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Table 1 Singing Group Intervention Program Sing4Health Description (TIDieR: Template for Intervention Description and Replication)

From: Sing4Health: protocol of a randomized controlled trial of the effects of a singing group intervention on the well-being, cognitive function and health of older adults

BRIEF NAME: Sing4Health - Sing for your Health, Singing Groups Intervention Programme for Older Adults
Previous literature has suggested benefits of singing groups for the well-being, cognitive function and health of older adults. Thus, the objective of this program is to invite a group of older adults to participate in a singing group intervention, to learn a set of exercises and vocal techniques, and collaborate in the creation of a singing show for the general public. The expected benefits of this social and artistic group activity are improvements in the emotional and social well-being, cognitive functioning and general health of the participants.
I Materials:
One rehearsal room with the capacity for 35 seated individuals and an additional 40 square meters for exercises and activities, one chair for each participant, one piano, one file with lyrics, one bottle of water for each participant, one separate coffee break room, transport for the older adults.
II Components and Procedures of the Group Singing Program:
1. Component of physical exercises for relaxation and vocal warm up - The rehearsals start with 15 mins of relaxation exercises (adapted to the age and physical mobility of the participants) and vocal warm-up exercises. Physical aspects of choral singing are exercised and discussed to promote body awareness, a healthy body posture and understanding of effective breathing during singing. The singing sessions include a combination of sitting and standing up, the use of movements to follow the rhythm and moving to different parts of the room to sing. Provided by the intervention team (pianist, maestro) with the support of older adults’ assistants.
2. Vocal technique - The program aims to provide a complete group singing experience for seniors without musical experience, teaching fundamental aspects of singing, sound, voice mechanics and group singing practice. Participants learn correct and healthy vocal production skills, using breathing techniques and listening skills. Participants learn to sing in different parts or voices, which are taught by hearing and repetition. They learn to listen to each other and to synchronize with each other. Provided by the intervention team (pianist, maestro) with the support of older adults’ assistants.
3. Rehearsal of repertoire – Sessions involve memorization and interpretation of songs and lyrics using different strategies (learning to listen to separate parts, singing lyrics or musical notation, call and response methods), reviewing previously learned songs and learning to harmonize the individual voices with the rest of the group. The repertoire is proposed by both the intervention team and the participants and selected by the whole group after discussion. The repertoire should also be chosen according to the responsiveness and meaning for the participants and with cultural interest for the community in general. Provided by the intervention team (pianist, maestro, invited artist) with the support of older adults’ assistants.
4. Social Component - Break for Socializing and Snacks - Each session has a break of about 20 min for a snack and socialization among the participants. During the break and at the end of each rehearsal, a social interaction is promoted in which group members share emotions, ideas and expectations about their participation in the program. The sessions also include work oriented towards a common goal, group dynamics exercises and discussions about the meaning of the songs and their cultural history. Provided by the intervention team (pianist, maestro) with the support of older adults’ assistants.
5. Creation and Presentation of a Public Performance - The sessions are organized in order to prepare a final performance for the general public. A singer is invited to sing with the group. Families of the participants, older adults from day care centres and the public in general are invited. The participants will benefit from make-up and hair styling before the show. Provided by the intervention team (pianist, maestro, and invited artists) make-up artists, supported by the older adults’ assistants.
6. Evaluation – Participants’ tuning will be assessed at the beginning and at the end of the program. To better adjust objectives, the intervention team will monitor the evolution of each participant, in terms of the skills acquired, record of attendance, and achievement of objectives. The quality of the programme and intervention team will be evaluated by the participants by a questionnaire. Provided by the intervention team (pianist, maestro), assistant researchers and supported by older adults’ assistants.
7. Audio-visual Recoding of the Programme – A media audio-visual team will collect images from the development of sessions and reports from the participants and the final show, to produce a documentary (20 to 30 min) and two short videos, for the dissemination of the program. The team will be integrated in the singing groups from the beginning. Provide by the media team.
Team expertise:
Maestro – Master in Music specialising in Choral Direction by the Escola Superior de Música de Lisboa; Maestro (Substitute) – Degree in Music in the Community by the Escola Superior de Educação e Música de Lisboa; Pianist – Master in Jazz Performance by the Royal Welsh College of Music and Drama; Artistic Director and Invited Artist – Professional Singer, Musicals’ Performer and Master in Psychology by the Universidade Autónoma de Lisboa; Invited Artist – Tenor, Resident Opera Singer of Teatro Nacional de São Carlos; Older Adults’ Assistant – Degree in Social Education, specialising in Rehabilitation. Older Adults’ Caretakers – Professional caretakers from the social support institution.
Training for the Program:
A workshop of two sessions will be provided for all members of the intervention team on the components and goals of the intervention program and on working with the elderly.
Sessions will be conducted in the rehearsal rooms of local theatres in Lisboa and Almada. The performance will take place in public theatres.
Singing Program Duration: 34 sessions, for about 4 months, 2 days a week, each with 2 h of group singing, with a 20-min break for socializing.
Participants: Four groups of 30–35 participants.