Implementation of health education interventions at Dutch music schools

Abstract

A randomized controlled trial was conducted comparing the effects of a biopsychosocial course (PRESTO-Play) vs. physical activity promotion (PRESTO-Fit) to reduce disability related to musculoskeletal disorders in music students. The current study provides an external validation and a formative and process evaluation, allowing for a better interpretation of results. First, a group of experts was asked to complete a structured evaluation of design and content of the trial. Second, quantitative and qualitative data were analysed from different stakeholders (students, therapists and conservatory staff) using questionnaires, logs, field notes and emails to evaluate fidelity, dose delivered, dose received, reach and context. Results are presented descriptively. Two authors independently identified key responses that were merged into themes. Although no difference in disability was found between interventions, closer evaluation revealed that participants in PRESTO-Play reported that they learned about prevention of physical complaints and were more satisfied with course contents compared with PRESTO-Fit. Study design and contents of the interventions were found to be valid, with an appropriate dose delivered. Feedback from students and logs suggested that behavioural change and psychosocial principles in PRESTO-Play might have not been implemented optimally. Only moderate fidelity in both groups and too little contrast between interventions could have influenced results. Low attendance rates and a presumed lack of generalization further decreased possible effectiveness. Context greatly influenced implementation. Implementing a future health course with closer collaboration with the institution could optimize accessibility and communication, encourage attendance and enhance motivation for behavioural change.

A qualitative study exploring the implementation determinants of rehabilitation and global wellness programs for orchestral musicians

“…38 A more specific form is the healthy settings approach, which is ‘concerned to embed health within the culture, ethos, structures and routine life of settings’, 39 and seems particularly pertinent for impacting workplace and university/school culture. Numerous recent studies concluded that there is a need for health promotion and/or healthy settings approaches in school, university and professional-level musicians, 5,16,17,22,34,40 and all our results support this conclusion.…”

“…In the only one other than ours where musicians (conservatory students) had already tried a preliminary program, one of the three main determinants, along with institutional support and communication, was student’s motivation. 22 Indeed, end user’s motivation, regardless of population, is considered critical for behaviour change and positive implementation outcomes. 20,26 Although motivation emerged only as a secondary theme in our results, a strong connection between Intervention Characteristics and determinants such as social influences , self-efficacy and motivation became apparent from our data; our participants spoke of the importance of frequent supervision, group activities and short exercise sessions, among other intervention characteristics, to optimise these determinants.…”

“…3 This stresses the importance of developing workplace interventions such as ours, but also of health promotion rather than health education and rehabilitation alone. 22 Health promotion goes beyond education to include promotion of healthy environments through action on organisational and community levels. 38 A more specific form is the healthy settings approach, which is ‘concerned to embed health within the culture, ethos, structures and routine life of settings’, 39 and seems particularly pertinent for impacting workplace and university/school culture.…”

“…The only two published studies did not use a theoretical framework and neither was in a population of orchestral musicians. 21,22 We perceived a need to systematically explore these determinants to better adapt the pilot program to the population and to facilitate knowledge translation and implementation.…”

Impact of El-Poems study: the e-learning for postural education in music students: a randomized controlled trial protocol

“…Music students at this age are able to assume personal responsibilities for changing their behaviors and choices [ 13 ]. Unfortunately, MP prevention behaviors are less common among music students [ 14 , 15 ], and there is a rising demand for educating them to take care of their own health and adopt proper postures during music practices [ 14 ]. According to Salonen (2018), there is a need to develop more prevention programs to promote health and well-being in music students [ 16 ].…”