Health Promotion and Injury Prevention Education for Student Singers

INTRODUCTION THE LATIN MAXIM SCIENTIA POTENTIA EST (knowledge is power) deserves renewed consideration from educators involved in the training of singers. The connection between professional singing and occupation-related voice problems has been well established,1 and evidence suggests voice problems in professional singers may commence as early as the singer's tenure as a student.2 In fact, as many as 56.5% of student singers report a current voice problem.3 That figure, however, may actually underestimate the true extent of voice problems in student singers, as demonstrated by clinically significant laryngoscopic findings among asymptomatic singing students.4 Whereas some student singers are unaware of laryngeal or vocal changes, other student singers are rather troubled by a vocal impairment, leading some to express serious mental health concerns as a result.5 Such students may forego singing-related opportunities, and some even abandon performing altogether.6 Clearly, one important aim in the training of student singers is to promote their vocal health and prevent injury to enhance academic and professional success. HEALTH PROMOTION IN SCHOOLS In response to the potential threat health problems pose to academic and later professional success in all domains, the World Health Organization (WHO) Division of Health Promotion, Education, and Communication launched an initiative called the Health Promotion in Schools.7 The WHO Global School Health Promotion Initiative emerged in response to the Ottawa Charter for Health Promotion in 1986, the recommendations of the WHO Expert Committee on Comprehensive School Health Education and Promotion in 1995, and the Jakarta Declaration of the Fourth International Conference on Health Promotion in 1997.8 Specifically, the WHO Expert Committee reviewed research from developed and developing countries and found a preponderance of evidence indicating that the creation of school-based programs promoting health and reducing health risks in schools leads to improved educational outcomes. An effort has been made to increase the number of health promoting schools, that is, schools that strive to prevent health problems among students by changing the conditions that affect risk. One mechanism by which health promotion and injury prevention can be accomplished is with the establishment of curricula. Coursework should not only focus on developing students' understanding of factors that affect health, but should also instill skills to help students navigate situations that potentially threaten health. Paramount to achieving this goal is a joint effort among health professionals, school personnel, parents, students, and the community at large. In 2004, professionals in performing arts medicine and music set out to address the challenge set forth by the WHO. These individuals collaborated to develop a set of initial recommendations addressing health promotion and injury prevention specifically in schools of music at the university level.9 Four recommendations were established by the Health Promotion in Schools of Music Project (HPSM): (1) schools of music should adopt a framework to become a health promoting school; (2) music students should enroll in an undergraduate occupational health course that addresses injury prevention; (3) music students should receive education during ensemble-based instructions about music-related hearing loss; and (4) music students should receive assistance in seeking out health care resources. The remaining focus of this article is the HPSM's second recommendation-the development of an occupational health course-with specific suggestions for research-based content built around two complementary conceptual frameworks. In addition, data from the limited number of previously published studies as well as a recently completed study will be presented, providing preliminary evidence about potential benefits of occupational health courses for student singers. …

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