The United States is experiencing a rapid increase in the number of older adults. In 2009, there were 39.6 million individuals over age 65, and this number is expected to almost double by 2030. During the same time period, there will be an increase in the number of older adults with diverse racial/ethnic and socioeconomic status (SES) backgrounds who are at increased risk for poor health outcomes relative to non-minority elders. Thus, there is an immediate need to identify cost-effective, widely applicable, and sustainable programs that promote health and well-being of older adults. A growing body of literature suggests that participation in community choral singing may also have positive health benefits for older adults, but there is a need to evaluate the efficacy of a choral program for diverse older adults, and a well-designed randomized controlled trial (RCT) is needed to help strengthen the evidence base. Thus, the overall objective of this proposal is to test the efficacy of community choir program for maintaining health and well-being in culturally diverse older adults. To address the aims of the study, we will evaluate a comprehensive set of outcomes that are hypothesized to be related to choral singing and complete a cost analysis. We will recruit 450 diverse older adults and will utilize 12 existing Administration on Aging-supported senior centers to implement a multi-site, randomized (by center) clinical trial (RCT). Centers will be randomized to receive the choir program immediately (intervention group) or after a 6-month delayed intervention phase (control group). The community choirs will be led by professional music directors. We will assess both primary and secondary outcomes at baseline, 6 and 12 months (and 18 months for the delayed intervention group). We will also evaluate the start- up and ongoing program costs for senior centers, including cost/person served and determine quality adjusted life years. If successful, results from this RCT may help develop and further the premise that creative arts can be applied to helping solve national health priorities, such as keeping older adults active, independent, and involved in their communities in readily accessible, affordable, and sustainable ways.

Public Health Relevance

The United States is experiencing a rapid increase in the number of older adults from diverse racial/ethnic backgrounds, a group that is at increased risk of poor health relative to non-minorities. There is an immediate need to identify cost-effective, widely applicable, and sustainable programs that promote health, wellbeing and independence and that are appropriate for our increasingly diverse population of older adults.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Project (R01)
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Study Section
Community-Level Health Promotion Study Section (CLHP)
Program Officer
Onken, Lisa
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University of California San Francisco
Other Health Professions
Schools of Nursing
San Francisco
United States
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Johnson, Julene K; Louhivuori, Jukka; Siljander, Eero (2017) Comparison of Well-being of Older Adult Choir Singers and the General Population in Finland: A Case-Control Study. Music Sci 21:178-194
Johnson, Julene K; Nápoles, Anna M; Stewart, Anita L et al. (2015) Study protocol for a cluster randomized trial of the Community of Voices choir intervention to promote the health and well-being of diverse older adults. BMC Public Health 15:1049
Johnson, Julene K; Chow, Maggie L (2015) Hearing and music in dementia. Handb Clin Neurol 129:667-87
Brewster, Paul W H; Melrose, Rebecca J; Marquine, María J et al. (2014) Life experience and demographic influences on cognitive function in older adults. Neuropsychology 28:846-58
Johnson, Julene K; Louhivuori, Jukka; Stewart, Anita L et al. (2013) Quality of life (QOL) of older adult community choral singers in Finland. Int Psychogeriatr 25:1055-64