1 2372 196 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
2 156 44 A QUALITATIVE STUDY OF LOVEYOURBRAIN YOGA: A GROUP-BASED YOGA WITH PSYCHOEDUCATION INTERVENTION TO FACILITATE COMMUNITY INTEGRATION FOR PEOPLE WITH TRAUMATIC BRAIN INJURY AND THEIR CAREGIVERS. PURPOSE: TO EXPLORE PARTICIPANTS' EXPERIENCES IN A GROUP-BASED YOGA WITH PSYCHOEDUCATION INTERVENTION DESIGNED TO FACILITATE COMMUNITY INTEGRATION FOR PEOPLE WITH TRAUMATIC BRAIN INJURY AND THEIR CAREGIVERS.MATERIALS AND METHODS: WE CONDUCTED SEMI-STRUCTURED INTERVIEWS WITH 13 PEOPLE WITH TRAUMATIC BRAIN INJURY AND THREE CAREGIVERS WHO HAD COMPLETED LOVEYOURBRAIN YOGA, A 6-SESSION, MANUALIZED, GROUP-BASED YOGA INTERVENTION THAT INCORPORATES BREATHING EXERCISES, YOGA, MEDITATION, AND PSYCHOEDUCATION. INTERVIEWS WERE ANALYZED USING CONTENT ANALYSIS.RESULTS: WE IDENTIFIED SEVEN THEMES: EASE OF PARTICIPATION, BELONGING, SUSTAINING COMMUNITY CONNECTION, PHYSICAL HEALTH, SELF-REGULATION, SELF-EFFICACY, AND RESILIENCE. ALL PARTICIPANTS VALUED THE COMMUNITY-BASED YOGA STUDIO ENVIRONMENT AND MULTIFACETED STRUCTURE OF THE PROGRAM. PARTICIPANTS REPORTED IMPROVEMENTS IN STRENGTH, BALANCE, FLEXIBILITY, AND ATTENTION CONTROL, AND A GREATER SENSE OF BELONGING, COMMUNITY CONNECTION, AND ABILITY TO MOVE FORWARD WITH THEIR LIVES. PARTICIPANTS REPORTED ONGOING USE OF TOOLS (E.G., BREATHING EXERCISES) TO COPE WITH NEGATIVE EMOTIONS AND STRESS. ABOUT HALF OF PARTICIPANTS SUSTAINED RELATIONSHIPS BUILT DURING LOVEYOURBRAIN YOGA AND FELT MORE CAPABLE OF ACCESSING OTHER ACTIVITIES IN THEIR COMMUNITY.CONCLUSIONS: LOVEYOURBRAIN YOGA SUCCESSFULLY PROMOTED COMMUNITY INTEGRATION FOR PEOPLE WITH TRAUMATIC BRAIN INJURY. IT ALSO FACILITATED DIVERSE AND MEANINGFUL PHYSICAL, PSYCHOLOGICAL, AND SOCIAL HEALTH BENEFITS, WHICH SUGGEST THAT IT MAY BE AN EFFECTIVE MODE OF COMMUNITY-BASED REHABILITATION.IMPLICATIONS FOR REHABILITATIONTRAUMATIC BRAIN INJURY SURVIVORS OFTEN STRUGGLE TO PARTICIPATE IN THEIR COMMUNITY, THE ULTIMATE GOAL OF REHABILITATIONYOGA IS A HOLISTIC THERAPY WITH MANY BENEFITS, YET IS NOT ACCESSIBLE TO THE TRAUMATIC BRAIN INJURY POPULATION AT THE COMMUNITY LEVELPARTICIPANTS IN A COMMUNITY-BASED YOGA WITH PSYCHOEDUCATION INTERVENTION IN SIX STATES EXPERIENCED DIVERSE AND MEANINGFUL PHYSICAL, PSYCHOLOGICAL, AND SOCIAL HEALTH BENEFITSGROUP-BASED YOGA WITH PSYCHOEDUCATION MAY BE AN EFFECTIVE MODE OF COMMUNITY INTEGRATION AND COMMUNITY-BASED REHABILITATION FOR TRAUMATIC BRAIN INJURY SURVIVORS. 2020
3 2763 42 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
4 1244 39 FEASIBILITY OF ESTABLISHING A COMPREHENSIVE YOGA PROGRAM AND ITS DOSE-EFFECT RELATIONSHIP ON CARDIOVASCULAR RISK FACTORS AND WELLNESS PARAMETERS: A PILOT STUDY. BACKGROUND: WE SOUGHT TO STUDY THE FEASIBILITY OF ESTABLISHING A COMPREHENSIVE, MOSTLY SELF-DIRECTED YOGA PROGRAM IN A HOSPITAL AND ITS DOSE-EFFECT RELATIONSHIP ON CARDIOVASCULAR RISK FACTORS AND QUALITY OF LIFE (QOL) MEASURES OVER SIX MONTHS. METHODS: YOGA-BASED TECHNIQUES (ADVANCED YOGA PRACTICES; AYP; ADVANCEDYOGAPRACTICES.COM) WERE TAUGHT IN 12 BIWEEKLY GROUP SESSIONS AND SELF-DIRECTED PRACTICE AT HOME WAS EMPHASIZED. CARDIOVASCULAR RISK FACTORS WERE ELUCIDATED BY INTERVIEW AND REVIEW OF MEDICAL HISTORY. QUALITY OF LIFE (QOL) OUTCOMES INCLUDED THE SF-36, THE COHEN PERCEIVED STRESS SCALE (CPSS), AND THE HOSPITAL ANXIETY AND DEPRESSION SCALE (HADS). RISK FACTORS AND QOL MEASURES WERE COMPARED IN PARTICIPANTS AT BASELINE AND SIX MONTHS, AS WELL AS BETWEEN THOSE PRACTICING >/= 7 TIMES VERSUS < 7 TIMES PER WEEK. RESULTS: A TOTAL OF 22 INDIVIDUALS (19 WOMEN, MEAN AGE 59 +/- 8.7 YEARS) COMPLETED THE STUDY. AT SIX MONTHS, CHANGES WERE NOTED IN THE MENTAL COMPONENT SCALE (MCS) OF THE SF-36 (P=0.0004) AND THE CPSS (P = 0.022). A GREATER IMPROVEMENT IN CPSS WAS NOTED IN THOSE PRACTICING >/= 7 TIMES VERSUS < 7 TIMES A WEEK (P=0.045). NO CHANGES WERE NOTED IN CARDIOVASCULAR RISK FACTORS. CONCLUSIONS: THE PRESCRIPTION OF A SELF-DIRECTED YOGA PROGRAM WAS FEASIBLE IN A HOSPITAL SETTING AND RESULTED IN IMPROVEMENT IN QOL MEASURES AT SIX MONTHS. PRACTICING MORE THAN SEVEN TIMES PER WEEK CORRELATED WITH GREATER IMPROVEMENT IN THE PERCEPTION OF STRESS. THUS, AT LEAST A ONCE-DAILY DOSE OF AYP TECHNIQUES FOR A SIGNIFICANT IMPROVEMENT IN PERCEIVED STRESS IS AN APPROPRIATE DOSE TO EMPLOY AND STUDY IN HOSPITAL SETTINGS. 2015
5 2275 51 THE ROLE OF YOGA IN WORKING FROM HOME DURING THE COVID-19 GLOBAL LOCKDOWN. BACKGROUND: THE COVID-19 PANDEMIC HAS BECOME A MAJOR CAUSE OF STRESS AND ANXIETY WORLDWIDE. DUE TO THE GLOBAL LOCKDOWN, WORK, EMPLOYMENT, BUSINESSES AND THE ECONOMIC CLIMATE HAVE BEEN SEVERELY AFFECTED. IT HAS GENERATED STRESS AMONG PEOPLE FROM ALL SECTIONS OF SOCIETY, ESPECIALLY TO WORKERS WHO HAVE BEEN ASSIGNED TO CATER TO HEALTHCARE SERVICE OR THOSE CONSTRAINED TO SECURE DAILY ESSENTIAL ITEMS. IT IS WIDELY PERCEIVED THAT ELDERLY OR THOSE AFFECTED BY DIABETES, HYPERTENSION AND OTHER CARDIOVASCULAR DISEASES ARE PRONE TO COVID-19. AS PER AN ONGOING SURVEY, THE INITIAL DATA SHOWS THAT THE ABOVE-MENTIONED ANXIETY AND STRESS CAUSE INSOMNIA, AND HAS THE CONSIDERABLE POTENTIAL TO WEAKEN THE IMMUNE SYSTEM, THE SOLE PROTECTION AGAINST THE VIRUS. OBJECTIVE: THIS STUDY FOCUSES ON THE NEED OF YOGA PRACTICE AT WORK PLACES AND AT HOME DURING THE GLOBAL LOCKDOWN DUE TO THE COVID-19 PANDEMIC. METHODS: LITERATURE WAS SEARCHED USING PUBMED AND GOOGLE SCHOLAR FOR COVID-19-RELATED STRESS AND ANXIETY AT WORK AND SOCIETY DUE TO THE WORLDWIDE LOCKDOWN. THE PREDISPOSING COMORBIDITIES, VIRAL MECHANISM OF ACTION AND TREATMENT REGIMEN WERE ALSO SEARCHED. YOGA-BASED INTERVENTION STUDIES AND ONLINE PROGRAMS WERE ALSO SEARCHED. RESULTS: AS THE LOCKDOWN CANNOT LAST FOREVER AND WORKPLACES WILL HAVE TO BE FUNCTIONAL SOON, THERE IS AN INCREASED POSSIBILITY OF RECURRENT INFECTION. THEREFORE, YOGA CAN PROVIDE THE NECESSARY TOOL FOR RISK REDUCTION, AMELIORATION OF STRESS AND ANXIETY AND STRENGTHENING OF THE IMMUNE FUNCTION. THE ONLINE PLATFORMS PROVIDE A GOOD MEDIA FOR YOGA TRAINING AT WORK PLACES AND HOMES. CONCLUSION: DUE TO SOCIAL DISTANCING NORMS, THE AVAILABILITY OF YOGA TRAINERS HAS BECOME RESTRICTED. YOGA PRACTICE IS ACTIVELY SOUGHT TO ACHIEVE REDUCED ANXIETY AND STRESS SO THAT IMPROVED SLEEP MAY POSITIVELY IMPACT IMMUNITY. AS A CONSEQUENCE, THERE IS A SPURT IN SOCIAL MEDIA, CATERING TO DAILY ONLINE YOGA SESSIONS WHICH APPARENTLY PROVE USEFUL IN PROVIDING ACCESSIBLE MEANS TO ACHIEVE MENTAL AS WELL AS PHYSICAL WELL-BEING. 2020
6 151 50 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
7 2520 43 YOGA COMPLEMENTS COGNITIVE BEHAVIOUR THERAPY AS AN ADJUNCT TREATMENT FOR ANXIETY AND DEPRESSION: QUALITATIVE FINDINGS FROM A MIXED-METHODS STUDY. OBJECTIVES: COGNITIVE BEHAVIOUR THERAPY (CBT) IS RECOMMENDED FOR TREATING ANXIETY AND DEPRESSION, DEMONSTRATING GOOD EFFICACY AND MODERATE RATES OF ENGAGEMENT. TO FURTHER IMPROVE OUTCOMES AND ACCESS TO EVIDENCE-BASED TREATMENTS, RESEARCHERS HAVE SOUGHT TO ENHANCE CBT PROTOCOLS WITH MINDFULNESS-BASED APPROACHES, SUCH AS YOGA. THIS STUDY AIMED TO EXAMINE WHETHER YOGA IS AN ACCEPTABLE AND COMPLEMENTARY ADJUNCT TO CBT THROUGH EXPLORING THE LIVED EXPERIENCES OF ADULTS WITH ANXIETY AND DEPRESSION WHO ENGAGED IN AN ADJUNCT THERAPEUTIC YOGA PROGRAMME ALONGSIDE GROUP CBT. DESIGN: SINGLE-GROUP QUALITATIVE DESIGN WITH POST-INTERVENTION AND FOLLOW-UP TIMEPOINTS. METHODS: THIRTY-SIX ADULTS WITH ANXIETY AND DEPRESSION SELF-SELECTED INTO A THERAPEUTIC YOGA PROGRAMME AS AN ADJUNCT TO GROUP CBT. QUALITATIVE INTERVIEWS WERE CONDUCTED WITH 27 PARTICIPANTS IMMEDIATELY AFTER THE EIGHT-WEEK PROGRAMME AND AGAIN THREE MONTHS LATER. THEMATIC ANALYSIS WAS USED TO IDENTIFY COMMON THEMES FROM THE LIVED EXPERIENCES. RESULTS: THREE PRIMARY THEMES, WITH NINE SUBTHEMES, WERE IDENTIFIED WHICH REFLECT THE EXPERIENCES OF THE COMBINED THERAPIES, THE COMPLEMENTARY ELEMENTS, AND PROCESS OF ENGAGEMENT OVER TIME. THE ADJUNCT YOGA PROGRAMME WAS HIGHLY ACCEPTABLE TO ADULTS WITH ANXIETY AND DEPRESSION, ENHANCING ENGAGEMENT AND PERCEIVED OUTCOMES. YOGA WAS IDENTIFIED AS PROVIDING A UNIQUE COMBINATION OF ELEMENTS THAT COMPLEMENTED PROCESSES OF CBT, SUCH AS BEHAVIOURAL ACTIVATION AND THOUGHT DISPUTATION. YOGA PRACTICES REPRESENTED MENTAL HEALTH SELF-MANAGEMENT TOOLS THAT ARE ACCESSIBLE AND AVAILABLE AS RELAPSE PREVENTION STRATEGIES. CONCLUSIONS: THERAPEUTIC YOGA WARRANTS CONSIDERATION AS AN ADJUNCT TREATMENT FOR ANXIETY AND DEPRESSION AS IT OFFERS UNIQUE AND COMPLEMENTARY ELEMENTS TO CBT AND CAN ENHANCE ENGAGEMENT AND PERCEIVED CLINICAL OUTCOMES. PRACTITIONER POINTS: ADULTS WITH ANXIETY AND DEPRESSION EXPERIENCED A THERAPEUTIC YOGA PROGRAMME AS A SUITABLE AND APPEALING ADJUNCT THAT ENHANCED ENGAGEMENT WITH PSYCHOLOGICAL TREATMENT. YOGA OFFERS A UNIQUE COMBINATION OF ELEMENTS, INCLUDING A VALUES SYSTEM, BODY-BASED MINDFULNESS PRACTICES, AND BREATHING TECHNIQUES, THAT COMPLEMENT CBT PROCESSES, SUCH AS BEHAVIOURAL ACTIVATION, AWARENESS OF MALADAPTIVE PATTERNS, AND THOUGHT DISPUTATION. A THERAPEUTIC YOGA PROGRAMME PROVIDES ADULTS WITH ANXIETY AND DEPRESSION WITH AN ACCESSIBLE AND SUSTAINABLE MENTAL HEALTH SELF-MANAGEMENT TOOL. THERAPEUTIC YOGA CAN BE CONSIDERED FOR INTEGRATION TO MODELS OF MENTAL HEALTH SERVICE PROVISION TO ENHANCE ENGAGEMENT AND CLINICAL OUTCOMES FOR ADULTS WITH ANXIETY AND DEPRESSION. 2021
8 1903 41 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
9 13 44 "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
10 1175 40 EVALUATION OF AN INTEGRATED YOGA PROGRAM IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE: A PILOT STUDY. BACKGROUND: THE EFFECTS OF INTEGRATED YOGA PROGRAMS ON MENTAL HEALTH OUTCOMES IN INFLAMMATORY BOWEL DISEASE (IBD) HAVE NOT BEEN WELL EXPLORED. TO EXPLORE THE ACCEPTABILITY, IMPLEMENTATION AND EFFECTIVENESS OF AN INTEGRATED EIGHT-WEEK YOGA PROGRAM PLUS AROMATHERAPY MASSAGE IN PATIENTS WITH IBD. METHODS: NINE PARTICIPANTS WITH DOCUMENTED IBD WERE RECRUITED FROM A GASTROENTEROLOGY CLINIC IN CALGARY, ALBERTA, CANADA TO PARTICIPATE IN AN INTEGRATED YOGA PROGRAM WEEKLY FOR EIGHT WEEKS WITH OUTCOMES ASSESSED AT BASELINE AND WEEK 8. PRIMARY OUTCOMES WERE ASSESSED USING THEORY OF PLANNED BEHAVIOUR AS A GUIDING THEORY TO IDENTIFY SALIENT BELIEFS FROM QUALITATIVE ANALYSIS OF A SEMI-STRUCTURED INTERVIEW, SURVEY ITEMS MEASURING THE STRENGTH OF BELIEFS AND A DAILY LOG WAS USED TO CAPTURE ADHERENCE AND ADVERSE EVENTS. SECONDARY OUTCOMES WERE COLLECTED USING VALIDATED SURVEY TOOLS EXAMINING ANXIETY, DEPRESSION, STRESS, SLEEP QUALITY, AND PHYSICAL AND MENTAL QUALITY OF LIFE. RESULTS: ATTITUDE, SUBJECTIVE NORM AND PERCEIVED BEHAVIORAL CONTROL BELIEFS PERTINENT TO THE YOGA INTERVENTION AND DAILY PRACTICE WERE IDENTIFIED. PARTICIPANTS REPORTED FEELING THE INTERVENTION WAS VERY HELPFUL; HOWEVER, FELT GUILT ABOUT NOT COMPLETING DAILY PRACTICES WHICH DECREASED CONFIDENCE AND INTENTION TO CONTINUE WITH THE PRACTICE. AN AVERAGE OF 55.6% OF IN-PERSON SESSIONS WERE ATTENDED AND DECREASED OVER TIME. PARTICIPANTS PRACTICED ON AVERAGE OF 5.4 DAYS PER WEEK. DEPRESSION AND MENTAL HEALTH SCORES IMPROVED AT WEEK 8 FROM BASELINE. CONCLUSIONS: WE WERE ABLE TO IDENTIFY KEY SALIENT BELIEFS OF IBD PATIENTS IN REGARD TO AN INTEGRATED YOGA PLUS AROMATHERAPY MASSAGE INTERVENTION. THIS INTERVENTION APPEARS TO BE ACCEPTABLE AND FURTHER RESEARCH SHOULD EXPLORE ITS POTENTIAL TO IMPROVE MENTAL AND PHYSICAL HEALTH OUTCOMES INCLUDING IBD SYMPTOMS. 2022
11 2658 41 YOGA IN ADULT CANCER: A PILOT SURVEY OF ATTITUDES AND BELIEFS AMONG ONCOLOGISTS. BACKGROUND: DEPENDING ON INTEREST, KNOWLEDGE, AND SKILLS, ONCOLOGISTS ARE ADAPTING CLINICAL BEHAVIOUR TO INCLUDE INTEGRATIVE APPROACHES, SUPPORTING PATIENTS TO MAKE INFORMED COMPLEMENTARY CARE DECISIONS. THE PRESENT STUDY SOUGHT TO IMPROVE THE KNOWLEDGE BASE IN THREE WAYS: TEST THE ACCEPTABILITY OF A SELF-REPORTED ONLINE SURVEY FOR ONCOLOGISTS.PROVIDE PRELIMINARY DATA COLLECTION CONCERNING KNOWLEDGE, ATTITUDES, BELIEFS, AND CURRENT REFERRAL PRACTICES AMONG ONCOLOGISTS WITH RESPECT TO YOGA IN ADULT CANCER.LIST THE PERCEIVED BENEFITS OF AND BARRIERS TO YOGA INTERVENTION FROM A CLINICAL PERSPECTIVE. METHODS: A 38-ITEM SELF-REPORT QUESTIONNAIRE WAS ADMINISTERED ONLINE TO MEDICAL, RADIATION, AND SURGICAL ONCOLOGISTS IN BRITISH COLUMBIA. RESULTS: SOME OF THE 29 ONCOLOGISTS WHO COMPLETED THE SURVEY (N = 10) REPORTED HAVING RECOMMENDED YOGA TO PATIENTS TO IMPROVE PHYSICAL ACTIVITY, FATIGUE, STRESS, INSOMNIA, AND MUSCLE OR JOINT STIFFNESS. OTHER RESPONDING ONCOLOGISTS WERE HESITANT OR UNLIKELY TO SUGGEST YOGA FOR THEIR PATIENTS BECAUSE THEY HAD NO KNOWLEDGE OF YOGA AS A THERAPY (N = 15) OR BELIEVED THAT SCIENTIFIC EVIDENCE TO SUPPORT ITS USE IS LACKING (N = 11). ALL 29 RESPONDENTS WOULD RECOMMEND THAT THEIR PATIENTS PARTICIPATE IN A CLINICAL TRIAL TO TEST THE EFFICACY OF YOGA. IN QUALITATIVE FINDINGS, ONCOLOGISTS COMPARED YOGA WITH EXERCISE AND SUGGESTED THAT IT MIGHT HAVE SIMILAR PSYCHOLOGICAL AND PHYSICAL HEALTH BENEFITS THAT WOULD IMPROVE PATIENT CAPACITY TO ENDURE TREATMENT. BARRIERS TO AND LIMITATIONS OF YOGA IN ADULT CANCER ARE ALSO DISCUSSED. CONCLUSIONS: AN ONLINE SELF-REPORT SURVEY IS FEASIBLE, BUT HAS RESPONSE RATE LIMITATIONS. A SMALL NUMBER OF ONCOLOGISTS ARE CURRENTLY RECOMMENDING YOGA TO IMPROVE HEALTH-RELATED OUTCOMES IN ADULT CANCER. RESPONDENTS WOULD SUPPORT CLINICAL YOGA INTERVENTIONS TO IMPROVE THE EVIDENCE BASE IN CANCER PATIENTS, INCLUDING MEN AND WOMEN IN ALL TUMOUR GROUPS. 2015
12 905 30 EFFECTIVENESS OF AN EXTENDED YOGA TREATMENT FOR WOMEN WITH CHRONIC POSTTRAUMATIC STRESS DISORDER. BACKGROUND: YOGA HAS BEEN FOUND TO BE AN EFFECTIVE POSTTRAUMATIC STRESS DISORDER (PTSD) TREATMENT FOR A VARIETY OF TRAUMA SURVIVORS, INCLUDING FEMALES WITH CHRONIC PTSD. AIM/PURPOSE: THE CURRENT STUDY BUILDS ON EXTANT RESEARCH BY EXAMINING AN EXTENDED TRAUMA-SENSITIVE YOGA TREATMENT FOR WOMEN WITH CHRONIC PTSD. THE STUDY SOUGHT TO OPTIMIZE THE RESULTS OF A TREATMENT PROTOCOL EXAMINED IN A RECENT RANDOMIZED CONTROLLED TRIAL WITH A SHORTER DURATION AND WITHOUT ASSIGNMENT OR MONITORING OF HOME PRACTICE. MATERIALS AND METHODS: THE AUTHORS EXAMINED A 20-WEEK TRAUMA-SENSITIVE YOGA TREATMENT IN A NON-RANDOMIZED SINGLE-GROUP TREATMENT FEASIBILITY STUDY FOR WOMEN WITH CHRONIC TREATMENT-RESISTANT PTSD (N = 9). THE AUTHORS EXAMINED PTSD AND DISSOCIATION SYMPTOM REDUCTION OVER SEVERAL ASSESSMENT PERIODS. RESULTS: THE RESULTS INDICATE THAT PARTICIPANTS EXPERIENCED SIGNIFICANT REDUCTIONS IN PTSD AND DISSOCIATIVE SYMPTOMATOLOGY ABOVE AND BEYOND SIMILAR TREATMENTS OF A SHORTER DURATION. CONCLUSIONS: THE FINDINGS SUGGEST THAT MORE INTENSIVE TRAUMA-SENSITIVE YOGA TREATMENT CHARACTERIZED BY LONGER DURATION AND INTENTIONAL ASSIGNMENT AND MONITORING OF HOME PRACTICE MAY BE MORE ADVANTAGEOUS FOR INDIVIDUALS WITH SEVERE AND CHRONIC PTSD. THE IMPLICATIONS OF THE FINDINGS FOR THE POTENTIALLY MORE SUBSTANTIAL ROLE OF YOGA AS AN INTERVENTION FOR A SUBSET OF ADULTS WITH CHRONIC TREATMENT-RESISTANT PTSD ARE DISCUSSED. 2017
13 122 49 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
14 1240 45 FEASIBILITY OF A MINDFUL YOGA PROGRAM FOR WOMEN WITH METASTATIC BREAST CANCER: RESULTS OF A RANDOMIZED PILOT STUDY. PURPOSE: PATIENTS WITH METASTATIC BREAST CANCER (MBC) EXPERIENCE HIGH LEVELS OF SYMPTOMS. YOGA INTERVENTIONS HAVE SHOWN PROMISE FOR IMPROVING CANCER SYMPTOMS BUT HAVE RARELY BEEN TESTED IN PATIENTS WITH ADVANCED DISEASE. THIS STUDY EXAMINED THE ACCEPTABILITY OF A COMPREHENSIVE YOGA PROGRAM FOR MBC AND THE FEASIBILITY OF CONDUCTING A RANDOMIZED TRIAL TESTING THE INTERVENTION. METHODS: SIXTY-THREE WOMEN WITH MBC WERE RANDOMIZED WITH A 2:1 ALLOCATION TO YOGA OR A SUPPORT GROUP COMPARISON CONDITION. BOTH INTERVENTIONS INVOLVED EIGHT WEEKLY GROUP SESSIONS. FEASIBILITY WAS QUANTIFIED USING RATES OF ACCRUAL, ATTRITION, AND SESSION ATTENDANCE. ACCEPTABILITY WAS ASSESSED WITH A STANDARDIZED SELF-REPORT MEASURE. PAIN, FATIGUE, SLEEP QUALITY, PSYCHOLOGICAL DISTRESS, MINDFULNESS, AND FUNCTIONAL CAPACITY WERE ASSESSED AT BASELINE, POST-INTERVENTION, AND 3 AND 6 MONTHS POST-INTERVENTION. RESULTS: WE MET GOALS FOR ACCRUAL AND RETENTION, WITH 50% OF ELIGIBLE PATIENTS ENROLLED AND 87% OF RANDOMIZED PARTICIPANTS COMPLETING POST-INTERVENTION SURVEYS. SIXTY-FIVE PERCENT OF WOMEN IN THE YOGA CONDITION AND 90% IN THE SUPPORT GROUP ATTENDED >/= 4 SESSIONS. EIGHTY PERCENT OF PARTICIPANTS IN THE YOGA CONDITION AND 65% IN THE SUPPORT GROUP INDICATED THAT THEY WERE HIGHLY SATISFIED WITH THE INTERVENTION. FOLLOWING TREATMENT, WOMEN IN THE YOGA INTERVENTION HAD MODEST IMPROVEMENTS IN SOME OUTCOMES; HOWEVER, OVERALL SYMPTOM LEVELS WERE LOW FOR WOMEN IN BOTH CONDITIONS. CONCLUSIONS: FINDINGS SUGGEST THAT THE YOGA INTERVENTION CONTENT WAS HIGHLY ACCEPTABLE TO PATIENTS WITH MBC, BUT THAT THERE ARE CHALLENGES TO IMPLEMENTING AN INTERVENTION INVOLVING EIGHT GROUP-BASED IN-PERSON SESSIONS. ALTERNATIVE MODES OF DELIVERY MAY BE NECESSARY TO REACH PATIENTS MOST IN NEED OF INTERVENTION. 2019
15 551 43 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
16 2320 36 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
17 1538 34 KNOWLEDGE AND ATTITUDES TOWARD PRENATAL YOGA AMONG WOMEN WITH HIGH-RISK PREGNANCIES. THIS STUDY SOUGHT TO EVALUATE ATTITUDES AND KNOWLEDGE ABOUT PRENATAL YOGA AND TO INVESTIGATE BARRIERS AND FACILITATORS TO YOGA PARTICIPATION IN HIGH-RISK PREGNANT WOMEN RECEIVING PRENATAL CARE IN AN ACADEMIC TERTIARY CARE CENTER. WE SURVEYED A CONVENIENCE SAMPLE OF WOMEN RECEIVING PRENATAL CARE THROUGH THE MATERNAL-FETAL MEDICINE PRACTICE AT BRIGHAM AND WOMEN'S HOSPITAL. WE CLASSIFIED PARTICIPANTS AS YOGA-EXPERIENCED OR YOGA-NAIVE DEPENDING ON SELF-REPORT. WE COMPARED DIFFERENCES BETWEEN THE TWO GROUPS USING THE APPROPRIATE NONPARAMETRIC TESTS AND COMPARED BIVARIATE ODDS RATIOS FOR SURVEY RESULTS USING LOGISTIC REGRESSION. OF THE 100 RESPONDENTS, 53% HAD PRACTICED YOGA PREVIOUSLY. WOMEN WITH YOGA EXPERIENCE WERE OLDER (AGE 34.9 +/- 5.6 VS. 31.0 +/- 6.0 YEARS, P = 0.004), MORE LIKELY TO BE COLLEGE GRADUATES (94% VS. 68%, P = 0.002), AND MORE LIKELY TO BE WHITE (77% VS. 47%, P = 0.002) THAN WOMEN WITHOUT PREVIOUS YOGA EXPERIENCE. PREVIOUS YOGA EXPERIENCE WAS ASSOCIATED WITH PARTICIPANT AGREEMENT THAT YOGA WAS SAFE DURING THEIR CURRENT PREGNANCY (ODDS RATIO 5.9, 95% CONFIDENCE INTERVAL 1.9-17.7). OF THE WOMEN SURVEYED, 56% AGREED THAT THEY WOULD LIKE TO ATTEND A PRENATAL YOGA CLASS. IN A MULTIVARIATE MODEL INCLUDING AGE, RACE, AND EDUCATION, PREVIOUS YOGA EXPERIENCE WAS THE ONLY SIGNIFICANT PREDICTOR ASSOCIATED WITH WILLINGNESS TO PARTICIPATE IN PRENATAL YOGA CLASSES DURING CURRENT PREGNANCY (ODDS RATIO 3.1, 95% CONFIDENCE INTERVAL 1.1-8.6). PRIOR YOGA EXPERIENCE WAS THE STRONGEST PREDICTOR OF WILLINGNESS TO ATTEND A PRENATAL YOGA CLASS IN OUR POPULATION. OUR RESULTS SUGGEST THAT WOMEN WITH HIGH-RISK PREGNANCIES WHO MAY BENEFIT FROM PRENATAL YOGA INTERVENTIONS BUT LACK PRIOR YOGA EXPERIENCE MAY NEED ADDITIONAL EDUCATION TO FACILITATE PARTICIPATION. 2020
18 501 61 COMMUNITY BASED YOGA CLASSES FOR TYPE 2 DIABETES: AN EXPLORATORY RANDOMISED CONTROLLED TRIAL. BACKGROUND: YOGA IS A POPULAR THERAPY FOR DIABETES BUT ITS EFFICACY IS CONTESTED. THE AIM OF THIS STUDY WAS TO EXPLORE THE FEASIBILITY OF RESEARCHING COMMUNITY BASED YOGA CLASSES IN TYPE 2 DIABETES WITH A VIEW TO INFORMING THE DESIGN OF A DEFINITIVE, MULTI-CENTRE TRIAL METHODS: THE STUDY DESIGN WAS AN EXPLORATORY RANDOMISED CONTROLLED TRIAL WITH IN-DEPTH PROCESS EVALUATION. THE SETTING WAS TWO MULTI-ETHNIC BOROUGHS IN LONDON, UK; ONE WITH AVERAGE AND ONE WITH LOW MEAN SOCIO-ECONOMIC DEPRIVATION SCORE. CLASSES WERE HELD AT A SPORTS CENTRE OR GP SURGERY. PARTICIPANTS WERE 59 PEOPLE WITH TYPE 2 DIABETES NOT TAKING INSULIN, RECRUITED FROM GENERAL PRACTICE LISTS OR OPPORTUNISTICALLY BY GENERAL PRACTICE STAFF. THE INTERVENTION GROUP WERE OFFERED 12 WEEKS OF A TWICE-WEEKLY 90-MINUTE YOGA CLASS; THE CONTROL GROUP WAS A WAITING LIST FOR THE YOGA CLASSES. BOTH GROUPS RECEIVED ADVICE AND LEAFLETS ON HEALTHY LIFESTYLE AND WERE ENCOURAGED TO EXERCISE. PRIMARY OUTCOME MEASURE WAS HBA1C. SECONDARY OUTCOME MEASURES INCLUDED ATTENDANCE, WEIGHT, WAIST CIRCUMFERENCE, LIPID LEVELS, BLOOD PRESSURE, UKPDS CARDIOVASCULAR RISK SCORE, DIABETES-RELATED QUALITY OF LIFE (ADDQOL), AND SELF-EFFICACY. PROCESS MEASURES WERE ATTENDANCE AT YOGA SESSIONS, SELF-REPORTED FREQUENCY OF PRACTICE BETWEEN TAUGHT SESSIONS, AND QUALITATIVE DATA (INTERVIEWS WITH PATIENTS AND THERAPISTS, ETHNOGRAPHIC OBSERVATION OF THE YOGA CLASSES, AND ANALYSIS OF DOCUMENTS INCLUDING MINUTES OF MEETINGS, CORRESPONDENCE, AND EXERCISE PLANS). RESULTS: DESPITE BROAD INCLUSION CRITERIA, AROUND TWO-THIRDS OF THE PATIENTS ON GP DIABETIC REGISTERS PROVED INELIGIBLE, AND 90% OF THE REMAINDER DECLINED TO PARTICIPATE. MEAN AGE OF PARTICIPANTS WAS 60 +/- 10 YEARS. ATTENDANCE AT YOGA CLASSES WAS AROUND 50%. NOBODY DID THE EXERCISES REGULARLY AT HOME. YOGA TEACHERS FELT THAT MOST PARTICIPANTS WERE UNSUITABLE FOR 'STANDARD' YOGA EXERCISES BECAUSE OF LIMITED FLEXIBILITY, LACK OF BASIC FITNESS, CO-MORBIDITY, AND LACK OF CONFIDENCE. THERE WAS A SMALL FALL IN HBA1C IN THE YOGA GROUP WHICH WAS NOT STATISTICALLY SIGNIFICANT AND WHICH WAS NOT SUSTAINED SIX MONTHS LATER, AND NO SIGNIFICANT CHANGE IN OTHER OUTCOME MEASURES. CONCLUSION: THE BENEFITS OF YOGA IN TYPE 2 DIABETES SUGGESTED IN SOME PREVIOUS STUDIES WERE NOT CONFIRMED. POSSIBLE EXPLANATIONS (APART FROM LACK OF EFFICACY) INCLUDE RECRUITMENT CHALLENGES; PRACTICAL AND MOTIVATIONAL BARRIERS TO CLASS ATTENDANCE; PHYSICAL AND MOTIVATIONAL BARRIERS TO ENGAGING IN THE EXERCISES; INADEQUATE INTENSITY AND/OR DURATION OF YOGA INTERVENTION; AND INSUFFICIENT PERSONALISATION OF EXERCISES TO INDIVIDUAL NEEDS. ALL THESE FACTORS SHOULD BE CONSIDERED WHEN DESIGNING FUTURE TRIALS. TRIAL REGISTRATION: NATIONAL RESEARCH REGISTER (1410) AND CURRENT CONTROLLED TRIALS (ISRCTN63637211). 2009
19 1159 48 ESTABLISHING KEY COMPONENTS OF YOGA INTERVENTIONS FOR REDUCING DEPRESSION AND ANXIETY, AND IMPROVING WELL-BEING: A DELPHI METHOD STUDY. BACKGROUND: PREVIOUS RESEARCH SUGGESTS BENEFITS OF YOGA IN REDUCING DEPRESSION AND ANXIETY. HOWEVER, COMMON CONCERNS IN REVIEWS OF THE RESEARCH INCLUDE LACK OF DETAIL, RATIONALE AND CONSISTENCY OF APPROACH OF INTERVENTIONS USED. ISSUES RELATED TO HETEROGENEITY INCLUDE AMOUNT, TYPES AND DELIVERY OF YOGA INTERVENTIONS. THIS STUDY AIMS TO DOCUMENT CONSENSUS-BASED RECOMMENDATIONS FOR CONSISTENCY OF YOGA INTERVENTIONS FOR REDUCING DEPRESSION AND ANXIETY. METHODS: THE DELPHI METHOD WAS USED TO ESTABLISH CONSENSUS FROM EXPERIENCED YOGA TEACHERS. THIRTY-THREE ELIGIBLE TEACHERS WERE INVITED TO PARTICIPATE, FROM FOUR DIFFERENT COUNTRIES. TWO ROUNDS OF AN ONLINE SURVEY WERE SENT TO PARTICIPANTS. THE FIRST ROUND SOUGHT INITIAL VIEWS. THE SECOND ROUND SOUGHT CONSENSUS ON A SUMMARY OF THOSE VIEWS. SURVEY QUESTIONS RELATED TO FREQUENCY AND DURATION (DOSAGE) OF THE YOGA, APPROACHES AND TECHNIQUES TO BE INCLUDED OR AVOIDED, AND TRAINING AND EXPERIENCE FOR YOGA TEACHERS. RESULTS: TWENTY-FOUR TEACHERS AGREED TO PARTICIPATE. EIGHTEEN COMPLETED THE SECOND ROUND (N = 18). GENERAL CONSENSUS (>75% OF PARTICIPANTS IN AGREEMENT) WAS ACHIEVED ON PARAMETERS OF PRACTICE (DOSAGE): AN AVERAGE OF 30 TO 40 MINUTES, TO BE DONE 5 TIMES PER WEEK, OVER A PERIOD OF 6 WEEKS. NUMEROUS RECOMMENDATIONS FOR YOGA TECHNIQUES TO INCLUDE OR AVOID WERE COLLECTED IN THE FIRST ROUND. THE SECOND ROUND PRODUCED A CONSENSUS STATEMENT ON THOSE RECOMMENDATIONS. BREATH REGULATION AND POSTURES WERE CONSIDERED VERY IMPORTANT OR ESSENTIAL FOR PEOPLE WITH DEPRESSION; AND RELAXATION, BREATH REGULATION AND MEDITATION BEING VERY IMPORTANT OR ESSENTIAL FOR PEOPLE WITH ANXIETY. OTHER RECOMMENDED COMPONENTS ALSO ACHIEVED CONSENSUS. THERE WAS ALSO GENERAL CONSENSUS THAT IT IS VERY IMPORTANT OR ESSENTIAL FOR TEACHERS TO HAVE A MINIMUM OF 500 TRAINING HOURS OVER 2 YEARS, AT LEAST 2 YEARS TEACHING EXPERIENCE, TRAINING IN DEVELOPING PERSONALISED YOGA PRACTICES, TRAINING IN YOGA FOR MENTAL HEALTH, AND PROFESSIONAL SUPERVISION OR MENTORING. CONCLUSIONS: THE DELPHI PROCESS HAS ACHIEVED A CONSENSUS STATEMENT ON THE APPLICATION OF YOGA FOR REDUCING ANXIETY AND DEPRESSION. THIS CONSENSUS PROVIDES A CHECKLIST FOR IDENTIFICATION OF COMMONALITIES AND EVALUATION OF PAST RESEARCH. FUTURE RESEARCH CAN PROCEED TO DEVELOP AND EVALUATE CONSENSUS-BASED YOGA INTERVENTION PROTOCOLS FOR THE REDUCTION OF ANXIETY AND DEPRESSION, AND IMPROVEMENTS IN WELL-BEING. 2015
20 2632 31 YOGA FOR TRAUMA AND RELATED MENTAL HEALTH PROBLEMS: A META-REVIEW WITH CLINICAL AND SERVICE RECOMMENDATIONS. HEALTH AND HUMAN SERVICE PROVIDERS HAVE EXPRESSED GROWING INTEREST IN THE BENEFITS OF YOGA TO HELP INDIVIDUALS COPE WITH THE EFFECTS OF TRAUMA, INCLUDING ANXIETY, DEPRESSION, AND POSTTRAUMATIC STRESS DISORDER (PTSD). DESPITE THE GROWING POPULARITY AND STRONG APPEAL OF YOGA, PROVIDERS MUST BE MINDFUL OF THE EVIDENCE REGARDING THE EFFICACY OF YOGA IN TREATING TRAUMA EFFECTS AS WELL AS TRAUMA-RELATED MENTAL HEALTH SYMPTOMS AND ILLNESSES. THEREFORE, OUR RESEARCH TEAM SOUGHT TO ANSWER TWO QUESTIONS: (A) WHAT IS THE EVIDENCE REGARDING YOGA AS A TREATMENT FOR TRAUMA EFFECTS, INCLUDING ANXIETY, DEPRESSION, AND PTSD AND (B) WHAT ARE THE CLINICAL AND SERVICE RECOMMENDATIONS FOR USING YOGA WITH TRAUMA-EXPOSED INDIVIDUALS? OUR INITIAL SCANS IDENTIFIED A SUBSTANTIAL BODY OF RESEARCH, INCLUDING REVIEWS. RATHER THAN REPLICATE EARLIER EFFORTS, WE UNDERTOOK A SYSTEMATIC META-REVIEW OF 13 LITERATURE REVIEWS, ONE OF WHICH INCLUDED A META-ANALYSIS. WE DETERMINED THE 13 REVIEWS EXAMINED 185 DISTINCT STUDIES. FINDINGS SHOW THAT THE EVIDENCE REGARDING YOGA AS AN INTERVENTION FOR THE EFFECTS OF TRAUMA AS WELL AS THE MENTAL HEALTH SYMPTOMS AND ILLNESSES OFTEN ASSOCIATED WITH TRAUMA IS ENCOURAGING BUT PRELIMINARY. OVERALL, THE BODY OF RESEARCH IS LACKING IN RIGOR AS WELL AS SPECIFICITY REGARDING TRAUMA. REVIEW RESULTS ALSO ONLY ALLOW FOR THE RECOMMENDATION OF YOGA AS AN ANCILLARY TREATMENT. FURTHER, THE REVIEWS HAD CONSIDERABLE DIFFERENCES IN THEIR METHODS AND LIMITATIONS. NONETHELESS, THE RESULTS YIELDED FINDINGS CONCERNING HOW CLINICIANS AND SERVICE PROVIDERS CAN USE YOGA IN THEIR OWN PRACTICES, WHICH IS AN IMPORTANT STEP FOR BUILDING AN EVIDENCE BASE IN THIS AREA. 2018