title: A pilot study of yoga as self-care for arthritis in minority communities.
abstract: 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
  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.
  
  
  CONCLUSIONS
  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.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT01617421.
authors.affiliation: National Institutes of Health, Clinical Center, Nursing Department, Bethesda, MD, USA. middletonk@cc.nih.gov
authors.forename: Kimberly R
authors.initials: KR
authors.lastname: Middleton
authors.forename: Michael M
authors.initials: MM
authors.lastname: Ward
authors.forename: Steffany
authors.initials: S
authors.lastname: Haaz
authors.forename: Sinthujah
authors.initials: S
authors.lastname: Velummylum
authors.forename: Alice
authors.initials: A
authors.lastname: Fike
authors.forename: Ana T
authors.initials: AT
authors.lastname: Acevedo
authors.forename: Gladys
authors.initials: G
authors.lastname: Tataw-Ayuketah
authors.forename: Laura
authors.initials: L
authors.lastname: Dietz
authors.forename: Barbara B
authors.initials: BB
authors.lastname: Mittleman
authors.forename: Gwenyth R
authors.initials: GR
authors.lastname: Wallen
mesh_terms: D000328:Adult; D001168:Arthritis / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy; D055812:Community-Based Participatory Research; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006801:Humans; D008396:Maryland; D026441:Mind-Body Therapies; D054580:National Institute of Arthritis and Musculoskeletal and Skin Diseases (U.S.); D018579:Patient Selection; D019984:Quality Indicators, Health Care; D012107:Research Design; D012648:Self Care / Q000379:methods*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States; D015013:Yoga
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