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岁以上的老年人有3960万人，预计到2030年，这一数字将几乎翻一番。在同一时期，与非少数民族老年人相比，具有不同种族/民族和社会经济地位（SES）背景的老年人健康状况不佳的风险将增加。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，以促进老年人的健康和福祉。越来越多的文献表明，参加社区合唱也可能对老年人的健康有积极的好处，但有必要评估合唱项目对不同老年人的功效，并需要一个精心设计的随机对照试验（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项目在保持文化多样化老年人健康和福祉方面的功效。为了实现研究的目的，我们将评估一套全面的结果，这些结果被假设与合唱有关，并完成成本分析。我们将招募450名不同类型的老年人，并利用12个现有的老年管理中心来实施一项多地点、随机（按中心）临床试验（RCT）。中心将被随机分为立即接受合唱团项目（干预组）或在6个月的延迟干预阶段（对照组）后接受合唱团项目。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）评估主要和次要结果。我们还将评估老年中心的启动和正在进行的项目成本，包括服务成本/人，并确定质量调整寿命年。如果成功，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重点问题，例如使老年人保持活跃、独立，并以容易获得、负担得起和可持续的方式参与社区活动。

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.