Table 1.
Overview of the components of the ENO Breathe programme
| People present | Description | Content | |
|---|---|---|---|
| One-to-one | Two ENO Breathe team members (ENO vocal specialist and ENO group coordinator) and participant | Overview and review current individual participation suitability (20 min) | Introduce course content in more depth; discuss suitability for the programme at current time; answer questions; address technical difficulties for those with limited online video conferencing software experience to ensure full participation regardless of initial technological proficiency |
| Welcome pack | .. | Welcome pack delivered by mail at beginning of programme | Contains a welcome card, ENO tote bag, ENO mug, tea, biscuits, and a reusable straw (for straw phonation exercises) |
| Weekly online group sessions | Led by an ENO vocal specialist with up to 20 participants | Encourage participation in exercises and activities to support breathing control, providing tools for self-management of breath and anxiety (six 1 h sessions) | Warm-up exercises to prepare the body and mind; practical tools to support improvement in posture and breath control, encouraging self-management of anxiety and breathlessness; guided and supported singing of culturally diverse lullabies selected for their power to calm and soothe (memorable and accessible to all); a moment for participants to connect with each other in a safe and supportive environment; homework (session leaders give participants homework each week, encouraging participants to focus on particular exercises, and to engage with the material in a specific way, learning the exercise and integrating it into their daily routine); related online supporting resources (below) are provided |
| Midpoint focus group | Participants who attended the third group session | Semi-structured participant discussion about how they are finding the programme | Provides an opportunity to feedback in more depth to session leaders; sharing of experiences between participants; identify any issues arising |
| Online resources | Participant self-directed | Bespoke online digital resources to support participants between sessions (as per participant preference) | Lullabies to sing along with or listen to from a specially recorded playlist of lullabies used in the ENO Breathe programme; lullabies from operas performed by ENO singers and players, selected and recorded especially for ENO Breathe participants to watch and listen to; downloadable playlists for bedtime or moments of anxiety or panic; filmed exercise videos explaining and guiding viewers through breathing, vocal, and warm-up techniques; further exercises and tools for daily practice, or as frequently as the participant feels is appropriate for them; in addition, towards the end of a session, the session leader shows the relevant week's online page by sharing their screen and guiding participants to the exercises and lullabies for that week |
| Regular emails and point of contact provided | All participants during the 6-week course | Emails (minimum of three per week) from group leaders to participants | Encouraging engagement with online resources; weekly release of a specially filmed opera lullaby performed by the ENO, emailed directly to participants; pre-session email reminding to attend upcoming session, sheet of music and lyrics of any lullabies to be covered, and the link to the session; group text reminder is sent to all participants within a group before a session starts to remind them to join the online link for the session; email following session recapitulates session content and reminds them of key exercise homework with links to online resources; other emails, throughout the week, depending on the needs of each participant; all emails received from participants are answered by their group coordinator; group coordinators are provided with a mobile telephone by ENO; participants have the phone number of their group coordinator and can call and text |
| Twilight sessions | Open to all previous ENO Breathe participants | Fortnightly evening sessions (these were not included as a component of the research study intervention, which was limited to the core 6-week programme) | Open to anyone who has previously completed the core ENO Breathe programme, to provide ongoing sessions for individuals wanting to continue |
ENO=English National Opera.