Community Choirs to Promote Healthy Aging and Independence of Older Adults

描述(由申请者提供)：美国老年人的数量正在迅速增加。2009年，65岁以上的人口为3960万，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/族裔和社会经济地位的老年人的数量将会增加，他们比非少数族裔老年人健康状况差的风险更大。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，参与社区合唱对老年人的健康也有积极的好处，但需要评估合唱计划对不同老年人的有效性，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，这项提议的总体目标是测试社区合唱团计划在不同文化背景的老年人中保持健康和福祉的有效性。为了达到研究的目的，我们将评估一组假设与合唱有关的综合结果，并完成成本分析。我们将招募450名不同的老年人，并将利用现有的12个由老龄化管理局支持的老年中心来实施一项多地点、随机(按中心)的临床试验(RCT)。中心将被随机分为立即接受合唱团计划(干预组)或在6个月延迟干预阶段后接受合唱团计划(控制组)。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)时评估主要和次要结果。我们还将评估老年中心的启动和持续计划成本，包括每名服务人员的成本，并确定质量调整后的寿命年。如果成功，这一随机对照研究的结果可能有助于发展和推进这样一个前提，即创意艺术可以应用于帮助解决国家卫生优先事项，例如让老年人保持活跃、独立，并以容易获得、负担得起和可持续的方式参与他们的社区。

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.