Browsing by Subject "music therapy"

Now showing 1 - 7 of 7
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    Community-Based Referential Music Making with Limited-Resource Adolescents: A Pilot Study
    (Oxford, 2020) Thomas, Natasha; Music and Arts Technology, School of Engineering and Technology
    Black/African American adolescents from limited-resource communities face challenges and circumstances that are unique to their racialization and socioeconomic status; this merits community-engaged resources, such as community music therapy, that are equally unique in creating culturally responsive opportunities for limited-resource adolescents to engage socially with peers and experience meaningful success in a safe, supportive environment. The purpose of this study was to pilot and explore the feasibility of and behavioral processes in a community-based referential music-making intervention for limited-resource adolescents labeled as “at-risk.” The methods consisted of a concurrent nested (embedded) mixed methods design based on the principles of participatory actions research (PAR), during which qualitative data were collected during 8 focus group style music-making sessions. Quantitative data assessing self-efficacy were collected prior to first and following the 8th music-making session. The validity of quantitative results was challenged by the lowered reading level of participants and a high amount of mis-labeled (and thus unusable) data. Qualitative data suggest 3 themes, including creating community, artistic prioritization, and pride. All results were impacted by issues, such as inconsistent attendance and malfunctioning recording equipment. Nevertheless, participants expressed a collective desire to share their work with their community group. Discussion points are raised including how participants in this community music therapy-based approach were able to create and direct their own stories. The implementation of community music therapy approaches seems a valuable way to bring authentic representations of limited-resource adolescent participants into clinical practice.
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    Implementing NIH Behavior Change Consortium Treatment Fidelity Recommendations in a Multi-Site Randomized Controlled Trial of an Active Music Engagement Intervention for Young Children with Cancer and Parents
    (Sage, 2022) MacLean, Jessica A.; Stegenga, Kristin A.; Henley, Amanda K.; Robb, Sheri L.; School of Nursing
    Treatment fidelity is the use of methodological strategies to monitor and enhance reliability and validity of behavioral intervention trials. Despite availability of guidelines and checklists, treatment fidelity remains underreported, hindering evaluation, interpretation, and cross-study comparisons. Treatment fidelity is particularly important for music interventions given the inherent complexity of musical stimuli and flexibility required for tailored delivery. The purpose of this paper is to define and describe treatment fidelity strategies for our trial of a music-based play intervention for young children with cancer and parents grounded in the NIH Behavior Change Consortium Treatment Fidelity Recommendations. We report strategies for all 5 areas: study design, training providers, delivery of treatment, receipt of treatment, and enactment of treatment skills. We also discuss 4 challenges our team encountered, including: (1) standardizing live music delivery, (2) defining boundaries for tailored intervention delivery, (3) managing extended time between participants, and (4) minimizing risk for bias. This paper expands on current fidelity literature and may provide a working model for other investigators examining dyadic and/or active music interventions.
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    Mediators and Moderators of Active Music Engagement to Reduce Traumatic Stress Symptoms and Improve Well-being in Parents of Young Children With Cancer
    (Sage, 2023-12-25) Robb, Sheri L.; Stegenga, Kristin; Perkins, Susan M.; Stump, Timothy E.; Moody, Karen M.; Henley, Amanda K.; MacLean, Jessica; Jacob, Seethal A.; Delgado, David; Haut, Paul R.; School of Nursing
    Objective: This trial examined the effects of proximal/distal mediators and moderators of an Active Music Engagement (AME) intervention on young child/parent distress, quality of life, and family function outcomes. Methods: Child/parent dyads (n = 125) were randomized to AME or Audio-storybooks attention control condition. Each group received 3 sessions with a credentialed music therapist for 3 consecutive days with data collection at baseline, post-intervention (T2), and 30-days later (T3). Potential proximal mediators included within session child and parent engagement. Potential distal mediators included changes in perceived family normalcy, parent self-efficacy, and independent use of play materials. Potential moderators included parent/child distress with prior hospitalizations, parent traumatic stress screener (PCL-6), and child age. Outcomes included child emotional distress and quality of life; parent emotion, traumatic stress symptoms (IES-R), well-being; and family function. Mediation effects were estimated using ANCOVA, with indirect effects estimated using the percentile bootstrap approach. Moderation effects were tested by including appropriate interaction terms in models. Results: No significant mediation effects were observed. Child distress with prior hospitalizations moderated AME effects for IES-R intrusion subscale scores at T2 (P = .01) and avoidance subscale scores at T3 (P = .007). Traumatic stress screener scores (PCL-6) moderated intervention effects for IES-R hyperarousal subscale scores at T2 (P = .01). There were no moderation effects for child age. Conclusions: AME is a promising intervention for mitigating traumatic stress symptoms and supporting well-being in parents of children with cancer, particularly for parents who screen high for traumatic stress and whose children are more highly distressed with hospitalization.
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    Music Therapy Clinical Practice in Hospice: Differences Between Home and Nursing Home Delivery
    (Oxford, 2015) Liu, Xiaodi; Burns, Debra S.; Stump, Timothy E.; Unroe, Kathleen T.; Department of Music and Arts Technology, School of Engineering and Technology
    Background: Hospice music therapy is delivered in both homes and nursing homes (NH). No studies to date have explored differences in music therapy delivery between home and NH hospice patients. Objective: To compare music therapy referral reasons and delivery for hospice patients living in NH versus home. Methods: A retrospective, electronic medical record review was conducted from a large U.S. hospice of patients receiving music therapy between January 1, 2006, and December 31, 2010. Results: Among the 4,804 patients, 2,930 lived in an NH and 1,847 patients lived at home. Compared to home, NH hospice patients were more likely to be female, older, unmarried, and Caucasian. For home hospice patients, the top referral reasons were patient/family emotional and spiritual support, quality of life, and isolation. The most frequent referral reasons for NH hospice patients were isolation, quality of life, and patient/family emotional and spiritual support. Differences in music therapy delivery depended mainly on patients’ primary diagnosis and location of care. Conclusions: Results suggest differences in referral reasons and delivery based on an interaction between location of care and patient characteristics. Delivery differences are likely a result of individualized assessment and care plans developed by the music therapist and other interdisciplinary team members to address the unique needs of the patient. Thus, it is important to have professionally trained music therapists assess and provide tailored music-based interventions for patients with different referral reasons and personal characteristics. This study also supports staffing decisions based on patient need rather than average daily census.
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    Principles and Strategies for Monitoring Data Collection Integrity in a Multi-site Randomized Clinical Trial of a Behavioral Intervention
    (2011-08) Phillips-Salimi, Celeste R.; Stickler, Molly A.; Stegenga, Kristin; Lee, Melissa; Haase, Joan E.
    Although treatment fidelity strategies for enhancing the integrity of behavioral interventions have been well described, little has been written about monitoring data collection integrity. This article describes the principles and strategies developed to monitor data collection integrity of the "Stories and Music for Adolescent/Young Adult Resilience During Transplant" study (R01NR008583; U10CA098543; U10CA095861) -- a multi-site Children's Oncology Group randomized clinical trial of a music therapy intervention for adolescents and young adults undergoing stem cell transplant. The principles and strategies outlined in this article provide one model for development and evaluation of a data collection integrity monitoring plan for behavioral interventions that may be adapted by investigators and may be useful to funding agencies and grant application reviewers in evaluating proposals.
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    A Survey of Music Therapists Working in Pediatric Medical Settings in the United States
    (Oxford, 2020) Knott, David; Biard, Marial; Nelson, Kirsten E.; Epstein, Stephanie; Robb, Sheri L.; Ghetti, Claire M.; School of Nursing
    Music therapy is becoming a standard supportive care service in many pediatric hospitals across the United States. However, more detailed information is needed to advance our understanding about current clinical practice and increase availability of pediatric music therapy services. The purpose of this cross-sectional survey study was to collect and summarize data about music therapists working in pediatric medical settings. Specifically, we collected information about (1) therapist demographics, (2) organizational structure, (3) service delivery and clinical practice, and (4) administrative/supervisory responsibilities. Board-certified music therapists working in pediatric medical settings (n = 118) completed a 37-item online questionnaire. We analyzed survey data using descriptive statistics and content analysis. Findings indicated that there is a ratio of approximately one music therapist for every 100 patient beds, that one-third of respondents are the only music therapist in their setting, and that half of the surveyed positions are philanthropically funded. Prioritizing patient referrals based on acuity was common (95.7%, n = 110), with palliative care and pain as the most highly prioritized needs. More than half of respondents reported serving in high acuity areas such as the pediatric intensive care, hematology/oncology, or neonatal intensive care units. We recommend replication of this survey in five years to examine growth and change in service delivery among pediatric music therapists over time, with additional studies to (a) explore how therapist-to-patient ratios influence quality of care, (b) identify factors that contribute to sustainability of programs, and (c) determine how expansion of services support a broader population of patients and families.
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    Teaching pursed-lip breathing through music: MELodica Orchestra for DYspnea (MELODY) trial rationale and protocol
    (Taylor & Francis, 2020-10-16) McGrath, Mackenzie; Smith, Joseph; Rattray, Nicholas A.; Lillie, Aimee; Crow, Shannon; Myers, Laura J.; Myers, Jennifer; Perkins, Anthony J.; Wasmuth, Sally; Burns, Debra S.; Cheatham, Ariel J.; Patel, Himalaya; Bravata, Dawn M.; Medicine, School of Medicine
    Background Patients with chronic obstructive pulmonary disease (COPD) commonly experience dyspnea, which may limit activities of daily living. Pursed-lip breathing improves dyspnea for COPD patients; however, access to pursed-lip breathing training is limited. Methods The proposed MELodica Orchestra for DYspnea (MELODY) study will be a single-site pilot study to assess the safety, feasibility, and efficacy of a music-based approach to teach pursed-lip breathing. Patients with COPD and moderate-severe dyspnea are randomized to intervention, education-control, or usual care control groups. Intervention patients meet twice weekly for eight weeks for melodica instruction, group music-making, and COPD education. Safety, feasibility, and efficacy is assessed qualitatively and quantitatively. Results This manuscript describes the rationale and methods of the MELODY pilot project. Conclusions If pilot data demonstrate efficacy, then a multi-site randomized control trial will be conducted to evaluate program effectiveness and implementation.