Abstract
This study explores the public health potential of music and cultural institutions through an examination of Carnegie Hall’s Well-Being Concert series. The series, initiated by the Weill Music Institute, the Hall’s education and social impact arm, aims to create immersive concert experiences that amplify the social, physical, emotional, and educational benefits of music engagement. Grounded in the rich historical and cross-cultural relationship between music and well-being, the series embraces holistic approaches to concert design, curating musical, environmental, and experiential elements for both artists and their audiences. Through observations, interviews, focus groups, and surveys, this mixed-methods study describes the development and evaluates the impact of the inaugural season of Well-Being Concerts among two separate audiences: individuals impacted by the justice system and health care workers. Findings highlight how these concerts foster well-being through relaxation, introspection, and interpersonal connection. Participants described their experience as peaceful and novel, allowing for both focus on oneself and social connection. Venue ambiance curation and the communication of the series’ intention facilitated a sense of inclusivity and comfort for the audience, while also serving to challenge perceptions of cultural elitism. Quantitative analysis revealed significant increases in perceived well-being from pre-concert expectations to post-concert reflections, underscoring the potential effectiveness of such experiences in helping audiences reach individually identified well-being goals. This study contributes to the growing body of evidence that cultural organizations can be productive public health partners and that musical engagement can promote health and well-being. By harmonizing music and listening with self- and community-care practices, Carnegie Hall’s Well-Being Concerts offer a model for an innovative, evidence-informed, and culturally based approach to well-being.
Background
Historical Perspectives on Music for Healing
Music has supported human well-being for millennia (Burnett, 2017; Jiang et al., 2021; Matney, 2019; Meymandi, 2009). Early modern humans created cave art in “acoustic hot spots,” where sound reverberation likely amplified emotional impact and meaning (Miyagawa et al., 2018, p. 3). The Pythagoreans believed music could transform negative emotions, such as sorrow and anger, into their opposites (Pelosi, 2018). In ancient Mesopotamia, Africa, and Greece, the musician-healer duality was less delineated than in the modern day, and sound-based ceremonies were often conducted to cure the sick, among other purposes (Aluede, 2006). Moreover, many of the world’s faith and wisdom traditions note the use of auditory stimuli to recover from illness as well as soothe the mind and body (American Bible Society, 1995; Babikian et al., 2013; Kannan et al., 2022; Zhang et al., 2022). The scientific investigation of music and well-being, however, only emerged toward the end of the 19th century when Doigel, a French physician, studied the impact of music on physiological responses, such as blood pressure and heart rate, by bringing live musicians to his patients’ bedsides (Meymandi, 2009).
Modern Applications of Music for Healing
Today, a significant body of evidence demonstrates the potential of the arts to promote health and prevent, manage, and treat disease across the lifespan (Gouk et al., 2018; MacDonald, 2013; McCrary et al., 2021). The evidence base for the biological impact of music is growing but nondefinitive (Chanda & Levitin, 2013; Finn & Fancourt, 2018). In laboratory settings, participants listening to relaxing music reached baseline values of neuroendocrine, autonomic, and cognitive indicators of human stress faster than when at rest without musical stimulation (Bernardi et al., 2006; Nakamura et al., 1999; Thoma et al., 2013). In a systematic review of the biological impact of music listening, 55% (n = 11/20) of clinical and 40% (n = 2/5) of nonclinical studies without a high overall risk of bias showed reductions in the stress hormone cortisol (Finn & Fancourt, 2018). In the same review, several studies without high risk of bias found smaller increases in blood glucose among participants listening to music than among the control group (Abd-Elshafy et al., 2015; Calcaterra et al., 2014; Kar et al., 2015). Psychologically, listening to music is associated with reducing depressive symptoms (Chan et al., 2011) and alleviating anxiety among a number of study populations (Harney et al., 2023), as well as promoting well-being, self-development, recovery, and quality of life in individuals with long-term illness (Batt-Rawden et al., 2005).
At a population level, analyses of a stratified random sample from the Australian Unity Wellbeing Index (n = 1,000) demonstrated that individuals who attend concerts report greater well-being and enjoyment than those who do not (Weinberg & Joseph, 2017). Engagement in music-based activity, such as attending a concert, has a demonstrated positive impact on individual and collective well-being, by promoting emotional regulation, respite from problems, and the facilitation of social connection and self-development (Perkins et al., 2020). Diverse musical experiences have the potential to expand perspectives, challenge biases and assumptions, and facilitate empathy among listeners (Stupacher et al., 2022). These findings support evolutionary theory that listening to music serves as an adaptation associated with increased interpersonal trust and bonding among people of all ages (Huron, 2001).
Therapeutic Music, Music Therapy, and Public Health
One way that modern Western society has institutionalized the impact of music on health has been the development of “music therapy.” The first formal discussion of music therapy dates to an unsigned article in a 1789 issue of Columbian Magazine titled “Music Physically Considered” (Hillecke et al., 2005; History of Music Therapy, n.d.; Meymandi, 2009). However, it was not until the 1950s that music therapy became a standardized and accredited field of study in the United States (History of Music Therapy, n.d.; Landis-Shack et al., 2017) where, as of 2021, the Certification Board for Music Therapists reported 9,483 board certified music therapists (American Music Therapy Association, 2021). Despite evidence that music therapy may be an effective treatment approach for a number of conditions (Hillecke et al., 2005; Kamioka et al., 2014), the stigma associated with clinical care, as well as limited access and cost, may create barriers to the use of music therapy that community-based, nonclinical music programming may help to resolve (Camic & Chatterjee, 2013).
This evidence base for art and music’s positive health benefits, coupled with a mental health emergency in the United States that is driven in part by an extreme shortage of behavioral health providers, has led to increased calls for the arts to be used as a tool to promote mental health support and well-being (Centers for Disease Control and Prevention Foundation, 2022; Exec. Order No. 14084, 2022; Golden et al., 2024; World Health Organization Regional Office for Europe, 2019). Over one-third of Americans live in communities where there are not enough mental health providers to meet the populations’ needs (USAFacts, 2021). As such, encouraging cultural organizations to adapt and increase access to musical experiences could provide key support to ongoing public health efforts to further individual and collective well-being. This study, conducted during the inaugural season of the Well-Being Concerts at Carnegie Hall, responds to the need within the arts and health field for more investigation into how the concert experience impacts well-being and how arts organizations can “lean in” to their identity as public health partners (Gouk et al., 2018; MacDonald, 2013).
Definitions of Well-Being
While the definition of well-being is debated, there is consensus that it includes the absence of negative emotion and the presence of life satisfaction, positive emotion, and social and physical functioning (Centers for Disease Control and Prevention, 2022). Importantly, the concept of well-being assumes an asset-based, salutogenic approach to health that emphasizes individual and collective resources and capacities (Antonovsky, 1987b). This contrasts with the dominant biomedical model of care, which centers on pathogenesis, diagnosis, and treatment of disease (Antonovsky, 1987a, 1987b). The salutogenic approach to well-being does not place health and disease into separate, mutually exclusive categories. Rather, it suggests a more interconnected relationship between the two, where both can cohabit in the same space of an individual’s life. Such a view allows for the possibility of well-being even in the face of adversity, chronic conditions, and/or specific diagnoses given the right resources (Antonovsky, 1987b). The Well-Being Concerts described in this paper do not seek to treat or cure specific illness, but rather to promote and support a sense of well-being as personally defined by audience members.
Methods
The Weill Music Institute, the Hall’s education and social impact arm, initiated the Well-Being Concerts, a series of curated concerts that amplify music’s social, physical, emotional, and educational benefits, to explore the impact of live music on individual and collective well-being. Each uniquely designed concert was co-created by a diverse team of Carnegie Hall staff, performers, expert advisors, and event hosts, though the series was connected as a whole by the intention to create immersive, nurturing musical experiences that integrate self- and communal-care practices with performance. Musicians and hosts were selected for both their artistic or scientific excellence and their ability to support an inclusive and healing environment. Audience members were invited to recline on floor mats or sit in chairs or on cushions placed on the ground, all positioned in concentric circles at the same level as the performers, to facilitate an intimate and shared experience.
The research team included an interdisciplinary group with expertise in performing arts, integrative medicine, clinical research, neuroscience, public health, and qualitative methodologies. This series included four one-hour-long concerts, each with a different set of musicians and hosts (March to June 2023). For the 2023 season, the Well-Being Concerts centered on two focus audiences with whom Carnegie Hall has long-standing relationships:
Health care workers, in partnership with NYC Health + Hospitals Arts In Medicine program, attended Concerts 1 and 3
Individuals impacted by the justice system, in partnership with multiple organizations and community groups including The Fortune Society, Osborne Association, and Columbia University Justice Lab attended Concerts 2 and 4. None of the concert attendees or study participants were currently incarcerated.
The overarching goals of this inaugural series were to (1) support Carnegie Hall’s community partners and their constituents via unique healing musical experiences, (2) assess existing concert curation and design strategies, and (3) explore methods to evaluate the impact of these concerts on well-being. The Well-Being Concert series builds on previous studies demonstrating the potential of music-based programs to improve the well-being of both health care professionals (Colin et al., 2023; Matoso et al., 2022) and individuals impacted by the justice system (Bensimon, 2024) by addressing the need for more programming that supports (1) health care workers in nonstigmatizing, nonclinical contexts (Colin et al., 2023) and (2) formerly incarcerated individuals and their families during community reentry (Bensimon, 2024).
As noted, however, the Well-Being Concerts are not music therapy, which involves the expert facilitation of music-based practices by a trained music therapist (O’Neill, 2010). While music therapy is an effective treatment option for a variety of conditions, across symptoms and demographics (Kamioka et al., 2014), its reliance on specially trained health care professionals may be stigmatizing for some, and places inherent limits on generalizability and scalability (Camic & Chatterjee, 2013). The Well-Being Concerts aim to provide a model that addresses some of these limitations and complements existing music therapy approaches by curating nonclinical, well-being focused, musical events for the general public.
Theoretical Perspectives
Bronfenbrenner’s bioecological systems theory explains that human development is shaped by the interaction of multiple environmental systems, which influence well-being across interconnected scales (Bronfenbrenner, 2000, 2005). Music-based interventions can support well-being at various levels, including the “microsystem” by fostering personal engagement with music, the “exosystem” through the formation of community networks and partnerships between organizations, and the “macrosystem” by shaping cultural and societal attitudes toward inclusivity and health. These interventions may also influence public health approaches to music and the arts as tools for healing and well-being (Bronfenbrenner, 1979, 2005). For example, the World Music School Helsinki has implemented a large-scale music-centered program aimed at enhancing community resilience and empowerment over time (Chen et al., 2022).
Similarly, the Arts and Culture in Public Health Framework underscores how arts-based health interventions have wide potential to positively impact different facets of health and well-being, including but not limited to improving health care access, promoting inclusivity, sparking social and cultural change, and enhancing research paradigms. These larger-scale changes stem from the impact of arts and health interventions on individuals, through promoting self-efficacy, strengthening cultural connections, cultivating aesthetically and emotionally engaging experiences, facilitating personal expression, fostering meaning-making, and inspiring individual growth and fulfillment across age groups (Golden et al., 2024). The World Health Organization (WHO) further supports these perspectives through its 2020 Health Policy Framework, which identifies the arts as a “low-risk, highly cost-effective, integrative and holistic option” for addressing complex health challenges (World Health Organization Regional Office for Europe, 2019, p. 1).
Interview and Focus Group Research Design
This study employed a mixed-methods approach to data collection, consisting of qualitative observations and interviews, a focus group, and a brief survey administered at pre-, during-, and post-concert timepoints. Focus group and interview data were collected from a single concert for individuals impacted by the justice system, to provide an understanding of the experience from multiple stakeholder perspectives. Survey data were collected during the final three pilot concerts, across both audience populations, to compare individuals’ pre-concert goals and expectations to the perceived post-concert impact on their well-being.
Interview and focus group participants were informed of their rights and the study’s purpose and procedures verbally and through written consent forms. Each focus group participant received a $50 VISA gift card. Interviewed artists and Carnegie Hall staff did not receive monetary compensation. All interview and focus group data were collected, analyzed, and anonymized by researchers based in Copenhagen, spearheaded by E.B., then a Master’s student at the University of Copenhagen. 1
Data Collection
Individual 1-hour-long interviews were conducted with key stakeholders involved in the concerts’ delivery and design. A 1.5-hour focus group discussion was held via Zoom with seven audience members. Interview and focus group guides anchored in the Reciprocal Feedback (RF) model (Hargreaves et al., 2005) delved into participants’ personal backgrounds in relation to the concert experience, concert design and execution, challenges, expectations, perceived impact, and future recommendations.
Data Analysis
Video and audio recordings were transcribed verbatim using the web-based automated transcription platform, Trint, and proofread by E.B. for accuracy. E.B. used NVivo, a qualitative data analysis software, to code transcripts using thematic networks analysis (Attride-Stirling, 2001), given the robust framework for structuring and visualizing complex datasets that characterizes this approach. All data were analyzed inductively using the RF model (Hargreaves et al., 2005); common topics were given codes which were further grouped into themes Figure 2. Final codes were developed based on the main experiences reported by participants, paired with the elements of the concert that participants associated with said experiences. Main themes emerged based on recurrence across participants, relevance to the research question, and the richness of the supporting data, as well as alignment with the RF model (Hargreaves et al., 2005).
Survey Research Methods
Quantitative data were collected via survey (Figure 1), inspired by the Measure Yourself Medical Outcome Profile® (MYMOP), which ensures “individualized assessment of patient-centered outcomes” in clinical health care settings (Ishaque et al., 2019, p. 879; Paterson, 1996). Through an iterative process (Figure 1 and Table 1), the research team created The Concert Well-Being Expectation and Impact Survey (CWEIS), an individualized assessment tool that allows audience members to (1) define their own well-being goal in the context of a single concert, (2) assess their expectation of achieving that goal through the experience, and (3) report how successfully their goal was achieved via Likert-type scale. This allowed for a comparison of audience intentions, expectations, and perceived results of the concert experience at the individual level (Supplemental Material, Table S6).
Format of the Final Iteration of the Convert Well-Being Expectation, and Impact Survey (CWEIS)
Thematic Network Detailing Audience Perspectives
Summary of the Benefits and Limitations of the Design Choices Made for the Concert Well-Being Expectation and Impact Survey (CWEIS) Over the Course of the Full Pilot Series
For the final concert, the CWEIS was administered immediately before and after the concert, and once mid-performance, to facilitate recall of small in-performance events that impact aesthetic judgments of experience quality (Waddell & Williamon, 2017). All survey-based data collection operated under the ethical guidelines set by the MIT Committee on the Use of Humans as Experimental Subjects (COUHES), Protocol E-4774.
Quantitative Analysis
Data were analyzed using the Wilcoxon signed rank test and simple descriptive statistics, including mean, frequency, and standard deviation, using R (R Core Team, 2021) and RStudio (RStudio Team, 2020). Incomplete and illegible responses were excluded.
Qualitative Analysis
Open responses to the initial CWEIS prompt (Figure 1, Question 1a) were independently coded by K.L. and I.K. into specific subthemes (Figure 3; Supplemental Material, Table S5) using an adapted version of the PERMA model, which identifies five essential elements of well-being (Seligman, 2011). Alongside the traditional PERMA themes of “Positive Emotions,” “Engagement,” “Relationships,” “Meaning,” and “Accomplishments,” the research team also coded for “Reduced Negative Emotions,” “Equanimity,” “Physical Impact,” “Unclear,” “Expectation Unstated,” and “No Expected Benefit.”
Breakdown of Subthemes of the 144 Included Audience Member Responses
Results
Participants
Interviews were conducted with five concert organizers: the creative director, host, guest singer/songwriter, a member of the featured band, and a representative from The Fortune Society (n.d.) whose mission is to, “support successful reentry from incarceration and promote alternatives to incarceration, thus strengthening the fabric of our communities.” Concert attendees were invited to the performances through community partner outreach. Seven of these audience members (two female and five male) participated in a single focus group discussion, six of whom had prior justice system involvement, and one who had been impacted by the justice system through a family member’s incarceration. A total of 168 2 audience members filled out the survey – 12 from the second concert, 82 from the third, and 74 from the fourth. The first concert was reserved as a pilot session, and no data were collected. No demographic information was collected from survey participants. A convenience sample was recruited from attendees upon arrival at Carnegie Hall.
Focus Group Results
A thematic network detailing audience perspectives was developed by assigning codes to common topics and subsequently grouping them into relevant themes (refer to Figure 2).
Escape to a Peaceful Place
Participants described the concert as an escape to a place of serenity with a sense that all would be well, with one mentioning that the experience was akin to being at the beach under the sun, watching the waves (Participant 7). These themes of relaxation, rejuvenation, and escape were supported by most respondents, who noted that the concert transported them to a serene, tranquil state that offered a respite from daily life.
Focus on Oneself
Many participants noted that the concert allowed them to focus on themselves and feel engaged without distraction, creating a sense of balance and an alignment of feelings, thoughts, and experiences. Others noted the concert’s positive impact on their mental state and how the space it provided allowed for self-reflection, evoking healing yet deeply emotional and, at times, somber states. Participant 2 noted that, “[the concert] just had me thinking about things that I had been through and where my mental state is at now.”
Connection
Multiple participants mentioned a strong sense of connection with other attendees. One noted how important social connection and community are to his personal journey of reintegration and self-improvement. Participant 5 shared how the concert helped him to connect with his daughter, who attended the show with him, by offering a way to bridge a gap in their relationship via shared points of interest despite missing “the past six, seven years of her life” (Supplemental Material, Table S2: P6C).
The Experience of Something New
The opportunity to “experience something new” was a widely recognized and appreciated outcome of the concert. Participants reported feeling gratitude for the opportunity to participate in an experience usually unavailable to their broader communities, including Participant 6, who stated that, “formerly incarcerated and some of the communities we come from, we don’t get to experience things” (Supplemental Material, Table S1: P6A).
Lyrical Storytelling for Reflection and Emotion
Four out of seven participants reported powerful emotions and deep reflection in response to songs written and performed by an individual whose life had been impacted by the justice system. Several participants felt a stronger connection to lyrics because they were more stylistically familiar than purely instrumental tracks, which immersed them in stories that resonated with their personal experiences. Participant 2 noted that: . . . the words to the song, it hit home for me because I lost my daughter two years ago, so not being able to say goodbye and not being able to tell [sic.] how much I loved her, it really hit home (Supplemental Material, Table S2: P2B).
Power of Novel Musical Experience
Two of the seven participants mentioned that experiencing new sounds sparked their curiosity about instrumental and brass music, with Participant 6 noting that the experience created an unexpected connection with his child, stating that, “I didn’t play an instrument in school, my daughter actually plays one right now. . . You know, it gives me something to connect with her on, and just learn in [sic] period” (Supplemental Material, Table S2: P6C). Conversely, three participants noted how lack of familiarity with brass music was an obstacle to full appreciation. Two suggested that preparatory educational materials or activities could enhance the overall experience. Relatedly, several participants noted that recent workshops and jazz concerts organized by Carnegie Hall helped them be more receptive to unfamiliar sounds and find additional meaning in the concert. Participant 5 highlights the value of such exposure, noting that: . . . the more that I experienced these types of concerts, so if you will ask me three months ago, I would say that, ‘oh, hell no, that was just boring. Why would I want to do that to myself?’ But now that I actually understand it better, I can tell you that it is a remedy (Supplemental Material, Table S2: P5A).
Emotional Diversity Beyond Meditative Music
Participants felt that the overall atmosphere primed them to be contemplative and relaxed. Several wished for more musical diversity, such as different genres, tempos, and emotional range to include the up-beat and celebratory aspects of well-being. Specifically, Participant 4 remarked that: . . . for me, in wellness, one of the things that I look for is different styles of music. I don’t always want to hear slow music, but I don’t always want to hear fast music either, but I do want to hear combination of both (Supplemental Material, Table S2: P4A).
Active Participation for Connectedness and Mind-Body Integration
Active participation in the concert was reported to bolster feelings of connectedness, both to oneself and others. A “humming exercise” invited the audience to sing or hum along to a note played by the brass quartet. Five out of seven participants noted that the immersive experience created feelings of being “in tune with [their] body” (Participant 6) and “connected to everybody in the room” (Participant 2) around them (Supplemental Material, Table S2: P2C and P6B).
Communicating Intention to Focus Experience
Calling the series “the Well-Being Concerts” primed several participants to reflect on their own well-being, thus increasing their openness to the experience. Participant 1 noted that setting his own well-being goals through the CWEIS helped ground him in the mission of the series and engage with the overall concert experience, beyond simple entertainment, and that: there are so much things that come from music, how it affects us all. . . it’s just depending on what your mood is and how you’re coming into the space.. the way the concert was, to have it, like, to explain to everyone what it is, I guess it’s a way to kind of put people into that mode (Supplemental Material, Table S3: P1A).
Environment that Enhances Musical Immersion and Relaxation
Many participants described the venue as inclusive and inviting, highlighting the cool room temperature, dim and colorful lightning, and presence of nontraditional concert seating, such as mats, cushions, and pillows. Participant 1 noted that the lighting in particular was, “in and of itself. . . calming, just being in that setting” (Supplemental Material, Table S3: P1B). According to all participants, these intentional design choices created a comfortable and relaxing space, facilitating experiences of peace, escape, and active engagement, with Participant 5 specifically noting that there was a, “sense of feeling safe in there, like I knew nothing was going to happen. I closed my eyes and just experience [sic.]” (Supplemental Material, Table S3: P5B).
Perception of Carnegie Hall: Enhancing Participant Experience and Challenging Elitist Narratives
Most participants noted that neither they, nor anyone they knew, had ever been to Carnegie Hall. Several felt that the design of a community-centered concert series, rooted in inclusion, positively challenged their perceptions of Carnegie Hall as an elitist institution. Participant 4 in particular remarked that: I’m 60 years old and when I was younger, going to Carnegie Hall, it was a big deal. To have been impacted by the justice system and to be able to have an institution like Carnegie Hall willing to have a concert to support, because I feel like it’s supported me and my wellness, to have that type of concert for a person who has a justice impacted background, I think, that’s a big deal (Supplemental Material, Table S3: P4B).
Navigating Complex Dynamics of Exclusivity
Several participants felt that specifying the audience for a concert—individuals impacted by the justice system—could reinforce feelings of shame and exclusion. Participant 6 noted that, “I think, they could really just target our communities, period, without singling us out, because no matter what our communities are impacted by, you know, the justice system, it’s not a label that we necessarily want to wear” (Supplemental Material, Table S3: P6D). Moreover, Participant I4, who works for The Fortune Society, remarked that the concert experience provided, “nothing that was helpful” or specific to the community (Supplemental Material, Table S4: PI4A). Another suggested that integrating specific communities into regular programming at prestigious venues through focused outreach and community partnerships would better foster interactions among groups that might not otherwise cross paths, creating more inclusive cultural centers.
Concert Organizer and Collaborator Interviews
Cultivation of a Mindful Experience
The series’ creative director (CD) and the concert’s host hoped to nudge the audience’s focus inwards through opportunities for mindful contemplation and self-reflection. Participant I1, one of the musicians who performed during the Well-Being Concerts, noted the intention that went into curating a set list with musical qualities that would, “. . . make people settle into their seats or their mats on the floor and get into a sort of meditative headspace rather than want to get up and dance” (Supplemental Material, Table S4: I1), that “provokes and invites active participation, a consideration of lyric and of melody and structure within the song so that the message is one that resonates with the person” (Supplemental Material, Table S4: I2A).
Emphasis on Comfort
The CD discussed the deliberate effort to create an accessible and welcoming environment through lighting, set design, diverse seating options, and explicit invitations for the audience to prioritize their personal comfort, emphasizing the importance of, “something as small as, let’s not be in this cramped chair where you, a person who is six feet tall, have your knees all up in your chest” (Supplemental Material, Table S4: I2B).
Authentic Inclusion
According to the CD, specific audiences were invited to the inaugural series to combat the idea that cultural and artistic spaces are exclusionary and inaccessible. However, and as noted in Navigating Complex Dynamics of Exclusivity, such focus could also have the unintended effect of making individuals feel marginalized and excluded from “regular” programming (Supplemental Material, Table S4: I4A).
The Fortune Society representive noted that the invitation to Carnegie Hall provided a new perspective for what the Hall is and could be. The experience furthered the organization’s broader goal of encouraging members to participate in diverse and novel experiences that complement reintegration and rehabilitation efforts, noting that, . . . “hey, there’s a string quartet. Would people be interested? They may not. They may not have been. They just may not like it. They may not have been exposed to it yet. But at least it’s an opportunity” (Supplemental Material, Table S4: I4B). Another representative also appreciated the concert’s positive and uplifting environment, noting that cultural institutions often only want to engage around themes of trauma and suffering, and that, “often, because of the makeup of the community, if there’s a movie that’s about slavery, it’s a drama based on things that’s been inflicted on people of color, then they’re like, “We should call The Fortune Society” (Supplemental Material, Table S4: I3).
However, they also noted the limited value of sporadic or one-off events, expressing that long-term partnership is necessary for long-lasting impact and true integration. One of the musicians, who has collaborated with Carnegie Hall for many years and has a history of incarceration, supports this call for deeper connections between community partners and institutions by highlighting how active participation in the Well-Being Concert has been transformative for him, remarking that: ... it allowed me to see myself in a different light, frankly, because. . . I didn’t know whether or not that role as an artist, as a songwriter, as a voice of these people, I didn’t know whether or not that would translate [outside of the justice system] (Supplemental Material, Table S4: I2C).
Survey Results
During the series, the research team made several adaptations to the CWEIS (Table 1). When the final version (Figure 1) was administered, 168 responses were collected and 24 were discarded due to missing or illegible data. There were statistically significant differences between participants pre-concert expectations and during-concert responses (Wilcoxon signed rank test, V = 392, p = .0453), during- and post-concert responses (Wilcoxon signed rank test, V = 345.5, p < .001), and pre-concert expectations and post-concert reflections (Wilcoxon signed rank test, V = 598, p = .00019). These results suggest that the Well-Being Concert experience significantly surpassed participants’ expectations of its effectiveness in helping them achieve their well-being goal, and that this level of success increased significantly over the course of the experience. On average, audience members in the final concert reported that the experience was 86.5% (SD = 20.72) successful in helping them achieve their well-being goal, on a scale of 0% to 100%.
One hundred and forty-four audience members provided legible responses to how they hoped the concert would impact their well-being, which were categorized into 27 subthemes and further consolidated into ten central themes: “Reduced Negative Emotions”; “Equanimity”; “Physical Impact”; “Unclear”; “Expectation Unstated”; “No Expected Benefit”; “Positive Emotions”; “Engagement”; “Relationships”; “Meaning” (Figure 3). Examples of coded responses can be found in Supplemental Material, Table S5. The colors of the circles in Figure 3 correspond to the themes mentioned above. All “Positive Emotions” subthemes are shaded in purple, “Engagement” in pink, “Relationships” in teal, “Meaning” in blue-purple, “Reduced Negative Emotions” in red, “Equanimity” in sky blue, “Physical Impact” in yellow, “Unclear” in blue-green, “Expectation Unstated” in light green, and “No Expected Benefit” in dark green. The numbers below each label represent the number of responses for a given subtheme. Size corresponds to the prevalence of the subtheme among audience responses.
Discussion
Key Insights
This mixed-methods study evaluates Carnegie Hall’s inaugural Well-Being Concert series, designed to support individual and community well-being through immersive musical experiences. Participating audience members reported increased relaxation, self-reflection, emotional resonance, and social connection. Quantitative results indicated that the concerts exceeded expectations in helping individuals achieve personally defined well-being goals. However, the findings also revealed important limitations. Some participants expressed ambivalence about the specificity of audience population, noting that being singled out as “justice-impacted” could reinforce stigma rather than alleviate it. Others highlighted that, while the calming, contemplative design fostered relaxation, a broader range of musical styles and more active participation might better capture the emotional diversity of well-being. Nevertheless, the series offers a promising model for how cultural institutions can serve as inclusive public health partners—provided such efforts remain responsive to community feedback and embedded within longer-term commitments.
These findings align with a growing body of research emphasizing the role of community-rooted, co-created arts programming in fostering health and well-being (Camic & Chatterjee, 2013; Golden et al., 2024). The Well-Being Concert series partially met this goal by building on long-standing connections to organizations across New York City that Carnegie Hall’s Weill Music Institute has been working with, in some cases, for nearly two decades. However, participant feedback revealed that, even with these foundations, experiences can fall short without sustained, adaptive, and reciprocal engagement. This reflects recent findings that highlight that the success of music-based programs for under served populations depends not just on access, but on cultural relevance, emotional resonance, continuity, and agency (Bensimon, 2024). The call from participants for broader musical diversity and deeper integration into regular programming mirrors critiques of tokenistic engagement within the arts-health field, and supports the WHO Regional Office for Europe’s assertion that long-term, inclusive arts strategies are essential for sustained public health impact (World Health Organization Regional Office for Europe, 2019).
Focus group results informed several key adaptations to the concert series, building on evidence suggesting that performing arts engagement can foster both individual and community well-being (Clift & Camic, 2016; MacDonald et al., 2012/2013). The success and popularity of the inaugural season resulted in the decision to increase the number of concerts offered per season from four to sixteen. Private concerts limited to focus populations will be reserved for special situations only, aligned with participants’ critique of the ways that specifying the audience for a concert could reinforce feelings of shame and exclusion. As such, inspired by participants’ calls for more community integration, moving forward, concerts will be open to the public with a set number of tickets reserved for focus populations. This shift aligns with studies advocating for increased inclusivity in the arts as a means of promoting social integration and community connection (Van de Vyver & Abrams, 2018). By fostering a more inclusive environment, arts institutions can play a meaningful role in supporting social connectedness and communities’ sense of belonging, reducing the potential for feelings of isolation or marginalization (Parkinson & White, 2013).
Recognizing that inclusivity and integration extend beyond the physical boundaries of cultural institutions and are often grounded in the broader community (Alegria et al., 2010; Golden et al., 2024), in future seasons, Carnegie Hall will explore concert curation in alternative venues, including but not limited to secure and nonsecure detention facilities, classrooms, and public spaces, to provide greater access to the concert series and promote Carnegie Hall’s mission to more equitably navigate the complex dynamics of exclusivity highlighted by participants. In addition, Carnegie Hall will encourage guests to bring friends and family to Well-Being Concerts, to strengthen the sense of community within the concert context itself, creating opportunities for shared experiences among intimates to promote social cohesion. Carnegie Hall is also committed to the continued exploration of the concert’s physical environment through curation of such elements as lighting, temperature, and seating freedom to continue to enhance audience experience and build upon the positive impact noted by participants.
Finally, Carnegie Hall has started experimenting with listening strategies designed to enhance the concert experience and amplify well-being effects, including but not limited to well-being playlists and “savoring prompts.” Research indicates that pre-event anticipatory prompts can increase engagement by fostering a sense of excitement and connection, while post-event savoring activities can help participants internalize and extend the emotional benefits of the experience (Bryant & Veroff, 2017).
Limitations
Preliminary qualitative and quantitative data indicate that Carnegie Hall’s Well-Being Concert model is feasible, acceptable, and supports well-being. Strengths of this study include the development of a brief and highly personalizable survey instrument to assess well-being impact and the rich, multistakeholder insights that emerged from the interview and focus group data. However, the small sample size and nonexperimental design of this study reduce generalizability and do not allow for causal inferences; all preliminary effectiveness data should therefore be interpreted as exploratory. A further limitation of this study is the absence of demographic data, which restricts our ability to evaluate participant representativeness and response patterns across different groups. However, secondary data provide useful insights into the population likely to engage with and benefit from such programs. For example, data from “The Sentencing Project” indicate that nearly 7 in 10 incarcerated individuals in the United States are predominantly Black and Latinx people of color (Nellis, 2021). Future studies should address this limitation by collecting demographic information to further assess program reach and effectiveness across diverse populations.
Implications for Practice
This study offers concrete, actionable insights for health promotion practitioners seeking to integrate the arts, particularly music, into their efforts to support community well-being. Health promotion practitioners should explore partnerships with performing arts venues and cultural organizations to co-design inclusive, trauma-informed, and emotionally resonant experiences that support psychosocial well-being. For those working with focus populations (e.g., justice-impacted communities or health care workers), it is important to balance audience integration with thoughtful segmentation. While creating shared experiences that include, rather than isolate, these groups can reduce stigma and foster belonging, there are contexts in which dedicated, affinity-based programming may offer psychological safety, build trust, or meet specific needs. Health promotion efforts should be guided by community input and remain flexible in determining when integration supports inclusion and when thoughtful segmentation is more responsive.
Practitioners should also consider the environment itself as a form of intervention. The curatorial strategies piloted in this study, including attention to light, sound, physical space, and invitation cues, serve as low-cost, high-impact tools for enhancing the therapeutic potential of arts-based experiences, and the adoption of similar environmental and aesthetic considerations could support emotional regulation and promote a sense of safety. Further, embedding relational engagement, such as parent-child co-participation, into program design may help strengthen social bonds, promote community cohesion, and amplify well-being outcomes. Finally, the incorporation of “savoring” and “anticipation” techniques could extend the emotional and psychological benefits of health-promoting activities, such as attending a concert (Bryant & Veroff, 2017), though further work is needed to assess the efficacy of such approaches. Strategies such as pre-event prompts and post-event reflection, are adaptable across settings, from clinics to community events. Overall, this work supports a broader reframing of cultural and creative programming as essential tools in the health promotion toolkit, particularly for underrepresented and underserved populations, and provides a series of potential strategies to do so.
Implications for Research
Future research should consider mixed-methods experimental designs that allow for both rich personal data and causal relationships between intervention and outcomes to emerge (Fancourt, 2017). Future teams working to investigate and amplify the impact of the performing arts on health may benefit from considering research as part of the curatorial process to help ensure that evaluation methods do not detract from the aesthetic experience but rather contribute to it. This integration may also motivate audience members to participate in data collection by framing their involvement as a meaningful contribution to the advancement of arts-based health initiatives.
Implications for Policy
This work also holds relevance for policy advocates seeking to build the case for integrating arts into public health systems. While recent policy at the national (Exec. Order No. 14084, 2022) and international (World Health Organization Regional Office for Europe, 2019) levels affirm the value of the arts in promoting well-being, operationalizing this vision requires clear models of implementation. There is a need for the creation of funding mechanisms that incentivize joint programming between cultural institutions and health systems, ensuring sustainability of such interventions beyond pilot phases. As interest in arts-in-health initiatives grows, national bodies can develop voluntary standards or best practice frameworks for health-supportive cultural programming, particularly those that prioritize inclusion, community co-creation, and measurable impact. Moreover, policies that incentivize partnerships between researchers, cultural institutions, and public health organizations can help generate robust, practice-based evidence that in turn will inform future funding and program design, promoting the creation of a generative arts in health ecosystem. In this work, we provide a model for how performing arts venues can function as psychologically safe, accessible, and identity-affirming public spaces that promote well-being. Policymakers can advance this paradigm by including cultural spaces by in health equity and social determinants of health frameworks. By grounding these policy recommendations in the practical and evaluative insights of this study, health promotion advocates and policymakers can make stronger cases for embedding the arts not only in cultural life, but in the architecture of public health.
Supplemental Material
sj-docx-1-hpp-10.1177_15248399251361095 – Supplemental material for Beyond Performance: A Mixed-Methods Study of Carnegie Hall’s Well-Being Concerts
Supplemental material, sj-docx-1-hpp-10.1177_15248399251361095 for Beyond Performance: A Mixed-Methods Study of Carnegie Hall’s Well-Being Concerts by Kimaya Lecamwasam, Elina Bresle, Kristian Moltke Martiny, Manuel Bagorro, Sarah Johnson, Sam Livingston, Morten Kristensen and Ian Koebner in Health Promotion Practice
Footnotes
Authors’ Note:
The authors declare the following conflicts of interest: KL has no conflicts of interest to disclose. SJ and SL are employees of Carnegie Hall, which produced the Well-Being Concerts described in this manuscript. KM and MK work for Enact:Lab hired as a paid consultant to evaluate the inaugural season of the Well-Being Concerts. EB previously worked as a Cultural Projects Assistant for Enact:Lab but did not receive compensation or pay as part of this project. MB and IK are paid consultants for Carnegie Hall. As a producer of the series, MB was also interviewed for this study. We wish to acknowledge the editorial support provided by Nisha Sajnani.
Data Availability Statement
The raw qualitative data from this study are not being publicly archived for use by other researchers because the data contain information that could compromise the privacy of research participants. The quantitative data collected as part of the study will be made available upon request. To discuss data availability, please contact
Notes
References
Supplementary Material
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