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How group singing facilitates recovery from the symptoms of postnatal depression: A comparative qualitative study

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Background: Previous research has demonstrated that making music can enhance positive emotions as well as support positive psychological functioning. However, studies tend to be limited by lack of comparison with other psychosocial interventions. This study builds on a three-arm randomised controlled trial (RCT) that demonstrated that group singing for mothers and babies, but not group creative play, can lead to faster recovery from moderate-severe symptoms of postnatal depression than usual care. The aim was to elucidate the mechanisms of the group singing intervention in order to account for its recovery properties. Methods: Qualitative research was conducted with 54 mothers who had experienced symptoms of postnatal depression. Mothers completed a 10-week programme of either group singing or group creative play as part of the wider RCT study. Data were collected via a series of 10 semi-structured focus groups conducted at the end of each 10-week programme. These were designed to elicit subjective and constructed experiences of the singing and play interventions and were analysed inductively for emergent themes. Results: Five distinctive features of the group singing emerged: (i) providing an authentic, social and multicultural creative experience, (ii) ability to calm babies; (iii) providing immersive 'me time' for mothers; (iv) facilitating a sense of achievement and identity; (v) enhancing mother-infant bond. Conclusions: Community group singing interventions may reduce symptoms of postnatal depression through facilitating a functional emotional response rooted in the needs of new motherhood. These features are of relevance to others seeking to implement creative interventions for maternal mental health. Trial registration: NCT02526407 . Registered 18 August 2015.
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... Fourth, previous research has demonstrated that in-person group singing can speed up recovery from PND 22 as well as support connections with other mothers and enhance motherebaby closeness. 23,24 While the COVID-19 pandemic catalysed research into the efficacy of online singing groups for PND, 25 evidence in this field remains in its infancy, and further studies are required. Songwriting has been previously investigated in a variety of clinical settings, including for addressing emotional or psychological challenges and facilitating the telling or sharing of stories. ...
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Objective: Loneliness is a public health challenge associated with postnatal depression (PND). This study developed and tested an online songwriting intervention, with the aim of reducing loneliness and symptoms of PND and enhancing social connectedness among women with young babies. Study design: This was a two-armed non-blinded randomised controlled trial (RCT, ISRCTN17647261). Methods: Randomisation was conducted in Excel using a 1:1 allocation, with participants (N = 89) allocated to an online 6-week songwriting intervention (Songs from Home) or to waitlist control. Inclusion criteria were women aged ≥18 years, with a baby ≤9 months old, reporting loneliness (4+ on UCLA 3-Item Loneliness Scale) and symptoms of PND (10+ on Edinburgh Postnatal Depression Scale [EPDS]). Loneliness (UCLA-3) was measured at baseline, after each intervention session and at 4-week follow-up. The secondary measures of PND (EPDS) and social connectedness (Social Connectedness Revised 15-item Scale [SC-15]) were measured at baseline, postintervention and at 4-week follow-up (Week 10). Factorial mixed analyses of variance with planned custom contrasts were conducted for each outcome variable comparing the intervention and control groups over time and across baseline, Weeks 1-6 and the follow-up at Week 10 for each outcome variable. Results: Compared with waitlist control, the intervention group reported significantly lower scores postintervention and at follow-up for loneliness (P < 0.001, η2P = 0.098) and PND (P < 0.001, η2P = 0.174) and significantly higher scores at follow-up for social connectedness (P < 0.001, η2P = 0.173). Conclusions: A 6-week online songwriting intervention for women with young babies can reduce loneliness and symptoms of PND and increase social connectedness.
... distraction from stress, worry and rumination; facilitate problem solving, foster self-esteem and positive emotions) (Cotter & Pawelski, 2022;Crone et al., 2018;Fancourt & Williamon, 2016;Hoffmann & Russ, 2012;Ivcevic & Brackett, 2015;McCrary et al., 2022), provide health promoting cognitive and intellectual stimulation (e.g. facilitating reflective thought or contemplative states, feelings of being immersed or absorbed in an artwork) (Bone & Fancourt, 2022;Camic & Chatterjee, 2013;Fancourt & Steptoe, 2018a;Wang & Blazer, 2015), build resilience and enhance coping mechanisms (Bolwerk et al., 2014;Fancourt & Steptoe, 2018b;Hutchinson et al., 2003;Perkins et al., 2018), provide opportunities for social interaction (conducive to social support and the buffering of stress) (Cohen, 2006;Cotter & Pawelski, 2022;Pearce et al., 2015Pearce et al., , 2016Vogelpoel & Jarrold, 2014;Wilson et al., 2017), reduce sedentary behaviours and promote health behaviours and interaction with the outside world (in contrast to the social withdrawal and isolation associated with depression) (Clift et al., n.d.;Clift et al., 2008;Løkken et al., 2020;Teychenne et al., 2010). Furthermore, a recent meta-analysis across 26 studies of music-interventions found that engaging with music -whether actively (music making) or receptively (music listening) -has similar effects on mental health (albeit at the low end of the range) as other established non-pharmaceutical and medical interventions (e.g. ...
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Objectives: International literature suggests that arts and culture activities may benefit mental health, however, such survey studies conducted in the Danish population are scarce. Further, studies have investigated the associated risk for incident depression, but not for persistent depression. The objective of the current prospective study was to assess associations of engagement in arts and culture activities with incident/persistent depression and also mental wellbeing among Danish adults in the general population. Design: Observational prospective study. Methods: Data stem from a Danish nationally representative panel study of 5000 adults (aged 15+ years) conducted in 2019 and 2020, which was linked to Danish register data. An exposure variable was constructed for frequency of attending concerts, theatres, museums, and cinemas. Validated scales were used to assess the presence of depression (PHQ-8) and levels of mental wellbeing (SWEMWBS). Binary logistic regression analyses were conducted to assess the risk of incident depression (among participants free of depression at baseline), as well as the risk of persistent depression (among participants with depression at baseline), while multinomial logistic regression was used to assess odds for moderate and high mental wellbeing (low as base outcome) while adjusting for baseline values. Result: In terms of incident depression, quarterly engagement in arts and culture activities (compared to never) was associated with an OR of .43 (95%CI .23-.80), while 8 times or more was associated with an OR of .53 (.29-.97). In terms of persistent depression, quarterly engagement was associated with an OR of .30 (.10-.90), while 8 times per year or more was associated with an OR of .26 (.07-.92). Similar to the patterns for incident/persistent depression, associations with moderate mental wellbeing showed higher odds for quarterly engagement and 8 times per year or more. Quarterly engagement was also associated with higher odds for high mental wellbeing but did not reach statistical significance. Conclusions: The results support the involvement of the cultural and creative sectors in health strategies. Mental health promotion initiatives as well as arts and culture sectors may encourage the general public to engage in arts and culture activities with frequencies of at least once per quarter.
... Of note, it has been theorised that leisure engagement (which includes creative and community activities) can support health and wellbeing through underlying social mechanisms, such as reducing loneliness and improving social networks and community cohesion (10). Examples include Men's Sheds (community-based organisations that provide meaningful spaces for older men) reducing social isolation to improve wellbeing, group creative writing fostering belonging to support mental health (11,12), and community singing groups facilitating social cohesion to reduce symptoms of post-natal depression (13). #KindnessByPost (KbP) is a national "kindness exchange" that has the potential to improve participants' wellbeing by increasing their sense of connectedness to others and reduce feelings of social isolation and loneliness. ...
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Background #KindnessbyPost (KbP) is a “national kindness exchange”. Participants send and receive a card by post to different, unknown people containing messages of good will. Previous evidence suggests participation in KbP may improve loneliness and wellbeing. We evaluated the outcomes and associated costs of KbP and explored the feasibility of collecting health economic measures for future research. Methods We used a pre-post, observational study design. Participants in two KbP exchanges in 2021 were invited to complete an online questionnaire. It included self-reported measures of psychological wellbeing and loneliness, capability, and healthcare service use. Data were collected at three time-points: exchange start (baseline), exchange-end (2 weeks), and 3-months post-exchange. Additional cost data were obtained from the KbP programme organisers. Results Across exchanges, baseline data were obtained for 1,285 participants (from 1,142 individuals). In total, 623 (48%) of participants were followed up at exchange-end, and 414 (32%) at 3-months. 70% of participants were aged between 31 and 60 (n = 789). 94% of participants were female (1,075) and 95% of white ethnicity (1,078). Compared to baseline, loneliness and wellbeing improved at exchange end (‑0.21, 95% CI: -0.29 to -0.12; 0.68, 0.47 to 0.88 respectively) and at 3 months follow up (-0.40, -0.50 to -0.30; 1.01, 0.77 to 1.25 respectively). We observed no difference from baseline in capability at both follow up points (mean (SD) at baseline: 0.52(0.22); exchange-end: 0.53(0.22); 3-months: 0.53(0.22)). The average cost of delivering the intervention was £0.67–0.87 per participant. Conclusions We observed a small, sustained improvement to people’s wellbeing and loneliness following participation in a KbP exchange. Given the study design, causal attribution to KbP is uncertain. However, our results are consistent with previous evaluations and offer preliminary evidence that KbP may be an effective mental wellbeing intervention. Given its cheap cost (estimated at £0.67-£0.87 per participant) and highly scalable design, KbP could be an effective and cost-effective intervention for improving public mental health, which warrants definitive evaluation of effectiveness and cost-effectiveness in future. Our study also demonstrates the feasibility of collecting the wellbeing and health economic outcome measures needed for this research.
... As part of the same trial, qualitative research also supported these findings, showing that reduced symptoms were facilitated through fostering a functional emotional response rooted in the needs of new motherhood, including providing 'me time' for mothers and 'tools' for calming and bonding with babies. 23 Music and Motherhood and the SHAPER Study The 'Music and Motherhood' trial comparing the effects of singing and play interventions for PPD was led from 2015 to 2017 by the Centre for Performance Science (a joint research centre that sits between the Royal College of Music and Imperial College, London) with support from University College London (UCL) in the United Kingdom. 24 Following the research, the programme was developed into practice for the first time and expanded from 2017 onwards by an organisation called Breathe Arts Health Research as part of their 'Melodies for Mums' Programme. ...
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