Nature in Harmony: Music and Nature-based Self-care for Individuals With Acquired Brain Injuries and Their Care Partners

The goal of this pilot study is to determine the initial impact on wellbeing for clients with acquired brain injury and their care partner after engaging in a nature & music-based program facilitated by occupational therapy and music therapy. The main questions it aims to answer are:

• Primary Question: What is the impact on wellbeing for clients with acquired brain injury and their care partner after engaging in a nature & music-based program facilitated by occupational therapy and music therapy?

• Secondary Question: What is the feasibility of a four-session nature & music-based wellness program for clients with acquired brain injury and care partner dyads?

  • Attendance
  • Satisfaction
  • Accessibility
  • Carryover of Strategies

Participants will complete self-reported surveys before and after completing 4 sessions of a nature & music-based program facilitated by occupational therapy and music therapy.

Study Overview

• Status: Enrolling by invitation
• Conditions: Caregivers; Acquired Brain Injury (Including Stroke)
• Intervention / Treatment: Behavioral: Nature in Harmony

• Study Type: Interventional
• Enrollment (Estimated): 10
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Pennsylvania
    • Pittsburgh, Pennsylvania, United States, 15228
      • Duquesne University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• All participants must be above the age of 18 to participate.
• Able to communicate in English
• A person with an ABI can include persons with a diagnosis of traumatic brain injury, stroke, aneurysm, brain infection, and/or brain cancer.
• A care partner is broadly defined as a social support person who has been identified as a family member or friend of the person with the acquired brain injury.
• Capacity for consent - Person must be their own medical power of attorney
• Capacity for Self-Reflection (have a score of 23/35 on the MOCA or have a 5/6 on the Design Memory Test sub test of Cognition and Language Quick Test)

Exclusion Criteria:

• Self-reported severe-to profound hearing loss with the use of hearing aid(s)
• Cannot communicate in English
• Have a diagnosis of a progressive neurological disorder, such as Amyotrophic lateral sclerosis, Parkinson's disease, Dementia, Multiple Sclerosis
• Have a severe aphasia

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Nature In Harmony; The Nature in Harmony program involves four in-person sessions held at Duquesne University's campus using the outdoor pavilion and community garden with the final session occurring at Frick Park at their Environmental Center located in Pittsburgh, PA, between May and June of 2026. Each session will have a minimum of two principal investigators to lead the activities. Graduate assistants will be at each session to provide additional hands-on support for safety, mobility, and participant engagement. Participants will be instructed to complete carryover activities between sessions: one to be completed together dyadically (person with ABI & care partner) and one to be completed individually. Dyads will reflect on the experience in their activity journal and share and the beginning of sessions 2-4.

Behavioral: Nature in Harmony; Session 1- Duquesne University -120 minutes- Building Rapport: Psychoeducation on Music & Nature; Session 2 - Duquesne University - 90 minutes - Using the Senses for Wellness; Session 3 - Duquesne University - 90 minutes - Connections & Community; Session 4 - Frick Park Environmental Center - 4 Hours including Lunch - Self Care Immersion in Nature Retreat

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
EUROHIS-QOL 8-item index	EUROHIS-QOL 8 is a standardized assessment of general quality of life that assesses four domains of QOL: physical, psychological, social, and environmental. This assessment has been validated for persons with traumatic brain injury (Balalla et al., 2019). This is 5-point scale from "not at all" to "completely." A high total point value indicates a better quality of life rating.	First session to end of program approximately 4 weeks.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The Connor-Davidson Resilience Scale	The 10-item Connor-Davidson Resilience Scale will be administered as a secondary outcome to determine if any impacts are seen after this brief program because of participation. This measure has been used with persons post-traumatic brain injury, stroke, and caregivers. Rating scale goes from 0-4 with higher total scores indicating better resilence.	First session to end of program approximately 4 weeks.
Dyadic Relationship Scale	The 10-item Dyadic Relationship Scale will be administered as a secondary outcome to examine any changes in both positive and negative interactions between individuals with ABI and their care partners after this program (Sebern & Whitlatch, 2007). This is a four point scale with a higher score indicating more negative dyad experiences.	First day to end of program approximately 4 weeks
Client Satisfaction Questionnaire (CSQ-8)	This measure uses eight questions on a four point Likert-scale strongly agree to strongly disagree to assess participants' overall satisfaction with the program with a maximum score of 32 (Attkisson & Greenfield, 2004). The average score for the group on the CSQ-8 is at least 24.	Last session, approximately 4 weeks after first session
Attendance	Session attendance will be tracked at every session throughout the program as either present "1" or absent "0". Participants who attend all sessions will have a total of 4.	Every week for 4 weeks.
Accessibility of the strategies	4-point Likert scale survey will be used to document participants' interest in using the covered strategies in the sessions. Items will not be totaled and scales vary by question.	Every week of the program for four weeks.
Carryover of the strategies	A self-reported journal includes date, the name of the activity, length, and personnels will be provided for documenting the carryover activities outside of the session time.	Weekly journal entries for weeks 2,3, and 4.

Collaborators and Investigators

• Sponsor: Duquesne University

Study record dates

Study Major Dates

• Study Start (Actual): March 4, 2026
• Primary Completion (Estimated): May 21, 2026
• Study Completion (Estimated): June 1, 2026

Study Registration Dates

• First Submitted: April 21, 2026
• First Submitted That Met QC Criteria: April 28, 2026
• First Posted (Actual): May 5, 2026

Study Record Updates

• Last Update Posted (Actual): May 5, 2026
• Last Update Submitted That Met QC Criteria: April 28, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: music therapy; nature-based; dyad intervention
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Wounds and Injuries; Craniocerebral Trauma; Trauma, Nervous System; Brain Injuries
• Other Study ID Numbers: 2025/11/22

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: This was not included in the original IRB due to the small and local nature of the sample.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No