A hybrid in-person and online group singing program for older adults with breathing limitations: A pilot mixed-methods study.

Introduction: Group singing (GS) programs have emerged as a promising option to address both the respiratory and psychological needs of patients with breathing limitations. No study has documented a hybrid delivery mode that simultaneously combines in-person and online modalities. This study aims to explore participants' experiences and the effects on respiratory control, quality of life, and social inclusion of a hybrid GS program that includes in-person and online groups. Methods: Using a mixed-method convergent design, we recruited twenty individuals with breathing limitations. The GS program was delivered weekly over 12 weeks, with sessions lasting two hours. Participants joined either in person ( Results: Participants primarily attended either in person or online. Both groups reported a sense of connection with the other participants but expressed concerns about using the technology. Online participants valued the opportunity to engage despite mobility or health limitations, though technological challenges affected feedback and group cohesion. Quantitative and qualitative findings revealed perceived improvements in pulmonary health and social inclusion, despite mixed outcomes regarding overall quality of life. Conclusion: Hybrid GS programs are well-received and beneficial for individuals with breathing limitations. They offer a promising complement to traditional pulmonary rehabilitation by enhancing accessibility and supporting long-term engagement.