Strategies to enhance treatment fidelity and music-based intervention reporting in dementia research.

ABSTRACT

Creative solutions are needed to address the well-being of the growing number of individuals living with dementia. Music-based interventions (MBIs) are promising and can be cost-effective; however, empirical evidence for MBIs is limited and published findings have not been widely translated into practice. Here, we describe how we implemented strategies to enhance rigor in a randomized clinical trial of an MBI for persons with dementia. We examined the impact of a singing-based MBI on feelings, emotions, and social engagement, relative to a non-music treatment (verbal discussion), delivered in small group format (25 minutes, 3 times/week for 2 weeks). We implemented National Institutes of Health Behavior Change Consortium strategies regarding (i) design, (ii) interventionist training, (iii) treatment delivery, (iv) treatment receipt, and (v) treatment skills enactment. We applied the MBI Reporting Criteria including (i) theoretical framework, (ii) musical content, (iii) dosage, (iv) interventionist, (v) treatment fidelity, (vi) setting, and (vii) delivery unit. We analyzed data with a separate linear mixed model for each dependent variable. 32 older adults with dementia (65-97 years) participated. The MBI yielded significant positive effects on all measured outcomes (all p's < .05). Application of established guidelines enhanced methodological rigor and MBI reproducibility. To support translation of research into practice, clinicians should understand how to implement an MBI reported in research. Our study illustrates practical steps to address the need for improved MBI research in persons with dementia and can provide a model for others to enhance evidence-based practice with this population.

Music-based interventions (MBIs) can be very effective in improving the psychosocial well-being of persons with dementia. Nonetheless, scientific evidence to support the use and appropriate application of MBIs for this population is very limited and often not applied in care settings. Here, we describe how we used established guidelines to conduct a rigorous experiment of an MBI for persons with dementia in nursing homes. Specifically, we examined the impact of a live singing-based MBI on feelings, emotions, and social engagement, relative to a non-music treatment (verbal discussion). We implemented National Institutes of Health Behavior Change Consortium strategies regarding study design and implementation and the MBI Reporting Criteria to thoroughly describe implementation principles and components of the MBI. We learned that the MBI resulted in significant, positive effects on all measured outcomes. Application of established guidelines helped ensure that our study was rigorous and the MBI could be reproduced in practice. Clinicians should understand how to implement an MBI reported in research. Our study illustrates practical steps to appropriately describe an MBI and addresses the need for improved MBI research in persons with dementia. Our work provides a model for how such an approach could be used in other similar work.