1 1291 121 GROUP ACUPUNCTURE THERAPY WITH YOGA THERAPY FOR CHRONIC NECK, LOW BACK, AND OSTEOARTHRITIS PAIN IN SAFETY NET SETTING FOR AN UNDERSERVED POPULATION: DESIGN AND RATIONALE FOR A FEASIBILITY PILOT. CHRONIC PAIN IS PREVALENT IN THE UNITED STATES, WITH IMPACT ON PHYSICAL AND PSYCHOLOGICAL FUNCTIONING AS WELL AS LOST WORK PRODUCTIVITY. MINORITY AND LOWER SOCIOECONOMIC POPULATIONS HAVE INCREASED PREVALENCE OF CHRONIC PAIN WITH LESS ACCESS TO PAIN CARE, POORER OUTCOMES, AND HIGHER RISK OF FATAL OPIOID OVERDOSE. ACUPUNCTURE THERAPY IS EFFECTIVE IN TREATING CHRONIC PAIN CONDITIONS INCLUDING CHRONIC LOW BACK PAIN, NECK PAIN, SHOULDER PAIN, AND KNEE PAIN FROM OSTEOARTHRITIS. ACUPUNCTURE THERAPY, INCLUDING GROUP ACUPUNCTURE, IS FEASIBLE AND EFFECTIVE, AND SPECIFICALLY SO FOR UNDERSERVED AND DIVERSE POPULATIONS AT RISK FOR HEALTH OUTCOME DISPARITIES. ACUPUNCTURE THERAPY ALSO ENCOURAGES PATIENT ENGAGEMENT AND ACTIVATION. AS CHRONIC PAIN IMPROVES, THERE IS A NATURAL PROGRESSION TO WANT AND NEED TO INCREASE ACTIVITY AND MOVEMENT RECOVERY. DIVERSE MOVEMENT APPROACHES ARE IMPORTANT FOR IMPROVING RANGE OF MOTION, MAINTAINING GAINS, STRENGTHENING, AND PROMOTING PATIENT ENGAGEMENT AND ACTIVATION. YOGA THERAPY IS AN ACTIVE THERAPY WITH PROVEN BENEFIT IN MUSCULOSKELETAL PAIN DISORDERS AND PAIN ASSOCIATED DISABILITY. THE AIM OF THIS QUASI-EXPERIMENTAL PILOT FEASIBILITY TRIAL IS TO TEST THE BUNDLING OF THESE 2 EFFECTIVE CARE OPTIONS FOR CHRONIC PAIN, TO INFORM BOTH THE DESIGN FOR A LARGER RANDOMIZED PRAGMATIC EFFECTIVENESS TRIAL AS WELL AS IMPLEMENTATION STRATEGIES ACROSS UNDERSERVED SETTINGS. 2020 2 375 40 BARRIERS AND FACILITATORS TO IMPLEMENTING BUNDLED ACUPUNCTURE AND YOGA THERAPY TO TREAT CHRONIC PAIN IN COMMUNITY HEALTHCARE SETTINGS: A FEASIBILITY PILOT. OBJECTIVE: TO IDENTIFY FACTORS ASSOCIATED WITH IMPLEMENTING BUNDLED GROUP ACUPUNCTURE AND YOGA THERAPY (YT) TO TREAT UNDERSERVED PATIENTS WITH CHRONIC PAIN IN COMMUNITY HEALTH CENTER (CHC) SETTINGS. THIS IS NOT AN IMPLEMENTATION SCIENCE STUDY, BUT RATHER AN ORGANIZED APPROACH FOR IDENTIFICATION OF BARRIERS AND FACILITATORS TO IMPLEMENTING THESE THERAPIES AS A PRECURSOR TO A FUTURE IMPLEMENTATION SCIENCE STUDY. DESIGN: THIS STUDY WAS PART OF A SINGLE-ARM FEASIBILITY TRIAL, WHICH AIMED TO TEST THE FEASIBILITY OF BUNDLING GA AND YT FOR CHRONIC PAIN IN CHCS. TREATMENT OUTCOMES WERE MEASURED BEFORE AND AFTER THE 10-WEEK INTERVENTION PERIOD. IMPLEMENTATION FEASIBILITY WAS ASSESSED THROUGH WEEKLY RESEARCH TEAM MEETINGS, WEEKLY YOGA PROVIDER MEETINGS, MONTHLY ACUPUNCTURE PROVIDER MEETINGS, AND WEEKLY PROVIDER SURVEYS. SETTINGS: THE STUDY WAS CONDUCTED IN NEW YORK CITY AT TWO MONTEFIORE MEDICAL GROUP (MMG) SITES IN THE BRONX, AND ONE INSTITUTE FOR FAMILY HEALTH (IFH) SITE IN HARLEM. SUBJECTS: PARTICIPANTS IN THE FEASIBILITY TRIAL WERE RECRUITED FROM IFH AND MMG SITES, AND NEEDED TO HAVE HAD LOWER BACK, NECK, OR OSTEOARTHRITIS PAIN FOR >3 MONTHS. IMPLEMENTATION STAKEHOLDERS INCLUDED THE RESEARCH TEAM, PROVIDERS OF ACUPUNCTURE AND YT, REFERRING PROVIDERS, AND CHC STAFF. RESULTS: IMPLEMENTATION OF THESE THERAPIES WAS ASSESSED USING THE CONSOLIDATED FRAMEWORK FOR IMPLEMENTATION RESEARCH. WE IDENTIFIED ISSUES ASSOCIATED WITH SCHEDULING, TREATMENT FIDELITY, COMMUNICATION, THE THREE-WAY DISCIPLINARY INTERACTION OF ACUPUNCTURE, YOGA, AND BIOMEDICINE, SPACE ADAPTATION, SITE-SPECIFIC LOGISTICAL AND OPERATIONAL REQUIREMENTS, AND PATIENT-PROVIDER LANGUAGE BARRIERS. ISSUES VARIED AS TO THEIR FREQUENCY AND RESOLUTION DIFFICULTY. CONCLUSIONS: THIS FEASIBILITY TRIAL IDENTIFIED IMPLEMENTATION ISSUES AND RESOLUTION STRATEGIES THAT COULD BE FURTHER EXPLORED IN FUTURE IMPLEMENTATION STUDIES. CLINICAL TRIAL REGISTRATION NO.: NCT04296344. 2021 3 17 36 "THE PAIN LEFT, I WAS OFF AND RUNNING": A QUALITATIVE ANALYSIS OF GROUP ACUPUNCTURE AND YOGA THERAPY FOR CHRONIC PAIN IN A LOW-INCOME AND ETHNICALLY DIVERSE POPULATION. INTRODUCTION: CHRONIC PAIN AND THE CURRENT OPIOID EPIDEMIC ARE PRESSING PUBLIC HEALTH CONCERNS, ESPECIALLY IN LOW-INCOME AND ETHNICALLY DIVERSE COMMUNITIES. NONPHARMACOLOGIC THERAPIES THAT ARE SAFE, EFFECTIVE, AND ACCEPTABLE FOR THE TREATMENT OF CHRONIC PAIN CONDITIONS MAY PROVIDE A SOLUTION FOR ADDRESSING THIS ISSUE. THIS QUALITATIVE ANALYSIS EXPLORES THE EXPERIENCE OF STUDY PARTICIPANTS WHO RECEIVED COMBINED ACUPUNCTURE AND YOGA THERAPY (YT) TO TREAT CHRONIC PAIN DELIVERED IN A PRIMARY CARE SETTING. METHODS: THE GROUP ACUPUNCTURE WITH YOGA THERAPY FOR CHRONIC NECK, LOW BACK, AND OSTEOARTHRITIC PAIN TRIAL (GAPYOGA) ASSESSED THE FEASIBILITY AND EFFECTIVENESS OF GROUP ACUPUNCTURE (GA) COMBINED WITH YT IN A LOW-INCOME, RACIAL, AND ETHNICALLY DIVERSE POPULATION. INDIVIDUAL IN-DEPTH INTERVIEWS WERE CONDUCTED WITH A SUBSET OF PATIENTS IN THE TRIAL. NINETEEN PARTICIPANTS WERE INTERVIEWED FOR QUALITATIVE ANALYSIS OF THEIR EXPERIENCE. USING THE IMMERSION AND CRYSTALLIZATION METHOD, TRANSCRIBED INTERVIEWS WERE ANALYZED FOR THEMES MEANINGFULLY REPRESENTING PARTICIPANT EXPERIENCE. RESULTS: THE COMBINED GA AND YT RESULTED IN SIGNIFICANT PAIN RELIEF AND TRANSFORMATIVE HEALING EXPERIENCES. THREE THEMES EMERGED FROM PARTICIPANT NARRATIVES: (1) TRANSFORMATIVE ENGAGEMENT WITH SELF IN THE HEALING PROCESS THROUGH PAIN RELIEF, PSYCHOLOGICAL WELL-BEING, AND SELF-EFFICACY; (2) THERAPEUTIC RELATIONSHIP WITH ACUPUNCTURE AND YOGA PROVIDERS; AND (3) FOSTERING RELATIONSHIPS WITH FELLOW PARTICIPANTS IN THE GROUP. DISCUSSION: IN THIS STUDY OF A LOW-INCOME AND ETHNICALLY DIVERSE POPULATION, THE COMBINATION OF ACUPUNCTURE AND YT WAS FOUND TO ALLEVIATE PAIN, IMPROVE FUNCTION, PROMOTE PSYCHOLOGICAL WELL-BEING, AND ENGAGE PARTICIPANTS IN SELF-CARE PRACTICES IN A TRANSFORMATIVE HEALING PROCESS-RESULTING IN PHYSICAL AND PSYCHOLOGICAL BENEFITS. 2022 4 2788 35 YOGA THERAPY DYADS: A NOVEL APPROACH TO CHRONIC PAIN MANAGEMENT IN UNDERSERVED POPULATIONS. YOGA THERAPY IS AN EMERGING INTEGRATIVE HEALTH APPROACH THAT APPLIES THE PRACTICES AND TEACHINGS OF YOGA FOR INDIVIDUALS WITH CLINICAL CONCERNS. IT IS GENERALLY OFFERED AS INDIVIDUAL SESSIONS BETWEEN A YOGA THERAPIST AND CLIENT OR IN A SMALL GROUP SETTING WITH SEVERAL CLIENTS WHO SHARE A CLINICAL CONCERN. HERE WE DESCRIBE A THIRD MODEL FOR CONSIDERATION- THE YOGA THERAPY DYAD. A DYAD INCLUDES TWO CLIENTS WORKING SIMULTANEOUSLY WITH A SINGLE YOGA THERAPIST AND DIFFERS FROM BOTH INDIVIDUAL AND SMALL GROUP SESSIONS IN THE POTENTIAL BENEFITS AND CHALLENGES. THE YOGA THERAPY DYAD MODEL THAT IS DETAILED HERE WAS IMPLEMENTED AS PART OF A FEASIBILITY TRIAL ALONG WITH GROUP ACUPUNCTURE THERAPY FOR CHRONIC PAIN IN AN UNDERSERVED POPULATION. UNDERSERVED POPULATIONS ARE AT RISK FOR PAIN AND REDUCED ACCESS TO CARE. THIS PILOT MAY INFORM FUTURE RESEARCH, POLICY, EDUCATION, AND CLINICAL PRACTICE. 2022 5 2852 36 YOGA, PHYSICAL THERAPY, OR EDUCATION FOR CHRONIC LOW BACK PAIN: A RANDOMIZED NONINFERIORITY TRIAL. BACKGROUND: YOGA IS EFFECTIVE FOR MILD TO MODERATE CHRONIC LOW BACK PAIN (CLBP), BUT ITS COMPARATIVE EFFECTIVENESS WITH PHYSICAL THERAPY (PT) IS UNKNOWN. MOREOVER, LITTLE IS KNOWN ABOUT YOGA'S EFFECTIVENESS IN UNDERSERVED PATIENTS WITH MORE SEVERE FUNCTIONAL DISABILITY AND PAIN. OBJECTIVE: TO DETERMINE WHETHER YOGA IS NONINFERIOR TO PT FOR CLBP. DESIGN: 12-WEEK, SINGLE-BLIND, 3-GROUP RANDOMIZED NONINFERIORITY TRIAL AND SUBSEQUENT 40-WEEK MAINTENANCE PHASE. (CLINICALTRIALS.GOV: NCT01343927). SETTING: ACADEMIC SAFETY-NET HOSPITAL AND 7 AFFILIATED COMMUNITY HEALTH CENTERS. PARTICIPANTS: 320 PREDOMINANTLY LOW-INCOME, RACIALLY DIVERSE ADULTS WITH NONSPECIFIC CLBP. INTERVENTION: PARTICIPANTS RECEIVED 12 WEEKLY YOGA CLASSES, 15 PT VISITS, OR AN EDUCATIONAL BOOK AND NEWSLETTERS. THE MAINTENANCE PHASE COMPARED YOGA DROP-IN CLASSES VERSUS HOME PRACTICE AND PT BOOSTER SESSIONS VERSUS HOME PRACTICE. MEASUREMENTS: PRIMARY OUTCOMES WERE BACK-RELATED FUNCTION, MEASURED BY THE ROLAND MORRIS DISABILITY QUESTIONNAIRE (RMDQ), AND PAIN, MEASURED BY AN 11-POINT SCALE, AT 12 WEEKS. PRESPECIFIED NONINFERIORITY MARGINS WERE 1.5 (RMDQ) AND 1.0 (PAIN). SECONDARY OUTCOMES INCLUDED PAIN MEDICATION USE, GLOBAL IMPROVEMENT, SATISFACTION WITH INTERVENTION, AND HEALTH-RELATED QUALITY OF LIFE. RESULTS: ONE-SIDED 95% LOWER CONFIDENCE LIMITS WERE 0.83 (RMDQ) AND 0.97 (PAIN), DEMONSTRATING NONINFERIORITY OF YOGA TO PT. HOWEVER, YOGA WAS NOT SUPERIOR TO EDUCATION FOR EITHER OUTCOME. YOGA AND PT WERE SIMILAR FOR MOST SECONDARY OUTCOMES. YOGA AND PT PARTICIPANTS WERE 21 AND 22 PERCENTAGE POINTS LESS LIKELY, RESPECTIVELY, THAN EDUCATION PARTICIPANTS TO USE PAIN MEDICATION AT 12 WEEKS. IMPROVEMENTS IN YOGA AND PT GROUPS WERE MAINTAINED AT 1 YEAR WITH NO DIFFERENCES BETWEEN MAINTENANCE STRATEGIES. FREQUENCY OF ADVERSE EVENTS, MOSTLY MILD SELF-LIMITED JOINT AND BACK PAIN, DID NOT DIFFER BETWEEN THE YOGA AND PT GROUPS. LIMITATIONS: PARTICIPANTS WERE NOT BLINDED TO TREATMENT ASSIGNMENT. THE PT GROUP HAD DISPROPORTIONATE LOSS TO FOLLOW-UP. CONCLUSION: A MANUALIZED YOGA PROGRAM FOR NONSPECIFIC CLBP WAS NONINFERIOR TO PT FOR FUNCTION AND PAIN. PRIMARY FUNDING SOURCE: NATIONAL CENTER FOR COMPLEMENTARY AND INTEGRATIVE HEALTH OF THE NATIONAL INSTITUTES OF HEALTH. 2017 6 2831 33 YOGA VS. PHYSICAL THERAPY VS. EDUCATION FOR CHRONIC LOW BACK PAIN IN PREDOMINANTLY MINORITY POPULATIONS: STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN CAUSES SUBSTANTIAL MORBIDITY AND COST TO SOCIETY WHILE DISPROPORTIONATELY IMPACTING LOW-INCOME AND MINORITY ADULTS. SEVERAL RANDOMIZED CONTROLLED TRIALS SHOW YOGA IS AN EFFECTIVE TREATMENT. HOWEVER, THE COMPARATIVE EFFECTIVENESS OF YOGA AND PHYSICAL THERAPY, A COMMON MAINSTREAM TREATMENT FOR CHRONIC LOW BACK PAIN, IS UNKNOWN. METHODS/DESIGN: THIS IS A RANDOMIZED CONTROLLED TRIAL FOR 320 PREDOMINANTLY LOW-INCOME MINORITY ADULTS WITH CHRONIC LOW BACK PAIN, COMPARING YOGA, PHYSICAL THERAPY, AND EDUCATION. INCLUSION CRITERIA ARE ADULTS 18-64 YEARS OLD WITH NON-SPECIFIC LOW BACK PAIN LASTING >/= 12 WEEKS AND A SELF-REPORTED AVERAGE PAIN INTENSITY OF >/= 4 ON A 0-10 SCALE. RECRUITMENT TAKES PLACE AT BOSTON MEDICAL CENTER, AN URBAN ACADEMIC SAFETY-NET HOSPITAL AND SEVEN FEDERALLY QUALIFIED COMMUNITY HEALTH CENTERS LOCATED IN DIVERSE NEIGHBORHOODS. THE 52-WEEK STUDY HAS AN INITIAL 12-WEEK TREATMENT PHASE WHERE PARTICIPANTS ARE RANDOMIZED IN A 2:2:1 RATIO INTO I) A STANDARDIZED WEEKLY HATHA YOGA CLASS SUPPLEMENTED BY HOME PRACTICE; II) A STANDARDIZED EVIDENCE-BASED EXERCISE THERAPY PROTOCOL ADAPTED FROM THE TREATMENT BASED CLASSIFICATION METHOD, INDIVIDUALLY DELIVERED BY A PHYSICAL THERAPIST AND SUPPLEMENTED BY HOME PRACTICE; AND III) EDUCATION DELIVERED THROUGH A SELF-CARE BOOK. CO-PRIMARY OUTCOME MEASURES ARE 12-WEEK PAIN INTENSITY MEASURED ON AN 11-POINT NUMERICAL RATING SCALE AND BACK-SPECIFIC FUNCTION MEASURED USING THE MODIFIED ROLAND MORRIS DISABILITY QUESTIONNAIRE. IN THE SUBSEQUENT 40-WEEK MAINTENANCE PHASE, YOGA PARTICIPANTS ARE RE-RANDOMIZED IN A 1:1 RATIO TO EITHER STRUCTURED MAINTENANCE YOGA CLASSES OR HOME PRACTICE ONLY. PHYSICAL THERAPY PARTICIPANTS ARE SIMILARLY RE-RANDOMIZED TO EITHER FIVE BOOSTER SESSIONS OR HOME PRACTICE ONLY. EDUCATION PARTICIPANTS CONTINUE TO FOLLOW RECOMMENDATIONS OF EDUCATIONAL MATERIALS. WE WILL ALSO ASSESS COST EFFECTIVENESS FROM THE PERSPECTIVES OF THE INDIVIDUAL, INSURERS, AND SOCIETY USING CLAIMS DATABASES, ELECTRONIC MEDICAL RECORDS, SELF-REPORT COST DATA, AND STUDY RECORDS. QUALITATIVE DATA FROM INTERVIEWS WILL ADD SUBJECTIVE DETAIL TO COMPLEMENT QUANTITATIVE DATA. TRIAL REGISTRATION: THIS TRIAL IS REGISTERED IN CLINICALTRIALS.GOV, WITH THE ID NUMBER: NCT01343927. 2014 7 2032 26 TAILORING TRAUMA-SENSITIVE YOGA FOR HIGH-RISK POPULATIONS IN PUBLIC-SECTOR SETTINGS. LOW-INCOME, RACIAL-MINORITY, HIGH-RISK POPULATIONS HAVE LIMITED ACCESS TO EVIDENCE-BASED TREATMENTS FOR POSTTRAUMATIC STRESS DISORDER (PTSD), AND THEIR ACCEPTANCE OF COMPLEMENTARY INTERVENTIONS IS UNKNOWN. TRAUMA CENTER TRAUMA-SENSITIVE YOGA (TC-TSY), WHICH HAS DEMONSTRATED EFFICACY IN COMMUNITY SAMPLES, HAS NOT YET BEEN WIDELY USED WITH ETHNIC MINORITY LOW-INCOME INDIVIDUALS. THIS ARTICLE PRESENTS A CULTURALLY TAILORED VERSION OF A TC-TSY INTERVENTION DELIVERED AS A DROP-IN SERVICE IN A PUBLIC HOSPITAL-BASED CLINIC TO PATIENTS WITH HISTORIES OF INTERPERSONAL VIOLENCE AND SUICIDE ATTEMPTS. TC-TSY WAS ITERATIVELY TAILORED TO MEET THE UNIQUE CLINICAL NEEDS OF INDIVIDUALS WITHIN THIS SETTING. GROUP FACILITATOR OBSERVATIONS ARE SUMMARIZED; THEY DESCRIBE A SUCCESSFUL INITIAL IMPLEMENTATION AND CULTURALLY INFORMED ADAPTATION OF THE GROUP INTERVENTION. THE FACILITATORS' OBSERVATIONS ILLUSTRATED THAT GROUP MEMBERS ACCEPTED THE INTEGRATION OF THIS STRUCTURED, GENTLE YOGA PRACTICE INTO OUTPATIENT BEHAVIORAL HEALTH PROGRAMMING AND IDENTIFIED SITE-SPECIFIC MODIFICATIONS TO INFORM FORMAL STUDY. THE PROCESS BY WHICH TC-TSY WAS ADAPTED AND IMPLEMENTED FOR BLACK INDIVIDUALS WITH A HISTORY OF INTERPERSONAL TRAUMA AT RISK FOR SUICIDAL BEHAVIOR CAN SERVE AS A GUIDE FOR TAILORING OTHER COMPLEMENTARY, INTEGRATIVE INTERVENTIONS TO MEET THE NEEDS OF UNIQUE CLINICAL SETTINGS. THIS PROCESS IS OFFERED AS A FOUNDATION FOR FUTURE SYSTEMATIC TESTING OF THIS COMPLEMENTARY, INTEGRATED, CULTURALLY ADAPTED TRAUMA THERAPY IN HIGH-RISK CLINICAL POPULATIONS. 2021 8 151 37 A QUALITATIVE INVESTIGATION TO INFORM YOGA INTERVENTION RECRUITMENT PRACTICES FOR RACIAL/ETHNIC MINORITY ADOLESCENTS IN OUTPATIENT MENTAL HEALTH TREATMENT. OBJECTIVE: YOGA IS RECOGNIZED AS AN EFFECTIVE APPROACH TO IMPROVING OVERALL PHYSICAL AND MENTAL HEALTH; HOWEVER, THERE MAY BE PERCEIVED BARRIERS TO YOGA PARTICIPATION, PARTICULARLY AMONG POPULATIONS MOST AT RISK FOR MENTAL HEALTH ISSUES. WE CONDUCTED QUALITATIVE FORMATIVE RESEARCH TO HELP INFORM RECRUITMENT PRACTICES FOR A FUTURE STUDY AND TO SPECIFICALLY UNDERSTAND THE BARRIERS AND FACILITATORS TO ENGAGEMENT IN YOGA PRACTICE AMONG RACIAL/ETHNIC MINORITY ADOLESCENTS, AS WELL AS ADOLESCENTS IN OUTPATIENT MENTAL HEALTH TREATMENT. METHODS: QUALITATIVE DATA WERE COLLECTED AT A COMMUNITY HEALTH CLINIC THAT SERVES LOW INCOME FAMILIES IN SOUTHEASTERN FLORIDA. USING SEMI STRUCTURED INTERVIEWS WITH RACIAL AND ETHNIC MINORITY ADOLESCENTS BETWEEN 12 AND 17 YEARS OLD, PARTICIPANTS WERE ASKED ABOUT BELIEFS AND PERCEPTIONS ABOUT YOGA, AS WELL AS RECOMMENDATIONS ON RECRUITING PEERS. A THEMATIC ANALYSIS APPROACH WAS USED TO IDENTIFY AND EXAMINE COMMON THEMES. RESULTS: TWENTY INTERVIEWS WERE CONDUCTED AND EIGHT MAJOR THEMES EMERGED FROM THE DATA. THEMES WERE GROUPED AS (1) FACILITATORS TO RECRUITMENT AND (2) BARRIERS TO RECRUITMENT. INTERPRETATION: ADVERTISING FREE YOGA THAT EMPHASIZES THE SOCIAL, PHYSICAL, AND MENTAL BENEFITS CAN HELP ASSUAGE NEGATIVE PERCEPTIONS OF YOGA AND PROMOTE THE ADVANTAGES OF YOGA AMONG TEENAGERS. HAVING RECRUITMENT MATERIALS AND MODALITIES THAT HIGHLIGHT INCLUSIVITY OF ALL GENDERS AND PHYSICAL ABILITIES IN THE YOGA CLASSES ARE ALSO IMPORTANT IN FACILITATING PARTICIPATION. UNDERSTANDING PERCEPTIONS OF YOGA, AS WELL AS PERCEIVED BARRIERS AND FACILITATORS, AMONG RACIALLY/ETHNICALLY DIVERSE ADOLESCENTS IN OUTPATIENT MENTAL HEALTH TREATMENT, CAN ASSIST RECRUITMENT EFFORTS, INCREASE YOGA INTERVENTION PARTICIPATION, AND ULTIMATELY, IMPROVE MENTAL HEALTH OUTCOMES FOR UNDERSERVED POPULATIONS. 2020 9 1155 27 ENHANCING YOGA PARTICIPATION: A QUALITATIVE INVESTIGATION OF BARRIERS AND FACILITATORS TO YOGA AMONG PREDOMINANTLY RACIAL/ETHNIC MINORITY, LOW-INCOME ADULTS. YOGA IS UNDERUTILIZED AMONG RACIAL/ETHNIC MINORITIES AND LOW-INCOME POPULATIONS. TO ENHANCE PARTICIPATION AMONG THESE DEMOGRAPHIC GROUPS AND TO INFORM A FUTURE CLINICAL TRIAL, WE CONDUCTED A QUALITATIVE FORMATIVE INVESTIGATION, INFORMED BY THE SOCIAL CONTEXTUAL MODEL OF HEALTH BEHAVIOR CHANGE, TO IDENTIFY BARRIERS AND FACILITATORS TO YOGA THAT COULD IMPACT STUDY PARTICIPATION. WE RECRUITED TWENTY-FOUR RACIALLY/ETHNICALLY DIVERSE ADULTS, WITH AND WITHOUT PRIOR YOGA EXPERIENCE, FROM A LOW-INCOME, URBAN HOUSING COMMUNITY TO PARTICIPATE IN EITHER AN INDIVIDUAL INTERVIEW OR FOCUS GROUP. A THEMATIC DATA ANALYSIS APPROACH WAS EMPLOYED. BARRIERS TO YOGA ENGAGEMENT INCLUDED THE PERCEPTION THAT YOGA LACKS PHYSICALITY AND WEIGHT LOSS BENEFITS, FEAR OF INJURY, LACK OF ABILITY/SELF-EFFICACY TO PERFORM THE PRACTICES, PREFERENCE FOR OTHER PHYSICAL ACTIVITIES, AND SCHEDULING DIFFICULTIES. FACILITATORS OF YOGA ENGAGEMENT INCLUDED A QUALITY YOGA INSTRUCTOR WHO PROVIDES INDIVIDUALIZED INSTRUCTION, BEGINNER LEVEL CLASSES, AND PROMOTIONAL MESSAGING THAT HIGHLIGHTS THE POTENTIAL BENEFITS OF YOGA, SUCH AS STRESS REDUCTION. 2017 10 2035 25 TELE-YOGA FOR CHRONIC PAIN: CURRENT STATUS AND FUTURE DIRECTIONS. PAIN IS A PERVASIVE, DEBILITATING DISORDER THAT IS RESISTANT TO LONG-TERM PHARMACOLOGICAL INTERVENTIONS. ALTHOUGH PSYCHOLOGICAL THERAPIES SUCH AS COGNITIVE BEHAVIOR THERAPY DEMONSTRATE MODERATE EFFICACY, MANY INDIVIDUALS CONTINUE TO HAVE ONGOING DIFFICULTIES FOLLOWING TREATMENT. THERE IS A CURRENT TREND TO ESTABLISH COMPLEMENTARY AND INTEGRATIVE HEALTH INTERVENTIONS FOR CHRONIC PAIN, FOR WHICH YOGA HAS BEEN FOUND TO HAVE EXCITING POTENTIAL. NEVERTHELESS, AN IMPORTANT CONSIDERATION WITHIN THE FIELD IS ACCESSIBILITY TO ADEQUATE CARE. TELEHEALTH CAN BE USED TO PROVIDE REAL-TIME INTERACTIVE VIDEO CONFERENCING LEADING TO INCREASED ACCESS TO HEALTH CARE FOR INDIVIDUALS LOCATED REMOTELY OR WHO OTHERWISE HAVE DIFFICULTY ACCESSING SERVICES, PERHAPS THROUGH ISSUES OF MOBILITY OR PROXIMITY OF ADEQUATE SERVICES. THIS ARTICLE ASSESSES THE CURRENT STATUS AND FEASIBILITY OF IMPLEMENTING TELE-YOGA FOR CHRONIC PAIN. METHODOLOGICAL LIMITATIONS AND RECOMMENDATIONS FOR FUTURE RESEARCH ARE DISCUSSED. 2018 11 122 38 A PILOT STUDY OF YOGA AS SELF-CARE FOR ARTHRITIS IN MINORITY COMMUNITIES. BACKGROUND: WHILE ARTHRITIS IS THE MOST COMMON CAUSE OF DISABILITY, NON-HISPANIC BLACKS AND HISPANICS EXPERIENCE WORSE ARTHRITIS IMPACT DESPITE HAVING THE SAME OR LOWER PREVALENCE OF ARTHRITIS COMPARED TO NON-HISPANIC WHITES. PEOPLE WITH ARTHRITIS WHO EXERCISE REGULARLY HAVE LESS PAIN, MORE ENERGY, AND IMPROVED SLEEP, YET ARTHRITIS IS ONE OF THE MOST COMMON REASONS FOR LIMITING PHYSICAL ACTIVITY. MIND-BODY INTERVENTIONS, SUCH AS YOGA, THAT TEACH STRESS MANAGEMENT ALONG WITH PHYSICAL ACTIVITY MAY BE WELL SUITED FOR INVESTIGATION IN BOTH OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS. YOGA USERS ARE PREDOMINANTLY WHITE, FEMALE, AND COLLEGE EDUCATED. THERE ARE FEW STUDIES THAT EXAMINE YOGA IN MINORITY POPULATIONS; NONE ADDRESS ARTHRITIS. THIS PAPER PRESENTS A STUDY PROTOCOL EXAMINING THE FEASIBILITY AND ACCEPTABILITY OF PROVIDING YOGA TO AN URBAN, MINORITY POPULATION WITH ARTHRITIS. METHODS/DESIGN: IN THIS ONGOING PILOT STUDY, A CONVENIENCE SAMPLE OF 20 MINORITY ADULTS DIAGNOSED WITH EITHER OSTEOARTHRITIS OR RHEUMATOID ARTHRITIS UNDERGO AN 8-WEEK PROGRAM OF YOGA CLASSES. IT IS BELIEVED THAT BY ATTENDING YOGA CLASSES DESIGNED FOR PATIENTS WITH ARTHRITIS, WITH RACIALLY CONCORDANT INSTRUCTORS; ACCEPTABILITY OF YOGA AS AN ADJUNCT TO STANDARD ARTHRITIS TREATMENT AND SELF-CARE WILL BE ENHANCED. SELF-CARE IS DEFINED AS ADOPTING BEHAVIORS THAT IMPROVE PHYSICAL AND MENTAL WELL-BEING. THIS CONCEPT IS QUANTIFIED THROUGH COLLECTING PATIENT-REPORTED OUTCOME MEASURES RELATED TO SPIRITUAL GROWTH, HEALTH RESPONSIBILITY, INTERPERSONAL RELATIONS, AND STRESS MANAGEMENT. ADDITIONAL MEASURES COLLECTED DURING THIS STUDY INCLUDE: PHYSICAL FUNCTION, ANXIETY/DEPRESSION, FATIGUE, SLEEP DISTURBANCE, SOCIAL ROLES, AND PAIN; AS WELL AS BASELINE DEMOGRAPHIC AND CLINICAL DATA. FIELD NOTES, QUANTITATIVE AND QUALITATIVE DATA REGARDING FEASIBILITY AND ACCEPTABILITY ARE ALSO COLLECTED. ACCEPTABILITY IS DETERMINED BY RESPONSE/RETENTION RATES, POSITIVE QUALITATIVE DATA, AND CONTINUING YOGA PRACTICE AFTER THREE MONTHS. DISCUSSION: THERE ARE A NUMBER OF CHALLENGES IN RECRUITING AND RETAINING PARTICIPANTS FROM A COMMUNITY CLINIC SERVING MINORITY POPULATIONS. ADOPTING BEHAVIORS THAT IMPROVE WELL-BEING AND QUALITY OF LIFE INCLUDE THOSE THAT INTEGRATE MENTAL HEALTH (MIND) AND PHYSICAL HEALTH (BODY). FEW STUDIES HAVE EXAMINED OFFERING INTEGRATIVE MODALITIES TO THIS POPULATION. THIS PILOT WAS UNDERTAKEN TO QUANTIFY MEASURES OF FEASIBILITY AND ACCEPTABILITY THAT WILL BE USEFUL WHEN EVALUATING FUTURE PLANS FOR EXPANDING THE STUDY OF YOGA IN URBAN, MINORITY POPULATIONS WITH ARTHRITIS. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT01617421. 2013 12 1224 26 FEASIBILITY AND ASSESSMENT OF OUTCOME MEASURES FOR YOGA AS SELF-CARE FOR MINORITIES WITH ARTHRITIS: A PILOT STUDY. BACKGROUND: WHILE THERE IS A GROWING INTEREST IN THE THERAPEUTIC BENEFITS OF YOGA, MINORITY POPULATIONS WITH ARTHRITIS TEND TO BE UNDER-REPRESENTED IN THE RESEARCH. ADDITIONALLY, THERE IS AN ABSENCE OF GUIDANCE IN THE LITERATURE REGARDING THE USE OF MULTICULTURAL TEAMS AND SOCIOCULTURAL HEALTH BELIEFS, WHEN DESIGNING YOGA STUDIES FOR A RACIALLY DIVERSE POPULATION WITH ARTHRITIS. THIS PILOT STUDY EXAMINED THE FEASIBILITY OF OFFERING YOGA AS A SELF-CARE MODALITY TO AN URBAN, BILINGUAL, MINORITY POPULATION WITH OSTEOARTHRITIS (OA) OR RHEUMATOID ARTHRITIS (RA), IN THE WASHINGTON, DC AREA. METHODS: THE PRIMARY OBJECTIVE OF THE STUDY WAS TO ASSESS THE FEASIBILITY OF OFFERING AN 8-WEEK, BILINGUAL YOGA INTERVENTION ADAPTED FOR ARTHRITIS TO A CONVENIENCE SAMPLE OF PRIMARILY HISPANIC AND BLACK/AFRICAN-AMERICAN ADULTS. A RACIALLY DIVERSE INTERDISCIPLINARY RESEARCH TEAM WAS ASSEMBLED TO DESIGN A STUDY TO FACILITATE RECRUITMENT AND RETENTION. THE SECOND OBJECTIVE IDENTIFIED OUTCOME MEASURES TO OPERATIONALIZE POTENTIAL FACILITATORS AND BARRIERS TO SELF-CARE AND SELF-EFFICACY. THE THIRD OBJECTIVE DETERMINED THE FEASIBILITY OF USING COMPUTER-ASSISTED SELF-INTERVIEW (CASI) FOR DATA COLLECTION. RESULTS: ENROLLED PARTICIPANTS (N = 30) WERE MOSTLY FEMALE (93%), SPANISH SPEAKING (69%), AND DIAGNOSED WITH RA (88.5%). FEASIBILITY WAS EVALUATED USING PRACTICALITY, ACCEPTABILITY, ADAPTATION, AND EXPANSION OF AN ARTHRITIS-ADAPTED YOGA INTERVENTION, MODIFIED FOR THIS POPULATION. RECRUITMENT (51%) AND PARTICIPATION (60%) RATES WERE SIMILAR TO PREVIOUS RESEARCH AND CLINICAL EXPERIENCE WITH THE STUDY POPULATION. OF THOSE ENROLLED, 18 STARTED THE INTERVENTION. FOR ADHERENCE, 12 OUT OF 18 (67%) PARTICIPANTS COMPLETED THE INTERVENTION. ALL (100%), WHO COMPLETED THE INTERVENTION, CONTINUED TO PRACTICE YOGA 3 MONTHS AFTER COMPLETING THE STUDY. USING NONPARAMETRIC TESTS, SELECTED OUTCOME MEASURES SHOWED A MEASURABLE CHANGE POST-INTERVENTION SUGGESTING APPROPRIATE USE IN FUTURE STUDIES. AN IN-PERSON COMPUTERIZED QUESTIONNAIRE WAS DETERMINED TO BE A FEASIBLE METHOD OF DATA COLLECTION. CONCLUSIONS: FINDINGS FROM THIS PILOT STUDY CONFIRM THE FEASIBILITY OF OFFERING YOGA TO THIS RACIALLY/ETHNICALLY DIVERSE POPULATION WITH ARTHRITIS. THIS ARTICLE PROVIDES RECRUITMENT/RETENTION RATES, OUTCOME MEASURES WITH ERROR RATES, AND DATA COLLECTION RECOMMENDATIONS FOR A PREVIOUSLY UNDER-REPRESENTED POPULATION. SUGGESTIONS INCLUDE ALLOCATING RESOURCES FOR TRANSLATION AND USING A MULTICULTURAL DESIGN TO FACILITATE RECRUITMENT AND RETENTION. TRIAL REGISTRATION: CLINICALTRIALS.GOV, NCT01617421. 2018 13 538 22 COMPLEMENTARY AND ALTERNATIVE TREATMENT FOR NECK PAIN: CHIROPRACTIC, ACUPUNCTURE, TENS, MASSAGE, YOGA, TAI CHI, AND FELDENKRAIS. OF THE MULTITUDE OF TREATMENT OPTIONS FOR THE MANAGEMENT OF NECK PAIN, NO OBVIOUS SINGLE TREATMENT MODALITY HAS BEEN SHOWN TO BE MOST EFFICACIOUS. AS SUCH, THE CLINICIAN SHOULD CONSIDER ALTERNATIVE TREATMENT MODALITIES IF A MODALITY IS ENGAGING, AVAILABLE, FINANCIALLY FEASIBLE, POTENTIALLY EFFICACIOUS, AND IS LOW RISK FOR THE PATIENT. AS EVIDENCE-BASED MEDICINE FOR NECK PAIN DEVELOPS, THE CLINICIAN IS FACED WITH THE CHALLENGE OF WHICH TREATMENTS TO ENCOURAGE PATIENTS TO PURSUE. TREATMENT MODALITIES EXPLORED IN THIS ARTICLE, INCLUDING CHIROPRACTIC, ACUPUNCTURE, TENS, MASSAGE, YOGA, TAI CHI, AND FELDENKRAIS, REPRESENT REASONABLE COMPLEMENTARY AND ALTERNATIVE MEDICINE METHODS FOR PATIENTS WITH NECK PAIN. 2011 14 2773 27 YOGA RESEARCH AND SPIRITUALITY: A CASE STUDY DISCUSSION. THERE IS GROWING EVIDENCE THAT YOGA CAN BE BENEFICIAL AS AN ASPECT OF SELF-CARE FOR PEOPLE WITH ARTHRITIS. HOWEVER, YOGA MAY BE LESS ACCEPTABLE TO THOSE FROM DIFFERENT CULTURES, SOCIOECONOMIC BACKGROUNDS, AND RACIAL/ETHNIC IDENTITIES. WHILE IMPLEMENTING A FEASIBILITY/ACCEPTABILITY PILOT STUDY OF YOGA AS SELF-CARE IN MINORITY COMMUNITIES, THE SUBJECT OF SPIRITUALITY SURFACED. THIS COMMENTARY SHARES THE EXPERIENCE OF THE RESEARCHERS AND YOGA TEACHERS COLLABORATING ON THE STUDY AND THE LARGER CONVERSATION THAT ENSUED FOLLOWING THE WITHDRAWAL OF ONE OF THE STUDY PARTICIPANTS. IT IS AN ATTEMPT TO START A RELEVANT AND NEEDED DIALOGUE AROUND YOGA RESEARCH AS AN INTEGRATIVE HEALTH MODALITY, AND WHY THE UNDERLYING BODY-MIND-SPIRIT APPROACH TO YOGA MAY SOMETIMES SERVE AS A BARRIER TO PARTICIPATION FOR DIVERSE POPULATIONS SUFFERING FROM ARTHRITIS. 2015 15 1699 39 PARTICIPANT CHARACTERISTICS ASSOCIATED WITH SYMPTOMATIC IMPROVEMENT FROM YOGA FOR CHRONIC LOW BACK PAIN. CONTEXT: STUDIES SUGGEST THAT YOGA IS EFFECTIVE FOR MODERATE TO SEVERE CHRONIC LOW BACK PAIN (CLBP) IN DIVERSE PREDOMINANTLY LOWER SOCIOECONOMIC STATUS POPULATIONS. HOWEVER, LITTLE IS KNOWN ABOUT FACTORS ASSOCIATED WITH BENEFIT FROM THE YOGA INTERVENTION. OBJECTIVE: IDENTIFY FACTORS AT BASELINE INDEPENDENTLY ASSOCIATED WITH GREATER EFFICACY AMONG PARTICIPANTS IN A STUDY OF YOGA FOR CLBP. DESIGN: FROM SEPTEMBER-DECEMBER 2011, A 12-WEEK RANDOMIZED DOSING TRIAL WAS CONDUCTED COMPARING WEEKLY VS. TWICE-WEEKLY 75-MINUTE HATHA YOGA CLASSES FOR 95 PREDOMINANTLY LOW-INCOME MINORITY ADULTS WITH NONSPECIFIC CLBP. PARTICIPANT CHARACTERISTICS COLLECTED AT BASELINE WERE USED TO DETERMINE FACTORS BEYOND TREATMENT ASSIGNMENT (REPORTED IN THE INITIAL STUDY) THAT PREDICTED OUTCOME. WE USED BIVARIATE TESTING TO IDENTIFY BASELINE CHARACTERISTICS ASSOCIATED WITH IMPROVEMENT IN FUNCTION AND PAIN, AND INCLUDED SELECT FACTORS IN A MULTIVARIATE LINEAR REGRESSION. SETTING: RECRUITMENT AND CLASSES OCCURRED IN AN ACADEMIC SAFETY-NET HOSPITAL AND FIVE AFFILIATED COMMUNITY HEALTH CENTERS IN BOSTON, MASSACHUSETTS. PARTICIPANTS: NINETY-FIVE ADULTS WITH NONSPECIFIC CLBP, AGES RANGING FROM 20-64 (MEAN 48) YEARS; 72 WOMEN AND 23 MEN. OUTCOME MEASURES: PRIMARY OUTCOMES WERE CHANGES IN BACK-RELATED FUNCTION (MODIFIED ROLAND-MORRIS DISABILITY QUESTIONNAIRE, RMDQ; 0-23) AND MEAN LOW BACK PAIN INTENSITY (0-10) IN THE PREVIOUS WEEK, FROM BASELINE TO WEEK 12. RESULTS: ADJUSTING FOR GROUP ASSIGNMENT, BASELINE RMDQ, AGE, AND GENDER, FOREIGN NATIONALITY AND LOWER BASELINE SF36 PHYSICAL COMPONENT SCORE (PCS) WERE INDEPENDENTLY ASSOCIATED WITH IMPROVEMENT IN RMDQ. GREATER THAN HIGH SCHOOL EDUCATION LEVEL, CLBP LESS THAN 1 YEAR, AND LOWER BASELINE SF36 PCS WERE INDEPENDENTLY ASSOCIATED WITH IMPROVEMENT IN PAIN INTENSITY. OTHER DEMOGRAPHICS INCLUDING RACE, INCOME, GENDER, BMI, AND USE OF PAIN MEDICATIONS WERE NOT ASSOCIATED WITH EITHER OUTCOME. CONCLUSIONS: POOR PHYSICAL HEALTH AT BASELINE IS ASSOCIATED WITH GREATER IMPROVEMENT FROM YOGA IN BACK-RELATED FUNCTION AND PAIN. RACE, INCOME, AND BODY MASS INDEX DO NOT AFFECT THE POTENTIAL FOR A PERSON WITH LOW BACK PAIN TO EXPERIENCE BENEFIT FROM YOGA. 2014 16 2813 33 YOGA TO TREAT NONSPECIFIC LOW BACK PAIN. LOW BACK PAIN IS COMMON AND POSES A CHALLENGE FOR CLINICIANS TO FIND EFFECTIVE TREATMENT TO PREVENT IT FROM BECOMING CHRONIC. CHRONIC LOW BACK PAIN CAN HAVE A SIGNIFICANT IMPACT ON AN EMPLOYEE'S ABILITY TO REMAIN AN ACTIVE AND PRODUCTIVE MEMBER OF THE WORK FORCE DUE TO INCREASED ABSENTEEISM, DUTY RESTRICTIONS, OR PHYSICAL LIMITATIONS FROM PAIN. LOW BACK PAIN IS THE MOST COMMON CAUSE OF WORK-RELATED DISABILITY AMONG EMPLOYEES YOUNGER THAN 46 YEARS. ADVANCING TECHNOLOGY AND LESS INVASIVE SURGICAL PROCEDURES HAVE NOT IMPROVED OUTCOMES FOR EMPLOYEES WHO SUFFER FROM LOW BACK PAIN. MOST CONTINUE TO EXPERIENCE SOME PAIN AND DYSFUNCTION AFTER CONVENTIONAL TREATMENTS SUCH AS INJECTIONS AND SURGERY. AN ALTERNATIVE TREATMENT THAT COULD REDUCE NONSPECIFIC CHRONIC LOW BACK PAIN WOULD BENEFIT BOTH EMPLOYEES AND EMPLOYERS. EXERCISING AND REMAINING ACTIVE ARE PART OF MOST GUIDELINES' ROUTINE CARE RECOMMENDATIONS BUT ARE NOT WELL DEFINED. 2011 17 2506 23 YOGA ATTITUDES IN CHRONIC LOW BACK PAIN: ROLES OF CATASTROPHIZING AND FEAR OF MOVEMENT. CHRONIC LOW BACK PAIN IS A SIGNIFICANT PUBLIC HEALTH PROBLEM AND, ALTHOUGH UNDERUSED, YOGA MAY BE AN EFFECTIVE COMPLEMENTARY TREATMENT. THE CURRENT STUDY EXAMINED ASSOCIATIONS OF PAIN CATASTROPHIZING AND FEAR OF MOVEMENT WITH ATTITUDES TOWARD YOGA IN ADULTS WITH CHRONIC LOW BACK PAIN. PARTICIPANTS COMPLETED THREE QUANTITATIVE QUESTIONNAIRES ASSESSING SPECIFIC CONSTRUCTS: BELIEFS ABOUT YOGA, FEAR OF MOVEMENT, AND PAIN CATASTROPHIZING. A SEMI-STRUCTURED IN-PERSON INTERVIEW WAS THEN CONDUCTED TO OBTAIN SPECIFIC PAIN-RELATED INFORMATION. HIERARCHICAL REGRESSION AND MEDIATIONAL ANALYSES WERE USED TO TEST HYPOTHESES. CONSISTENT WITH THE FEAR-AVOIDANCE MODEL OF CHRONIC PAIN, CATASTROPHIZING AND FEAR OF MOVEMENT WERE NEGATIVELY ASSOCIATED WITH YOGA ATTITUDES. SPECIFICALLY, FEAR OF MOVEMENT WAS A MEDIATOR BETWEEN CATASTROPHIZING AND ATTITUDES TOWARD YOGA. INDIVIDUALS WITH HIGHER LEVELS OF CATASTROPHIZING AND FEAR OF MOVEMENT MAY BE LESS LIKELY TO CONSIDER A PAIN TREATMENT INVOLVING PHYSICAL MOVEMENT. 2015 18 20 27 "WE'RE ALL IN THIS TOGETHER": A QUALITATIVE STUDY OF PREDOMINANTLY LOW INCOME MINORITY PARTICIPANTS IN A YOGA TRIAL FOR CHRONIC LOW BACK PAIN. OBJECTIVE: TO EXPLORE THE EXPERIENCES OF LOW-INCOME MINORITY ADULTS TAKING PART IN A YOGA DOSING TRIAL FOR CHRONIC LOW BACK PAIN. DESIGN: INDIVIDUAL SEMI-STRUCTURED INTERVIEWS WERE CONDUCTED WITH NINETEEN PARTICIPANTS RECRUITED FROM A RANDOMIZED YOGA DOSING TRIAL FOR PREDOMINANTLY LOW-INCOME MINORITY ADULTS WITH CHRONIC LOW BACK PAIN. INTERVIEWS DISCUSSED THE IMPACT OF YOGA ON LOW BACK PAIN AND EMOTIONS; OTHER PERCEIVED ADVANTAGES OR DISADVANTAGES OF THE INTERVENTION; AND FACILITATORS AND BARRIERS TO PRACTICING YOGA. INTERVIEWS WERE AUDIO TAPED AND TRANSCRIBED, CODED USING ATLAS.TI SOFTWARE, AND ANALYZED WITH INDUCTIVE AND DEDUCTIVE THEMATIC ANALYSIS METHODS. SETTING: BOSTON MEDICAL CENTER, BOSTON, MA, USA. RESULTS: PARTICIPANTS VIEWED YOGA AS A MEANS OF PAIN RELIEF AND ATTRIBUTED IMPROVED MOOD, GREATER ABILITY TO MANAGE STRESS, AND ENHANCED RELAXATION TO YOGA. OVERALL, PARTICIPANTS FELT EMPOWERED TO SELF-MANAGE THEIR PAIN. SOME FOUND YOGA TO BE HELPFUL IN BEING MINDFUL OF THEIR EMOTIONS AND ACCEPTING OF THEIR PAIN. TRUST IN THE YOGA INSTRUCTORS WAS A COMMONLY CITED FACILITATOR FOR YOGA CLASS ATTENDANCE. LACK OF TIME, MOTIVATION, AND FEAR OF INJURY WERE REPORTED BARRIERS TO YOGA PRACTICE. CONCLUSIONS: YOGA IS A MULTIDIMENSIONAL TREATMENT FOR LOW BACK PAIN THAT HAS THE POTENTIAL TO FAVORABLY IMPACT HEALTH IN A PREDOMINANTLY LOW-INCOME MINORITY POPULATION. 2016 19 144 27 A QUALITATIVE APPROACH EXPLORING THE ACCEPTABILITY OF YOGA FOR MINORITIES LIVING WITH ARTHRITIS: 'WHERE ARE THE PEOPLE WHO LOOK LIKE ME?' OBJECTIVES: TO EXAMINE THE ACCEPTABILITY OF YOGA RESEARCH TAILORED TO RECRUIT AND RETAIN A MINORITY POPULATION (BOTH ENGLISH AND SPANISH SPEAKING) WITH ARTHRITIS. YOGA RESEARCH FOR ARTHRITIS OFTEN UNDERREPRESENTS MINORITIES AND ACCEPTABILITY FOR THIS POPULATION HAS NOT PREVIOUSLY BEEN INVESTIGATED. DESIGN: ACCEPTABILITY WAS EVALUATED USING RETENTION, ADHERENCE, JOURNALS, AND SEMI-STRUCTURED EXIT INTERVIEWS FROM TWELVE PARTICIPANTS WITH OSTEOARTHRITIS OR RHEUMATOID ARTHRITIS UNDERGOING AN 8-WEEK YOGA INTERVENTION. JOURNAL QUOTES WERE ANALYZED USING CONTENT ANALYSIS TECHNIQUES. NVIVO SOFTWARE WAS USED TO ORGANIZE TRANSCRIPTS AND ASSEMBLE THEMES. TWO METHODS OF TRIANGULATION (DATA AND INVESTIGATOR) WERE USED TO OVERCOME POTENTIAL BIAS FROM A SINGLE-PERSPECTIVE INTERPRETATION. EXIT INTERVIEW COMMENTS WERE CONTENT ANALYZED USING A CARD SORT METHOD. THE STUDY WAS DESIGNED WITH A CULTURAL INFRASTRUCTURE INCLUDING A MULTICULTURAL RESEARCH TEAM, TRANSLATORS, AND BILINGUAL MATERIALS AND CLASSES, TO FACILITATE TRUST AND ACCEPTABILITY FOR PRIMARILY HISPANIC AND BLACK/AFRICAN-AMERICAN ADULTS. SETTING: WASHINGTON, D.C. METROPOLITAN AREA, USA. RESULTS: ON AVERAGE PARTICIPANTS ATTENDED 10 OF 16 CLASSES, WITH HOME PRACTICE 2-3DAYS A WEEK. ALL WHO COMPLETED WERE STILL PRACTICING YOGA THREE-MONTHS LATER. QUALITATIVE NARRATIVE ANALYSIS IDENTIFIED MAJOR THEMES RELATED TO FACILITATING FACTORS AND BARRIERS FOR YOGA PRACTICE, SELF-EFFICACY, AND SUPPORT. PARTICIPANT COMMENTS INDICATED THAT OFFERING AN ARTHRITIS-BASED YOGA INTERVENTION AND USING A CULTURALLY CONGRUENT RESEARCH DESIGN WAS FOUND TO BE ACCEPTABLE. CONCLUSIONS: AS YOGA RESEARCH GROWS, THERE IS A NEED TO UNDERSTAND AND PROMOTE ACCEPTABILITY FOR TYPICALLY UNDER-REPRESENTED POPULATIONS. THIS STUDY ATTEMPTS TO INFORM THE EXPANSION OF MULTICULTURAL RESEARCH DESIGNED TO RECRUIT AND RETAIN THOSE FROM DIVERSE BACKGROUNDS. 2017 20 1566 19 LOW BACK PAIN AND YOGA. ABSTRACT QUESTIONS FROM PATIENTS ABOUT PAIN CONDITIONS AND ANALGESIC PHARMACOTHERAPY AND RESPONSES FROM AUTHORS ARE PRESENTED TO HELP EDUCATE PATIENTS AND MAKE THEM MORE EFFECTIVE SELF-ADVOCATES. THE TOPIC ADDRESSED IN THIS ISSUE IS CHRONIC LOW BACK PAIN, ONE OF THE MOST COMMON REASONS TO VISIT ONE'S PRIMARY CARE DOCTOR. COMPLEMENTARY APPROACHES, INCLUDING YOGA, WILL BE ADDRESSED. 2014