1 144 157 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 2 1224 70 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 3 2831 34 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 4 20 47 "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 5 518 32 COMPARING ONCE- VERSUS TWICE-WEEKLY YOGA CLASSES FOR CHRONIC LOW BACK PAIN IN PREDOMINANTLY LOW INCOME MINORITIES: A RANDOMIZED DOSING TRIAL. BACKGROUND. PREVIOUS STUDIES HAVE DEMONSTRATED THAT ONCE-WEEKLY YOGA CLASSES ARE EFFECTIVE FOR CHRONIC LOW BACK PAIN (CLBP) IN WHITE ADULTS WITH HIGH SOCIOECONOMIC STATUS. THE COMPARATIVE EFFECTIVENESS OF TWICE-WEEKLY CLASSES AND GENERALIZABILITY TO RACIALLY DIVERSE LOW INCOME POPULATIONS ARE UNKNOWN. METHODS. WE CONDUCTED A 12-WEEK RANDOMIZED, PARALLEL-GROUP, DOSING TRIAL FOR 95 ADULTS RECRUITED FROM AN URBAN SAFETY-NET HOSPITAL AND FIVE COMMUNITY HEALTH CENTERS COMPARING ONCE-WEEKLY (N = 49) VERSUS TWICE-WEEKLY (N = 46) STANDARDIZED YOGA CLASSES SUPPLEMENTED BY HOME PRACTICE. PRIMARY OUTCOMES WERE CHANGE FROM BASELINE TO 12 WEEKS IN PAIN (11-POINT SCALE) AND BACK-RELATED FUNCTION (23-POINT MODIFIED ROLAND-MORRIS DISABILITY QUESTIONNAIRE). RESULTS. 82% OF PARTICIPANTS WERE NONWHITE; 77% HAD ANNUAL HOUSEHOLD INCOMES <$40,000. THE SAMPLE'S BASELINE MEAN PAIN INTENSITY [6.9 (SD 1.6)] AND FUNCTION [13.7 (SD 5.0)] REFLECTED MODERATE TO SEVERE BACK PAIN AND IMPAIRMENT. PAIN AND BACK-RELATED FUNCTION IMPROVED WITHIN BOTH GROUPS (P < 0.001). HOWEVER, THERE WERE NO DIFFERENCES BETWEEN ONCE-WEEKLY AND TWICE-WEEKLY GROUPS FOR PAIN REDUCTION [-2.1 (95% CI -2.9, -1.3) VERSUS -2.4 (95% CI -3.1, -1.8), P = 0.62] OR BACK-RELATED FUNCTION [-5.1 (95% CI -7.0, -3.2) VERSUS -4.9 (95% CI -6.5, -3.3), P = 0.83]. CONCLUSIONS. TWELVE WEEKS OF ONCE-WEEKLY OR TWICE-WEEKLY YOGA CLASSES WERE SIMILARLY EFFECTIVE FOR PREDOMINANTLY LOW INCOME MINORITY ADULTS WITH MODERATE TO SEVERE CHRONIC LOW BACK PAIN. THIS TRIAL IS REGISTERED WITH CLINICALTRIALS.GOV NCT01761617. 2013 6 1155 35 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 7 122 48 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 8 151 51 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 2032 32 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 10 1699 35 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 11 2558 35 YOGA FOR CHRONIC LOW BACK PAIN IN A PREDOMINANTLY MINORITY POPULATION: A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: SEVERAL STUDIES SUGGEST YOGA MAY BE EFFECTIVE FOR CHRONIC LOW BACK PAIN; HOWEVER, TRIALS TARGETING MINORITIES HAVE NOT BEEN CONDUCTED. PRIMARY STUDY OBJECTIVES: ASSESS THE FEASIBILITY OF STUDYING YOGA IN A PREDOMINANTLY MINORITY POPULATION WITH CHRONIC LOW BACK PAIN. COLLECT PRELIMINARY DATA TO PLAN A LARGER POWERED STUDY. STUDY DESIGN: PILOT RANDOMIZED CONTROLLED TRIAL. SETTING: TWO COMMUNITY HEALTH CENTERS IN A RACIALLY DIVERSE NEIGHBORHOOD OF BOSTON, MASSACHUSETTS. PARTICIPANTS: THIRTY ENGLISH-SPEAKING ADULTS (MEAN AGE 44 YEARS, 83% FEMALE, 83% RACIAL/ETHNIC MINORITIES; 48% WITH INCOMES < OR = $30,000) WITH MODERATE-TO-SEVERE CHRONIC LOW BACK PAIN. INTERVENTIONS: STANDARDIZED SERIES OF WEEKLY HATHA YOGA CLASSES FOR 12 WEEKS COMPARED TO A WAITLIST USUAL CARE CONTROL. OUTCOME MEASURES: FEASIBILITY MEASURED BY TIME TO COMPLETE ENROLLMENT, PROPORTION OF RACIAL/ETHNIC MINORITIES ENROLLED, RETENTION RATES, AND ADVERSE EVENTS. PRIMARY EFFICACY OUTCOMES WERE CHANGES FROM BASELINE TO 12 WEEKS IN PAIN SCORE (0=NO PAIN TO 10=WORST POSSIBLE PAIN) AND BACK-RELATED FUNCTION USING THE MODIFIED ROLAND-MORRIS DISABILITY QUESTIONNAIRE (0-23 POINT SCALE, HIGHER SCORES REFLECT POORER FUNCTION). SECONDARY EFFICACY OUTCOMES WERE ANALGESIC USE, GLOBAL IMPROVEMENT, AND QUALITY OF LIFE (SF-36). RESULTS: RECRUITMENT TOOK 2 MONTHS. RETENTION RATES WERE 97% AT 12 WEEKS AND 77% AT 26 WEEKS. MEAN PAIN SCORES FOR YOGA DECREASED FROM BASELINE TO 12 WEEKS (6.7 TO 4.4) COMPARED TO USUAL CARE, WHICH DECREASED FROM 7.5 TO 7.1 (P=.02). MEAN ROLAND SCORES FOR YOGA DECREASED FROM 14.5 TO 8.2 COMPARED TO USUAL CARE, WHICH DECREASED FROM 16.1 TO 12.5 (P=.28). AT 12 WEEKS, YOGA COMPARED TO USUAL CARE PARTICIPANTS REPORTED LESS ANALGESIC USE (13% VS 73%, P=.003), LESS OPIATE USE (0% VS 33%, P=.04), AND GREATER OVERALL IMPROVEMENT (73% VS 27%, P=.03). THERE WERE NO DIFFERENCES IN SF-36 SCORES AND NO SERIOUS ADVERSE EVENTS. CONCLUSION: A YOGA STUDY INTERVENTION IN A PREDOMINANTLY MINORITY POPULATION WITH CHRONIC LOW BACK PAIN WAS MODERATELY FEASIBLE AND MAY BE MORE EFFECTIVE THAN USUAL CARE FOR REDUCING PAIN AND PAIN MEDICATION USE. 2009 12 1291 27 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 13 2852 28 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 14 1787 37 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 15 2574 35 YOGA FOR EVERYONE: A QUALITATIVE STUDY OF A COMMUNITY YOGA CLASS FOR PEOPLE WITH DISABILITY. BACKGROUND AND OBJECTIVE: PEOPLE WITH MOBILITY IMPAIRMENTS FACE INCREASED BARRIERS TO PHYSICAL ACTIVITY. THE STUDY AIMED TO UNDERSTAND THE LIVED EXPERIENCES OF INDIVIDUALS WITH DISABILITY WHO ARE REGULAR PARTICIPANTS IN THE YOGA FOR EVERYONE CLASS TO INFORM FUTURE RESEARCH, INTERVENTION AND COMMUNITY PROGRAMS.METHODS: A PHENOMENOLOGICAL QUALITATIVE APPROACH UTILIZED SEMI-STRUCTURED INTERVIEWS AND CLASS OBSERVATIONS. DATA WAS ANALYZED THROUGH ITERATIVE INDUCTIVE THEMATIC ANALYSIS.RESULTS: SIX PEOPLE OF VARIED MOBILITY LIMITATIONS PARTICIPATED. THEMATIC ANALYSIS REVEALED THEMES ON INFLUENTIAL ENVIRONMENTAL AND PERSONAL FACTORS, A HOLISTIC-FOCUSED CLASS ENVIRONMENT, PHYSICAL IMPROVEMENTS, MENTAL/EMOTIONAL IMPACT, AND A SENSE OF BELONGING TO COMMUNITY.CONCLUSION: THE YOGA FOR EVERYONE CLASS FOSTERED MULTI-FACETED OUTCOMES FOR PEOPLE WITH DIVERSE MOVEMENT IMPAIRMENTS. FOCUSING ON COMMUNITY-CLINICAL PARTNERSHIPS, UTILIZING A CLASS STRUCTURE WITH VOLUNTEERS, AND FOSTERING AN ONGOING INCLUSIVE SOCIAL ENVIRONMENT ARE POTENTIAL STRATEGIES FOR SUCCESS IN OTHER COMMUNITY PROGRAMS FOR THOSE WITH DISABILITY. 2022 16 1872 20 RAPID CONVERSION OF A GROUP-BASED YOGA TRIAL FOR DIVERSE OLDER WOMEN TO HOME-BASED TELEHEALTH: LESSONS LEARNED USING ZOOM TO DELIVER MOVEMENT-BASED INTERVENTIONS. THIS BRIEF REPORT DESCRIBES THE RAPID CONVERSION OF A RANDOMIZED TRIAL OF A HATHA-BASED YOGA PROGRAM FOR OLDER WOMEN WITH URINARY INCONTINENCE TO A TELEHEALTH VIDEOCONFERENCE PLATFORM DURING THE CORONAVIRUS DISEASE 2019 (COVID-19) PANDEMIC. INTERIM RESULTS DEMONSTRATE THE FEASIBILITY OF RECRUITING AND RETAINING PARTICIPANTS ACROSS A WIDE RANGE OF AGES AND ETHNIC BACKGROUNDS, BUT ALSO POINT TO POTENTIAL OBSTACLES AND SAFETY CONCERNS ARISING FROM TELEHEALTH-BASED INSTRUCTION. THE INVESTIGATORS PRESENT LESSONS LEARNED ABOUT THE BENEFITS AND CHALLENGES OF USING TELEHEALTH PLATFORMS TO DELIVER MOVEMENT-BASED INTERVENTIONS AND CONSIDER STRATEGIES TO PROMOTE ACCESSIBLE AND WELL-TOLERATED TELEHEALTH-BASED YOGA PROGRAMS FOR OLDER AND DIVERSE POPULATIONS. CLINICAL TRIAL REGISTRATION NUMBER: NCT03672461. 2022 17 2773 31 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 18 2372 45 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 19 2824 34 YOGA VERSUS EDUCATION FOR VETERANS WITH CHRONIC LOW BACK PAIN: STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CHRONIC LOW BACK PAIN IS THE MOST FREQUENT PAIN CONDITION IN VETERANS AND CAUSES SUBSTANTIAL SUFFERING, DECREASED FUNCTIONAL CAPACITY, AND LOWER QUALITY OF LIFE. SYMPTOMS OF POST-TRAUMATIC STRESS, DEPRESSION, AND MILD TRAUMATIC BRAIN INJURY ARE HIGHLY PREVALENT IN VETERANS WITH BACK PAIN. YOGA FOR LOW BACK PAIN HAS BEEN DEMONSTRATED TO BE EFFECTIVE FOR CIVILIANS IN RANDOMIZED CONTROLLED TRIALS. HOWEVER, IT IS UNKNOWN IF RESULTS FROM PREVIOUSLY PUBLISHED TRIALS GENERALIZE TO MILITARY POPULATIONS. METHODS/DESIGN: THIS STUDY IS A PARALLEL RANDOMIZED CONTROLLED TRIAL COMPARING YOGA TO EDUCATION FOR 120 VETERANS WITH CHRONIC LOW BACK PAIN. PARTICIPANTS ARE VETERANS >/=18 YEARS OLD WITH LOW BACK PAIN PRESENT ON AT LEAST HALF THE DAYS IN THE PAST SIX MONTHS AND A SELF-REPORTED AVERAGE PAIN INTENSITY IN THE PREVIOUS WEEK OF >/=4 ON A 0-10 SCALE. THE 24-WEEK STUDY HAS AN INITIAL 12-WEEK INTERVENTION PERIOD, WHERE PARTICIPANTS ARE RANDOMIZED EQUALLY INTO (1) A STANDARDIZED WEEKLY GROUP YOGA CLASS WITH HOME PRACTICE OR (2) EDUCATION DELIVERED WITH A SELF-CARE BOOK. PRIMARY OUTCOME MEASURES ARE CHANGE AT 12 WEEKS IN LOW BACK PAIN INTENSITY MEASURED BY THE DEFENSE AND VETERANS PAIN RATING SCALE (0-10) AND BACK-RELATED FUNCTION USING THE 23-POINT ROLAND MORRIS DISABILITY QUESTIONNAIRE. IN THE SUBSEQUENT 12-WEEK FOLLOW-UP PERIOD, YOGA PARTICIPANTS ARE ENCOURAGED TO CONTINUE HOME YOGA PRACTICE AND EDUCATION PARTICIPANTS CONTINUE FOLLOWING RECOMMENDATIONS FROM THE BOOK. QUALITATIVE INTERVIEWS WITH VETERANS IN THE YOGA GROUP AND THEIR PARTNERS EXPLORE THE IMPACT OF CHRONIC LOW BACK PAIN AND YOGA ON FAMILY RELATIONSHIPS. WE ALSO ASSESS COST-EFFECTIVENESS FROM THREE PERSPECTIVES: THE VETERAN, THE VETERANS HEALTH ADMINISTRATION, AND SOCIETY USING ELECTRONIC MEDICAL RECORDS, SELF-REPORTED COST DATA, AND STUDY RECORDS. DISCUSSION: THIS STUDY WILL HELP DETERMINE IF YOGA CAN BECOME AN EFFECTIVE TREATMENT FOR VETERANS WITH CHRONIC LOW BACK PAIN AND PSYCHOLOGICAL COMORBIDITIES. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT02224183. 2016 20 2638 33 YOGA FOR VETERANS WITH CHRONIC LOW BACK PAIN: DESIGN AND METHODS OF A RANDOMIZED CLINICAL TRIAL. CHRONIC LOW BACK PAIN (CLBP) AFFLICTS MILLIONS OF PEOPLE WORLDWIDE, WITH PARTICULARLY HIGH PREVALENCE IN MILITARY VETERANS. MANY TREATMENT OPTIONS EXIST FOR CLBP, BUT MOST HAVE LIMITED EFFECTIVENESS AND SOME HAVE SIGNIFICANT SIDE EFFECTS. IN GENERAL POPULATIONS WITH CLBP, YOGA HAS BEEN SHOWN TO IMPROVE HEALTH OUTCOMES WITH FEW SIDE EFFECTS. HOWEVER, YOGA HAS NOT BEEN ADEQUATELY STUDIED IN MILITARY VETERAN POPULATIONS. IN THE CURRENT PAPER WE WILL DESCRIBE THE DESIGN AND METHODS OF A RANDOMIZED CLINICAL TRIAL AIMED AT EXAMINING WHETHER YOGA CAN EFFECTIVELY REDUCE DISABILITY AND PAIN IN US MILITARY VETERANS WITH CLBP. A TOTAL OF 144 US MILITARY VETERANS WITH CLBP WILL BE RANDOMIZED TO EITHER YOGA OR A DELAYED TREATMENT COMPARISON GROUP. THE YOGA INTERVENTION WILL CONSIST OF 2X WEEKLY YOGA CLASSES FOR 12WEEKS, COMPLEMENTED BY REGULAR HOME PRACTICE GUIDED BY A MANUAL. THE DELAYED TREATMENT GROUP WILL RECEIVE THE SAME INTERVENTION AFTER SIX MONTHS. THE PRIMARY OUTCOME IS THE CHANGE IN BACK PAIN-RELATED DISABILITY MEASURED WITH THE ROLAND-MORRIS DISABILITY QUESTIONNAIRE AT BASELINE AND 12-WEEKS. SECONDARY OUTCOMES INCLUDE PAIN INTENSITY, PAIN INTERFERENCE, DEPRESSION, ANXIETY, FATIGUE/ENERGY, QUALITY OF LIFE, SELF-EFFICACY, SLEEP QUALITY, AND MEDICATION USAGE. ADDITIONAL PROCESS AND/OR MEDIATIONAL FACTORS WILL BE MEASURED TO EXAMINE DOSE RESPONSE AND EFFECT MECHANISMS. ASSESSMENTS WILL BE CONDUCTED AT BASELINE, 6-WEEKS, 12-WEEKS, AND 6-MONTHS. ALL RANDOMIZED PARTICIPANTS WILL BE INCLUDED IN INTENTION-TO-TREAT ANALYSES. STUDY RESULTS WILL PROVIDE MUCH NEEDED EVIDENCE ON THE FEASIBILITY AND EFFECTIVENESS OF YOGA AS A THERAPEUTIC MODALITY FOR THE TREATMENT OF CLBP IN US MILITARY VETERANS. 2016