The Community Yoga Project: Health Benefits of Yoga in Underserved Clinical Settings David Goese, BS1; Angela Cano-García, BS2; Gregory J. Van Hyfte, MA, MA/HAP, RYT 5003; Kohar Jones, MD4; Sonia Oyola, MD4; Loretta Cain, PhD4; & Mari Egan, MD4
Methods
Background •Yoga has proven health benefits:
•Prospective cohort study
•75 health conditions benefited by yoga1
•Four yoga classes at two underserved health centers on Chicago’s south side
•Reduction in stress levels and anxiety symptoms2
•Setting: conference room, atrium
•Decreased symptoms in patients with lower back pain3, neck pain4, and chronic diseases5 •Prevalence of yoga increasing: 13 million US adults and children used during 2006-20076 •Lower relative use in AfricanAmerican and Hispanic populations7 •High stress levels and health disparities exist in underserved populations8 •Fewer yoga centers in medically underserved areas
Aim 1) Develop best practice models for integrating yoga programming into underserved community health centers Aim 2) Characterize health effects of yoga class in these settings Aim 3) Understanding motivations and barriers for attending the yoga class
Preliminary Results
•38 study enrollees in preliminary analysis; 60 target
•Analyzed data using SAS with wilcoxin signed rank sum test (non-parametric version of paired sample t-test)
•Average class size: 7.64 students Gender Distribution
•Incentives: yoga mats, free class
Class Title Gentle Yoga
Style of Yoga Gentle/ Hatha
Yoga for Therapeutic Pain Relief /Iyengar Yoga for Restorative Relaxation Gentle Yoga
Gentle/ Hatha
Time Sat 10:0011:45AM Wed 10:30AM12:00PM Tues 10:30-11:30AM Thurs 6:00-7:45PM
8% Yoga Instructor Greg Van Hyfte Julia Pedersen/ Greg Van Hyfte Lisa Espinoza
Male Female
92%
Health Outcomes
Pretest Mean (SD)
Posttest Mean (SD)
Age: Mean (SD)
Pain Scores p = 0.0463
2.56 ± 2.9
1.85 ± 2.4
52.4 (15.3)
Stress Scores p = 0.0047
Race/Ethnicity Distribution 3%
African American Hispanic
42% 55%
Caucasian
3-Month Qualitative Data
•Surveys and interviews conducted in person •What helped you most? - ”Everything at classes before or after class helped. The stretching and flexibility has helped me go beyond what I have for •Surveys in English and Spanish (group years. I learned how to relax.” translation) •Before first yoga class (pre-test) •After first yoga class (post-test) •3-month follow up (13 week post-test) 23question mixed methods survey/interviews •Telephone reminders for in-person surveys and interviews for 3-month follow up
3.33 ± 3.14
2.07 ± 3.0
Limitations •Study size •Recruitment •Generalizability •Study capacity •Timing of surveys •Recall bias •Measuring full effect on participants’ lives
Motivations:
Juliet Gutierrez
Instruments and Data Collection:
Specific Aims
Survey Response Demographics
•How important are the connections you made in this class? - “They were like family.” •What would you like to learn in future classes? - “More classes” - “Eventually to go up in difficulty. If we started doing it more, more than once a “ week, that would be good.”
To be more flexible For exercise/physical fitness For stress relief/reduction To improve overall health For muscle strength To improve emotional/ mental health To lose weight For spiritual connection To treat a medical condition To find out what yoga is all about
Barriers to Attending Class:
The time doesn’t work for me Work issues Not having child care Family obligations Medical issues
Discussion •Decreased pain and stress scores •Classes embraced by participants: some offer donations to attend the class •Strong motivations and barriers
Future Directions: •Developing models of integration: •Mixed funding model donation grants •Recruit well-trained invested instructors •Strong partnership with clinics •Explore strategies to address barriers •Explore research opportunities
References 1McCall,
Timothy (2007). Yoga as Medicine: the yogic prescription for health and healing: a yoga journal book, p. xvii. Bantam, New York. 2Li,
A. W., & Goldsmith, C. A. (2012). The effects of yoga on anxiety and stress.Alternative Medicine Review, 17(1), 21. 3Cramer,
H., Lauche, R., Haller, H., & Dobos, G. (2013). A systematic review and meta-analysis of yoga for low back pain. The Clinical journal of pain, 29(5), 450-460. 4Cramer,
H., Lauche, R., Hohmann, C., Lüdtke, R., Haller, H., Michalsen, A., ... & Dobos, G. (2013). Randomized-controlled trial comparing yoga and home-based exercise for chronic neck pain. The Clinical journal of pain, 29(3), 216-223. 5McCall,
M. C., Ward, A., Roberts, N. W., & Heneghan, C. (2013). Overview of Systematic Reviews: Yoga as a Therapeutic Intervention for Adults with Acute and Chronic Health Conditions. Evidence-Based Complementary and Alternative Medicine. 6Barnes,
P. M., Bloom, B., & Nahin, R. L. (2008). Complementary and alternative medicine use among adults and children: United States, 2007. 7Su,
D., & Li, L. (2011). Trends in the use of complementary and alternative medicine in the United States: 2002–2007. Journal of health care for the poor and underserved, 22(1), 296-310. 8Williams,
D. R., Mohammed, S. A., Leavell, J., & Collins, C. (2010). Race, socioeconomic status, and health: complexities, ongoing challenges, and research opportunities. Annals of the New York Academy of Sciences, 1186(1), 69-101.
Acknowledgements Funding Sources: Schweitzer Fellowship Program, AMA Foundation, and University of Chicago Institute of Translational Medicine Affiliations: 1. University of Chicago Pritzker School of Medicine 2. University of Illinois College of Medicine 3. CommunityHealth 4. University of Chicago Department of Family Medicine Project Interns: Crystal Unzueta (MS4, UIC), Tatiana Ormaza (MSW, MPH Candidate), Frances Kobiernicki (BA, UChicago), Esther Schoenfeld (BA, UChicago); Yoga Teachers: Julia Pedersen, Juliet Gutierrez, Lisa Espinoza Contact: gregory@uchciago.edu