The goal of this clinical trial is to learn whether a music-based intervention can improve mental and physical health and strengthen coping skills among adults living in residential care settings in northern Arizona. The main questions it aims to answer are: Does participation in the music-based intervention reduce stress, anxiety, depression, and pain?, and Does participation increase the use of music as a coping strategy and improve overall well-being?

Researchers will compare participants' pre-intervention and post-intervention responses to determine whether the music classes are associated with improvements in health and coping outcomes. Participants will: Attend a 6-week music class held once per week for one hour; participate in active music activities such as drumming and rhythm exercises; complete a brief survey before and after the intervention. Some participants are also invited to complete a short interview about their experiences.

Approximately one in five adults in Arizona report symptoms of mental health disorders each year. These outcomes have been particularly challenging in rural and medically underserved areas, where long-term care residents face elevated risks of chronic stress, cognitive decline, and social isolation. Older adults with memory-related impairments are especially vulnerable to the loss of meaningful interpersonal and sensory engagement.

Music-based interventions (MBIs) have demonstrated strong potential to support both cognitive and emotional well-being. Active music-making may improve physical symptoms (e.g., chronic pain) and reduce mental health symptoms (e.g., anxiety, stress, depression). However, there is limited research examining how familiarity, personalization, and continuity of musical exposure influence intervention outcomes among older adults.

Older adults with cognitive impairment-particularly those living in long-term care-often experience reduced autonomy, fragmented social networks, and limited access to non-pharmacological therapies that support holistic well-being. This project responds to that gap by assessing how a structured MBI can engage older adults with varying levels of cognitive function. The proposed research will inform feasible, ethically grounded strategies for delivering a 6-week music-based intervention in ways that are meaningful, safe, and responsive to the needs of aging populations. Our central hypothesis is that participation in the MBI will improve stress, anxiety, depressive symptoms, reduce chronic pain, and increase coping skills to manage health conditions among all participants.

Inclusion Criteria:

• residency at one of the two elder care facilities
• ability to communicate in English.

Exclusion Criteria:

• not a resident at one of the two elder care facilities
• inability to communicate in English.

Individual participant data will not be shared due to the small sample size, the inclusion of qualitative interview data, and the potential risk of participant re-identification within residential care and recovery settings. Given the community-engaged nature of the study and the involvement of potentially vulnerable populations, data sharing decisions will prioritize participant confidentiality, community trust, and applicable IRB and community partner agreements.