A Culturally Grounded Music-Based Intervention for Indigenous Older Adults in Long-Term Care: Protocol for a Mixed Methods Pilot Study.

Indigenous older adults in long-term care settings face particular vulnerability to social isolation, psychological distress, chronic pain, and reduced cultural engagement.

• These vulnerabilities are associated with historical trauma, structural inequities, and disruptions to cultural continuity affecting Indigenous communities broadly.
• The study targets this population specifically because few music-based interventions have been culturally grounded in Indigenous worldviews or codeveloped with Indigenous communities.
• The study is situated in long-term care facilities in northern Arizona.

The study uses a quasi-experimental convergent parallel mixed methods design informed by the Indigenist Stress-Coping Model.

• Quantitative measures are collected before and after intervention participation and include assessments of depression, anxiety, perceived stress, pain, coping, and cultural connectedness.
• Qualitative data collection includes interviews, observational field notes, and implementation data collected concurrently with quantitative data.
• Qualitative data are used to assess participant experiences, cultural relevance, intervention fidelity, and contextual factors influencing implementation.
• Primary objectives are to assess feasibility, acceptability, and implementation of the intervention, and to generate preliminary data on mental health, pain, coping, and cultural connectedness outcomes.

The intervention was codeveloped through collaboration with a Community Advisory Board consisting of Indigenous elders, clinicians, researchers, and Indigenous musical consultants.

• The Community Advisory Board guided the culturally grounded development of the intervention.
• The 6-session curriculum incorporates active music participation including drumming, singing, storytelling, rhythmic engagement, and guided reflection.
• Participants are recruited from 2 residential long-term care facilities.

The study received funding from two separate sources beginning in February 2024 and September 2025.

• Initial funding was provided in February 2024 by The NARBHA Institute and the James Wurgler, MD Endowed Chair.
• Continued funding was secured in September 2025 through the National Institute on Minority Health and Health Disparities via the Southwest Health Equity Research Collaborative Pilot Project Program (grant U54MD012388).

As of June 2026, 39 participants have been enrolled across 2 residential long-term care facilities.

• Recruitment and intervention implementation began in March 2024 and are expected to conclude in May 2027.
• Quantitative and qualitative analyses are expected to begin in summer 2026.
• Initial results are anticipated in summer 2027.
• Findings will be disseminated through community stakeholder meetings, conference presentations, and peer-reviewed publications.

The study protocol is designed to inform intervention refinement, feasibility assessment, and future large-scale studies of culturally responsive behavioral health interventions for Indigenous communities.

• The pilot study is explicitly positioned as a precursor to larger-scale evaluation.
• The authors note that few music-based interventions have been culturally grounded in Indigenous worldviews, positioning this study as addressing a gap in the literature.
• Findings are intended to support the development of culturally responsive behavioral health interventions more broadly for Indigenous communities.