Melbourne Conservatorium of Music - Research Publications
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ItemNo Preview AvailableHome-based family caregiver-delivered music and reading interventions for people living with dementia (HOMESIDE trial): an international randomised controlled trial(ELSEVIER, 2023-11)BACKGROUND: Music interventions provided by qualified therapists within residential aged care are effective at attenuating behavioural and psychological symptoms (BPSD) of people with dementia (PwD). The impact of music interventions on dementia symptom management when provided by family caregivers is unclear. METHODS: We implemented a community-based, large, pragmatic, international, superiority, single-masked randomised controlled trial to evaluate if caregiver-delivered music was superior to usual care alone (UC) on reducing BPSD of PwD measured by the Neuropsychiatric Inventory-Questionnaire (NPI-Q). The study included an active control (reading). People with dementia (NPI-Q score ≥6) and their caregiver (dyads) from one of five countries were randomly allocated to caregiver-delivered music, reading, or UC with a 1:1:1 allocation stratified by site. Caregivers received three online protocolised music or reading training sessions delivered by therapists and were recommended to provide five 30-min reading or music activities per week (minimum twice weekly) over 90-days. The NPI-Q severity assessment of PwD was completed online by masked assessors at baseline, 90- (primary) and 180-days post-randomisation and analysed on an intention-to-treat basis using a likelihood-based longitudinal data analysis model. ACTRN12618001799246; ClinicalTrials.govNCT03907748. FINDINGS: Between 27th November 2019 and 7th July 2022, we randomised 432 eligible of 805 screened dyads (music n = 143, reading n = 144, UC n = 145). There was no statistical or clinically important difference in the change from baseline BPSD between caregiver-delivered music (-0.15, 95% CI -1.41 to 1.10, p = 0.81) or reading (-1.12, 95% CI -2.38 to 0.14, p = 0.082) and UC alone at 90-days. No related adverse events occurred. INTERPRETATION: Our findings suggested that music interventions and reading interventions delivered by trained caregivers in community contexts do not decrease enduring BPSD symptoms. FUNDING: Our funding was provided by National Health and Medical Research Council, Australia; The Research Council of Norway; Federal Ministry of Education and Research, Germany; National Centre for Research and Development, Poland; Alzheimer's Society, UK, as part of the Joint Programme for Neurodegenerative Diseases consortia scheme.
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ItemRecruitment approaches and profiles of consenting family caregivers and people living with dementia: A recruitment study within a trial(ELSEVIER INC, 2023-04)BACKGROUND: While studies have identified strategies that are useful for recruiting people living with dementia, none have focused on psychosocial interventions involving arts therapies, or have examined the profiles of older people living in the community who consent or decline participation, particularly during a global pandemic. We aimed to identify the most effective recruitment strategies according to participant characteristics and transnational differences and develop a profile of consenting and non-consenting participants. METHODS: Recruitment teams in Australia, Norway, Germany, Poland, and the United Kingdom, recorded participants' source of study awareness and characteristics of consenting and non-consenting participants. Distributions of participants 'consenting to participate' were compared and logistic regressions were used to estimate the odds ratios. RESULTS: Consenting female caregivers were disproportionally represented. Study awareness differed between countries but overall, most expressions of interest to participate were derived from referrals from professionals or organisations, or from databases of people wanting to participate in research. Troughs in recruitment rates occurred during Northern Hemisphere summer vacation periods, and during Christmas periods. CONCLUSIONS: This study found that recruiting for a trial with community-dwelling family caregivers and people living with dementia is challenging, especially during a global pandemic. While spousal caregivers comprised the highest proportion of dyads recruited, overall spousal caregivers were more reluctant to consent to participate than adult child caregivers. More targeted recruitment strategies designed for minority groups are also needed to ensure broader representation in dementia treatment studies.
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ItemWhose choice? Exploring multiple perspectives on music therapy access under the National Disability Insurance Scheme(Australian Music Therapy Association, 2018)The National Disability Insurance Scheme (NDIS) is a new national funding system for people with disabilities in Australia, which has been tested in some trial sites since 2013 and is now instigated across the Nation. Whilst music therapy and other music services are included on the list of recognised providers, inclusion of these services within individual case plans has been questioned at times by those with authority within NDIS trial sites. This research project aimed to build a collaborative relationship between the University of Melbourne, Australian Music Therapy Association (AMTA), and the National Disability Insurance Agency (NDIA) to better understand the needs and capacity for contribution of each organisation involved in the access of people to music therapy. To this end, interviews were conducted with three NDIA employees, five Registered Music Therapists (RMTs) who had experiences providing music therapy services as NDIS providers, and one parent of an eight-year old participant in the scheme who had accessed music therapy. Interpretative Phenomenological Analysis was used to identify gaps in knowledge and awareness between the different stakeholders. Fourteen emergent themes and three final themes revealed different perspectives on the matter, but all agreed that it is a significant time to promote music therapy and educate the NDIS planners, allied health professionals, the participants of the scheme and their families. In plain language:This research study investigates how different stakeholders perceived access to music therapy under the National Disability Insurance Scheme (NDIS) in the trial sites between 2013 and 2015. Nine people who had the lived experience of the matter such as NDIS planners, Registered Music Therapists (RMTs) and a parent of a boy with a disability were individually interviewed. Interpretative Phenomenological Analysis reveals that everyone believed that music therapy was not fully understood or received well by everyone, and RMTs need to take more active roles in educating and promoting music therapy to staff in the National Disability Insurance Agency (NDIA), allied health professionals, as well as parents of people with disabilities.
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ItemSupporting positive parenting practices within a community-based music therapy group program: Pilot study findings(WILEY, 2019-05)The aim of this study was to evaluate the benefits of a short-term, community-based music therapy group program on positive parenting practices. Parent-child dyads receiving early intervention family services (N = 199) participated in 8 weekly, 45-60 minute, music-based group play sessions. We analyzed pre-post parent self-reports that measured parenting competency and clinician-observed ratings of parental responsiveness that evaluated behavioral domains of play, praise, and consistency. Significant results were found for parent-reported efficacy (p = 0.008, d = 0.21) and satisfaction (p = 0.004, d = 0.19) but not for interest (p = 0.149, d = 0.12). Significant results were found for clinician-rated observations of parental responsiveness, including play (p < 0.001), praise (p < 0.001), and consistency (p < 0.001). Short-term, music-based parenting programs may be an effective way to improve parents' sense of competency and foster greater parental responsiveness for those receiving family services.