Benefits of Choir for Older Adults With Unaddressed Hearing Loss (WP2)

September 13, 2025 updated by: Frank Russo, Toronto Metropolitan University

Speech-in-noise, Psychosocial, and Heart Rate Variability Outcomes of Group Singing or Audiobook Club Interventions for Older Adults With Unaddressed Hearing Loss: a SingWell Project Multisite, Randomized Controlled Trial.

Unaddressed age-related hearing loss is highly prevalent among older adults, typified by negative consequences for speech-in-noise perception and psychosocial wellbeing. There is promising evidence that group singing may enhance speech-in-noise perception and psychosocial wellbeing. However, there is a lack of robust evidence, primarily due to the literature being based on small sample sizes, single site studies, and a lack of randomized controlled trials. Hence, to address these concerns, this SingWell Project study utilizes an appropriate sample size, multisite, randomized controlled trial approach, with a robust preplanned statistical analysis.

The objective of the study is to explore if group singing may improve speech-in-noise perception and psychosocial wellbeing for older adults with unaddressed hearing loss.

The investigators designed an international, multisite, randomized controlled trial to explore the benefits of group singing for adults aged 60 years and older with unaddressed hearing loss. After undergoing an eligibility screening process and completing an information and consent form, the investigators intend to recruit 210 participants that will be randomly assigned to either group singing or an audiobook club (control group) intervention for a training period of 12-weeks. The study has multiple timepoints for testing, that are broadly categorized as macro (i.e., pre- and post-measures across the 12-weeks), or micro timepoints (i.e., pre- and post-measures across a weekly training session). Macro measures include behavioural measures of speech and music perception, and psychosocial questionnaires. Micro measures include psychosocial questionnaires and heart-rate variability.

The investigators hypothesize that group singing may be effective at improving speech perception and psychosocial outcomes for older adults with unaddressed hearing loss-more so than participants in the control group.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

210

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

  • Name: Kay F Wright-Whyte, MSc
  • Phone Number: 554989 4169795000
  • Email: kww@torontomu.ca

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Adults aged 60 years and older;
  2. Bilateral mild-to-moderate hearing loss (20-49 dB hearing level), measured using four-frequency pure-tone average across both ears (4FPTA) measured at 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz;
  3. Unaddressed hearing loss (i.e., participants must not currently use a hearing aid, cochlear implant, or assistive listening device);
  4. No significant cognitive impairment, to be assessed with the Montreal Cognitive Assessment for people with hearing impairment (MoCA-H), with participants requiring a score ≥ 24;
  5. Not use a pacemaker or anti-arrhythmic agents/medications;
  6. Not currently participating in regular active music learning (e.g., choir, formal music training) or audiobook clubs within the last year; and
  7. Sufficient language capacity to understand and complete the test materials. Note: all materials will be presented written and/or aurally in English at the sites located in Canada, United States of America, and Australia; Dutch at the Netherlands site; and German at the Germany site.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Group Singing
12 week group singing program consisting of 1.5 hours of in-person choir instruction per week.
Behavioral: Audiobook Club
12 week audiobook club program consisting of 1.5 hours of in-person discussion per week.
Active Comparator: Audiobook Club
12 week group program consisting of 1.5 hours of in-person audiobook club discussion per week.
Behavioral: Group Singing
12 week choir program consisting of 1.5 hours of in-person instruction per week.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Speech-in-noise perception
Time Frame: Baseline and completion (week 0 and week 13)
The Coordinate Response Matrix (CRM) generates signal-to-noise ratio (SNR). A lower SNR is indicative of better speech-in-noise perception.
Baseline and completion (week 0 and week 13)
Emotional speech perception
Time Frame: Baseline and completion (week 0 and week 13)
The EmoHI is calculated as the mean accuracy of correct responses as a percentage (0 to 100%).
Baseline and completion (week 0 and week 13)
Quality of Life/Wellness
Time Frame: Baseline and completion (week 0 and week 13)
The 12-item short-form survey version 2 (SF-12v2) from the Medical Outcomes Study (MOS) generates a Physical Summary and a Mental Summary of patient quality of life. Scores range from 0 to 100, where a zero score indicates the lowest level of health and 100 indicates the highest level of health.
Baseline and completion (week 0 and week 13)
Anxiety and Depression
Time Frame: Baseline and completion (week 0 and week 13)
The Hospital Anxiety and Depression Scale (HADS) provides a score between 0 and 21, with higher scores indicative of higher levels of anxiety or depression.
Baseline and completion (week 0 and week 13)
Self Esteem
Time Frame: Baseline and completion (week 0 and week 13)
The Collective Self-Esteem Scale (CSES) consists of four scales: Membership self-esteem, Private collective self-esteem, Public collective self-esteem, and Importance to Identity. Each scale is scored between 1 and 7, with a higher score indicating high levels of self-esteem.
Baseline and completion (week 0 and week 13)
Social Connectedness
Time Frame: Baseline and completion (week 0 and week 13)
The revised Social Connectedness Scale (SCS-R) is scored as a total between 8 and 48 points, with higher scores indicating higher levels of social connectedness.
Baseline and completion (week 0 and week 13)
Pitch perception
Time Frame: Baseline and completion (week 0 and week 13)
The Frequency Difference Limen (FDL) task evaluates pitch perception threshold. A lower threshold indicates better pitch perception abilities.
Baseline and completion (week 0 and week 13)
Rhythm perception
Time Frame: Baseline and completion (week 0 and week 13)
The Beat Alignment Test (BAT) measures rhythm perception accuracy between 0 and 100%.
Baseline and completion (week 0 and week 13)
Timbre perception
Time Frame: Baseline and completion (week 0 and week 13)
The Spectral-temporally Modulated Ripple Test (SMRT) is a proxy measure of timbre perception. It generates a threshold based on performance. A higher ripple-per-octave threshold is indicative of better spectro-temporal (timbre) perception.
Baseline and completion (week 0 and week 13)
Higher-level Music perception
Time Frame: Baseline and completion (week 0 and week 13)
The Music-in-Noise Task (MINT) is an auditory stream segregation task that is a proxy measure of higher-level music perception. It is scored as proportion correct between 0 and 1.
Baseline and completion (week 0 and week 13)
Positive and Negative Affect
Time Frame: Pre- and post-session (week 2, 7, 11)
The Positive and Negative Affect Schedule (PANAS) consists of a positive and negative outcome measure; each ranging between 10 and 50. For the positive scale, a higher score represents higher levels of positive affect. One the negative scale, a lower score represents lower levels of negative affect.
Pre- and post-session (week 2, 7, 11)
Anxiety and Discomfort
Time Frame: Pre- and post-session (week 2, 7, 11)
The Subjective Units of Discomfort Scale (SUDS) is scored between 0 and 100, with descriptive anchor points. 0 = "no anxiety, calm, relaxed"; 25 = "mild anxiety, alert, able to cope"; 50 = "moderate anxiety, some trouble concentrating"; 75 = "severe anxiety, thoughts of leaving"; and 100 = "very severe anxiety, worst ever experienced".
Pre- and post-session (week 2, 7, 11)
Social closeness
Time Frame: Pre- and post-session (week 2, 7, 11)
The Inclusion of Other in the Self Scale (IOS) is scored between 1 and 7, with a higher score representing more social closeness.
Pre- and post-session (week 2, 7, 11)

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Heart rate variability and social bonding
Time Frame: Pre- and post-session (week 2, 7, 11)
Heart rate variability (HRV) is a proxy measure of social bonding. Higher HRV is anticipated to be associated with higher levels of social bonding.
Pre- and post-session (week 2, 7, 11)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Toronto Metropolitan University

Collaborators

University of Nottingham
University of Southern California
University of Groningen
Flinders University
Memorial University of Newfoundland
Concordia University, Montreal
University of Oldenburg
The Bionics Institute of Australia

Investigators

  • Study Director: Frank Russo, PhD, Toronto Metropolitan University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 15, 2025

Primary Completion (Estimated)

September 1, 2026

Study Completion (Estimated)

September 1, 2026

Study Registration Dates

First Submitted

August 22, 2024

First Submitted That Met QC Criteria

August 29, 2024

First Posted (Actual)

August 30, 2024

Study Record Updates

Last Update Posted (Estimated)

September 18, 2025

Last Update Submitted That Met QC Criteria

September 13, 2025

Last Verified

September 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Multisite HL 2024-103

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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