Health-promoting behaviours in conservatoire students

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Psychology of Music OnlineFirst, published on August 12, 2008 as doi:10.1177/0305735607086047

A RT I C L E

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Health-promoting behaviours in conservatoire students

Psychology of Music Psychology of Music Copyright © 2008 Society for Education, Music and Psychology Research 1–14 10.1177/0305735607086047 http://pom.sagepub.com

GUNTER KREUTZ CA R L VO N O S S I E T Z K Y U N I V E R S I T Y O L D E N BU RG , G E R M A N Y

JA N E G I N S B O RG R O YA L N O RT H E R N C O L L E G E O F M U S I C , U K

A A RO N W I L L I A M O N R O YA L C O L L E G E O F M U S I C , U K

A B S T R A C T This study focuses on health-promoting behaviours in students from two conservatoires, the Royal Northern College of Music (RNCM, Manchester, UK; n !199) and the Royal College of Music (RCM, London, UK; n ! 74). The research questions concern (a) the levels and types of health-promoting behaviours among performance students and (b) the association of health-promoting behaviours with emotional state, perceived general self-regulation and self-efficacy. To address these questions, the students were surveyed using server-based inventories over the internet. Results revealed varying levels of adherence to individual aspects of health-promoting behaviours. No significant differences between the populations of the two conservatoires with respect to health-promoting behaviours were observed. In general, values for health responsibility, physical activity and stress management were lower than values for nutrition, interpersonal relations and spiritual growth. Significant correlations were found between all subscales of health-promoting behaviours, emotional state, self-efficacy and self-regulation. These results suggest that music performance students tend to focus more strongly on psychosocial than physical aspects of health while particularly neglecting health responsibility. It is also concluded that health-promoting behaviours are weakly and differentially associated with both positive and negative emotional states, as well as with perceived self-efficacy and self-regulation. KEYWORDS:

emotional state, health promotion, music students, self-efficacy, self-regulation

Introduction Behaviours promoting well-being and health are essential to our quality of life. Consequently, they have been investigated across a wide range of clinical and nonclinical contexts (Pender, 1996), including university and college student populations (Lee & Yuen Loke, 2005; Oleckno & Blacconiere, 1990). There is consensus that, irrespective of the specific model of health underlying research efforts, both physical and psychosocial factors can influence healthy lifestyles (Pender, 1996). The purpose of this article is to explore healthy behaviours in music performance students at

Copyright 2008 by Society for Education, Music, and Psychology Research.

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conservatoires, particularly in relation to their emotional state as well as their selfefficacy and self-regulation beliefs. Health-related problems are experienced by many professional musicians from early on in their careers (e.g., Brandfonbrener & Kjelland, 2002; Middlestadt & Fishbein, 1988) and even at music college (e.g., Williamon & Thompson, 2006). There are clear similarities between the demands of practising and performing on various musical instruments, including singing, and playing sports (Wynn Parry, 2004). For example, the long hours of practice required to develop and maintain fine motor skills place high demands on the musculoskeletal system; moreover, the demands are not only physical in nature but also psychological, as can be seen in the vast literature on stress and performance anxiety (see Kenny & Osborne, 2006, for a recent review). Therefore, much research into practice strategies has been carried out in order to determine the most appropriate and efficient ways for individuals to manage the demands of learning and making music (e.g., Hallam, 1997; Lehmann, 1997). Recent research findings illustrate the role of health in music performance and its relationship with individual and environmental factors (e.g., Langendoerfer, Hodapp, Kreutz, & Bongard, 2006). Thus a need has been identified for greater health promotion in post-secondary music schools (Chesky, Dawson, & Manchester, 2006). However, to date there is a paucity of work devoted to the understanding and promotion of healthy lifestyles among musicians, especially during the formative years of conservatoire training (Williamon & Thompson, 2006). It is believed that health behaviours formed during young adulthood may have a sustaining impact on health across later life and that interventions are mandatory to help students adapt to the challenges of college life (e.g., Von Ah, Ebert, Ngamvitroj, Park, & Kang, 2005). During this time, most students are leading independent lives away from home for the first time. Healthcare and health promotion thus become the responsibility of the individual, while there also remains a critical role of the tertiary educational institutions to provide healthy and safe environments for their clients. Thus, health prevention has been recently acknowledged a larger role in the education of professional musicians, as identified in a programmatic editorial article in the journal Medical Problems of Performing Artists (Manchester, 2007). At the same time, students find new social networks of social communication and interaction, while some may be prone to expose themselves to risky behaviours (e.g., Seal & Agostinelli, 1996). Although the overall personal and educational effects of such life changes are far from clear, one may speculate that they have a multifaceted impact on learning and performance, especially as relationships develop with peers who may or may not be encountering similar issues and challenges. However, music students differ from nonmusic students in that some of their health concerns and associated behaviours may be music specific. For example, marked differences have been observed between university singers’ and non-singers’ approaches to vocal health and symptoms (Sapir, Mathers-Schmidt, & Larson, 1996). According to Bandura (1997), perceived self-efficacy refers to ‘beliefs in one’s capabilities to organize and execute the courses of action required to produce given attainments’ (p. 3). Perceived self-efficacy entails motivation, emotion, thought processes and many other aspects of individual and social cognitive and affective

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Kreutz et al.: Health-promoting behaviours in conservatoire students

processes and behaviours across a wide range of situations. For example, associations between perceived self-efficacy and health-promoting behaviours have been studied in relation to the initiation and maintenance of personal change (Bandura, 1997, p. 279). With respect to the challenges with which music performance students are confronted, two findings are worth considering. First, self-efficacy beliefs have been shown to function as a mediating variable in the communication of (preventative) health practices (e.g., Callaghan, 2005). In other words, people who perceive themselves as highly self-efficacious are likely to engage in healthy behaviours; it is not that people who engage in healthy behaviours perceive themselves, necessarily, to possess high self-efficacy. Second, perceived self-efficacy has significant predictive power in the maintenance of healthy habits. Therefore, when a personal health-promotion programme is devised, it is important to determine that individual’s level of perceived self-efficacy to estimate future adherence to the programme (McAuley, 1991). The constructs of self-efficacy and self-regulation have recently become both influential and widely used in research on and learning processes in the context of formal education (e.g., Winne & Hadwin, 1998; Zimmerman, 2000). The few studies that have looked at self-efficacy in the context of music education, however, have been conducted almost exclusively in relation to music practice (e.g., Hallam, 2002; Nielsen, 2004). For example, Nielsen (2004) found significant correlations between perceived musical self-efficacy and a number of practice-related variables including elaboration, organization, time and study environment, critical thinking, peer learning, help seeking and metacognition (Nielsen, 2004, p. 424). Moreover, there is evidence that young musicians’ beliefs that they will succeed in a musical assessment (i.e., their musical self-efficacy) are strong predictors of the assessment outcome (McCormick & McPherson, 2003; McPherson & McCormick, 2006). However, the role of perceived self-efficacy and self-regulation in music students’ health-promoting behaviour is still unclear. In general terms, self-regulation can be defined as a learning process aimed at the attainment and maintenance of personal goals (Maes & Karoly, 2005). It encompasses psychological aspects of attention-regulation and emotion-regulation (Schwarzer, Diehl, & Schmitz, 1999), as well as various psychophysiological parameters (e.g., see Gruzelier & Egner, 2004, for a review of research on performance enhancement via biofeedback and neurofeedback). Positive and negative emotions have been observed to play important roles in the context of both health-promotion and perceived self-efficacy. Bandura (1997) considers the role of emotions specifically in relation to health communication. He maintains that ‘[p]ositive emotions increase the availability of thoughts about personal success, whereas negative emotions make personal failures more salient. These affective biasing processes can alter the impact of health communication‘ (Bandura, 1997, pp. 280). Thus, it is expected that the current emotional state of an individual may also impact on his or her healthy behaviours. The present study addresses two research questions. First, what are the levels of general health-promoting behaviours in the student populations at two UK conservatoires? Second, to what extent are health-promoting behaviours associated with emotional affect state, perceived self-regulation and self-efficacy? Subsidiary to these questions, we explored the influences of students’ age and sex on these measures.

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Method PA RT I C I PA N T S A N D I N S T I T U T I O N S

A total of 273 students (174 female; 99 male; mean age !21.94 years, SD !3.15 years) from the Royal Northern College of Music (RNCM, n !199) and the Royal College of Music (RCM, n !74) responded to the survey. They represent approximately 29.7 percent (RNCM) and 10.6 percent (RCM) of the student populations at these conservatoires. The RNCM provides all students with a general health and safety induction and offers special treatment for students with music practice- and performance-related injuries. It does not, however, offer preventative health programmes on a regular basis. By contrast, all RCM undergraduate students who participated in this study took part in an annual seminar series, ‘Healthy Body, Healthy Mind, Healthy Music’, during their first year of study at the college. The series, which has run since the 2003–04 academic year and now forms part of a compulsory course unit entitled Level 1 Professional Skills, introduces students to principles of physical and psychological health that can inform and improve their music-making. The seminars are delivered in the autumn term (September to December) to the entire first-year cohort through seven one-hour presentations. The rationale behind this introductory series is that the adoption of a healthy approach to engaging in music, especially early on in one’s career, can have a substantial impact on achieving and maintaining peak performance (see Williamon & Thompson, 2006, pp. 425–26, for further information on the series). Almost half of the sample or 41.9 percent (n !139) were in their first year, 26 percent (n !70) in their second year, 11.4 percent (n !31) in their third year and 9.9 percent (n !27) in their fourth year. The remaining 2.6 percent (n !7) of the students were postgraduates. The difference between the average ages of the male and female students was not statistically significant (t (270) !.26, NS): 21.9 and 22 years respectively. For the purposes of analysis the students were divided into two age groups, 18–22 (n !176) and 23–46 (n !93); four students did not provide their age. M E A S U R E M E N T I N S T RU M E N T S

A battery of questionnaires was administered. The first was designed to collect basic demographic information (age, sex, affiliation to one of the two conservatoires, year of study, main instrument played and estimated hours of practice undertaken each week). The instruments used to measure the four variables of interest were the Health-Promoting Lifestyle Profile (HPLPII), the Positive-and-Negative-AffectSchedule (PANAS), and the Self-Efficacy Expectation Scale (SES) and Self-Regulation Expectation Scale (SRS). The HPLPII measures the frequency of engagement in health-promoting behaviours. It consists of 52 items that are rated on a four-point Likert-type scale: 1 (never), 2 (occasionally), 3 (frequently) and 4 (routinely). Scores for all items thus range from 52 to 208 with a midpoint of 130 (Walker, Sechrist, & Pender, 1987). This instrument provides a total score for health-promoting behaviour, as well as six subscales (see Table 1). The PANAS consists of 20 adjectives that describe positive (10 items) and negative feeling states (10 items) (Watson, Clark, & Tellegen, 1988). Each item is rated on a

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five-point Likert-type scale ranging from 1 (very slightly) to 5 (extremely). Total scores for the two sets of items represent each affect state (see Table 1). The unidimensional SES (Schwarzer & Jerusalem, 1995) and SRS (Schwarzer et al., 1999) scales each consist of 10 self-reflective statements. They describe expected behaviours in situations that require coping (SES) or regulation of moods (SRS). Each item is rated on four-point Likert-type scales ranging from 1 (not at all true) to 4 (completely true). Previous work has identified a correlation of .57 between these measures. In addition, the self-regulation scale was found to correlate with a measure of proactive coping, r !.55 (Schwarzer et al., 1999). Finally, in a sample of N ! 239 respondents the scale yielded a retest stability of .62 after six weeks (Schwarzer et al., 1999) (see Table 1, below). D E S I G N A N D P RO C E D U R E

Participants were invited via email to take part in a survey, referred to as ‘RNCM Health Survey’ for the RNCM students and ‘RCM Health Survey’ for the RCM students. The emails, which were nearly identical for the two institutions, contained a very brief introduction to the nature and purpose of the survey. It was also stated that respondents would be eligible to take part in a prize draw. The RNCM and RCM email invitations included the information that 25 £20 cash prizes would be awarded to student respondents. The only other difference between the two messages was that the links to the survey website were different. The survey itself was constructed using the environment provided by Surveymonkey® (url: http://www.surveymonkey.com) to which the various measurement instruments were adapted. All respondent information questionnaires and inventories contained in the respective RNCM and RCM versions of the survey were identical. The only difference between them was the logo at the top of the first page of each survey identifying the institutions. TA B L E

1 Summary of psychometric instruments, subscales and reliability measures

HPLPII (Walker et al., 1987) Subscale Health responsibility Physical activity Nutrition Interpersonal relations Spiritual growth Stress management PANAS (Watson et al., 1988) Positive affect Negative affect SES (Schwarzer & Jerusalem, 1995) SRS (Schwarzer et al., 1999)

Example

N

"

9

.80

8 9 9 9 8

.79 .76 .75 .81 .64

Excited Nervous I am certain that I can accomplish my goals

10 10 10

.85 .83 .88

I can concentrate on one activity for a long time, if necessary

10

.74

Discuss my health concerns with health professionals Follow a planned exercise programme Eat 3–5 servings of vegetables every day Touch and am touched by people I care about Am aware of what is important in my life Pace myself to prevent tiredness

Notes: N !Number of items per scale; "! Cronbach’s alpha for present study.

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First, the welcome page informed the respondents about the nature, purpose and scope of the study. It also provided an opportunity to give informed consent immediately after reading through the general information, or after having read more detailed information on a separate page that could be accessed by clicking an optional link. Respondents provided basic demographic information on the next page and were then routed to different pages depending on whether they indicated themselves to be students, academic staff or administrative staff. The only differences between the student and staff pages were that year of study and musical instrument currently studied were omitted from the latter. All respondents were then directed to the inventories in the following order: (1) PANAS; (2) HPLPII; (3) SES; and (4) SRS. Then they were asked to complete a specially constructed health survey, the results of which are not reported in this article. Finally, respondents were invited to take part in the prize draw by inserting their email address in an appropriate box. Reassurance was given that questionnaire data and email addresses would be kept separate. DATA A NA LYS E S

The statistical software package SPSS 15.0 was used to perform the descriptive and inferential statistical analyses. Specifically, the General Linear Model (GLM) algorithm was used to identify any influences of institution and demographic variables on the dependent measures. Pearson’s correlations were calculated on the various scales and subscales to identify any associations between measures.

Results H E A LT H - P RO M O T I N G B E H AV I O U R S

Analysis of variance revealed no statistically significant differences between the scores of students at the two institutions on either the total scores for HPLPII or any of its subscales. Therefore, the data from the two conservatoires were collapsed for subsequent analyses. Table 2 presents mean scores and standard deviations for the HPLPII measures, showing values for grand means, the two age groups and the two sexes in separate columns. 2 Means (and standard deviations) for the HPLPII scales: Grand means, values for the two age groups and for both sexes are presented in separate columns

TA B L E

Age group Measure Health-promoting behaviour Health responsibility Physical activity Stress management Nutrition Spiritual growth Interpersonal relations

Grand mean 18–22 (n ! 269) (n !176) 2.47 1.81 2.22 2.26 2.71 2.88 2.95

(.40) (.52) (.63) (.49) (.60) (.56) (.54)

2.43 1.75 2.18 2.26 2.63 2.88 2.95

(.37) (.48) (.60) (.50) (.56) (.54) (.53)

Sex

23–46 (n !93) 2.52 1.92 2.29 2.26 2.85 2.87 2.94

(.44) (.58) (.69) (.47) (.63) (.60) (.57)

Females (n !174) 2.52 1.91 2.24 2.28 2.82 2.88 3.03

(.39) (.54) (.62) (.49) (.56) (.53) (.51)

Males (n ! 99) 2.36 1.63 2.19 2.23 2.51 2.85 2.80

(.39) (.44) (.63) (.49) (.58) (.60) (.57)

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Mean scores were near the midpoint of the scale with the median close to the average value. Reported engagement in healthy behaviours thus fell between ‘occasional’ and ‘frequent’. The grand mean of total scores on HPLPII was 2.47 (SD !.40). Respondents scored below this grand mean for health responsibility, physical activity and stress management, but above it for nutrition, spiritual growth and interpersonal relations. A mixed factorial, 2 (sex) #2 (age group: 18–22; 23–46) # 6 (scores on each of the HPLPII subscales) ANOVA was conducted with the first two as independent variables and the last one as the dependent measure. Mauchly’s test of Sphericity was significant, so the Greenhouse-Geisser Epsilon was used to adjust the F-ratio. There was a significant main within-subjects effect of scale indicating differences between the scores on each subscale (F [4, 1168] !242.04, p $.0001, partial !2 !.48), and significant interactions between scale and sex (F [4, 1168] !4.46, p $ .001, partial !2 !.02) and scale and age group (F[4, 1168] !3.93, p $.01, partial !2 !.02). There was a significant main between-subjects effect of sex (F[1, 265] ! 10.82, p $ .001, partial !2 !.04). A comparison of the mean scores for each of the six subscales of the HPLPII revealed highly significant differences for all but one of the 15 paired comparisons, ranging from t(d.f. !268) !2.43, p $.05 to 32.14, p $ .0001. The only paired comparison that failed to produce a significant difference was between physical activity and stress management, t(d.f. !268) !1, NS. These results indicate that respondents engage with varying frequencies in the different aspects of health-promoting behaviour measured by the HPLPII. In order to explore these results further, a series of univariate ANOVAs was carried out using sex and age-group as independent variables with the total scores on the HPLPII and with the scores on each of the subscales as the dependent measures (see Table 2 for means and standard deviations). Entering the total scores in the analysis produced a significant main effect of sex (F [1, 265] !11.84, p $.001, partial !2 !.04), but no significant effect of age group. With respect to the HPLPII subscales, a number of significant main effects and interactions for individual scales were observed. Health responsibility: Sex (F[1, 265] !13.27, p $ .0001, partial !2 ! .045) and age group (F[1, 265] ! 7.15, p ! .01, partial !2 ! .027). Nutrition: Sex (F [1, 265] !18.17, p $.001, partial !2 !.064) and age group (F[1, 265] !8.10, p $.005, partial !2 !.03). Spiritual growth: Interaction between the two independent variables (F[1, 265] !7.32, p $ .01, partial !2 ! .03). Interpersonal relations: Sex (F[1, 265] !9.86, p $.005, partial !2 !.04). There were no significant main effects on scores for the remaining subscales, physical activity and stress management, nor any interactions between these and the independent variables. E M O T I O NA L S TAT E , S E L F - E F F I CAC Y A N D S E L F - R E G U L AT I O N

No significant differences were observed between scores on any of the measures with respect to institution, sex or age group. Positive and negative affect scores are both in the range of values found in previous studies (Watson et al., 1988, p. 1065) and appear to be normal. By contrast, the general perceived self-efficacy score appears considerably above the average of 2.95 (SD !.53) reported in a survey of 18,000 respondents worldwide (Schopaus & Wolf, 2000). Notably, the values for self-regulation were

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higher than the midpoint of the scale indicating enhanced belief in the capacity for self-regulation. C O R R E L AT I O N S B E T W E E N D E P E N D E N T M E A S U R E S

Pearson’s correlations were calculated to assess the strength of associations between the HPLPII, affect, self-efficacy and self-regulation measures. Table 3 presents a matrix of the correlation coefficients. Note that most correlations are positive and highly significant suggesting strong associations between the 11 measures. The only exception is negative affect, which is negatively correlated with most of the other measures. In order to explore the potential causal links between perceived self-efficacy and health-promoting behaviour, these two variables were correlated controlling for positive and negative affect. The resulting partial coefficient, r !.22, was still significant, although the association between self-efficacy and health-promoting behaviour was weaker than indicated by the original coefficient, r ! .49. Both affect scales were found to be associated with age. Age correlated positively with positive affect, r !.12; p $.05, i.e., older students tended to score higher. Likewise, age correlated negatively with negative affect, r ! ".16; p $ .01, i.e., older students tended to score lower. Age also correlated positively with self-regulation, r $.22; p $.01.

Discussion This study is concerned with health-promoting behaviours in music performance students. In addition, it addresses the associations of these behaviours with respondents’ emotional state, self-efficacy and self-regulation. Perhaps not surprisingly, healthy behaviours were similar in both the institutions from which students were recruited. Overall, only moderate levels of engagement in health-promoting behaviour were observed. However, this engagement varied with respect to the behaviours measured by the individual subscales. Specifically, scores were highest on the two scales measuring psychosocial behaviour, namely interpersonal relations and spiritual growth, and nutrition. Scores on the remaining scales, i.e., stress management, physical activity and health responsibility, were below average, suggesting that a high proportion of students either never or only occasionally engage in the behaviours measured. Inter-correlations between the subscales were observed indicating mutual influences on and interdependences between behaviours; nevertheless, it is instructive to discuss them individually because they represent distinct psychosocial and physical aspects of the student experience. First, the lowest scores by far were for health responsibility. Only a small proportion of students report, for example, that they frequently or regularly discuss their physical ailments, or seek consultation with a specialist when experiencing physical or emotional problems. The other two subscales on which particularly low scores were recorded were physical activity and stress management. According to a World Health Organization (WHO) survey across Europe in 2002, less than 30 percent of the British population above 15 years of age were classified as sufficiently physically active (Cavil, Kahlmeier, & Racioppi, 2006, p. 9). Thus, lack of physical activity may

2.47 1.81 2.22 2.26 2.71 2.88 2.95 3.43 2.09 3.57 3.18

Health-promoting behaviour Health responsibility Physical activity Stress management Nutrition Spiritual growth Interpersonal relations Positive Affect Negative Affect Self-efficacy Self-regulation

*p $ .05; **p $ .01.

Mean .40 .52 .62 .49 .59 .56 .54 .75 .73 .63 .57

SD

HR

.74** .69** .43** .67** .38** .74** .51** .71** .40** .72** .42** .48** .32** ".21** ".08 .52** .33** .44** .32**

HP

.39** .43** .32** .28** .31** ".12* .36** .30**

PA

.28** .55** .44** .28** ".26** .39** .36**

SM

.37** .43** .27** ".00 .25** .27**

NU

.57** .55** ".36** .56** .40**

SG

.37** ".18** .40** .28**

IR

.23** .42** .39**

PoA

".21** ".38**

NeA

.42**

SES

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Measure

3 Means, standard deviations and correlation matrix for scores on the 11 measures of the study

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TA B L E

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not be specific to this group but rather a reflection of macro- and micro-environmental constraints, e.g., urban environment and situational settings that could be detrimental to engagement in physical activity. Another possibility is that music performance students do engage in physical activity in the course of practising and performing but their scores on the HPLPII subscale, which focuses primarily on recreational physical activity, do not reflect this. In fact, weekly practice time for music performance students has been estimated at an average of 23 hours 40 minutes (SD !9 hours) in a previous study (Jørgensen, 1996, p. 129, Table 6.2) for instrumentalists. A similar average value of 23 hours 20 minutes for accumulated weekly practice time was obtained in the present study. There is evidence that long practice hours often lead to musculoskeletal problems that are, for example, due to unhealthy practice habits (see Wynn Parry, 2004, for discussion). In any event, the interpretation of the extremely low scores on the physical activity scale must be treated with caution as they would seem to reflect a neglect of recreational physical activity rather than musical physical activity. The third subscale on which relatively low scores were recorded is stress management. This finding is particularly disturbing in light of the high incidence of performance anxiety at music colleges that has been observed in studies over the last years (see Kenny & Osborne, 2006). The strong correlation between scores on the stress management and self-regulation scales suggests that music performance students do not manage stress effectively in their daily lives. Participants scored higher on the remaining three subscales of the HPLPII representing nutrition, spiritual growth and interpersonal relations – although perhaps not to the extent one would expect considering the demands placed on music performance students. We pointed out that the present sample’s (recreational) physical activity might reflect reduced levels of physical activity in the UK population at large. Similarly, we must consider the findings for the nutrition subscale in the context of typical behaviour. For example, current recommendations include the advice to eat five servings of fruit and vegetables per day (Department of Health, 2005, p. 8) while the average intake is in fact only 2.8 servings per day. The present sample of music performance students report nutritional behaviour that reflects that of the wider population despite the increased nutritional demands necessitated by practice and performance. Finally, respondents scored highest on the subscales representing interpersonal relations and spiritual growth. It is heartening that students’ reported attitudes – if not their actual behaviours – in these psychosocial domains are healthy, enhancing their well-being. In comparison with a previous study of university students in Hong Kong (Lee & Yuen Loke, 2005), which identified only marginal differences in male and female students’ health-promoting behaviour and higher physical activity in male students, the present study revealed significantly more frequent engagement in health-promoting activities by female students than male students. Nevertheless, the results suggest that the health-promoting behaviours of both sexes are deficient. Age had a systematic influence on respondents’ scores on health responsibility and nutrition. It can thus be inferred that music performance students have a growing awareness – if only slight – that their individual lifestyles and behaviours can affect their careers. However, this cross-sectional study leaves open the question as to whether these changes are subject to developmental and/or cohort effects.

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Measures of affect and self-belief were found positive and above average. Positive affect (and negative affect in the opposite direction) was found to be associated with healthy behaviour as well as having a moderating influence on the relationship between self-efficacy and health-promoting lifestyle. It might be argued that students’ higher levels of positive affect and self-efficacy may compensate for their relatively low levels of healthy behaviour, particularly health responsibility, stress management and physical activity. If this were the case, we would expect to see negative correlations between these scales. However, correlations were all positive, indicating that positive feeling states and self-efficacy enhance the healthy lifestyle. This interpretation is further supported by the results of the partial correlation analysis linking self-efficacy, positive affect and HPLPII total score. These findings suggest that positive self-beliefs play an important role in initiating and maintaining healthy behaviours, corroborating observations in other contexts and settings showing that self-beliefs, emotions, and behaviours are interdependent (Bandura, 1997). One key finding of Williamon and Thompson (2006), who looked at the health behaviours of first-year music performance students, was the high reliance on their instrumental teacher for advice in the event of health problems. In light of the present findings, instrumental tutors may have strong influences on students’ behaviour in relation to health, and must therefore be part of any attempts to increase students’ healthpromoting behaviour. In addition, specific programmes should be devised to encourage students to take more responsibility themselves for adopting healthy behaviours. In sum, the present survey has identified the levels of healthy behaviour in music performance students at two UK conservatoires. These levels are lower than might be expected in a group of individuals who engage daily, psychologically and physically, in a highly demanding, specialized set of activities. Lack of responsibility for health, such as failure to self-screen for symptoms indicating physical and psychological problems, and stress management were noted, as were low reported levels of engagement in recreational physical activity. Moreover, the health-promoting behaviours were associated with psychometric measures of self-beliefs and emotional affect, with some moderating influence of respondents’ sex and age. The findings further underscore the necessity for health promotion programmes at conservatoires (see Williamon & Thompson, 2006, p. 426). Such programmes should incorporate general information on achieving and maintaining healthy lifestyles, as well as specific guidance on how to prevent and respond to problems arising from music-making. Ideally, this should be based on the findings of future studies addressing the health-promoting behaviours that are most appropriate for students participating in music at conservatoire level. Moreover, such guidance must take into account the day-to-day challenges of individual practice and reflect the high physical, mental and emotional demands of the music profession. REFERENCES

Bandura, A. (1997). Self-efficacy: The exercise of control. New York: W. H. Freeman. Brandfonbrener, A. G., & Kjelland, J. M. (2002). Music medicine. In R. Parncutt and G. McPherson (Eds.), The science and psychology of music performance (pp. 83–96). New York: Oxford University Press.

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G U N T E R K R E U T Z has been Professor of Systematic Musicology at the Carl von Ossietzky University Oldenburg since May 2008. He received his PhD from the University of Bremen, Germany, in 1996 and his formal qualification to teach at German universities (Habilitation) from the Goethe-University Frankfurt in 2004. His research interests include the psychology and psychophysiology of music perception and performance in amateurs and professionals. Address: Fakultät 3, Department of Music, Carl von Ossietzky University Oldenburg, Ammerländer Heerstr. 114–118, D-26129 Oldenburg, Germany. [email: [email protected]] JA N E G I N S B O RG has been a Research Fellow in the Centre for Music Performance Research, part of the Centre for Excellence in Teaching and Learning at the Royal Northern College of Music, since September 2005. Following a successful freelance career as a professional singer and singing teacher, she studied psychology with the Open University and did her PhD at Keele

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Psychology of Music University. Jane has published widely on expert musicians’ approaches to practising and memorizing, and won the British Voice Association’s Van Lawrence Award in 2002 for her research on singers’ memorizing strategies. Address: Centre for Music Performance Research, Royal Northern College of Music, 124 Oxford Road, Manchester M13 9RD, UK. [email: [email protected]] is a Research Fellow at the Royal College of Music, London, where he heads the Centre for Performance Science. His research focuses on music cognition, skilled performance, and applied psychological and health-related initiatives that inform music learning and teaching. In addition, he is interested in how audiences perceive and evaluate musical performances and, in 1998, was awarded the Hickman Prize by SEMPRE. Address: Centre for Performance Science, Royal College of Music, Prince Consort Road, London SW7 2BS, UK. [email: [email protected]]

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