Feasibility and assessment of outcome measures for yoga as self-care for minorities with arthritis: a pilot study

Kimberly R Middleton, Michael M Ward, Steffany Haaz Moonaz, Miriam Magaña López, Gladys Tataw-Ayuketah, Li Yang, Ana T Acevedo, Zavera Brandon, Gwenyth R Wallen, Kimberly R Middleton, Michael M Ward, Steffany Haaz Moonaz, Miriam Magaña López, Gladys Tataw-Ayuketah, Li Yang, Ana T Acevedo, Zavera Brandon, Gwenyth R Wallen

Abstract

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.

Keywords: Feasibility study; Minority; Osteoarthritis; Rheumatoid arthritis; Yoga.

Conflict of interest statement

Approval to conduct the study was obtained through the National Institute of Diabetes and Digestive and Kidney Disease/ National Institute of Arthritis and Musculoskeletal and Skin Disease’s intramural institutional review board.The following language is included in the informed consent signed by each participant, “Data analyses will occur and results will be reported for presentation and/or publication”.SHM reports consulting fees from NIH during the conduct of the study and provides arthritis-related continuing education for yoga professionals. All remaining authors declare that there is no competing of interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Conceptual model for potential relationships between facilitators/impediments, self-care, and exercise self-efficacy
Fig. 2
Fig. 2
Flow Diagram
Fig. 3
Fig. 3
Distribution of Health-Promoting Lifestyle Profile II (HPLP-II) average values of overall score and subscales
Fig. 4
Fig. 4
Scatterplot matrix and Spearman’s rho values for variables correlated with exercise self-efficacy

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