Search

Purpose: To contribute to the treatment fidelity literature by providing real-world examples and suggestion for future research and potential clinical application, this article reports on implementation, assessment, and evaluation of treatment fidelity in mind–body self-care approaches in at-risk women. Method: Aligning with best practices, treatment fidelity was integrated into three randomized clinical trials. The first examined the effects of a tai chi intervention designed to decrease cardiometabolic risk factors in women; the second examined the effects of a tailored guided imagery intervention on pregnancy outcomes in African American women; and the third explored effects of a mindful physical activity intervention (yoga) on psychological outcomes in women with moderate to severe depressive symptoms. Findings: Each of the studies successfully designed, implemented, and evaluated strategies to address recommended treatment fidelity components. These strategies provided qualitative and quantitative data that informed intervention refinement, directions for future research, and application in clinical practice. Conclusions: The treatment fidelity framework used here is based on best practices and was a feasible and reliable approach for ensuring and reporting on treatment fidelity, which is contributing to future research to foster translation of potentially effective mind–body self-care approaches into practice.

Background: Persistent low back pain is a significant problem worldwide. Early identification and treatment of individuals at high risk for persistent low back pain have been suggested as strategies to decrease the rate of disability associated with this condition. Purpose: To examine and compare demographic, pain-related, psychological, and somatosensory characteristics in a cohort of participants with acute low back pain who later went on to experience persistent low back pain or whose pain resolved within the first 6 weeks after initial onset. Methods: A descriptive study was conducted among men and women 18–50 years of age who had an acute episode of low back pain. Study questionnaires were administered to collect demographic information and measures of pain, coping, reactivity, mood, work history and satisfaction, and disability. A standardized protocol of quantitative sensory testing was performed on each participant at the painful area of their low back and at a remote site on their arm. Results: The sample consisted of 48 participants, of whom 19 went on to develop persistent low back pain and 29 resolved. Compared to the resolved group, the persistent low back pain group was significantly older and had a lower level of educational attainment, a higher body mass index, and higher mean “least” pain score on the Brief Pain Inventory–Short Form. Significantly higher thermal detection thresholds at the painful and remote sites as well as signs of central sensitivity differentiated the persistent pain group from the resolved group during the acute stage of low back pain.

BACKGROUND: Approximately 20% of women in the United States practice prenatal yoga, but there is a paucity of information about the experience of these women. OBJECTIVE: This study examines women’s experiences participating in community-based prenatal yoga. METHOD: A qualitative descriptive exploratory design used focus groups with a convenience sample of pregnant and postpartum women ( n = 14) who engaged in prenatal yoga within the previous 6 months. Content analysis was employed to identify key themes and subthemes. RESULTS: Three themes arose: (a) stress and depressive symptoms commonly instigate women’s interest in prenatal yoga, (b) prenatal yoga is perceived to be psychologically and physically beneficial, and (c) prenatal yoga is perceived as more beneficial than other group classes. CONCLUSIONS: Pregnant women with stress and depressive symptoms may be drawn to prenatal yoga for the psychological and physical benefits. It is imperative that health care providers and researchers focus on these needs, particularly when designing prevention and intervention strategies with this population.

Liver disease affects over 25 million people in the United States and, despite advances in medical management resulting in increased survival, a majority of these individuals report multiple co-occurring symptoms that severely impair functioning and quality of life. The purpose of this review is to (1) propose defining these co-occurring symptoms as a symptom cluster of chronic liver disease (CLD), (2) discuss putative underlying biological mechanisms related to CLD, including the liver–gut–brain axis and influence of the microbiome, and (3) discuss the implications for biobehavioral research in this patient population. Biobehavioral research focusing on the interrelated, and possibly synergistic, mechanisms of these symptoms may lead to the development and testing of targeted symptom management interventions for improving function and quality of life in this growing patient population.

The present study investigated whether a brief yoga intervention would be feasible and acceptable for dental students. Based on empirical evidence about state mindfulness (SM), change in self-reported SM was assessed as a measure of the intervention’s feasibility and acceptability. A repeated-measures within-subjects design was used. Participants were third- and fourth-year dental and dental hygiene students (76% female). The State Mindfulness Scale (SMS), a validated self-report measure of SM with 2 subscales, Mind and Body, was used. Students (n = 132) completed the SMS immediately prior to and following a 1-hour yoga intervention. Dispositional mindfulness, burnout, perceived stress, and depressive symptoms were also investigated as moderators of changes in state mindfulness to determine whether psychological variables had an effect on feasibility in this sample. Total SM significantly increased from pre- to post-intervention, t(46) = 10.26, P < .001. An analysis of covariance showed a significant interaction effect in the relationship between pre-/post-intervention SM of Mind ( β = 0.51, P = .048), such that higher levels of stress saw greater increases in SM of Mind. No other psychological variables were significant moderators. A brief yoga intervention for dental students significantly increased SM, suggesting that yoga interventions may be feasible and acceptable in this population. The results of moderation analyses suggest that a brief yoga intervention may be especially effective at increasing SM for those with high levels of stress. Future research should use a randomized control group to test group differences in SM after a brief yoga intervention for dental students.

Introduction:Health guidelines suggest that pregnant women should participate in daily physical activity, yet rarely do they meet these guidelines. Means to enhance accessibility of physical activity for pregnant women are required, and yoga has been suggested as a possible method to enhance women’s sense of confidence and competence with physical activity. In this pilot study, our primary aim is to evaluate pregnant women’s perceptions about their lived experience of an intervention which integrates a low-intensity form of physical activity, yoga, into prenatal care; our secondary aim is to evaluate changes in participants’ self-efficacy for physical activity and time spent in physical activity over time.Methods:Held in an outpatient obstetrics department of an urban hospital system in the United States, this pilot study enrolled 16 pregnant women to participate in the intervention throughout their pregnancy. We explored participants’ lived experience of the intervention using qualitative methods (phenomenology). Means, variances, and covariances were calculated for the 2 measures (self-efficacy and time spent in physical activity) over the intervention period.Results:Qualitative findings from focus groups suggest that it is acceptable for prenatal yoga to be integrated into group prenatal care classes and women reported increased confidence with physical activity during pregnancy. Participants did not consider the intervention to fit within the traditional definition of exercise. Women reported increased amounts of time spent in physical activity from baseline to the end of pregnancy, but there were no statistically significant changes in self-efficacy over time.Discussion:The integration of gentle physical activity into the group prenatal care model warrants further attention for potential benefits with regard to maternal physical and mental wellness.