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Qualitative similarities and distinctions between participants’ experiences with a yoga intervention and an attention control

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Abstract

Purpose

This manuscript aims to compare and contrast acceptability and perceived benefits of yoga-skills training (YST) and an empathic listening attention control (AC) in the Pro-You study, a randomized pilot trial of YST vs. AC for adults receiving chemotherapy infusions for gastrointestinal cancer.

Methods

Participants were invited for a one-on-one interview at week 14 follow-up, after completing all intervention procedures and quantitative assessments. Staff used a semi-structured guide to elicit participants’ views on study processes, the intervention they received, and its effects. Qualitative data analysis followed an inductive/deductive approach, inductively identifying themes and deductively guided by social cognitive theory.

Results

Some barriers (e.g., competing demands, symptoms), facilitators (e.g., interventionist support, the convenience of clinic-based delivery), and benefits (e.g., decreased distress and rumination) were common across groups. YST participants uniquely described the importance of privacy, social support, and self-efficacy for increasing engagement in yoga. Benefits specific to YST included positive emotions and greater improvement in fatigue and other physical symptoms. Both groups described some self-regulatory processes, but through different mechanisms: self-monitoring in AC and the mind–body connection in YST.

Conclusions

This qualitative analysis demonstrates that participant experiences in a yoga-based intervention or an AC condition reflect social cognitive and mind–body frameworks of self-regulation. Findings can be used to develop yoga interventions that maximize acceptability and effectiveness and to design future research that elucidates the mechanisms by which yoga is efficacious.

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Data Availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We are grateful to Jordan Berlin, M.D., and other oncologists who helped us recruit participants, and to those who helped conduct the study, including Meg O’Mara, Kelsey Shore, Donatesa Dean, Shannon Golden, Donna Ashford, and Nicole Puccinelli-Ortega.

Funding

Research reported in this publication was supported by the National Center for Complementary & Integrative Health of the National Institutes of Health under Award Number K01AT008219 (Principal Investigator: SJS); the Qualitative and Patient-Reported Outcomes Shared Resource of the Wake Forest Baptist Comprehensive Cancer Center’s National Cancer Institute Cancer Center Support Grant P30CA012197; and the Wake Forest and Vanderbilt Institutes for Clinical and Translational Science supported by the National Center for Advancing Translational Sciences under grant award numbers UL1TR001420 and UL1TR002243. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Elizabeth L. Addington

  2. Vanderbilt University School of Nursing, Nashville, TN, USA

    David Schlundt, Kemberlee Bonnet & Sheila Ridner

  3. Vanderbilt University School of Medicine, Nashville, TN, USA

    Gurjeet Birdee & Russell L. Rothman

  4. Wake Forest University School of Medicine, Winston-Salem, NC, USA

    Nancy E. Avis, Lynne I. Wagner, Janet A. Tooze & Stephanie J. Sohl

  5. California State University, San Bernardino, CA, USA

    Amy Wheeler

  6. Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Julie B. Schnur

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  1. Elizabeth L. Addington
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Contributions

Elizabeth L. Addington, Stephanie J. Sohl, David Schlundt, Sheila Ridner, Amy Wheeler, and Russell L. Rothman contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by Elizabeth L. Addington, Stephanie J. Sohl, Janet A. Tooze (quantitative), David Schlundt, and Kemberlee Bonnet. Nancy E. Avis, Lynne I. Wagner, Janet A. Tooze, Gurjeet Birdee, and Julie B. Schnur provided guidance on study implementation. The first draft of the manuscript was written by Elizabeth L. Addington, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Elizabeth L. Addington.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Institutional Review Boards of Vanderbilt University and Wake Forest University Health Sciences.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent for publication

The authors affirm that human research participants provided informed consent for the publication of de-identified information.

Competing interests

Addington, Birdee, Bonnet, Ridner, Schlundt, Schnur: none

Avis: Grants from NIH and no other competing interests

Sohl: The above-listed K01 from the NIH and no other competing interests

Wagner has income for patient-reported outcome consultation outside of the submitted work from Celgene Inc. and Athenex Inc., and for journal section editor work outside of this manuscript from the American Cancer Society.

Rothman: the family owns equity in Moderna not related to the current work.

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Addington, E.L., Schlundt, D., Bonnet, K. et al. Qualitative similarities and distinctions between participants’ experiences with a yoga intervention and an attention control. Support Care Cancer 31, 172 (2023). https://doi.org/10.1007/s00520-023-07639-0

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