Global advances in integrative medicine and health最新文献

{"title":"Clinician Experiences With Integrative Group Medical Visits for Chronic Pain.","authors":"Mary Jackson, Paula Gardiner, Jennifer Leeman, Isabel Roth","doi":"10.1177/27536130241304772","DOIUrl":"10.1177/27536130241304772","url":null,"abstract":"<p><strong>Background: </strong>The well-being of healthcare teams is an important consideration when seeking to improve patient experience and quality of care. Prior studies have found that changes to working conditions are most effective in improving clinician well-being. Integrative Group Medical Visits (IGMVs) modify working conditions in ways that have potential to improve clinician experience.</p><p><strong>Objective: </strong>The objective of this study was to understand healthcare teams' experiences with IGMVs.</p><p><strong>Methods: </strong>In this qualitative study, interviews were conducted via Zoom and telephone with 21 clinicians, administrators, and staff from safety-net healthcare settings throughout the United States (U.S.) who have implemented IGMVs for patients with chronic pain. Interviews included questions about clinician experience, well-being, and satisfaction with the IGMV model. Interviews were recorded, transcribed, and coded using thematic content analysis by a team of trained qualitative researchers.</p><p><strong>Results: </strong>The authors identified five themes describing how IGMV positively affected clinician well-being: organizational supports, human-centered engagement, collaboration with an interprofessional team, provision of guideline-concordant care, and enhanced meaning and purpose for the clinicians.</p><p><strong>Conclusion: </strong>The current study was the first to use interviews from healthcare teams who have implemented IGMV to assess their experience. The themes identified warrant further investigation into IGMVs as a strategy to promote clinician well-being and mitigate aspects of burnout.</p>","PeriodicalId":73159,"journal":{"name":"Global advances in integrative medicine and health","volume":"13 ","pages":"27536130241304772"},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Role of Medical School Faculty in Developing Students' Cultural Humility Skills: Insights From a Single-Center Multimethod Study.","authors":"Dhanesh D Binda, Angelique C Harris, Taralyn Tan, Krisztina Fischer, Rose L Molina, Darshan Mehta","doi":"10.1177/27536130241305087","DOIUrl":"https://doi.org/10.1177/27536130241305087","url":null,"abstract":"<p><strong>Background: </strong>While the Liaison Committee on Medical Education emphasizes the teaching of cultural competence in medical education, the concept of cultural humility, focusing on self-reflection and lifelong learning, has been proposed as a more effective approach. Although there have been numerous discussions on both topics, understanding how faculty in clinical settings help students develop cultural humility skills remains limited.</p><p><strong>Objective: </strong>Our multimethod study utilized a survey and semi-structured interviews to identify strategies that faculty at one institution use to help students develop cultural humility skills.</p><p><strong>Methods: </strong>We administered a 10-question survey to assess faculty demographics, teaching characteristics, and familiarity with cultural humility. Participants most familiar with cultural humility were invited for semi-structured interviews. Survey data were analyzed with descriptive statistics, and interview data were thematically analyzed to identify key teaching strategies.</p><p><strong>Results: </strong>In our study of 49 medical faculty members, the majority of participants were female (61%) and predominantly White (67%), covering a wide range of specialties and years of teaching. Of the participants, 74% expressed being at least somewhat familiar with cultural humility, and 10 consented to interviews. Strategies for cultural humility education included one-on-one instruction, feedback, and reflections. Thematic analysis underscored fostering learner curiosity about cultures, early patient exposure, and incorporating diverse learning perspectives as essential in developing students' cultural humility skills.</p><p><strong>Conclusion: </strong>Cultural humility is an important attribute for healthcare professionals that can enhance patient-centered care. Through focused interviews with faculty in our study and subsequent thematic analysis, our results suggest the need for longitudinal and multimodal educational strategies to cultivate cultural humility among medical students. By understanding current teaching methods, educators can design and assess more effective curricula to prepare future doctors for a culturally diverse patient population.</p>","PeriodicalId":73159,"journal":{"name":"Global advances in integrative medicine and health","volume":"13 ","pages":"27536130241305087"},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Group-Based Integrative Pain Management in Primary Care: A Study Protocol for Multilevel Interventions to Address Health Disparities.","authors":"Maria T Chao, Ariana Thompson-Lastad, Pamela Swedlow, Sudha Prathikanti, Wendy Hartogensis, Folashade Wolfe-Modupe, Jesse Wennik","doi":"10.1177/27536130241302043","DOIUrl":"10.1177/27536130241302043","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomically disadvantaged populations have a high prevalence of chronic pain, exacerbated by social isolation, intersectional stigma, and disparities in pain assessment and treatment. Effective interventions using a multilevel, biopsychosocial approach are needed to decrease the unequal burden of pain. Group-based integrative pain management in primary care safety net clinics is a promising model to improve pain care for racially and ethnically diverse low-income people.</p><p><strong>Objective: </strong>To describe a study protocol to test the impacts of 2 group-based models - group acupuncture and integrative group medical visits - on multilevel pain-related outcomes.</p><p><strong>Methods: </strong>The study uses a 2x2 factorial randomized clinical trial to test two 12 week group-based models: group acupuncture and integrative group medical visits (IGMV, with psychoeducation, mind-body approaches, and social support). English or Spanish-speaking adults with chronic pain for ≥3 months receiving care in San Francisco Department of Public Health primary care clinics are eligible for the trial. All participants will receive usual care and be randomized to group acupuncture, IGMV, both, or waitlist control. The primary outcomes are changes from baseline to 3 month follow-up in pain impact and in social support for chronic pain. Secondary outcomes include pain interference, pain intensity, depression, anxiety, quality of life, and social isolation. Data will include patient-reported outcomes, electronic health record data, and qualitative interviews, focus groups and observations to assess multilevel individual, interpersonal and organizational outcomes.</p><p><strong>Discussion: </strong>Multilevel approaches are needed to advance health equity in pain management. Our study contributes to knowledge of group-based integrative pain management in primary care safety net clinics to address multilevel barriers and disparities in pain care.</p>","PeriodicalId":73159,"journal":{"name":"Global advances in integrative medicine and health","volume":"13 ","pages":"27536130241302043"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qigong and Tai Chi for ME/CFS: A Systematic Review of Randomized Controlled Trials.","authors":"Michaela Markwart, Donna Felsenstein, Darshan H Mehta, Samreen Sethi, Erika Tsuchiyose, Melis Lydson, Gloria Y Yeh, Daniel L Hall","doi":"10.1177/27536130241275607","DOIUrl":"10.1177/27536130241275607","url":null,"abstract":"<p><strong>Objective: </strong>Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic and debilitating illness with symptoms such as post-exertional malaise and cognitive dysfunction that can be challenging for patients to manage independently. Randomized controlled trials (RCTs) have examined mind-body and psychological approaches that teach patients coping skills for mitigating ME/CFS symptoms, including emerging literature on Qigong or Tai Chi instruction programs. This systematic review aims to summarize the characteristics of these trials and highlight potential areas for future optimization and refinement.</p><p><strong>Methods: </strong>Ovid MEDLINE, Embase.com, Web of Science Core Collection, Cochrane CENTRAL, PsycINFO via Ovid, and ClinicalTrials.gov were searched in April 2023 using controlled vocabulary and keywords for the following eligibility criteria: Sample (ME/CFS), Design (RCT), Behavioral Intervention (mind-body or psychological interventions). Data extraction and reporting followed Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p><p><strong>Results: </strong>\"Qigong\" and \"Tai Chi\" yielded 142 and 80 abstracts, respectively. Of the 222 abstracts, full texts were available for 5 RCTs of Qigong (<i>k</i> = 5; N = 481). Notably, no trials of Tai Chi utilized a randomized control design. Among the 5 Qigong RCTs, the publication range was from 2012 to 2023. Details regarding intervention components and effects were summarized. Qigong intervention sessions (median = 12, mode = 10, 12) tended to last between 1-2 hours and occur across 5-12 weeks (median = 7, mode = 5). The Qigong interventions were all delivered in groups and incorporated at-home practice. Daily practice was a requirement (<i>k</i> = 4) or an advisement (<i>k</i> = 1). Patient-reported outcomes suggest an emerging evidence base for diffuse benefits on physical and emotional health outcomes.</p><p><strong>Conclusions: </strong>Qigong interventions are promising, yet relatively understudied, in improving ME/CFS symptom severity and frequency. Future trials must implement standardized eligibility criteria for ME/CFS history, integrate Qigong or Tai Chi with other empirically supported mind-body and psychological practices, and assess long-term resiliency outcomes relevant to ME/CFS survivorship.</p>","PeriodicalId":73159,"journal":{"name":"Global advances in integrative medicine and health","volume":"13 ","pages":"27536130241275607"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for a Pilot Study on the Neurocardiac Mechanism of an Interoceptive Compassion-Based Heart-Smile Training for Depression.","authors":"Eunmi Kim, Diane Joss, Frannie Marin, Alessandra Anzolin, Richa Gawande, Alexandra Comeau, Seneca Ellis, Clare Bumpus, B Rael Cahn, Misan W D Kim, Vitaly Napadow, Zev Schuman-Olivier","doi":"10.1177/27536130241299389","DOIUrl":"10.1177/27536130241299389","url":null,"abstract":"<p><strong>Background: </strong>Heart-Smile Training (HST) is an interoceptive compassion-based behavioral intervention that in case reports has been beneficial for depression. Interoception refers to the awareness and regulation of physiological signals from inside the body. Depressed patients often have diminished interoceptive awareness and often experience disconnection from bodily needs and sensations. In addition to interoceptive dysfunction, depression often involves negative self-evaluation and self-critical rumination. HST is a compassion-based meditation training program that explicitly cultivates interoceptive awareness of the heart area. This study aims to investigate the possible neurocardiac mechanisms engaged through HST for depression patients.</p><p><strong>Methods: </strong>We plan to enroll 50 subjects to be randomized into a 4-week HST intervention group and a waitlist group. A battery of psychological questionnaires will be administered at baseline and post-intervention timepoints, and electroencephalography (EEG) will be collected during compassion meditation guided by pre-recorded audio. The primary clinical outcome measures are on the feasibility of the intervention and research procedures, the primary mechanistic outcome measure is the post-intervention change in Heartbeat Evoked Potential (HEP) amplitude. Secondary outcome measures include changes in depression severity and EEG gamma spectral activity. Exploratory outcome measures include effects of HST on skin conductance response, heart rate variability, EEG spectral properties in other frequency bands, as well as a list of psychological questionnaires that measure depression and anxiety symptoms, emotion regulation, mindfulness, interoceptive awareness, self-compassion, gratitude, sleep quality, quality of life and social connectedness.</p><p><strong>Results: </strong>Results not yet available.</p><p><strong>Conclusion: </strong>This is the first study on the feasibility and interoceptive neurocardiac mechanism of HST. Our findings will provide frontier knowledge on the physiological working mechanism of behavioral interventions with an interoception-based meditative approach. https://clinicaltrials.gov/study/NCT05564533.</p>","PeriodicalId":73159,"journal":{"name":"Global advances in integrative medicine and health","volume":"13 ","pages":"27536130241299389"},"PeriodicalIF":0.0,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary Findings From a Pilot Professional Coaching Program on the Components of Burnout in a Diverse Group of Physician Leaders.","authors":"Vanessa Calderón, Ashley Mogul Wyman, Gregg Miller","doi":"10.1177/27536130241296088","DOIUrl":"10.1177/27536130241296088","url":null,"abstract":"<p><strong>Background: </strong>Burnout impacts physicians at alarming rates; physician leaders are not immune. While burnout of physician leaders is associated with decreased leadership efficacy, physician coaching has been associated with reduced burnout.</p><p><strong>Objective: </strong>This study aimed to assess the effect of a physician-leader specific coaching program on the components of burnout.</p><p><strong>Methods: </strong>A 10-week Wellness Coaching Program for physician medical directors was conducted and burnout was measured pre and post intervention using the Maslach Burnout Inventory-General Survey (MBI-GS).</p><p><strong>Results: </strong>All subscales of the MBI-GS trended towards a decrease in the components of burnout with a statistically significant decrease in Cynicism.</p><p><strong>Conclusion: </strong>Wellness coaching programs have the potential to positively impact the threat of burnout experienced by physician leaders in today's health care workforce.</p>","PeriodicalId":73159,"journal":{"name":"Global advances in integrative medicine and health","volume":"13 ","pages":"27536130241296088"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contribution of Ethnomedical Use Data to the Marketing Authorization of Traditional Herbal Medicines in Mali.","authors":"Aboubacar Sangho, Kampadilemba Ouoba, Rasmané Semdé, Rokia Sanogo","doi":"10.1177/27536130241296823","DOIUrl":"10.1177/27536130241296823","url":null,"abstract":"<p><strong>Background: </strong>To improve the supply of health care and health care products, traditional herbal medicines that are safe, effective, and of good quality need marketing authorizations. This study aims to determine the contribution of ethnomedical evidence to the marketing of traditional herbal medicines in Mali.</p><p><strong>Methods: </strong>This was a descriptive cross-sectional study conducted from December 2023 to March 2024 supplemented by a literature review of the legislative and regulatory provisions relating to traditional medicine and the requirements for marketing authorization of traditional herbal medicines in Mali and the West African sub-region.</p><p><strong>Results: </strong>The regulatory framework for marketing authorization is governed by decree no. 04-557/P-RM of 01 December 2004 and interministerial order no. 05-2203/MS-MEP-SG of 20 September 2005 in Mali. These texts set out the specific requirements for the marketing authorization of traditional plant-based medicines, depending on the category. They consider ethnomedical evidence drawn from long experience of traditional use as proof of efficacy and tolerance for category 2 traditional medicines. As a result, marketing authorizations were issued for 15 products derived from traditional medicine and pharmacopeia, 5 of which are included in the National List of Essential Medicines and the National Therapeutic Formulary of Mali.</p><p><strong>Conclusion: </strong>The use of ethnomedical evidence provides a good opportunity to obtain marketing authorization for phytomedicines derived from traditional medicine without having to go through long and costly non-clinical and clinical studies.</p>","PeriodicalId":73159,"journal":{"name":"Global advances in integrative medicine and health","volume":"13 ","pages":"27536130241296823"},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethyl Acetate Extract from Romdoul (<i>Sphaerocoryne affinis</i>) Fruit Induced Apoptosis in Human Promyelocytic Leukemia Cells.","authors":"Nguyen Thi Hoai Nga, Tran Thanh Long, Truong Thi Bich Ngoc, Nguyen Hoang Khoi Nguyen, Dang Thi Phuong Thao, Nguyen Thi My Trinh","doi":"10.1177/27536130241296826","DOIUrl":"10.1177/27536130241296826","url":null,"abstract":"<p><strong>Background: </strong>Romdoul (<i>Sphaerocoryne affinis</i>) is a flowering plant of the Annonaceae family and has been used customarily in folk medicine. The bioactivities of this plant, especially the anti-cancer effect, however, remain surprisingly few.</p><p><strong>Objective: </strong>this study aimed to elucidate the anti-leukemic effect of romdoul fruit extracts and their underlining mechanisms.</p><p><strong>Methods: </strong>The extracts were prepared from fresh fruits and the phytochemical contents were evaluated by biochemical assays and HPLC method. The promising extract was identified via the inhibition of HL60 as well as normal NIH-3T3 cell densities utilizing MTT assay. The underline mechanism of the extract's effect was studied by accessing the treated HL60 cell population overtime (via MTT assay). The morphology of abnormal cells was examined by bright-field microscopic imaging. Hallmarks of apoptosis including nucleus characteristics and caspase 3 activation were analyzed by fluorescence imaging. The underline mechanisms of apoptosis and proliferation inhibition were accessed via RT-qPCR examination of involved genes.</p><p><strong>Results: </strong>Our findings showed that the ethyl acetate extract of romdoul fruit (SA-EA) was found to be an exceptional anti-leukemic candidate (IC₅₀ was as low as 4.11 μg/mL). More interestingly, the treated HL60 cells expressed nuclear fragmentation and caspase 3 activation, indicating the effect could follow an apoptotic mechanism. Importantly, the transcription assessment of apoptotic and proliferative genes suggested that SA-EA might suppress the growth of HL60 cells and induce p21-dependent apoptotic pathway.</p><p><strong>Conclusion: </strong>This study demonstrated one of the first scientific evidence for the anti-cancer activity of <i>Sphaerocoryne affinis</i> fruit-derived extract. Thus, our findings exhibited a novel and promising anti-leukemic candidate for future studies.</p>","PeriodicalId":73159,"journal":{"name":"Global advances in integrative medicine and health","volume":"13 ","pages":"27536130241296826"},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Making a Case for Whole Person Health.","authors":"Patricia M Herman, Mark H Pitcher, Helene M Langevin","doi":"10.1177/27536130241293642","DOIUrl":"10.1177/27536130241293642","url":null,"abstract":"<p><p><b>Background:</b> Our conventional approach to health care tends to separate patients' health by body system, treating each independently and \"efficiently\"-e.g., minimal time with a provider, reliance on medications, and little investment to support behavioral and lifestyle improvements. Meanwhile, the United States has the most expensive health care in the world, with some of the worse outcomes. Purpose In this paper, we make the case for transforming health care from a disease-centric approach to a \"whole person\" model. <b>Research Design:</b> We provide detailed health and health care utilization assumptions for a hypothetical patient, Mrs. M, over her life from age 40 to 80 years under 2 care scenarios: the continuation of conventional care (Version A) and a whole person care approach (Version B). Analysis We developed a set of health care utilization assumptions for each scenario, applied 2023 U.S. dollar (USD) resource prices, and estimated cumulative total health care costs. The price and the health care utilization assumptions for the conventional care scenario were validated using Medical Expenditures Panel Survey (MEPS) data. <b>Results:</b> At age 80, with conventional care, we find Mrs. M increasingly frail and living in a skilled nursing facility, with total cumulative health care costs of $353,155. With whole person care, we find her active and generally healthy at age 80, with total cumulative health care costs of $52,425. <b>Conclusions:</b> Although based on an \"imagined\" case, the 2 versions of Mrs. M's history illustrate how an investment beginning in early middle age to support a healthy diet, physical activity, and stress management can plausibly lead to improved health and well-being, as well as reduced health care spending.</p>","PeriodicalId":73159,"journal":{"name":"Global advances in integrative medicine and health","volume":"13 ","pages":"27536130241293642"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of Virtual, Livestream Yoga Classes for Veterans at Home During the COVID-19 Pandemic: A Mixed-Methods Pilot Program Evaluation.","authors":"Catherine Pham, Caitlin Hildebrand, Gary Tarasovsky, Natalie Purcell, Karen Seal, Francesca Nicosia","doi":"10.1177/27536130241268107","DOIUrl":"10.1177/27536130241268107","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic and shut down of in-person complementary and integrative (CIH) wellness services at the San Francisco Veterans' Affairs Healthcare System (SFVAHCS) required implementation of virtual program delivery. In May 2020, VA in-person group yoga classes pivoted to virtual classes for existing attendees. In October 2020, we partnered with SFVAHCS Integrative Health and the VA Office of Rural Health to formalize the TeleYoga Program to expand yoga access to Veterans in SFVAHCS' geographically dispersed area.</p><p><strong>Objective: </strong>This pilot study evaluated Veterans' experiences and self-reported health outcomes after participating in at-home tele-yoga groups during the COVID-19 pandemic.</p><p><strong>Methods: </strong>The RE-AIM framework guided program delivery evaluation. Reach was assessed with medical record data. Adoption was assessed by the number of new facilities providing referrals to tele-yoga. Implementation, satisfaction, and patient-reported outcomes, were evaluated through structured interviews with Likert scale and open-ended responses.</p><p><strong>Results: </strong>We offered 4-6 weekly livestreamed classes between October 2020-September 2021. The program reached 70 Veterans, including 40 new participants, with 1208 total unique encounters. Referrals increased from 2 to 6 SFVAHCS facilities. Fourteen participants completed structured interviews. Over half rated highly the convenience and overall experience of tele-yoga classes and reported improvement with pain, stress management, exercise, and flexibility. Open-ended responses indicated opportunities for social connection, maintaining mental health, cultivating resilience, improving function, and managing pain. Suggestions for improvement focused on technological aspects, including audiovisual quality.</p><p><strong>Conclusions: </strong>During the COVID-19 pandemic, we successfully transitioned and expanded virtual group yoga delivery to Veterans from all geographic locations within SFVAHCS. We attribute this success to existing infrastructure for telehealth and CIH services and a virtual program orientation for new participants. The results of this pilot study suggest in-person group yoga may be successfully implemented virtually, serving as a viable modality that contributes to holistic wellbeing for Veterans.</p>","PeriodicalId":73159,"journal":{"name":"Global advances in integrative medicine and health","volume":"13 ","pages":"27536130241268107"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}