Music Therapy and Social Work Telehealth for Older Adult Well-Being

NCT06219148 | Completed

• 2 other identifiers: 63233Arthur Flagler Fultz Award
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 2

Brief Summary

This study investigates the benefits of using telehealth services, specifically a combination of music therapy and social work support, to improve the well-being of older adults. Investigators are focusing on outcomes such as reduced loneliness, improved cognition, and how well older adults with and without dementia perceive the quality of the services received. This research is crucial because as the population ages and conditions like Alzheimer's become more prevalent, effective psychosocial interventions are needed. The collaborative telehealth approach of the intervention in this study strives to connect older adults to community and health-related services. Older adults experience challenges in accessing services related to transportation, social support, and finances. While the pandemic prompted a rapid shift of healthcare services online, including music therapy and social work, questions remain about the quality of this transition, especially for older adults who may not be familiar with or have the resources for telehealth. In this pilot study, investigators are studying music therapy and social work support through telehealth to understand how this approach can impact the well-being, cognition, and service quality for older adults, both with and without dementia. Social workers, who focus on improving well-being and addressing various needs, can leverage the therapeutic relationship built by music therapists to better identify and meet service needs. This pilot study builds on a feasibility project, which indicated that this collaborative framework is acceptable, valuable, and of interest to older adults, facilitating remote community connection. Through this research, investigators aim to evaluate the effectiveness of telehealth services for older adults to inform a future larger trial.

Conditions

Aging Well; Dementia; Telemedicine

Keywords

Music Therapy; Social Work; Evidence-Based Practice; Quality of Life; Emotion; Cognition; Loneliness; Collaboration

Outcome Measures

Primary Outcomes (2)

• Mean Change from Baseline in World Health Organization-5 (WHO-5) Well-Being Index at 6 Weeks

  A simple 5-item measure of subjective well-being (a combination of feeling good and functioning well). The participant rates each item on a 6-point scale from 0 (at no time) to 5 (all of the time); total raw score ranges from 0 (worst possible) to 25 (best possible well-being); percentage score (raw X 4) ranges from 0 (worst possible) to 100 (best possible well-being). Administered by outcome assessor by phone or Zoom at participant's preference.

  Enrollment, end of Week 6.

• Mean Change from Baseline in WHO-5 Well-Being Index at 8 Weeks

  A simple 5-item measure of subjective well-being (a combination of feeling good and functioning well). The participant rates each item on a 6-point scale from 0 (at no time) to 5 (all of the time); total raw score ranges from 0 (worst possible) to 25 (best possible well-being); percentage score (raw X 4) ranges from 0 (worst possible) to 100 (best possible well-being). Administered by outcome assessor by phone or Zoom at participant's preference.

  Enrollment, end of Week 8.

Secondary Outcomes (9)

• Mean Change in Self-Reported Feelings for Participants with Dementia

  Immediately before and immediately after each music therapy session.

• Mean Change in Self-Reported Feelings for Participants without Dementia

  Immediately before and immediately after each music therapy session.

• Mean Change from Baseline in University of California, Los Angeles (UCLA) Loneliness Scale at 6 Weeks

  Enrollment, end of Week 6.

• Mean Change from Baseline in UCLA Loneliness Scale at 8 Weeks

  Enrollment, end of Week 8.

• Mean Change from Baseline in Montreal Cognitive Assessment (MoCA) at 6 Weeks

  Enrollment, end of Week 6.

Study Arms (2)

Collaborative

EXPERIMENTAL

Social workers and music therapists work together, and information collected during music therapy informs social work wellness sessions following a protocol developed during the feasibility study. There are 3 blocks of activities, identical to the non-collaborative arm: * Weeks 1-2: enrollment, stratification, random assignment * Weeks 3-6: music therapy and social work interventions * Weeks 7-8: social work follow up.

Behavioral: Music Therapy Telehealth; Behavioral: Collaborative Social Work Telehealth

Non-Collaborative

SHAM COMPARATOR

Social workers and music therapists operate independently. There are 3 blocks of activities, identical to the collaborative arm: * Weeks 1-2: enrollment, stratification, random assignment * Weeks 3-6: music therapy and social work interventions * Weeks 7-8: social work follow up.

Behavioral: Music Therapy Telehealth; Behavioral: Non-Collaborative Social Work Telehealth

Interventions

Music Therapy Telehealth BEHAVIORAL

Music Therapy: delivered via Zoom by a board-certified music therapist (MT-BC) 30-min 2x/week for 4 weeks (8 sessions total); follows the Clinical Practice Model, which guides customizations of various music experiences (e.g., singing, songwriting, movement, relaxation, lyric discussion, improvisation, instrument play, etc.) per participants' strengths, interests, preferences, culture, and momentary responses. Each participant works with the same MT-BC throughout the study.

Also known as: Music-based intervention (MBI)

Collaborative; Non-Collaborative

Non-Collaborative Social Work Telehealth BEHAVIORAL

Social Work: delivered via Zoom by a licensed social worker (SW) or supervised SW graduate student 3x for 30-min: 1) after 2 weeks MT (assessment), 2) after 4 weeks MT (service referral), 3) 2-week follow-up. SWs operate independently from MT-BCs to identify possible participant service referral needs using the Aging and Memory Quality of Life Survey (AMQoL), baseline data, SW session interactions, and SW Referral Worksheet. Each participant works with the same SW throughout the study.

Also known as: Independent social work intervention, independent wellness support

Non-Collaborative

Collaborative Social Work Telehealth BEHAVIORAL

Social Work: delivered via Zoom by a licensed SW or supervised SW graduate student 3x for 30-min: 1) after 2 weeks MT (assessment), 2) after 4 weeks MT (service referral), 3) 2-week follow-up. In addition to the AMQoL, baseline data, SW session interactions, and the SW Referral Worksheet, SWs collaborate fully with MT-BCs, have full access MT session notes, and can discuss participants' needs with MT-BC to identify possible participant service referral needs. Each participant works with the same SW throughout the study.

Also known as: Integrative social work intervention, integrative wellness support

Collaborative

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

• age 65 or older
• English-speaking
• reside in Kentucky
• willing to receive support from the research team on how to access Zoom (as needed)
• EITHER a) have familiarity using digital technology and/or a video conferencing app such as Zoom, FaceTime, or Facebook Messenger, OR b) have a family member or friend who can facilitate Zoom access (i.e., "helper").

You may not qualify if:

• substance use disorder, which could present a confounding variable relative to the aims;
• significant sensory impairment that interferes with Zoom use
• current music therapy and/or social work case manager recipient
• HELPERS: facilitate participation by older adults who are unfamiliar with using video conferencing technology and/or who lack consent capacity.
• at least 18 years old
• cognitively unimpaired
• live with or be able to go to the older adult's residence to assist them in participating in the study.
• under 18 years old
• cognitively impaired
• unable to assist the older adult in participating in the study for any reason

Sponsors & Collaborators

• Alaine E Hernandez, PhD: lead
• American Music Therapy Association: collaborator

Study Sites (2)

University of Kentucky

Lexington, Kentucky, 40506, United States

Location

Saint Louis University

St Louis, Missouri, 63103, United States

Location

Related Publications (10)

• Lam K, Lu AD, Shi Y, Covinsky KE. Assessing Telemedicine Unreadiness Among Older Adults in the United States During the COVID-19 Pandemic. JAMA Intern Med. 2020 Oct 1;180(10):1389-1391. doi: 10.1001/jamainternmed.2020.2671.

  PMID: 32744593 BACKGROUND

• Kistin C, Silverstein M. Pilot Studies: A Critical but Potentially Misused Component of Interventional Research. JAMA. 2015 Oct 20;314(15):1561-2. doi: 10.1001/jama.2015.10962. No abstract available.

  PMID: 26501530 BACKGROUND

• Gibson A, Bardach SH, Pope ND. COVID-19 and the Digital Divide: Will Social Workers Help Bridge the Gap? J Gerontol Soc Work. 2020 Aug-Oct;63(6-7):671-673. doi: 10.1080/01634372.2020.1772438. Epub 2020 Jun 5. No abstract available.

  PMID: 32500841 BACKGROUND

• Ng BP, Park C, Silverman CL, Eckhoff DO, Guest JC, Diaz DA. Accessibility and utilisation of telehealth services among older adults during COVID-19 pandemic in the United States. Health Soc Care Community. 2022 Sep;30(5):e2657-e2669. doi: 10.1111/hsc.13709. Epub 2022 Jan 6.

  PMID: 34994028 BACKGROUND

• Reschke-Hernández, A. E. (2019). A clinical practice model of music therapy to address psychosocial functioning for persons with dementia: Model development and randomized clinical crossover trial (NCT03643003). Doctoral dissertation, University of Iowa. https://doi.org/10.17077/etd.59oh-y06y

  BACKGROUND

• Reschke-Hernández, A. E. (2021). The Clinical Practice Model for Persons with Dementia: Application to music therapy. Music Therapy Perspectives, 39(2), 133-141. https://doi.org/10.1093/mtp/miab006

  BACKGROUND

• Reschke-Hernández, A. E., Gibson, A., Buckner, L. E., Sullivan, A. C., Posey, C., & Uecker, S. (2023). Development of a collaborative music therapy and social work telehealth framework to address the well-being of community-dwelling older adults. Research poster presented at: Alzheimer's Association International Conference, Amsterdam, Netherlands, 16-20 July 2023.

  BACKGROUND

• Wilhelm, L., & Wilhelm, K. (2022). Telehealth music therapy services in the United States with older adults: A descriptive study. Music Therapy Perspectives. Advance online publication. https://doi.org/10.1093/mtp/miab028

  BACKGROUND

• World Health Organization. (2017, December 7). Global action plan on the public health response to dementia 2017-2025. https://tinyurl.com/bdhm6wha

  BACKGROUND

• World Health Organization. (2010, September 1). Framework for action on interprofessional education and collaborative practice (WHO Reference Number WHO/HRH/HPN/10.3). https://tinyurl.com/28ykjrn3

  BACKGROUND

MeSH Terms

Conditions

Dementia

Condition Hierarchy (Ancestors)

Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurocognitive Disorders; Mental Disorders

Study Officials

• Alaine E Reschke-Hernandez, PhD

  University of Kentucky

  PRINCIPAL INVESTIGATOR

• Allison Gibson, PhD

  St. Louis University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Masking Details: Participants will remain masked to study objectives and their collaborative condition assignment. Research assistants and care providers (music therapists, social workers) will not be masked; social workers and music therapists will know if they are collaborating or not. Principal investigator Reschke-Hernandez and co-investigator Gibson will remain masked to allocation; research assistants will conduct allocation and assignment will be kept in a separate secure document that is not accessible to the PI or co-I.
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Assistant Professor of Music Therapy

Model Details: To ensure a balanced number of individuals in each study condition, a research team member will stratify participants as "with" or "without" dementia according to either their self-reported physician's diagnosis or score on the MoCA (score \<18 = "with dementia"). Participants will then be randomly assigned to either the collaborative or non-collaborative condition using a random number table.

Study Record Dates

• First Submitted: January 12, 2024
• First Posted: January 23, 2024
• Study Start: March 19, 2024
• Primary Completion: July 14, 2025
• Study Completion: July 25, 2025
• Last Updated: September 3, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
• Time Frame: 6 months after publication. The principal investigator will consider sharing data and study materials prior to that time frame in consultation with the study team.
• Access Criteria: The principal investigator will share data, qualitative and quantitative analysis plans, and study materials with other researchers who provide a reasonable rationale for intended use, by email. Requests will be reviewed by the principal investigator Reschke-Hernandez and co-investigator Gibson.

Locations

US (2)