The Impact Areas Questionnaire (IAQ): A Music Therapy Service Evaluation Tool

Service evaluation is a professional requirement for music therapy practitioners and organisations. Yet service evaluation findings are rarely published within the professional literature, and there is limited documentation of the processes and methods of such evaluations, including the rationale, dilemmas, and challenges encountered. This is perhaps due to the perceived status, methodological weaknesses, and context-specificity of service evaluation work. Drawing on our engagement with service evaluation in diverse settings, we have become aware of its potential beyond its typical current uses in the field as well as of the need for open discussion and debate about the service evaluation tools that are available. This is where the aim of this paper lies: to introduce a service evaluation tool, the Impact Areas Questionnaire (IAQ), alongside the studies that led to its construction. Developed originally through a review of 27 individually designed service evaluation projects, this questionnaire contains a number of different impact areas. Adopting an ecological perspective, these areas refer to music therapy’s perceived impact not only on service users, but also on families/carers/friends, staff, and the organisational context in its entirety. Following its original development within Nordoff Robbins England and Wales, this questionnaire was tested in the context of Nordoff Robbins Scotland with the aim of exploring its applicability and transferability to other music therapy settings. In addition to presenting the findings of this testing, we discuss the potential use of the IAQ, which is included as an appendix to this article, in other settings and its relevance for knowledge and policy making in the field

Promotion of physical activity interventions for community dwelling older adults: A systematic review of reviews

Objectives While there is strong evidence that regular participation in physical activity (PA) brings numerous health benefits to older adults, and interventions to effectively promote PA are being developed and tested, the characteristics and components of the most effective interventions remain unclear. This systematically conducted review of systematic reviews evaluated the effects and characteristics of PA promotion interventions aimed at community dwelling people over 50 years old. Methods Major databases were searched for reviews from January 1990 to May 2015. TIDieR guidelines aided data extraction and the ROBIS tool was used to assess the risk of bias. Primary outcomes were objective and self-reported levels of PA. Indicators of psychological wellbeing and participation rates were secondary outcomes. Results Of 1284 records identified, 19 reviews met inclusion criteria and eight included meta-analyses. Interventions typically incorporated behaviour change techniques (BCTs) and were delivered as face-to-face, remote, group, individual or as combined interventions. Despite their heterogeneity, interventions often resulted in sustained improvements in PA over the study period, typically at 12 months, and led to improvements in general wellbeing. However, ways to ensure effective maintenance beyond one year are unclear. Certain intervention components were more clearly associated with positive effects (e.g. tailoring promotion strategy with combination of cognitive and behavioural elements, low to moderate intensity activity recommended). We found no evidence that certain other intervention characteristics were superior in achieving positive outcomes (e.g. mode of delivery, setting, professional background of the intervention provider, type of PA recommended). Conclusion The evidence suggests that interventions to promote PA among older adults are generally effective but there is uncertainty around the most beneficial intervention components. There are indications that purely cognitive strategies and BCTs might be less suitable for older adults than motivators more meaningful to them, including social and environmental support, and enjoyment coming from being physically active. A whole system-oriented approach is required that is tailored to meet the needs of older adults and aligned with social, individual and environmental factors

Moderator analyses: Intervention characteristics—participants, interventionist, setting, mode, other characteristics.

<p>Moderator analyses: Intervention characteristics—participants, interventionist, setting, mode, other characteristics.</p

Harvest plot: Evidence for PA and psychological outcomes.

<p>Columns represent individual reviews with reference numbers below. Column height represents risk of bias assessed on four domains—higher columns represent lower risk of bias. Lighter shade designates narrative evidence, darker shade designates evidence from meta-analysis. Numbers above columns indicate number of studies reporting effect (for narrative reviews). Arrows indicate effect size (for meta-analyses: > small effect, >> mixed effects, >>> moderate effect).</p