1 1787 146 PREFERENCE AND EXPECTATION FOR TREATMENT ASSIGNMENT IN A RANDOMIZED CONTROLLED TRIAL OF ONCE- VS TWICE-WEEKLY YOGA FOR CHRONIC LOW BACK PAIN. BACKGROUND: IN STUDIES INVOLVING NONPHARMACOLOGICAL COMPLEMENTARY AND ALTERNATIVE MEDICINE INTERVENTIONS, PARTICIPANT BLINDING IS VERY DIFFICULT. PARTICIPANT EXPECTATIONS MAY AFFECT PERCEIVED BENEFIT OF THERAPY. IN STUDIES OF YOGA AS TREATMENT FOR CHRONIC LOW BACK PAIN, LITTLE IS KNOWN ABOUT THE RELATIONSHIP BETWEEN PATIENT EXPECTATIONS AND PREFERENCES ON OUTCOMES. THIS STUDY WAS DESIGNED TO IDENTIFY BASELINE PREDICTORS OF PREFERENCE AND TO DETERMINE IF EXPECTATIONS AND PREFERENCES FOR DIFFERENT DOSES OF YOGA AFFECT BACK-RELATED FUNCTION AND LOW BACK PAIN INTENSITY. METHODS: THIS WAS A SECONDARY DATA ANALYSIS OF A 12-WEEK RANDOMIZED CONTROLLED TRIAL COMPARING ONCE-WEEKLY VS TWICE-WEEKLY YOGA FOR TREATMENT OF CHRONIC LOW BACK PAIN IN 93 ADULTS FROM A PREDOMINANTLY LOW-INCOME MINORITY POPULATION. AT BASELINE, PARTICIPANTS WERE ASKED ABOUT BACK FUNCTION, BACK PAIN, TREATMENT EXPECTATIONS, AND TREATMENT PREFERENCES. WE CREATED A VARIABLE "CONCORDANCE" TO DESCRIBE THE MATCHING OF PARTICIPANT PREFERENCE TO RANDOMIZED TREATMENT. OUR OUTCOME VARIABLES WERE CHANGE IN BACK FUNCTION AND PAIN INTENSITY AFTER 12 WEEKS OF YOGA INSTRUCTION. WE PERFORMED LOGISTIC REGRESSION TO IDENTIFY PREDICTORS OF PREFERENCE FOR ONCE- OR TWICE-WEEKLY YOGA INSTRUCTION. WE CREATED LINEAR REGRESSION MODELS TO IDENTIFY INDEPENDENT ASSOCIATIONS BETWEEN EXPECTATIONS, PREFERENCE, CONCORDANCE, AND OUTCOMES. RESULTS: WORSE BACK FUNCTION AT BASELINE WAS ASSOCIATED WITH 20% HIGHER ODDS OF PREFERRING TWICE-WEEKLY YOGA (OR 1.2, CI 1.1, 1.3). INDIVIDUALS WITH HIGHER EXPECTATION SCORES FOR TWICE-WEEKLY YOGA HAD 90% HIGHER ODDS OF PREFERRING TWICE-WEEKLY VS ONCE-WEEKLY YOGA (OR 1.9, CI 1.3, 2.7). INDIVIDUALS WITH HIGHER EXPECTATION SCORES FOR ONCE-WEEKLY YOGA HAD 40% LESS ODDS OF PREFERRING TWICE-WEEKLY YOGA (OR 0.6, CI 0.5, 0.9). AFTER CONTROLLING FOR BASELINE CHARACTERISTICS, WE FOUND NO STATISTICALLY SIGNIFICANT RELATIONSHIP BETWEEN TREATMENT OUTCOMES, PREFERENCE, EXPECTATION SCORES, OR CONCORDANCE. CONCLUSION: IN A POPULATION OF PREDOMINANTLY LOW-INCOME MINORITY PARTICIPANTS WITH CHRONIC LOW BACK PAIN, WORSE BACK FUNCTION WAS ASSOCIATED WITH PREFERENCE FOR MORE FREQUENT YOGA CLASSES. THOSE WHO PREFERRED MORE YOGA CLASSES HAD HIGHER EXPECTATIONS FOR THOSE CLASSES. TWELVE-WEEK CHANGE IN BACK PAIN INTENSITY AND BACK FUNCTION WERE NOT AFFECTED BY DOSING PREFERENCE, EXPECTATION SCORE, OR CONCORDANCE. MORE RESEARCH IS NEEDED TO BETTER MEASURE AND QUANTIFY PREFERENCE, EXPECTATIONS, AND THEIR RELATIONSHIP TO OUTCOMES IN YOGA RESEARCH. 2015 2 604 32 DEVELOPMENT AND VALIDATION OF THE OUTCOME EXPECTATIONS FOR YOGA SCALE. OBJECTIVE: OUR OBJECTIVE WAS TO DEVELOP AN INSTRUMENT THAT CAN MEASURE OUTCOME EXPECTATIONS OF YOGA AND TO EVALUATE THE INSTRUMENT FOR INTERNAL CONSISTENCY AND INITIAL CONSTRUCT VALIDITY. METHODS: A 20-ITEM SCALE WAS DEVELOPED TO ASSESS PHYSICAL, MENTAL, AND SPIRITUAL HEALTH BENEFITS RELATED TO YOGA PRACTICE AMONG ADULTS. THE SCALE WAS TESTED IN A BASELINE SURVEY WITH ADULTS PARTICIPATING IN A CLINICAL TRIAL. PRINCIPAL COMPONENT ANALYSIS WAS USED TO INVESTIGATE THE INTERNAL STRUCTURE OF THE MEASURE. OUTCOME EXPECTATIONS FOR YOGA WERE EXAMINED FOR DEMOGRAPHIC DIFFERENCES. RESULTS: THE SAMPLE (N = 185) WAS 54% WOMEN, 89% WHITE AND HAD A MEAN AGE OF 46 YEARS. THE FINAL 20-ITEM SCALE HAD HIGH ITEM LOADINGS THAT RANGED FROM .57 TO .88 WITH A CRONBACH'S ALPHA VALUE OF .96. SIGNIFICANT DIFFERENCES WERE FOUND IN OUTCOME EXPECTATION SCORE BY SEX. CONCLUSION: THIS NEWLY DEVELOPED SCALE CAN BE USED TO ASSESS OUTCOME EXPECTATIONS FOR YOGA AND TAILOR INTERVENTIONS TO PROMOTE ADHERENCE TO YOGA PRACTICE. 2017 3 2320 48 TREATMENT CREDIBILITY, EXPECTANCY, AND PREFERENCE: PREDICTION OF TREATMENT ENGAGEMENT AND OUTCOME IN A RANDOMIZED CLINICAL TRIAL OF HATHA YOGA VS. HEALTH EDUCATION AS ADJUNCT TREATMENTS FOR DEPRESSION. BACKGROUND: HATHA YOGA MAY BE HELPFUL FOR ALLEVIATING DEPRESSION SYMPTOMS. THE PURPOSE OF THIS ANALYSIS IS TO DETERMINE WHETHER TREATMENT PROGRAM PREFERENCE, CREDIBILITY, OR EXPECTANCY PREDICT ENGAGEMENT IN DEPRESSION INTERVENTIONS (YOGA OR A CONTROL CLASS) OR DEPRESSION SYMPTOM SEVERITY OVER TIME. METHODS: THIS IS A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL (RCT) OF HATHA YOGA VS. A HEALTH EDUCATION CONTROL GROUP FOR TREATMENT OF DEPRESSION. DEPRESSED PARTICIPANTS (N=122) ATTENDED UP TO 20 CLASSES OVER A PERIOD OF 10 WEEKS, AND THEN COMPLETED ADDITIONAL ASSESSMENTS AFTER 3 AND 6 MONTHS. WE ASSESSED TREATMENT PREFERENCE PRIOR TO RANDOMIZATION, AND TREATMENT CREDIBILITY AND EXPECTANCY AFTER PARTICIPANTS ATTENDED THEIR FIRST CLASS. TREATMENT "CONCORDANCE" INDICATED THAT TREATMENT PREFERENCE MATCHED ASSIGNED TREATMENT. RESULTS: TREATMENT CREDIBILITY, EXPECTANCY, AND CONCORDANCE WERE NOT ASSOCIATED WITH TREATMENT ENGAGEMENT. TREATMENT EXPECTANCY MODERATED THE ASSOCIATION BETWEEN TREATMENT GROUP AND DEPRESSION. DEPRESSION SEVERITY OVER TIME DIFFERED BY EXPECTANCY LEVEL FOR THE YOGA GROUP BUT NOT FOR THE HEALTH EDUCATION GROUP. CONTROLLING FOR BASELINE DEPRESSION, PARTICIPANTS IN THE YOGA GROUP WITH AN AVERAGE OR HIGH EXPECTANCY FOR IMPROVEMENT SHOWED LOWER DEPRESSION SYMPTOMS ACROSS THE ACUTE INTERVENTION AND FOLLOW-UP PERIOD THAN THOSE WITH A LOW EXPECTANCY FOR IMPROVEMENT. THERE WAS A TREND FOR A SIMILAR PATTERN FOR CREDIBILITY. CONCORDANCE WAS NOT ASSOCIATED WITH TREATMENT OUTCOME. LIMITATIONS: THIS IS A SECONDARY, POST-HOC ANALYSIS AND SHOULD BE CONSIDERED HYPOTHESIS-GENERATING. CONCLUSIONS: RESULTS SUGGEST THAT EXPECTANCY IMPROVES THE LIKELIHOOD OF SUCCESS ONLY FOR A INTERVENTION THOUGHT TO ACTIVELY TARGET DEPRESSION (YOGA) AND NOT A CONTROL INTERVENTION. 2018 4 1165 50 EVALUATING THE FEASIBILITY AND IMPACT OF A YOGA INTERVENTION ON COGNITION, PHYSICAL FUNCTION, PHYSICAL ACTIVITY, AND AFFECTIVE OUTCOMES IN PEOPLE LIVING WITH HIV: PROTOCOL FOR A RANDOMIZED PILOT TRIAL. BACKGROUND: DESPITE LOWER MORTALITY RATES DUE TO COMBINATION ANTIRETROVIRAL THERAPY, PEOPLE LIVING WITH HIV (PLWH) ARE GRAPPLING WITH INCREASINGLY COMPLEX HEALTH ISSUES, INCLUDING COGNITIVE IMPAIRMENTS IN AREAS SUCH AS MEMORY, ATTENTION, PROCESSING SPEED, AND MOTOR FUNCTION. YOGA HAS BEEN SHOWN TO BE AN EFFECTIVE FORM OF EXERCISE AND MINDFULNESS-BASED STRESS REDUCTION FOR MANY CLINICAL POPULATIONS. HOWEVER, NO RANDOMIZED TRIALS HAVE EVALUATED THE IMPACT OF YOGA ON COGNITIVE AND PHYSICAL FUNCTION AMONG PLWH. OBJECTIVE: THE AIM OF THIS PILOT RANDOMIZED TRIAL WAS TO DETERMINE THE FEASIBILITY OF A YOGA INTERVENTION TO LAY THE GROUNDWORK FOR A FULL-SCALE, MULTISITE, COMMUNITY-BASED TRIAL FOR PLWH. SPECIFIC OBJECTIVES ARE TO (1) ASSESS THE FEASIBILITY OF STUDY PROTOCOL AND PROCEDURES, (2) COMPARE COGNITION IN THE YOGA GROUP WITH THE USUAL CARE CONTROL GROUP AFTER 12 WEEKS OF THE INTERVENTION IN PLWH, AND (3) COMPARE THE EFFECTS OF THE 12-WEEK YOGA INTERVENTION VERSUS CONTROL ON BALANCE, WALKING SPEED, PHYSICAL ACTIVITY, MENTAL HEALTH, MEDICATION ADHERENCE, AND QUALITY OF LIFE AMONG PLWH. METHODS: WE PROPOSE A PILOT RANDOMIZED TRIAL WITH 2 PARALLEL GROUPS (YOGA VERSUS CONTROL). WE WILL RECRUIT 25 PLWH (>35 YEARS) FROM COMMUNITY AND HEALTH ORGANIZATIONS IN HALIFAX, CANADA. AFTER BASELINE ASSESSMENT WITH BLINDED ASSESSORS, PARTICIPANTS WILL BE RANDOMLY ASSIGNED TO THE YOGA OR CONTROL GROUP, USING A RANDOM COMPUTER GENERATOR. PARTICIPANTS IN THE YOGA GROUP WILL ENGAGE IN SUPERVISED 60-MIN GROUP-BASED YOGA SESSIONS 3 TIMES A WEEK FOR 12 WEEKS AT A YOGA STUDIO. PARTICIPANTS IN THE CONTROL GROUP WILL MAINTAIN THEIR CURRENT PHYSICAL ACTIVITY LEVELS THROUGHOUT THE STUDY. RESULTS: AS PER THE CONSOLIDATED STANDARDS OF REPORTING TRIALS EXTENSION FOR PILOT STUDIES, MEANS OF ALL OUTCOMES, MEAN CHANGE, AND 95% CIS WILL BE CALCULATED FOR EACH GROUP SEPARATELY. TWO-TAILED INDEPENDENT T TESTS AND FISHER EXACT TESTS WILL BE USED TO COMPARE GROUPS AT BASELINE. WE WILL ANALYZE QUANTITATIVE POSTINTERVENTION QUESTIONNAIRE RESPONSES USING CHI-SQUARE TESTS, AND OPEN-ENDED RESPONSES WILL BE ANALYZED THEMATICALLY. INTENTION-TO-TREAT AND PER-PROTOCOL ANALYSES WILL BE USED TO ANALYZE SECONDARY VARIABLES. CHANGES IN OUTCOME VARIABLES WILL BE EXAMINED BETWEEN GROUPS AND WITHIN GROUPS. EFFECT SIZES WILL BE REPORTED FOR EACH OUTCOME. A PRIORI ADHERENCE AND SATISFACTION CRITERIA WILL BE MET IF PARTICIPANTS ATTEND >70% OF THE YOGA SESSIONS AND IF >70% OF THE PARTICIPANTS ARE SATISFIED WITH THE INTERVENTION AS DETERMINED BY A POSTPARTICIPATION QUESTIONNAIRE. STUDY ENROLLMENT BEGAN IN JANUARY 2018, WITH RESULTS EXPECTED FOR OCTOBER 2019. CONCLUSIONS: THIS PILOT RANDOMIZED TRIAL WILL BE THE FIRST TO INVESTIGATE THE FEASIBILITY AND EFFECT OF A YOGA INTERVENTION ON COGNITIVE AND PHYSICAL OUTCOMES AMONG PLWH. THIS WORK WILL INFORM THE FEASIBILITY OF FURTHER INVESTIGATIONS IN TERMS OF CAPACITY BUILDING, PARTICIPANT RECRUITMENT AND RETENTION, AND ASSESSMENT AND INTERVENTION PROTOCOLS. TRIAL REGISTRATION: CLINICALTRIALS.GOV NCT03071562; HTTPS://CLINICALTRIALS.GOV/CT2/SHOW/NCT03071562 (ARCHIVED BY WEBCITE AT HTTP://WWW.WEBCITATION.ORG/785SFHWKW). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/13818. 2019 5 1795 40 PRENATAL YOGA FOR YOUNG WOMEN A MIXED METHODS STUDY OF ACCEPTABILITY AND BENEFITS. BACKGROUND: HIGH RATES OF PSYCHOLOGICAL-DISTRESS, TRAUMA AND SOCIAL COMPLEXITY ARE REPORTED AMONG YOUNG PREGNANT WOMEN. AT THE ROYAL WOMEN'S HOSPITAL, AUSTRALIA, YOUNG PREGNANT WOMEN ACKNOWLEDGE WANTING TOOLS TO IMPROVE MATERNAL WELLBEING YET REMAIN CHALLENGING TO ENGAGE IN ANTENATAL EDUCATION AND SUPPORT. WHILE YOGA IS A WIDELY ACCEPTED AND PARTICIPATED ACTIVITY IN PREGNANCY, WITH DEMONSTRATED BENEFITS FOR ADULT PREGNANT WOMEN, ADOLESCENT WOMEN ARE OFTEN EXCLUDED FROM BOTH THESE YOGA INTERVENTIONS AND RELATED PREGNANCY STUDIES. METHODS: THIS MIXED METHODS STUDY EXAMINED THE ACCEPTABILITY AND BENEFITS OF YOGA FOR YOUNG WOMEN. WE RECRUITED 30 PARTICIPANTS AGED UNDER 24 YEARS, WHO WERE OFFERED TWICE A WEEK, ONE-HOUR VOLUNTARY PRENATAL YOGA SESSIONS THROUGHOUT THEIR PREGNANCY. A MEDICAL FILE AUDIT GATHERED BASELINE DEMOGRAPHICS, PRE AND POST YOGA SESSION SURVEYS WERE ADMINISTERED AND BRIEF INDIVIDUAL INTERVIEW WERE CONDUCTED WITH STUDY PARTICIPANTS. RESULTS: WHILE 26 STUDY PARTICIPANTS WERE POSITIVE ABOUT THE AVAILABILITY OF A YOGA PROGRAM, ONLY 15 COULD ATTEND YOGA SESSIONS (MEAN = 8 SESSIONS, RANGE 1-27). NO DIFFERENCES WERE FOUND IN THE DEMOGRAPHIC OR PSYCHOSOCIAL FACTORS BETWEEN THOSE WHO DID AND DID NOT ATTEND THE YOGA SESSIONS. THE MEDICAL FILE AUDIT FOUND THAT 60% OF ALL THE STUDY PARTICIPANTS HAD A DOCUMENTED HISTORY OF PSYCHOLOGICAL DISTRESS. BARRIERS TO PARTICIPATION WERE PRAGMATIC, NOT ATTITUDINAL, BASED ON THE TIMING OF THE GROUP SESSIONS, TRANSPORT AVAILABILITY AND THEIR OWN HEALTH. ALL STUDY PARTICIPANTS IDENTIFIED PERCEIVED BENEFITS, AND THE YOGA PARTICIPANTS IDENTIFIED THESE AS IMPROVED RELAXATION AND REDUCTION OF PSYCHOLOGICAL DISTRESS; LABOUR PREPARATION; BONDING WITH THEIR BABY IN UTERO; AND SOCIAL CONNECTEDNESS WITH THE YOGA GROUP PEERS. CONCLUSIONS: THIS STUDY DEMONSTRATED YOGA WAS ACCEPTABLE TO YOUNG PREGNANT WOMEN. FOR THOSE WHO DID PARTICIPATE IN THE SESSIONS, YOGA WAS FOUND TO DECREASE SELF-REPORTED DISTRESS AND INCREASE PERCEIVED SKILLS TO ASSIST WITH THEIR LABOUR AND THE BIRTH OF THEIR BABY. THE PROVISION OF ACCESSIBLE YOGA PROGRAMS FOR PREGNANT YOUNG WOMEN IS RECOMMENDED. 2019 6 345 32 ASSESSING FEASIBILITY AND ACCEPTABILITY OF YOGA AND GROUP CBT FOR ADOLESCENTS WITH DEPRESSION: A PILOT RANDOMIZED CLINICAL TRIAL. PURPOSE: GIVEN INCREASING RATES OF DEPRESSION IN ADOLESCENTS, THERE IS A CLEAR NEED FOR INNOVATIVE TREATMENTS. IN THIS PILOT RANDOMIZED CLINICAL TRIAL, WE ASSESSED ACCEPTABILITY AND FEASIBILITY OF TWO GROUP-BASED INTERVENTIONS: YOGA AND COGNITIVE-BEHAVIORAL THERAPY (CBT). THE GOAL OF THIS WORK IS TO PREPARE FOR A FUTURE FULLY POWERED RANDOMIZED TRIAL TO TEST THE HYPOTHESIS THAT YOGA IS NOT INFERIOR TO AN ESTABLISHED ADOLESCENT DEPRESSION TREATMENT, NAMELY, GROUP CBT. METHODS: WE ENROLLED 42 ADOLESCENTS WITH ELEVATED DEPRESSION SYMPTOMS. PARTICIPANTS WERE RANDOMLY ASSIGNED TO A 12-WEEK GROUP-BASED INTERVENTION, YOGA OR CBT. WE HAD A PRIORI FEASIBILITY AND ACCEPTABILITY TARGETS, INCLUDING FOR RECRUITMENT RATE, RETENTION RATE, EXPECTANCY, CREDIBILITY, PROGRAM SATISFACTION, CLASS ATTENDANCE, ENGAGEMENT IN HOME PRACTICE, AND INSTRUCTOR/LEADER MANUAL ADHERENCE. WE ASSESSED ADVERSE EVENTS, AND WITHIN-SUBJECT CHANGES IN OUTCOMES (DEPRESSION, ANXIETY, IMPAIRMENT, SLEEP DISTURBANCE) AND POSSIBLE MEDIATORS (MINDFULNESS, SELF-COMPASSION). RESULTS: BOTH INTERVENTIONS MET MOST ACCEPTABILITY AND FEASIBILITY TARGETS. THE ONLY TARGET NOT MET RELATED TO LOW ENGAGEMENT IN HOME PRACTICE. PARTICIPANTS WITHIN EACH STUDY ARM SHOWED DECREASED DEPRESSION SYMPTOMS OVER TIME AND INCREASED SELF-COMPASSION. CONCLUSIONS: A YOGA INTERVENTION APPEARS TO BE ACCEPTABLE AND FEASIBLE TO ADOLESCENTS WITH DEPRESSION. HOWEVER, IT MAY BE CHALLENGING FOR THIS GROUP TO ENGAGE IN UNSTRUCTURED HOME PRACTICE. 2022 7 1723 38 PERCEPTIONS OF HATHA YOGA AMONGST PERSISTENTLY DEPRESSED INDIVIDUALS ENROLLED IN A TRIAL OF YOGA FOR DEPRESSION. OBJECTIVES: TO UNDERSTAND DEPRESSED INDIVIDUALS' EXPERIENCES IN A 10-WEEK HATHA YOGA PROGRAM. DESIGN: IN A RANDOMIZED CONTROLLED TRIAL, PARTICIPANTS WERE ASSIGNED TO EITHER 10 WEEKS OF HATHA YOGA CLASSES OR A HEALTH EDUCATION CONTROL GROUP. THIS REPORT INCLUDES RESPONSES FROM PARTICIPANTS IN YOGA CLASSES. AT THE START OF CLASSES, AVERAGE DEPRESSION SYMPTOM SEVERITY LEVEL WAS MODERATE. MAIN OUTCOME MEASURES: AFTER 10 WEEKS OF YOGA CLASSES, WE ASKED PARTICIPANTS (N=50) TO PROVIDE WRITTEN RESPONSES TO OPEN-ENDED QUESTIONS ABOUT WHAT THEY LIKED ABOUT CLASSES, WHAT THEY DID NOT LIKE OR DID NOT FIND HELPFUL, AND WHAT THEY LEARNED. WE ANALYZED QUALITATIVE DATA USING THEMATIC ANALYSIS. RESULTS AND CONCLUSIONS: ELEMENTS OF YOGA CLASSES THAT MAY INCREASE ACCEPTABILITY FOR DEPRESSED INDIVIDUALS INCLUDE HAVING INSTRUCTORS WHO PROMOTE A NON-COMPETITIVE AND NON-JUDGMENTAL ATMOSPHERE, WHO ARE KNOWLEDGEABLE AND ABLE TO PROVIDE INDIVIDUALIZED ATTENTION, AND WHO ARE KIND AND WARM. INCLUDING DEPRESSION-RELATED THEMES IN CLASSES, TEACHING MINDFULNESS, TEACHING BREATHING EXERCISES, AND PROVIDING GUIDANCE FOR TRANSLATING CLASS INTO HOME PRACTICE MAY HELP TO MAKE YOGA EFFECTIVE FOR TARGETING DEPRESSION. PARTICIPANTS' COMMENTS REINFORCED THE IMPORTANCE OF ASPECTS OF MINDFULNESS, SUCH AS ATTENTION TO THE PRESENT MOMENT AND ACCEPTANCE OF ONE'S SELF AND ONE'S EXPERIENCE, AS POTENTIAL MECHANISMS OF ACTION. OTHER POTENTIAL MECHANISMS INCLUDE USE OF BREATHING PRACTICES IN EVERYDAY LIFE AND THE BIOLOGICAL MECHANISMS THAT UNDERLIE THE POSITIVE IMPACT OF YOGIC BREATHING. THE MOST SERIOUS CONCERN HIGHLIGHTED BY A FEW PARTICIPANTS WAS THE CONCERN THAT THE YOGA CLASSES WERE TOO DIFFICULT GIVEN THEIR PHYSICAL ABILITIES. 2017 8 1224 39 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 9 1617 37 MINDFUL YOGA FOR WOMEN WITH METASTATIC BREAST CANCER: DESIGN OF A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: WOMEN WITH METASTATIC BREAST CANCER (MBC) HAVE AVERAGE LIFE EXPECTANCIES OF ABOUT 2 YEARS, AND REPORT HIGH LEVELS OF DISEASE-RELATED SYMPTOMS INCLUDING PAIN, FATIGUE, SLEEP DISTURBANCE, PSYCHOLOGICAL DISTRESS, AND FUNCTIONAL IMPAIRMENT. THERE IS GROWING RECOGNITION OF THE LIMITATIONS OF MEDICAL APPROACHES TO MANAGING SUCH SYMPTOMS. YOGA IS A MIND-BODY DISCIPLINE THAT HAS DEMONSTRATED A POSITIVE IMPACT ON PSYCHOLOGICAL AND FUNCTIONAL HEALTH IN EARLY STAGE BREAST CANCER PATIENTS AND SURVIVORS, BUT HAS NOT BEEN RIGOROUSLY STUDIED IN ADVANCED CANCER SAMPLES. METHODS: THIS RANDOMIZED CONTROLLED TRIAL EXAMINES THE FEASIBILITY AND INITIAL EFFICACY OF A MINDFUL YOGA PROGRAM, COMPARED WITH A SOCIAL SUPPORT CONDITION THAT CONTROLS FOR ATTENTION, ON MEASURES OF DISEASE-RELATED SYMPTOMS SUCH AS PAIN AND FATIGUE. THE STUDY WILL BE COMPLETED BY DECEMBER 2017. SIXTY-FIVE WOMEN WITH MBC AGE >/= 18 ARE BEING IDENTIFIED AND RANDOMIZED WITH A 2:1 ALLOCATION TO MINDFUL YOGA OR A SUPPORT GROUP CONTROL INTERVENTION. THE 120-MIN INTERVENTION SESSIONS TAKE PLACE WEEKLY FOR 8 WEEKS. THE STUDY IS CONDUCTED AT AN URBAN TERTIARY CARE ACADEMIC MEDICAL CENTER LOCATED IN DURHAM, NORTH CAROLINA. THE PRIMARY FEASIBILITY OUTCOME IS ATTENDANCE AT INTERVENTION SESSIONS. EFFICACY OUTCOMES INCLUDE PAIN, FATIGUE, SLEEP QUALITY, PSYCHOLOGICAL DISTRESS, MINDFULNESS AND FUNCTIONAL CAPACITY AT POST-INTERVENTION, 3-MONTH FOLLOW-UP, AND 6-MONTH FOLLOW-UP. DISCUSSION: IN THIS ARTICLE, WE PRESENT THE CHALLENGES OF DESIGNING A RANDOMIZED CONTROLLED TRIAL WITH LONG-TERM FOLLOW-UP AMONG WOMEN WITH MBC. THESE CHALLENGES INCLUDE ENSURING ADEQUATE RECRUITMENT INCLUDING OF MINORITIES, LIMITING AND CONTROLLING FOR SELECTION BIAS, TAILORING OF THE YOGA INTERVENTION TO ADDRESS SPECIAL NEEDS, AND MAXIMIZING ADHERENCE AND RETENTION. THIS PROJECT WILL PROVIDE IMPORTANT INFORMATION REGARDING YOGA AS AN INTERVENTION FOR WOMEN WITH ADVANCED CANCER, INCLUDING PRELIMINARY DATA ON THE PSYCHOLOGICAL AND FUNCTIONAL EFFECTS OF YOGA FOR MBC PATIENTS. THIS INVESTIGATION WILL ALSO ESTABLISH RIGOROUS METHODS FOR FUTURE RESEARCH INTO YOGA AS AN INTERVENTION FOR THIS POPULATION. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFER: NCT01927081 , REGISTERED AUGUST 16, 2013. 2017 10 2372 43 WHAT HELPS OLDER PEOPLE PERSEVERE WITH YOGA CLASSES? A REALIST PROCESS EVALUATION OF A COVID-19-AFFECTED YOGA PROGRAM FOR FALL PREVENTION. BACKGROUND: FALLS AMONG OLDER PEOPLE ARE A MAJOR GLOBAL HEALTH CONCERN. THIS PROCESS EVALUATION INVESTIGATES THE EXPERIENCE OF PARTICIPANTS AGED 60+ IN A YOGA PROGRAM AIMED AT PREVENTING FALLS WHICH TRANSITIONED FROM STUDIO-BASED CLASSES TO ONLINE CLASSES IN RESPONSE TO COVID-19 RESTRICTIONS. WE SOUGHT TO UNDERSTAND HOW THE SUCCESSFUL AGEING (SAGE) YOGA PROGRAM FUNCTIONED IN BOTH SETTINGS AND AS A HYBRID PROGRAM, AND TO EXPLAIN WHY IT WORKED WELL FOR MOST PARTICIPANTS. METHODS: REALIST PROCESS EVALUATION WAS USED TO EXPLORE THE FACTORS THAT FACILITATED A SUCCESSFUL TRANSITION FOR MOST PARTICIPANTS, AND TO CONSIDER WHY IT DID NOT WORK FOR A MINORITY. THIS APPROACH DEVELOPS PROGRAM THEORIES THAT DESCRIBE WHICH MECHANISMS AN INTERVENTION IS (OR IS NOT) ACTIVATING, AND HOW THIS IS MEDIATED BY CONTEXT TO GENERATE PROCESS OUTCOMES. DATA INCLUDED INTERVIEWS WITH PARTICIPANTS (N = 21) AND YOGA INSTRUCTORS (N = 3), SELF-REPORT FEEDBACK FORMS (N = 46), OBSERVATION OF CLASSES AND ROUTINE PROCESS MEASURES. RESULTS: FACTORS THAT FACILITATED A SUCCESSFUL TRANSITION FOR MOST PARTICIPANTS INCLUDED THE QUALITY OF YOGA INSTRUCTION, THE PROGRAM FORMAT AND INHERENT CHARACTERISTICS OF YOGA. GAINS IN TRANSITIONING ONLINE INCLUDED CONTINUITY AND GREATER CONVENIENCE. LOSSES INCLUDED PERCEIVED REDUCTION IN THE EFFECTIVENESS OF YOGA INSTRUCTION. THERE WERE GREATER CHALLENGES FOR PEOPLE STRUGGLING WITH PAIN AND IN DISADVANTAGEOUS HOME ENVIRONMENTS. WE IDENTIFIED SIX PROGRAM THEORIES CONFIGURED AROUND 16 MECHANISMS: 1. IT'S WORTH THE EFFORT AND 2. IN EXPERT HANDS (THESE HAD THE SAME MECHANISMS: VALUE EXPECTANCY, THERAPEUTIC ALLIANCE AND ACHIEVEMENT/MASTERY), 3. A COMMUNAL EXPERIENCE (THESE MECHANISMS WERE SHARED EXPERIENCE, SOCIAL CONNECTION, SOCIAL COMPARISON AND PEER CHECKING), 4. PUTTING YOGA WITHIN REACH (ACCESSIBILITY, CONVENIENCE, GRATITUDE), 5. BUILDING YOGA HABITS (PURPOSEFUL STRUCTURE, MOMENTUM, ACCOUNTABILITY AND CONTINUITY), AND 6. YOGA'S SPECIAL PROPERTIES (EMBODIMENT AND MINDFULNESS). CONCLUSIONS: THIS STUDY SHOWED THAT ONLINE DELIVERY OF A YOGA PROGRAM FOR PEOPLE AGED 60+ RETAINED MUCH OF THE VALUE OF A FACE-TO-FACE PROGRAM FOR THE MAJORITY OF PARTICIPANTS, AND INCREASED THE VALUE FOR SOME. THE STRUCTURED, COMMUNAL NATURE OF AN ORGANISED GROUP PROGRAM DELIVERED BY A SKILLED INSTRUCTOR, TOGETHER WITH YOGA'S INTRINSIC FOCUS ON MINDFULNESS, FACILITATED CONTINUED ENGAGEMENT AND PERCEIVED HEALTH BENEFITS, DESPITE THE CHANGE IN DELIVERY MODE. 2022 11 9 39 "I'M MORE IN BALANCE": A QUALITATIVE STUDY OF YOGA FOR PATIENTS WITH CHRONIC NECK PAIN. OBJECTIVES: THIS STUDY INVESTIGATED THE PERCEIVED INFLUENCE OF YOGA ON BODY PERCEPTION AND PSYCHOSOCIAL ASPECTS OF LIFE FOR PATIENTS WITH CHRONIC NECK PAIN. DESIGN: THIS QUALITATIVE STUDY WAS CONDUCTED USING SEMISTANDARDIZED INTERVIEWS. SETTING: THE INTERVENTIONS AND INTERVIEWS TOOK PLACE IN A REFERRAL CENTER'S RESEARCH DEPARTMENT. SUBJECTS: EIGHTEEN (18) PATIENTS WITH CHRONIC NONSPECIFIC NECK PAIN WERE RECRUITED FROM A LARGER RANDOMIZED CONTROLLED TRIAL OF YOGA FOR CHRONIC NECK PAIN. INTERVENTIONS: PARTICIPANTS ATTENDED 90 MINUTES OF IYENGAR YOGA ONCE A WEEK FOR 9 WEEKS. OUTCOME MEASURES: PARTICIPANTS COMPLETED A DRAWING OF THEIR NECK AND SHOULDER REGIONS TO REFLECT THEIR SUBJECTIVE BODY PERCEPTIONS BEFORE AND AFTER THEIR YOGA PROGRAM. SEMISTANDARDIZED INTERVIEWS WERE USED TO EXPLORE THEIR BODY PERCEPTION, EMOTIONAL STATUS, EVERYDAY LIFE AND COPING SKILLS, AS WELL AS ANY PERCEIVED CHANGES IN THESE DIMENSIONS POSTPARTICIPATION. AN INTERDISCIPLINARY GROUP ANALYZED THE STUDY DATA USING CONTENT ANALYSIS TECHNIQUES. RESULTS: PARTICIPANTS REPORTED CHANGE ON FIVE DIMENSIONS OF HUMAN EXPERIENCE: PHYSICAL, COGNITIVE, EMOTIONAL, BEHAVIORAL, AND SOCIAL. PHYSICALLY, MOST PARTICIPANTS CITED RENEWED BODY AWARENESS, BOTH DURING THEIR YOGA PRACTICE AND IN THEIR DAILY LIVES. SUCH CHANGE WAS ECHOED IN THEIR POSTPARTICIPATION BODY DRAWINGS. COGNITIVELY, PARTICIPANTS REPORTED INCREASED PERCEIVED CONTROL OVER THEIR HEALTH. EMOTIONALLY, THEY NOTED GREATER ACCEPTANCE OF THEIR PAIN AND LIFE BURDENS. BEHAVIORALLY, THEY DESCRIBED ENHANCED USE OF ACTIVE COPING STRATEGIES. FINALLY, SOCIALLY, THEY REPORTED RENEWED PARTICIPATION IN AN ACTIVE LIFE. CONCLUSIONS: PARTICIPANTS LINKED YOGA TO CHANGE ON ALL DIMENSIONS OF HUMAN EXPERIENCE, ATTRIBUTING REDUCED PAIN LEVELS, INCREASED COPING ABILITY, BETTER PAIN ACCEPTANCE AND INCREASED CONTROL TO IT. BODY AWARENESS APPEARED A KEY MECHANISM IN THESE CHANGES. 2013 12 122 47 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 13 13 35 "MORE THAN I EXPECTED": PERCEIVED BENEFITS OF YOGA PRACTICE AMONG OLDER ADULTS AT RISK FOR CARDIOVASCULAR DISEASE. OBJECTIVE: THIS STUDY WAS CONDUCTED WITH PARTICIPANTS FROM TRIALS EXAMINING THE EFFECTS OF AN IYENGAR YOGA PROGRAM ON CARDIOVASCULAR DISEASE RISK. THE OBJECTIVE OF THE CURRENT STUDY WAS TO EVALUATE THE PERCEIVED BENEFITS OF YOGA IN A POPULATION OF OLDER, PREDOMINANTLY OVERWEIGHT ADULTS PARTICIPATING IN A GENTLE 8-WEEK YOGA PROGRAM. DESIGN: THIS STUDY USED A CONSTRUCTIVIST-INTERPRETIVE APPROACH TO NATURALISTIC INQUIRY. SETTING: A TOTAL OF 42 PARTICIPANTS COMPLETED THE INTERVENTION AND MET THE INCLUSION CRITERIA FOR THE CURRENT QUALITATIVE STUDY. INTERVENTION: THE 8-WEEK IYENGAR YOGA PROGRAM INCLUDED TWO 90-MIN YOGA CLASSES AND FIVE 30-MIN HOME SESSIONS PER WEEK. PARTICIPANTS COMPLETED WEEKLY LOGS AND AN EXIT QUESTIONNAIRE AT THE END OF THE STUDY. MAIN OUTCOME MEASURES: QUALITATIVE DATA FROM WEEKLY LOGS AND EXIT QUESTIONNAIRES WERE COMPILED AND CONVENTIONAL CONTENT ANALYSIS PERFORMED WITH THE USE OF ATLAS.TI TO FACILITATE THE PROCESS. RESULTS: FOUR BROAD THEMES EMERGED FROM CONTENT ANALYSIS: PRACTICING YOGA IMPROVED OVERALL PHYSICAL FUNCTION AND CAPACITY (FOR 83% OF PARTICIPANTS); PRACTICING YOGA REDUCED STRESS/ANXIETY AND ENHANCED CALMNESS (83% OF PARTICIPANTS); PRACTICING YOGA ENRICHED THE QUALITY OF SLEEP (21% OF PARTICIPANTS); AND PRACTICING YOGA SUPPORTED EFFORTS TOWARD DIETARY IMPROVEMENTS (14% OF PARTICIPANTS). CONCLUSIONS: THESE RESULTS SUGGEST THAT YOGA MAY HAVE ANCILLARY BENEFITS IN TERMS OF IMPROVED PHYSICAL FUNCTION, ENHANCED MENTAL/EMOTIONAL STATE, ENRICHED SLEEP QUALITY, AND IMPROVED LIFESTYLE CHOICES, AND MAY BE USEFUL AS A HEALTH PROMOTION STRATEGY IN THE PREVENTION AND MANAGEMENT OF CHRONIC DISEASE. 2013 14 2763 32 YOGA PROGRAM FOR TYPE 2 DIABETES PREVENTION (YOGA-DP) AMONG HIGH-RISK PEOPLE: QUALITATIVE STUDY TO EXPLORE REASONS FOR NON-PARTICIPATION IN A FEASIBILITY RANDOMIZED CONTROLLED TRIAL IN INDIA. BACKGROUND: YOGA-BASED INTERVENTIONS CAN BE EFFECTIVE IN PREVENTING TYPE 2 DIABETES MELLITUS (T2DM). WE DEVELOPED A YOGA PROGRAM FOR T2DM PREVENTION (YOGA-DP) AMONG HIGH-RISK PEOPLE AND CONDUCTED A FEASIBILITY RANDOMIZED CONTROLLED TRIAL (RCT) IN INDIA. THE OBJECTIVE OF THIS STUDY WAS TO IDENTIFY AND EXPLORE WHY POTENTIAL PARTICIPANTS DECLINED TO PARTICIPATE IN THE FEASIBILITY RCT. METHODS: AN EXPLORATORY QUALITATIVE STUDY, USING SEMI-STRUCTURED INTERVIEWS, WAS CONDUCTED AT A YOGA CENTER IN NEW DELHI, INDIA. FOURTEEN PEOPLE (10 WOMEN AND FOUR MEN) WHO DECLINED TO PARTICIPATE IN THE FEASIBILITY RCT WERE INTERVIEWED, AND 13 OF THEM COMPLETED THE NON-PARTICIPANT QUESTIONNAIRE, WHICH CAPTURED THEIR SOCIO-DEMOGRAPHICS, DIETS, PHYSICAL ACTIVITIES, AND REASONS FOR DECLINING. RESULTS: THREE TYPES OF BARRIERS WERE IDENTIFIED AND EXPLORED WHICH PREVENTED PARTICIPATION IN THE FEASIBILITY RCT: (1) PERSONAL BARRIERS, SUCH AS LACK OF TIME, PERCEIVED SUFFICIENCY OF KNOWLEDGE, PREFERENCES ABOUT SELF-MANAGEMENT OF HEALTH, AND TRUST IN OTHER TRADITIONAL AND ALTERNATIVE THERAPIES; (2) CONTEXTUAL BARRIERS, SUCH AS SOCIAL INFLUENCES AND LACK OF AWARENESS ABOUT PREVENTIVE CARE; AND (3) STUDY-RELATED BARRIERS, SUCH AS LACK OF STUDY INFORMATION, POOR ACCESSIBILITY TO THE YOGA SITE, AND LACK OF TRUST IN THE STUDY METHODS AND INTERVENTION. CONCLUSIONS: WE IDENTIFIED AND EXPLORED PERSONAL, CONTEXTUAL, AND STUDY-RELATED BARRIERS TO PARTICIPATION IN A FEASIBILITY RCT IN INDIA. THE FINDINGS WILL HELP TO ADDRESS RECRUITMENT CHALLENGES IN FUTURE YOGA AND OTHER RCTS. CLINICAL TRIAL REGISTRATION:WWW.CLINICALTRIALS.GOV, IDENTIFIER: CTRI/2019/05/018893. 2021 15 1206 35 EXPERIENCES OF PREGNANT WOMEN PARTICIPATING IN ANTENATAL YOGA: A QUALITATIVE STUDY. CONTEXT: PREGNANCY YOGA IS A MODIFIED VERSION OF YOGA FOR PREGNANT WOMEN, AND IT AIMS TO REDUCE PREGNANCY-RELATED SYMPTOMS, SUCH AS INSOMNIA, LOW BACK PAIN, TIREDNESS, CONSTIPATION, LEG CRAMPS, AND SHORTNESS OF BREATH. OBJECTIVE: THE STUDY AIMED TO IDENTIFY THE EXPERIENCES AND EXPECTATIONS OF PREGNANT WOMEN RELATED TO THE PRACTICE OF YOGA. METHOD: THE RESEARCH TEAM CONDUCTED A QUALITATIVE STUDY. SETTING: THE STUDY TOOK PLACE AT THE ANTENATAL CLINIC OF A PUBLIC HOSPITAL IN THE CENTRAL ANATOLIA REGION OF TURKEY. PARTICIPANTS: THE PARTICIPANTS WERE 24 PREGNANT WOMEN AT THE CLINIC. INTERVENTION: THE STUDY INCLUDED AN INTERVENTION GROUP THAT PERFORMED YOGA AND RECEIVED ROUTINE ANTENATAL CARE; HOWEVER, NO CONTROL GROUPS WERE USED. EACH YOGA INTERVENTION WAS HELD FOR APPROXIMATELY 40-45 MINUTES, WITH YOGA ASANA PERIODS LASTING 30 MINUTES. THE PREGNANT WOMEN WERE EXPECTED TO PARTICIPATE IN YOGA PRACTICE TWICE A WEEK ON A REGULAR BASIS FOR 8 WEEKS. OUTCOME MEASURES: DATA WERE COLLECTED THROUGH SEMI-STRUCTURED INTERVIEWS. THE INTERVIEWS WERE RECORDED AND TRANSCRIBED VERBATIM AND THEMATIC ANALYSIS WAS PERFORMED. RESULTS: FOUR MAJOR THEMES EMERGED: (1) PERCEPTIONS ABOUT PREGNANCY, (2) MANAGEMENT OF PREGNANCY SYMPTOMS, (3) PRENATAL ATTACHMENT, AND (4) BIRTH PERCEPTIONS. ACCORDING TO PARTICIPANTS, THE BENEFITS OF YOGA PRACTICE WERE MANAGEMENT OF PREGNANCY SYMPTOMS, INCREASED PRENATAL ATTACHMENT, A POSITIVE PERCEPTION OF THE BIRTH, NATURAL-BIRTH BELIEFS, AND MANAGEMENT OF FEAR AND PAIN DURING BIRTH. CONCLUSIONS: THE PARTICIPANTS REPORTED BARRIERS TO PERFORMING YOGA; HOWEVER, THEY ALSO SAID THAT THEY WOULD TRY PREGNANCY YOGA IF THEY WERE ENCOURAGED BY HEALTHCARE PROFESSIONALS. ALSO, THE PARTICIPANTS STATED THAT PREGNANCY YOGA PRACTICE SHOULD BE MADE A PART OF ANTENATAL EDUCATION TO FACILITATE PARTICIPATION. 2021 16 1769 37 POTENTIAL FOR PRENATAL YOGA TO SERVE AS AN INTERVENTION TO TREAT DEPRESSION DURING PREGNANCY. BACKGROUND: WHEN LEFT UNTREATED, ANTENATAL DEPRESSION CAN HAVE A SERIOUS NEGATIVE IMPACT ON MATERNAL, AND INFANT OUTCOMES. MANY AFFECTED WOMEN DO NOT OBTAIN TREATMENT FOR DEPRESSION OWING TO DIFFICULTIES ACCESSING CARE OR BECAUSE THEY DO NOT FIND STANDARD ANTIDEPRESSANT TREATMENTS TO BE ACCEPTABLE DURING PREGNANCY. THIS STUDY EXAMINED THE ACCEPTABILITY AND FEASIBILITY OF A GENTLE PRENATAL YOGA INTERVENTION, AS A STRATEGY FOR TREATING DEPRESSION DURING PREGNANCY. METHODS: WE DEVELOPED A 10-WEEK PRENATAL YOGA PROGRAM FOR ANTENATAL DEPRESSION AND AN ACCOMPANYING YOGA INSTRUCTORS' MANUAL, AND ENROLLED 34 DEPRESSED PREGNANT WOMEN FROM THE COMMUNITY INTO AN OPEN PILOT TRIAL. WE MEASURED CHANGE IN MATERNAL DEPRESSION SEVERITY FROM BEFORE TO AFTER THE INTERVENTION. RESULTS: RESULTS SUGGESTED THAT THE PRENATAL YOGA INTERVENTION WAS FEASIBLE TO ADMINISTER AND ACCEPTABLE TO THE WOMEN ENROLLED. NO STUDY-RELATED INJURIES OR OTHER SAFETY ISSUES WERE OBSERVED DURING THE TRIAL. ON AVERAGE, PARTICIPANTS' DEPRESSION SEVERITY DECREASED SIGNIFICANTLY BY THE END OF THE INTERVENTION BASED ON BOTH OBSERVED-RATED AND SELF-REPORT DEPRESSION ASSESSMENT MEASURES. CONCLUSION: THE CURRENT STUDY SUGGESTS THAT PRENATAL YOGA MAY BE A VIABLE APPROACH TO ADDRESSING ANTENATAL DEPRESSION, ONE THAT MAY HAVE ADVANTAGES IN TERMS OF GREATER ACCEPTABILITY THAN STANDARD DEPRESSION TREATMENTS. RESEARCH AND POLICY IMPLICATIONS ARE DISCUSSED. 2015 17 1903 39 RESULTS FROM A CLINICAL YOGA PROGRAM FOR VETERANS: YOGA VIA TELEHEALTH PROVIDES COMPARABLE SATISFACTION AND HEALTH IMPROVEMENTS TO IN-PERSON YOGA. BACKGROUND: YOGA IS INCREASINGLY POPULAR, THOUGH LITTLE DATA REGARDING ITS IMPLEMENTATION IN HEALTHCARE SETTINGS IS AVAILABLE. SIMILARLY, TELEHEALTH IS BEING UTILIZED MORE FREQUENTLY TO INCREASE ACCESS TO HEALTHCARE; HOWEVER WE KNOW OF NO RESEARCH ON THE ACCEPTABILITY OR EFFECTIVENESS OF YOGA DELIVERED THROUGH TELEHEALTH. THEREFORE, WE EVALUATED THE FEASIBILITY, ACCEPTABILITY, AND PATIENT-REPORTED EFFECTIVENESS OF A CLINICAL YOGA PROGRAM AT A VETERANS AFFAIRS MEDICAL CENTER AND ASSESSED WHETHER THESE OUTCOMES DIFFERED BETWEEN THOSE PARTICIPATING IN-PERSON AND THOSE PARTICIPATING VIA TELEHEALTH. METHODS: VETERANS WHO ATTENDED A YOGA CLASS AT THE VA PALO ALTO HEALTH CARE SYSTEM WERE INVITED TO COMPLETE AN ANONYMOUS PROGRAM EVALUATION SURVEY. RESULTS: 64 VETERANS COMPLETED THE SURVEY. PARTICIPANTS REPORTED HIGH SATISFACTION WITH THE CLASSES AND THE INSTRUCTORS. MORE THAN 80% OF PARTICIPANTS WHO ENDORSED A PROBLEM WITH PAIN, ENERGY LEVEL, DEPRESSION, OR ANXIETY REPORTED IMPROVEMENT IN THESE SYMPTOMS. THOSE WHO PARTICIPATED VIA TELEHEALTH DID NOT DIFFER FROM THOSE WHO PARTICIPATED IN-PERSON IN ANY MEASURE OF SATISFACTION, OVERALL IMPROVEMENT (P = .40), OR IMPROVEMENT IN ANY OF 16 SPECIFIC HEALTH PROBLEMS. CONCLUSIONS: DELIVERING YOGA TO A WIDE RANGE OF PATIENTS WITHIN A HEALTHCARE SETTING APPEARS TO BE FEASIBLE AND ACCEPTABLE, BOTH WHEN DELIVERED IN-PERSON AND VIA TELEHEALTH. PATIENTS IN THIS CLINICAL YOGA PROGRAM REPORTED HIGH LEVELS OF SATISFACTION AND IMPROVEMENT IN MULTIPLE PROBLEM AREAS. THIS PRELIMINARY EVIDENCE FOR THE EFFECTIVENESS OF A CLINICAL YOGA PROGRAM COMPLEMENTS PRIOR EVIDENCE FOR THE EFFICACY OF YOGA AND SUPPORTS THE USE OF YOGA IN HEALTHCARE SETTINGS. 2017 18 551 33 CONVENIENT AND LIVE MOVEMENT (CALM) FOR WOMEN UNDERGOING BREAST CANCER TREATMENT: CHALLENGES AND RECOMMENDATIONS FOR INTERNET-BASED YOGA RESEARCH. OBJECTIVE: TO CONDUCT A PILOT TRIAL OF INTERNET-BASED, CANCER-ADAPTED YOGA FOR WOMEN RECEIVING BREAST CANCER TREATMENT. DESIGN: WOMEN UNDERGOING RADIATION OR CHEMOTHERAPY FOR BREAST CANCER WERE RECRUITED FOR 12, 75-MIN, BIWEEKLY, CANCER-ADAPTED YOGA CLASSES DELIVERED VIA INTERNET-BASED, MULTIPOINT VIDEOCONFERENCING. DATA WERE COLLECTED ON FEASIBILITY AND ACCEPTABILITY, INCLUDING QUALITATIVE FEEDBACK FROM PARTICIPANTS AND THE YOGA INSTRUCTOR. RESULTS: AMONG 42 WOMEN APPROACHED, 13 DECLINED ELIGIBILITY SCREENING, AND 23 WERE INELIGIBLE. ALL 6 WOMEN WHO WERE ELIGIBLE PROVIDED CONSENT, BUT 2 WITHDREW PRIOR TO BEGINNING YOGA CLASSES. THE REMAINING 4 PARTICIPANTS ATTENDED 1-11 OF 12 ONLINE YOGA CLASSES. IN POST-INTERVENTION INTERVIEWS, PARTICIPANTS AND THE INSTRUCTOR AGREED THAT INTERNET-BASED YOGA CLASSES HOLD GREAT POTENTIAL FOR INCREASING ACCESS AND IMPROVING PSYCHOLOGICAL OUTCOMES IN ADULTS WITH CANCER. QUALITATIVE FEEDBACK FROM PARTICIPANTS REVEALED SUGGESTIONS FOR FUTURE TRIALS OF INTERNET-BASED, CANCER-ADAPTED YOGA CLASSES, INCLUDING: CONTINUED USE OF GROUP FORMAT; OFFERING MORE VARIED CLASS TIMES TO ACCOMMODATE PATIENTS' DEMANDING SCHEDULES AND FLUCTUATING SYMPTOMS; ENROLLING PATIENTS AFTER THEY HAVE ACCLIMATED TO OR COMPLETED CANCER TREATMENT; STREAMLINING THE TECHNOLOGY INTERFACE; AND CAREFUL ATTENTION TO PARTICIPANT BURDEN WHEN DESIGNING SURVEYS/FORMS. THE INSTRUCTOR RECOMMENDED CLOSED SESSION COURSES, AS OPPOSED TO ROLLING ENROLLMENT; TEACHING THE SAME MODIFIED POSES FOR ALL PARTICIPANTS, RATHER THAN INDIVIDUAL TAILORING; AND USING A LARGE SCREEN TO ALLOW CLOSER MONITORING OF STUDENTS' CLASS EXPERIENCE. CONCLUSIONS: INTERNET DELIVERY MAY INCREASE PATIENTS' ACCESS TO CANCER-ADAPTED YOGA CLASSES, BUT CANCER-RELATED AND TECHNOLOGICAL BARRIERS REMAIN. THIS STUDY INFORMS HOW TO OPTIMALLY DESIGN YOGA CLASSES, TECHNOLOGY, AND RESEARCH PROCEDURES TO MAXIMIZE FEASIBILITY AND ACCEPTABILITY IN FUTURE TRIALS. 2018 19 1997 48 STRATEGIES FOR EVALUATING SELF-EFFICACY AND OBSERVED SUCCESS IN THE PRACTICE OF YOGA POSTURES FOR THERAPEUTIC INDICATIONS: METHODS FROM A YOGA INTERVENTION FOR URINARY INCONTINENCE AMONG MIDDLE-AGED AND OLDER WOMEN. BACKGROUND: MOST CLINICAL INVESTIGATIONS INVOLVING YOGA LACK ADEQUATE DESCRIPTION OF THE SPECIFIC YOGA ELEMENTS, INCLUDING PHYSICAL POSTURES. FEW STUDIES HAVE MEASURED SELF-EFFICACY REGARDING THE PERFORMANCE OF YOGA POSTURES OR ASSESSED OBSERVED SUCCESS IN PERFORMING POSTURES. METHODS: WE DEVELOPED AND PILOTED SEVERAL TOOLS TO EVALUATE SELF-EFFICACY AND OBSERVED SUCCESS IN PRACTICING YOGA IN THE CONTEXT OF A RANDOMIZED FEASIBILITY TRIAL OF AN IYENGAR-BASED YOGA INTERVENTION FOR URINARY INCONTINENCE IN AMBULATORY WOMEN >/=50 YEARS. AT THE END OF THE 12-WEEK YOGA INTERVENTION INVOLVING TWICE WEEKLY GROUP YOGA CLASSES AND ONCE WEEKLY HOME PRACTICE, PARTICIPANTS RATED THEIR SELF-EFFICACY IN PERFORMING EACH OF THE INCLUDED 15 YOGA POSTURES ON A 5-POINT LIKERT SCALE. DURING THE 12TH WEEK, AN EXPERT YOGA CONSULTANT OBSERVED PARTICIPANTS AND RATED THEIR COMPETENCY IN PERFORMING POSTURES ON A 5-POINT SCALE. PARTICIPANTS COMPLETED A QUESTIONNAIRE ABOUT SELF-EFFICACY IN ADHERING TO HOME YOGA PRACTICE. WE EXAMINED THE DISTRIBUTION OF AND CORRELATIONS BETWEEN SCORES ON THE ABOVE MEASURES. RESULTS: AMONG 27 PARTICIPANTS (MEAN AGE 65 YEARS), THE RANGE OF MEANS FOR SELF-EFFICACY RATINGS FOR INDIVIDUAL POSTURES WAS 3.6 TO 4.5. THE RANGE OF MEANS FOR OBSERVED COMPETENCY RATINGS FOR INDIVIDUAL POSTURES WAS 3.3 TO 5.0. MEAN SELF-EFFICACY RATING FOR CONFIDENCE IN ADHERING TO THE ASSIGNED ONCE-WEEKLY HOME YOGA PRACTICE WAS 2.8 (RANGE 1 TO 5). POSTURE SELF-EFFICACY WAS INVERSELY CORRELATED WITH PARTICIPANT AGE (P = 0.01) AND POSITIVELY CORRELATED WITH SELF-REPORTED PHYSICAL FUNCTION (P = 0.03) AND MOBILITY (P = 0.01). NO SIGNIFICANT CORRELATIONS WERE FOUND BETWEEN POSTURE SELF-EFFICACY SCALE SCORES AND EXPERT-OBSERVED YOGA COMPETENCY RATINGS OR PRACTICE ADHERENCE SELF-EFFICACY SCORES. CONCLUSIONS: THESE MEASURES HOLD PROMISE FOR ADVANCING YOGA RESEARCH AND PRACTICE BY DESCRIBING METHODS TO: 1) MEASURE SELF-EFFICACY IN PERFORMING SPECIFIC YOGA POSTURES; 2) USE AN EXPERT OBSERVER TO ASSESS PARTICIPANTS' COMPETENCE IN PERFORMING YOGA POSTURES; AND 3) MEASURE SELF-EFFICACY IN ADHERING TO HOME PRACTICE. THESE PROPOSED MEASURES CAN BE USED TO DESCRIBE SPECIFIC COMPONENTS OF YOGA INTERVENTIONS, TO ASSESS WHETHER STUDY PARTICIPANTS ARE ABLE TO LEARN TO PRACTICE PHYSICAL ASPECTS OF YOGA AND/OR MAINTAIN THIS PRACTICE OVER TIME, AS WELL AS TO INVESTIGATE RELATIONSHIPS BETWEEN SELF-EFFICACY AND COMPETENCY IN PERFORMING YOGA POSTURES TO ACHIEVE SPECIFIC HEALTH OUTCOMES. TRIAL REGISTRATION: CLINICALTRIALS.GOV, NCT02342678, JANUARY 21, 2015. 2020 20 20 42 "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