Dance and Well-being in Older Adult Communities: Exploring Efficacy as a Mediator

As the population of older adults expands, it becomes increasingly important to develop effective interventions to ensure high levels of well-being. Previous research in a variety of populations has shown that dance produces broad benefits including improving physical mobility, social relationships, autonomy, and self-image. Given this, the present study attempted to clarify the mechanisms through which dance might lead to these improvements. Specifically, this research examined the role of self-efficacy, or beliefs that one can accomplish certain tasks, have in explaining the psychological benefits of dance. I hypothesized that when dance is a social activity it instills a sense of connectedness, which in turn benefits well-being. I also hypothesized that because dance encourages creativity and improves sense of control, it positively affects self-efficacy, which in turn improves well-being. In order to test these hypotheses, I collaborated with nearby centers for older adults and utilized a pretest-posttest design to examine changes in well-being following a one-hour dance class. Participants completed existing measures of general efficacy, physical efficacy, loneliness and well-being. One week later, they participated in an hour-long, seated dance class based in a curriculum titled “Dance for Veterans” and then completed the same measures as at pretest. Do to a sample size of N=9, there are no significant results. Further research in this area is crucial as the population continues to age. Existing dance programs are easily replicable and may provide aging individuals an opportunity to creatively engage their bodies while building efficacy and wellbeing. DANCE, EFFICACY AND WELL-BEING 2 Dance and Well-being in Older Adult Communities: Exploring Efficacy as a Mediator Stemming from factors such as the rapid growth in birthing-rate during the post-war baby boom and elongated life expectancy, the population of individuals over the age of 65 is expected to double in the next forty years (Ortman, Velkoff & Hogan, 2014). While the population of older adults increases, it becomes essential to confront the hindrances to quality of life that accompany aging. As individuals age, many confront declines in physical health, mental clarity and social support (Grimby, 1993; U.S. Center for Disease Control, 2003). Because of this, social scientists have turned their attention toward increasing well-being for the growing community of older adults. The research presented here will look specifically at the effects of a dance intervention on well-being and efficacy in older adults. Creative Programs Currently, researchers are turning to creative programs to improve health and happiness among the aging community. Across the country, geriatric care workers are collaborating with artists to involve older adults in painting, poetry, dance, music and other arts. Reflecting on the benefits of this engagement, Janine Tursini, the director of Arts for the Aging commented, “The arts open people up, giving them new vehicles for self-expression, a chance to tell their stories. The programs capitalize on assets that remain, not on what’s been lost” (Brody, 2016). Supporting the notion that artistic programs provide broad benefits to aging participants, researchers at George Washington University investigated the effects of involving older adults in comprehensive art programs (Cohen, 2006). Cohen recruited independently living individuals over the age of 65 to participate in weekly community engagement groups 9 months out of the year for 2 years. 150 of his participants were assigned to non-artistic programs, and 150 participants partook in an art and culture based intervention group led by professional artists. DANCE, EFFICACY AND WELL-BEING 3 Those in the art-focused group also attended performances and worked on a long-term artistic project. Cohen utilized five different measures of physical health, mental health and social interaction. Through this, he discovered that seniors who participated in cultural experiences with professional artists over a period of two years demonstrated improved health, fewer doctors visits, fewer falls, less depression and less loneliness than those participating in ordinary center activities. While this study established the benefits of general artistic programs, others researchers have narrowed the lens to investigate the specific benefits of dance. In an effort to enhance physical and mental wellness in a rural community in the United Kingdom, Lincolnshire’s Health and Wellbeing Fund supported the development of a local program entitled Dance4Life (Stickley, Paul, Crosbie, Watson, & Souter, 2015). The program aimed to train professional and volunteer teachers to provide access to a variety of dance classes. In doing so, they generated 34 new dance classes and gained over 1,000 participants. Researches at the University of Nottingham combined quantitative measures about health ideals and previous experience with qualitative interviews and focus groups to evaluate the success of this program. The researches restricted data collection to dancers who had attended 8 or more classes. Of those, they received 330 completed surveys, 74.5% of which were from women over the age of 50-years-old. In addition to 97% of the dancers stating that they enjoyed the experience, participants reported improvements in well-being (75.5%), energy level (66.1%), self-expression (57%), and social relationships (75.2). Qualitatively, participants recognized the dance classes as a space to be creative, a reminder of their past experiences, and a tool to refine their cognitive and physical strength. This research not only evaluated the effectiveness of this specific community dance program, but identified the holistic benefits that dance provides both mentally and physically. DANCE, EFFICACY AND WELL-BEING 4 The aforementioned studies on dance and other artistic programs clearly demonstrate the broad benefits of creative interventions for older adults. Because these studies incorporated larger timelines and had access to greater resources such as professional artists and dance teachers, the present study uses a more concentrated intervention, which was taught by the author of this paper. Further, the present study targets individuals living in senior care facilities who tend to have lower health ratings than participants in the previous studies. For this reason, this study utilizes a dance intervention that takes place entirely seated and encompasses all level of ability. Potential Mechanisms Beyond recognizing that dance and other creative programs provide a range of benefits for older-adults, the present study aims to examine how and why this is. In deciphering this mechanism, the construct of self-efficacy is central. Self-efficacy is defined as a sense of contribution or control in one’s own life (Bandura, 2010). Individuals with high levels of selfefficacy feel empowered to affect specific outcomes in their lives while those with low levels of efficacy believe that much happens outside of their control. In his research, Bandura argues that older adults experience diminished efficacy (2010). By enhancing aging individuals’ sense of efficacy, one might also enhance their overall wellbeing. Langer and Rodin demonstrated the significance of efficacy through their investigation on the effects of personal responsibility among older adults (1976). The researchers delivered a speech to one floor of a senior living facility about the facility’s role to care for each resident and the caretakers’ wishes for their happiness. These residents were then given a plant and told that their caretakers would tend the plant for them. For the experimental group, researchers gave a separate floor of residents a speech about their personal responsibility in creating their own DANCE, EFFICACY AND WELL-BEING 5 happiness. Residents of this floor were also given a plant but were made responsible for watering and caring for it. Three weeks after the speeches were given, residents in the experimental group showed a significant increase in happiness, activity and alertness in comparison to the control group. That is, residents who were reminded of their own personal responsibilities showed vast increases in well-being. Langer and Rodin’s study shows that as older adults confront the challenges of aging, such as moving to a care center, it is important to prime their sense of control. Through encouraging a sense of efficacy, individuals become empowered to pursue higher levels of well-being. Self-efficacy is a multi-faceted construct which can be refined to specific categories including health self-efficacy, measuring one’s perceived ability to change one’s health, social self-efficacy, measuring one’s confidence in relating to others, and academic self-efficacy, measuring students’ belief in their potential to succeed academically (Smith & Betz, 2000; Wallston, Stein & Smith, 1994); Pajares & Schunk, 2001). The present study will focus on two types of efficacy. The first, general self-efficacy, is one’s broad sense of control. This is an overarching sense of efficacy and encompasses all aspects of one’s perceived control. The second, physical self-efficacy, specifically looks at one’s confidence in movement and balance. This construct is particularly interesting because of the high rate of falling in older adults and the physical strength and coordination required in dance (Stubbs, Patchay, Soundy, & Schofield, 2014). Dance and Efficacy As an art that challenges its participants to connect mind and body, dance has the capacity to increase both general and physical efficacy. Aiming to analyze the effectiveness of creative therapies, Brauninger conducted an international survey with 113 Dance Therapists in DANCE, EFFICACY AND WELL-BEING 6 order to examine the benefits of Dance Therapy (Bräuninger, 2014). Through this, he discovered themes of improved physical