Community Choirs to Promote Healthy Aging and Independence of Older Adults

描述（由申请人提供）：美国正在经历老年人数量的快速增长。2009年，65岁以上的人有3 960万，预计到2030年这一数字将几乎翻一番。在同一时期，具有不同种族/民族和社会经济地位（SES）背景的老年人数量将增加，他们相对于非少数民族老年人而言，健康状况不佳的风险增加。因此，迫切需要确定具有成本效益，广泛适用和可持续的方案，促进老年人的健康和福祉。越来越多的文献表明，参与社区合唱也可能对老年人有积极的健康益处，但有必要评估合唱计划对不同老年人的有效性，并且需要设计良好的随机对照试验（RCT）来帮助加强证据基础。因此，本提案的总体目标是测试社区合唱团计划在维护文化多样性老年人健康和福祉方面的功效。为了解决研究的目的，我们将评估一套全面的假设与合唱有关的结果，并完成成本分析。我们将招募450名不同的老年人，并将利用12个现有的老龄化管理支持的老年中心实施多中心，随机（按中心）临床试验（RCT）。中心将随机接受合唱团计划立即（干预组）或6个月后延迟干预阶段（对照组）。社区合唱团将由专业音乐总监领导。我们将在基线、6个月和12个月（延迟干预组为18个月）评估主要和次要结局。我们还将评估老年中心的启动和正在进行的项目成本，包括成本/服务人员，并确定质量调整生命年。如果成功的话，这项随机对照试验的结果可能有助于发展和进一步的前提，即创造性艺术可以应用于帮助解决国家卫生优先事项，例如保持老年人活跃，独立，并以易于获得，负担得起和可持续的方式参与社区。

DESCRIPTION (provided by applicant): 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.