The goal of this quantitative pilot study is to evaluate the effectiveness of a
collaborative music therapy and social work telehealth framework for community-dwelling
older adults with and without dementia with regards to their emotions, well-being,
cognition, and perceived service quality. This pilot study builds on a feasibility study
that field tested logistics and provided proof-of-concept of the novel telehealth
framework. Specifically, the feasibility study evaluated the acceptability, barriers, and
facilitators of this framework for older adults with and without dementia. Both
music-based interventions were grounded in the person-centered Clinical Practice Model
for Persons with Dementia, which provides guidelines for adjusting the degree of support
and challenge offered to an individual. The investigators developed a collaborative
social work referral worksheet. The investigators conducted semi-structured qualitative
interviews with participants and care partners, who offered input about all aspects of
the study. The investigators also refined recruitment, data collection, protocol
training, and intervention processes. This pilot study builds on this past feasibility
work.
Older adults often experience changes in health, finances, and social support which
impede community involvement. Social distancing surrounding COVID-19 exacerbated such
hurdles and enhanced risk for loneliness, depression, and cognitive decline. Although
many services including music therapy and social work transitioned from in-person to
telehealth during the pandemic, the rapid shift suggests that innovation occurred
reactively, without sufficient time to evaluate the quality or effectiveness of this
service delivery model. Telehealth is likely to continue to be a component of the music
therapy profession and more broadly in healthcare. With thoughtful and systematic
development to bridge the digital divide, telehealth may offer some benefit to
community-dwelling older adults. This goal may be accomplished through interprofessional
collaboration. Music therapists can address psychosocial needs through a variety of
flexible and age-appropriate music experiences, while social workers have expertise to
reach isolated individuals and connect them to appropriate supports. This pilot study
advances a line of research to test a novel telehealth framework that integrates social
work and music therapy to promote older adult well-being.
In this quantitative pilot study, the investigators will test methods and procedures that
will be used in a future larger clinical trial to enhance the rigor and reproducibility
of this research. The objectives of this pilot study are to examine the effects of the
collaborative telehealth framework on older adults' well-being (primary aim), cognition,
loneliness, perception of service quality, and (in response to music therapy) emotions,
and to gather preliminary data for effect size estimation. Participants and
interventionists will be invited to engage in a semi-structured qualitative interview at
the conclusion of the study to inform further optimization of the collaborative
telehealth framework. Participants have the option to use their own or borrow equipment
(iPads). To reach those with limited resources, there will be 2 iPads with cellular data
available to ship to enable study participation. Participants will be community-dwelling
older adults with and without dementia. All participants will receive music therapy via
telehealth and social work wellness sessions via telehealth. Collaboration is the key
difference in the levels of independent variable: participants will be randomly assigned
to either a collaborative condition, or non-collaborative condition. In the collaborative
condition, information collected during music therapy will inform social work wellness
sessions following a protocol developed during the feasibility study. In the
non-collaborative condition, social workers and music therapists will operate telehealth
services independently.