community singing groups for people with COPD which ran over the course of ten months. Seventy-two people with COPD were followed up over this time and assessed using validated questionnaires, with St. George’s Respiratory Questionnaire (SGRQ) as the primary outcome measure. Spirometry was also used to assess lung function. Significant improvements were found on the total and impact scores from the SGRQ, and participants also improved in their lung function