Theory & Methods

Research Questions


Will group singing support social well-being and communication function in people living with communication challenges?


Will these benefits accrue over regular engagement with choir?


Will group singing show an added benefit to social wellbeing compared to other group activities?


What are the neurobiological underpinnings of these benefits?


Variables & Measures

SingWell will be exploring a variety of social and biological measures over the lifetime of the project by capitalizing on the variety of research studies that will be completed to inform the answers to the above research questions.

  • Cortisol is the body’s main stress hormone produced and released by the adrenal and endocrine glands. Researchers will obtain cortisol via the passive drool method, a rapid and non-invasive method, and will be analyzed in-house at Toronto Metropolitan University.
  • Heart rate (HR) is defined as the number of times the heart beats within a given period (usually a minute). Heart rate variability (HRV) is the amount of time between heartbeats. The amount of time can fluctuate slightly and are very small but can indicate levels of stress, and possible health problems and mental health issues.
  • Oxytocin is a hormone that has been associated with social bonding. Researchers will obtain oxytocin via the passive drool method, a rapid and non-invasive method, and will be analyzed at an off-site laboratory.
  • Pain threshold is defined as the point at which an individual discloses feeling any pain. Some say it is the behavioural proxy for an increase in beta-endorphins. Researchers will measure pain thresholds using the dolorimeter, an instrument that is used to apply pressure to the finger until it is deemed uncomfortable.
  • Adapted from the Disease Stigma Consciousness Scale (Pinel, 1999), the Age Stigma Consciousness Scale consists of 5 items that measure the degree to which individuals are chronically self-conscious about their stigmatized age.
    *SingWell adapted this item by substituting ‘age’ for ‘communication challenges’
  • The Collective Self-Esteem Scale (CSES) is a 16-item scale that evaluates individual identities and membership in social groups. The items are categorized by the following domains: public, private membership, and importance.
  • The De Jong Gierveld Loneliness Scale contains either 6 or 11 items that measures social and emotional loneliness. This measure is appropriate for large surveys or individual evaluations of personal isolation or social engagement.
  • Emotional communication (EMO-CHeQ) consists of 17 items designed to investigate hearing handicap related to affective (emotional) speech. Clinicians can use this to prompt emotion-related discussion and help to build rapport with their clients.
  • The Essentialist Beliefs about Aging Scale consists of 4 items that assess beliefs about aging as relatively “unchangeable” versus “modifiable”. It’s a tool that facilitates the investigation of aging belief differences and responses to negative aging stereotypes.
    *SingWell adapted this item by substituting ‘age’ for ‘communication challenges’
  • The European Social Values Survey (ESS) measures the attitudes, beliefs and behaviour patterns among Europeans. The sixth wave of the ESS consists of 3 items which assess individuals’ perspectives on trust.
  • The Flourishing Scale consists of 8 items that measure the respondent’s self-perceived success in areas including purpose, optimism, self-esteem and relationships. This tool produces a psychological well-being score.
  • The Friendship Scale consists of 5 items that measure social isolation and social connection. The scale requires participants to reflect on their relationships and emotions during the past four weeks.
  • The Goldsmiths Musical Sophistication Index (Gold-MSI) consists of 39 items that assess individual differences in musical sophistication. It measures individuals’ ability to engage with music in an effective and nuanced way. This self-report inventory has also been translated into many languages for user convenience.
  • The Hospital Anxiety and Depression Scale (HADS) consists of 14 items that measure symptoms of depression and anxiety in medical patients. It is a valid and reliable tool clinicians utilize to identify and quantify symptomology related to these mental disorders.
  • The Perceived Stress Scale (PSS) consists of 10 items which help researchers understand how people perceive stress and how different situations affect an individual’s feelings. The scale requires individuals to reflect on stressful events within the past month.
  • The Quality of Life Scale consists of 26 items which measure physical health, psychological health, social relationships and environments. It assesses the quality of life within domains of an individual’s cultures, value systems, personal goals, standards and concerns.
  • The Social Connectedness Scale consists of 20 items that assess the psychological sense of belonging and interpersonal closeness with the social world. In other words, it measures the degree to which individuals feel connected to others in their social environment.
  • The Social Desirability Scale consists of 13 items that measure individual-level social desirability bias. This scale specifically measures the “need for subjects to respond in culturally sanctioned ways” and “need for social approval” (Crowne & Marlowe, 1964).
  • The Social Network Index is a 12 item scale that is concerned with how many people one regularly sees or talks to. This can include family, friends, peers, co-workers etc. It also measures three components of network size, including network diversity, number of people and number of embedded networks.
  • The Voice-Related Quality of Life (V-RQOL) consists of 10 items designed and validated as a self-administered tool for individuals with voice disorders. It measures social-emotional and physical-functional aspects of voice problems.
  • The World Assumption Scale (WAS) consists of 32 items intended to depict assumptions about the benevolence of the world, the meaningfulness of events, and the worthiness of the self. This measure is often used in trauma research.
  • The Positive and Negative Affect Scale (PANAS) is a widely used measure of mood or emotion. It consists of 20-items, 10 positive and 10 negative items.
  • The Inclusion of Other in the Self Scale (IOS) consists of a single item that measures how close an individual feels with another person or group. The tool contains 7 diagrams, pairs of circles, that range from just touching eachother to almost completely overlapping. It prompts individuals to reflect on which image best describes their relationship with said group/person and choose the diagram that best demonstrates the relationship.
  • The Identification with All Humanity Scale (IWAH) consists of 27 items that measure the strength at which people feel connected to others across the globe, perceive them as members of their own group, and care for them. Each item requires ratings that focuses on one’s connection to their community, their nation and people all over the world.
  • The Social Connectedness Scale consists of 8/20 items that assess the degree to which individuals feel connected to others in their social environment. It utilizes a Likert scale ranging from 1 strongly disagree to 6 strongly agree.
    SingWell has adapted this measurement to apply to choirs. The adapted measure directly asks participants to rate other choir members on trust, likeability, similarity, and social connection. Please contact us if you would like to learn more about this measurement.
  • The Subjective Units of Discomfort Scale (SUDS) consists of a 0- to 100-point scale. The greater the number (closer to 100) indicates more anxiety and discomfort. There are descriptive labels at 0, 25, 50, 75, and 100 that indicate levels of discomfort/anxiety experienced by the individual.

Although there are many ability-focused activities that older adults can engage in, we contend that group singing may be particularly well suited to enhancing social identity, given the important role of the voice in shaping social identity Many adults will develop acute deficits in vocal production arising from age-associated diseases or milder deficits arising from age-related changes in vocal physiology. Singing directly challenges these deficits, which may result in a positive reconstruction of social identity. Social identity references: Wertsch, 1991. Blumstein et al., 1980. Torre & Barlow, 2009.

Group singing enables exquisite movement synchronization across individuals, spanning the lungs, larynx, head, and facial muscles. Research by our group and others has demonstrated that synchronous movement in the context of song (or dance) causes individuals to be more likely to share, to be more resilient to pain and to feel more socially connected.

Social connectedness references:

  • Weinstein et al., 2016. Dunbar, 2012.
  • Müller & Lindenberger, 2011. Thompson & Russo, 2007.
  • Good, Choma & Russo, 2017.
  • Good & Russo, 2016. Dunbar et al., 2012.
  • Weinstein et al., 2016. Wiltermuth & Heath, 2009.
  • Good, Choma & Russo, 2017. McGarry & Russo, 2011.
  • Pearce et al., 2016.
  • Tunçgenç, & Cohen, 2016.
  • Valdesolo, Ouyang, & DeSteno, 2010.
  • Cohen et al., 2010. Dunbar et al., 2012.
  • Sullivan, Rickers, & Gammage, 2014.
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