Music in Mind Training: Producing a theory of change model to evaluate the implementation of an improvisation-based music-making training programme for care home staff working with people with dementia

BackgroundIn the UK, care home staff are often involved in musical practices as part of their professional activities. However, to date there is a lack of relational evidence that underpins improvisational music-making programmes in care homes, as related to the wellbeing of care home staff and musicians who deliver such work. This process evaluation accesses Manchester Camerata's 20-week 'Music in Mind Training' programme for care home staff working with people living with dementia in care homes, with a focus on care home staff.Aims(i) To produce a Theory of Change model outlining the core mechanisms of change for Music in Mind Training; (ii) To evaluate the 'in-the-moment' and prospective impact of Music in Mind Training on participating care home staff practice and wellbeing.MethodsConducted in two care homes, the study employed online observation of hour-long training sessions (<i>n</i> = 18), semi structured interviews with participating staff and musicians (<i>n</i> = 4), and oral histories interviews with stakeholders involved in programme development (<i>n</i> = 18).FindingsParticipating care home staff reported a general increase in their motivation, wellbeing, and confidence through taking part in the training programme, while indicating a drop in confidence related to future delivery at the programme end. The study also indicated how care home staff implemented change to their day-to-day practice by incorporating their learning into interactions with residents in structured music sessions, and more broadly in daily interactions.ConclusionThe presented Theory of Change model details core interpersonal mechanisms of change for this musical training programme, centred on (1) collaboration, (2) shared values, (3) respect and validation, and (4) openness and reflection, outlining pathways for impact regarding practice change and staff wellbeing. Subject to further refinement and testing, the model could be applied to other contexts to help provide a more rounded account of education and training in dementia care settings.