Table 3.

Practical issues transferring face to face to online based on participant and facilitators experience

Informing participants	People are generally understanding of current requirement for physically distanced sessions.
Joining online	Participants may need support with digital access. Friends and family a good source of support. Dedicated ‘set up sessions’ could help in which session leader talks the participant through setting up, 1 to 1, separately and in advance of the SLH session.
Physical space	Clean, tidy and free from trip hazards.
Sound	Speakers advisable for better volume and sound quality
Feedback	Integration of formal feedback vital to facilitate responsive and participant appropriate sessions. More immediate feedback required from session leader as participants are not able to hear each other sing.
Maintaining/building relationships	Introductions. General catch up/social. Rapport building activities.
Session content	Cannon and multi-harmonies (live)—difficult. Prerecorded content to facilitate multipart songs possible, but complicated. Focusing on what works best in each method of delivery more important than trying to exactly emulate face-to-face sessions online. Discussion between singing leaders using similar participant groups and swapping ‘best practice’ from experience works well.
Keep up to date	The evidence base is in this area is evolving, so ongoing review of relevant research and guidelines is important, including related activities such as pulmonary rehabilitation.38
Safety	Ensure contact details are correct. Asking participants to provide next of kin details can be useful. Ensure participants take breaks or stop if feeling unwell in any way. Clear space, free from trip hazards important for participants.
Ethical Issues	Participants should consent to any use of their personal data. Closed/password-protected online sessions important to prevent uninvited interruptions.

SLH, singing for lung health.