Clarity and inclusivity as precursors to disseminate, implement, and translate yoga principles for behavioral health

dc.contributor.authorFrazier, Mary Clareen
dc.contributor.committeechairHarden, Samantha Marieen
dc.contributor.committeememberBasso, Julia C.en
dc.contributor.committeememberTurner, Broderick L.en
dc.contributor.committeememberArmbruster, Shannon D.en
dc.contributor.departmentGraduate Schoolen
dc.date.accessioned2025-06-06T08:01:59Zen
dc.date.available2025-06-06T08:01:59Zen
dc.date.issued2025-06-05en
dc.description.abstractTranslating health evidence is key to advance human flourishing. However, it takes 15-17 years to translate health interventions into real-world practice. Dissemination and implementation science can help bridge this gap for multiple interventions, including yoga-based ones. Yoga principles have positively impacted myriad populations and outcomes and align with scientific rigor across physiology, psychology, and neuroscience. However, several barriers to translating yoga principles exist. This dissertation presents three studies that highlight the importance of clarity and inclusivity as precursors for translation of yoga principles for behavioral health. The first study is a systematic review that used a novel qualitative synthesis to examine how yoga is defined and described in peer-reviewed mental health and wellbeing literature. Of 5206 studies identified, we included and reviewed 129. We present a qualitative analysis of 1291 meaning units (i.e., distinct pieces of data) of yoga definitions and descriptions. Furthermore, these data are presented via a sub-analysis across five continents and three study populations (e.g., population with chronic health conditions). While no one singular yoga definition arose from the data, yoga was most prominently operationalized as a mind-body practice comprised of mental, physical, and breathing components. We recommend a findings-based comprehensive framework combined with established reporting guidelines to define and describe yoga. The second study used a mixed methods cross-sectional survey to explore yoga end-user input for communicating and disseminating yoga benefits and yoga-based interventions. We surveyed 150 current and potential yoga end-users (mean age 36 years; 50% female; 54% people of color; 29% with higher body weight) with 28 open-ended questions. A subset of questions (n=4) was based on a dissemination model which posits that information is disseminated through various channels, messages, and sources. Using these overall themes, end-users contributed to 1133 meaning units. End-users overall preferred inclusive and clear content for yoga health messages, social media and fitness settings as channels, and health professionals and health organizations as sources. We propose an update to the dissemination model to include end-user input on health interventions, including yoga-based interventions. The final study is a sequential pre-implementation intervention study that used participatory and co-creation methods to adapt an existing yoga-based employee wellness intervention for community health educators. In this study, we triangulated data from integrated research-practice partners and data from focus groups (n=21) and a follow-up survey (n=17) with community health educators from multiple states (90% female, 62% White). Several data-driven contextual factors provide important insights for tailoring intervention materials and scheduling. We present lessons on how to enhance fit of intervention function and form to context and also on the importance of patience and slowing down for co-creation and participatory processes. Based on these findings, applying precursors of clarity and inclusivity to methods in dissemination and implementation science is key for translation of yoga-based interventions. Furthermore, these findings can be expanded and applied to bridge translation of other health evidence and interventions – towards meaningfully advancing human flourishing.en
dc.description.abstractgeneralTranslating findings from health research is important for actively improving the holistic health and wellbeing of people. However, it takes 15-17 years to translate health findings as information or programs into community, clinical, and public health practice. A field of research called dissemination and implementation science can help actively translate multiple health findings, including those related to yoga principles. Yoga principles have positively benefitted the health and quality of life of people with many different health conditions, and benefits of yoga are supported by other fields of physical and mental health research. However, it can be difficult to translate yoga principles for several reasons. This dissertation presents three studies that highlight that promoting ease of understanding and including consideration of the needs of all people are important first steps for doing high-quality research that translates yoga principles for behavioral health. The first study examines other studies and used an interesting method to understand how yoga is defined and described in research articles for mental health and wellbeing. We examined and assigned meaning to the words used to define and describe yoga from 129 studies from five continents and for different health conditions (e.g., chronic health). We learned that there is no one single definition of yoga and that researchers often used words related to mind-body practice and mental, physical, and breathing practices when describing yoga. We recommend yoga health researchers use specific methods to clearly and inclusively define and describe yoga. The second study used a survey with measures related to words and numbers to explore what people who already or might practice yoga would prefer for when information about yoga benefits and programs is shared. We had 150 people (average age 36 years; 50% female; 54% people of color; 29% with higher body weight) write out answers to survey questions. Some of what we learned is that people prefer yoga health messages that have inclusive and clear content and that are shared on social media or in fitness settings by health professionals or health organizations. We suggest that other researchers first ask people what they prefer so that shared health benefits and programs are clear and include what people need and want. The final study explored how to collaboratively adapt a yoga-based wellness program before delivering it to community health educators. We made program changes based on what we learned from partnering with, talking with, and sending questions to community health educators. From this we made specific changes to how the yoga-based wellness program is scheduled and designed so that community health educators can easily understand and feel that their wellbeing needs are considered. We share not only how to make programs better for specific people and places but also how it is important for researchers to slow down so that they can make changes with the help of the people they are trying to serve. Based on these findings, it is important to take early steps in dissemination and implementation science so that yoga health evidence can be clearly and inclusively translated into the real world. These findings can also be used to translate other health evidence – towards improving the holistic health and wellbeing of all people.en
dc.description.degreeDoctor of Philosophyen
dc.format.mediumETDen
dc.identifier.othervt_gsexam:43666en
dc.identifier.urihttps://hdl.handle.net/10919/135088en
dc.language.isoenen
dc.publisherVirginia Techen
dc.rightsIn Copyrighten
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/en
dc.subjectdisseminationen
dc.subjectimplementationen
dc.subjecttranslationen
dc.subjectinclusivityen
dc.subjectclarityen
dc.subjectaccessibilityen
dc.subjectflourishingen
dc.subjectyogaen
dc.subjectcontexten
dc.subjectrepresentationen
dc.subjectqualitativeen
dc.subjecttranslational science spectrumen
dc.subjecthealthen
dc.subjectbehavioral medicineen
dc.titleClarity and inclusivity as precursors to disseminate, implement, and translate yoga principles for behavioral healthen
dc.typeDissertationen
thesis.degree.disciplineTranslational Biology, Medicine and Healthen
thesis.degree.grantorVirginia Polytechnic Institute and State Universityen
thesis.degree.leveldoctoralen
thesis.degree.nameDoctor of Philosophyen

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