Read the two provided article and answer the question about scientific communication comparing the two articles. Each response should be 2-5 sentence per question.
Instructions: Access the Canvas Assignment details to read the assigned consumer-oriented article and the related peer reviewed journal article. Consider also watching the YouTube video posted in the assignment for a 3rd perspective. Respond to the following questions and write your thoughts and ideas (2-5 sentences per question). These ideas will be used to stimulate discussion during your live workshop. Use a graduate level writing style, including full/complete sentences with APA-style citations. This worksheet will be submitted prior to your self-registered live workshop.
1. Who is the targeted audience for each article?
2. What is the main take-home message of each article? How do these messages compare?
3. What do the authors report as "truth" and needs more research?
4. What biases do you see for each article? (Refer to Davies and Logan (2022) Reading Research: Selection bias, Attrition bias, Measurement bias, Performance bias and/or Reporting bias)
5. Is the consumer-oriented article an appropriate representation of the findings of the peer-reviewed article, or is the focus too narrow or broad? Provide examples from each article. For example, was one of the incidental findings of the peer-reviewed article blown out of proportion in the consumer-targeted message?
6. Regarding the peer-reviewed article, is this research important? Why or why not? When choosing a scientific or health study to discuss with patients or clients, consider what’s being contributed to the research field. Does it represent a major advance? Does it change the way people think about a problem? Not all studies are important; if you think this study is not, explain why.
7. Is the message over-generalized, or applied to a greater population than is reasonable? For example, did the authors conduct the study on a small sample, but the news-media article presents the findings as though they were applicable to all?
8. Is the research statistically and/or clinically significant? Take care not to overstate the importance of the study. A finding that is statistically significant may not be clinically significant.
9. What would you share with a client who brought the article to you? How would you respond? Consider Shared Decision Making in your response.
R.I. study finds group yoga helps stressed-out teens Gagosz, Alexa . Boston Globe (Online) ; Boston [Boston]. 18 Oct 2021.
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FULL TEXT The Boston Globe's weekly Ocean State Innovators column features a Q&A with Rhode Island innovators who are
starting new businesses and nonprofits, conducting groundbreaking research, and reshaping the state's economy.
Send tips and suggestions to reporter Alexa Gagosz at [email protected]
Researchers at Butler Hospital recently conducted a study of how group yoga programs could help teens who had
elevated levels of stress and who are depressed.
Dr. Lisa Uebelacker is a clinical psychologist at Butler Hospital and Brown University was the lead on the study. It's
not the first time she's researched the impact hatha yoga can have on people suffering from depression or chronic
In various ongoing and completed clinical trials, Uebelacker has focused on people with a partial response to
antidepressant treatments, people with chronic pain enrolled in medication-assisted treatment for opioid disorder,
people in prison, and pregnant depressed women.
Q: What is the study about?
Uebelacker: We are piloting a group of teens that had elevated levels of depression or stress and comparing the
yoga program to a group cognitive behavioral therapy treatment, which is an evidence-based treatment for
depression. With the pilot study, we're really looking at, can we do this? Are kids interested? Will they come to class
and how can we make the classes accessible for them?
We took the feedback from the pilot to prepare to be able to do a larger-scale study where we want to ultimately
compare a yoga class to a group CBT and whether they both are helpful for teens with depression, whether the
yoga is not inferior to the group CBT, and then that will allow us to look at for whom will a yoga class be better or
for whom will a group CBT be better?
(The pilot study was funded by the National Center for Complementary and Integrative Health at the National
Institutes of Health; Dr. Shirley Yen was the director of the study)
Q: Why yoga?
Uebelacker: Yoga really incorporates aspects of meditation, of breath awareness and breath control, as well as
movement. What I also really like about yoga is that for both adults and kids with depression, if you think about
meditation, it may be hard for some people to start a sitting-meditation practice. They are just sitting there with all
of these negative thoughts constantly. In yoga, though, it incorporates all of those things that you need: focusing
on their breathing, focusing on their movement, it teaches mindfulness but in the context where it might be easier
to access for some people with depression.
Plus, if you think about people who are depressed, who are sort of lethargic, it really helps to get them to move in
Q: And when you say “elevated levels of depression,” what does that mean?
Uebelacker: It varies quite a bit. Some of the teens in our program absolutely did have individual therapy that they
were engaged in, have a psychiatrist, and might be receiving some kind of medication.
Q: When did this program begin and how many participants did you have?
Uebelacker: It was a three-year study that we're just at the tail-end of now. In the beginning, we did focus groups
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with teens and parents. We looked at their needs and ideas about how yoga for teens and stress might look like.
Then we enrolled 11 kids in the yoga program.
In our third phase, we randomly assigned more than 40 kids in either the yoga program or the group CBT program.
Q: How did COVID-19 impact the program?
Uebelacker: Partway through the study, COVID-19 hit and we had to transition everything from in-person to online.
But, the silver-lining was that all the kids continued to attend, so they clearly liked it. If kids and parents don't think
something is working for them or they don't like it, they just won't return and waste their time. So it seems like the
program has been acceptable to these teens, and even doing it online.
Q: The study is nearly over. What have you found so far?
Uebelacker: Many of the teens have said they found it relaxing and helped them get through the stresses of
everyday life, especially during the last year. Now they can go to school and if there's a stressful moment where
their heart starts beating hard, they have techniques that they can use (like breathing exercises) to cope in the
moment. And that's exactly what they are reporting to us.
Q: You've looked at how yoga has helped other populations as well. What do you see with that data?
Uebelacker: I'm currently wrapping up a study that looks at how health education and yoga compare for depressed,
pregnant women. We don't have results yet, but there's also preliminary data that shows that yoga can help with
chronic pain that could help people with opioid use disorders who were prescribed medication to help with their
pain. We want to give them an alternative. So we're getting read to start a study in both Providence and in Boston
of yoga for chronic pain in that population. DETAILS
Subject: Pain; Mental depression; Coronaviruses; Yoga; COVID-19; Narcotics
Publication title: Boston Globe (Online); Boston
Publication year: 2021
Publication date: Oct 18, 2021
Section: Rhode Island Health
Publisher: Boston Globe Media Partners, LLC
Place of publication: Boston
Country of publication: United States, Boston
Publication subject: General Interest Periodicals–United States
Source type: Newspaper
Language of publication: English
Document type: News
ProQuest document ID: 2582728502
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Complementary Therapies in Medicine 59 (2021) 102723
Available online 22 April 2021 0965-2299/© 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Teens’ perspectives on yoga as a treatment for stress and depression
L.A. Uebelacker a, b,*, J.C. Wolff a, c, J. Guo b, S. Feltus b, C.M. Caviness a, b, G. Tremont a, c, K. Conte c, R.K. Rosen d, S. Yen a, e
a Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States b Butler Hospital, Providence, RI, United States c Rhode Island Hospital, Providence, RI, United States d Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, United States e Massachusetts Mental Health Center at Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, United States
A R T I C L E I N F O
Keywords: Yoga Adolescent Depression
A B S T R A C T
Objective: To understand adolescents’ experiences and attitudes toward yoga, with a particular focus on acceptability and feasibility of a yoga intervention for depressed adolescents. Design: Qualitative analysis of data from three focus groups and eight individual interviews, for a total of 22 teen participants. Setting: Outpatient setting in a psychiatric hospital in the U.S. Main outcome measures: Teens were asked about their own and their peers’ attitudes toward, and experiences with, hatha yoga; reactions to a study-created yoga video; and opinions on class logistics. Results: Teens had both positive and negative attitudes toward, and experiences with, hatha yoga. They com- mented on “who does yoga;” many responses suggested a limited group (e.g., moms; people with money and time). Participants agreed that yoga could be potentially beneficial for depressed or stressed teens. Self- consciousness while being in a yoga class was a major concern. Overall, teens reacted favorably to the study- created yoga video. Teens had varied opinions about class logistics including class duration and size. Teens cited barriers to class, such as transportation, as well as barriers to home yoga practice. Conclusions: Key points for developing a yoga class that might be appealing to depressed or stressed teens include: creating a class with variety that teens will find interesting; taking concrete steps to decrease teen self- consciousness; incorporating messages relevant for teens and consistent with yoga philosophy; and actively countering stereotypes about who practices yoga. Limitations of this study include the lack of data from male teens.
Depression is a leading cause of disability for adolescents globally.1
In the US, the 12-month prevalence rate of Major Depressive Episodes in teens increased from 8.7 % in 2005 to 13.2 % in 2017.2 However, many adolescents do not receive treatment for depression.3 Barriers to existing treatments include low perceived need, a preference to manage depression on one’s own,4 cost, medication side effects, and a limited number of adolescent behavioral health professionals. Thus, there is an urgent need to develop and test novel approaches for depressed adolescents.
Yoga is a system of philosophy and practice with roots in ancient India.5 In addition to physical practices, yoga includes ethical precepts
for healthy living, called yamas and niyamas. In the west, hatha yoga, which emphasizes physical aspects of yoga, is the most commonly practiced form of yoga. Although hatha yoga may include breath control exercises, physical postures, and meditation, styles of hatha yoga vary greatly in vigor and emphasis.6 Despite heterogeneity, a meta-analysis of 12 randomized controlled trials (RCTs) of yoga for depression in adults documented that yoga was significantly better than usual care, relaxa- tion exercises, or aerobic exercise, in decreasing depressive symptoms.7
Recent research supports these findings.8–10 There is also evidence that yoga reduces stress.11
Several studies have examined yoga for adolescents; however, to date, no published study addresses yoga specifically for adolescent depression. Single yoga classes can have a positive impact on mood or
* Corresponding author at: Butler Hospital, 345 Blackstone Blvd., Providence, RI, 02906, United States. E-mail address: [email protected] (L.A. Uebelacker).
Contents lists available at ScienceDirect
Complementary Therapies in Medicine
journal homepage: www.elsevier.com/locate/ctim
https://doi.org/10.1016/j.ctim.2021.102723 Received 5 October 2020; Received in revised form 15 March 2021; Accepted 19 April 2021
Complementary Therapies in Medicine 59 (2021) 102723
distress in non-depressed adolescents12 and adolescent psychiatric pa- tients.13 Studies of yoga for other conditions, including weight man- agement,14 eating disorders,15,16 and irritable bowel syndrome,17
demonstrate the acceptability of yoga with adolescents. In this study, we conducted individual interviews and focus groups to
collect qualitative data from adolescents regarding their experiences with and attitudes toward yoga, with a particular focus on how yoga may ameliorate stress or depression. We also asked logistical questions about conducting yoga classes. All questions were developed to inform marketing, content, and structure of a yoga program for depressed ad- olescents. That is, we were interested on learning how to increase acceptability and feasibility of a yoga intervention for depressed adolescents.
2. Materials and methods
To meet criteria for inclusion, adolescents: 1) reported elevated depressive symptoms (i.e, PHQ-8 18 score > 8) including sad mood or anhedonia; 2) were aged 13–18; 3) were medically cleared for physical activity by a physician per adolescent/parent report; 4) were able to read and write English; 5) assented to study participation, and their parent/legal guardian consented to their participation (if aged 13–17); OR consented to participation (if aged 18). Adolescents were excluded for: 1) suicide ideation or behavior warranting immediate treatment; or 2) regular attendance at yoga classes.
Butler Hospital IRB approved the protocol. We recruited via social media and community advertisements, seeking teens with depression or stress. Research staff conducted a telephone screen with interested in- dividuals to determine eligibility. Of 122 teens expressing interest, 71 completed the screen, 45 were not eligible (primarily due to insufficient depression severity, n = 36), and four chose to not participate, resulting in 22 teens who were enrolled.
We conducted three focus groups with 14 teens and eight individual interviews (format determined by teen’s schedule). Focus groups ranged from 71− 84 min; interviews ranged from 23− 59 min. We used the same agenda for both formats; relevant questions are in Table 1. Initial questions were about perceptions of yoga. The interviewer then pro- vided a brief overview of yoga, describing yoga as a practice that in- cludes postures, breathing exercises, and meditation, and emphasizing that yoga is about the internal experience of self-exploration and acceptance, and NOT about being flexible or being able to do chal- lenging poses. Next, teens watched a short video of a yoga teacher illustrating simple yoga practices. While seated, the teacher invited participants to notice their breathing, and then led them through sitting cat-cow postures, side stretches, and prayer breath. The interviewer invited teens to simply watch the video or to engage in the practices as they watched. Subsequent discussion questions covered reactions to the video.
Next, interviewers handed out a list of potential “messages” that could be emphasized in yoga classes. These included: accepting our- selves exactly as we are; being kind to ourselves; using breath to increase calm and cope with stress; gratitude; noticing thoughts, feelings, and sensations right now; and physical and emotional balance. These mes- sages were developed by the research team to be consistent with tradi- tional yoga philosophy and potentially relevant to teens’ experiences. Subsequent questions focused on these messages. Finally, the third set of questions covered class logistics.
Participants were paid $30 for participation. Interviews and focus groups were audio recorded and transcribed.
2.3. Data analysis
We used applied thematic analysis 19 to guide analysis. One of the study PIs developed an initial codebook, with deductive codes derived from interview questions. Four staff members reviewed the initial codes and then independently coded transcripts, adding inductive codes as needed to capture emergent concepts. The revised codebook was reviewed by the study team. Each remaining transcript was then inde- pendently coded by two raters who met to review codes. They assigned final codes via consensus and entered them into NVivo qualitative data analysis software. One study PI and two staff members wrote thematic memos summarizing each code. Another staff member read each memo and associated codes, adding comments or clarifications as needed. Codes fell into three major categories: beliefs and experiences with yoga, reactions to study materials, and class logistics. Below, codes are demarcated with an underline.
The 22 teens were aged 14–18 and predominantly female. Table 2 provides more demographic and clinical information.
3.2. Beliefs about and experiences with yoga
We asked teens to tell us their first thoughts regarding “yoga.”
Table 1 Focus group and interview questions.
Questions about Yoga
• What is the first thing that comes to mind when you think of yoga? • Have you or your friends or family ever done yoga before?
o What was it like? o What did you like about it? What did you not like?
• What kinds of people do you think do yoga? • What do your friends or peers think about yoga? • What might make you (or other teens) uncomfortable in a yoga class? Are there
barriers to fully participating? • What do you think the benefits of yoga might be for teens who are feeling stressed,
down, or depressed?
Reactions to Yoga Education, Video, and Materials
[Interviewers asked these questions immediately after teens watched the video.] • How did you feel about that?
o Did anything make you feel uncomfortable? • If you were in yoga classes, what would you hope to get out of them?
o Physical, mental, or emotional results? [Interviewers asked these questions while teens reviewed a list of potential themes for
yoga classes.] • What do you think of [these themes]? What do you think would be useful to you or
others you know? What would NOT be useful? • What else do you think would help?
Questions about Class Logistics
• How would you feel about being in a class with other teens who might have depression?
• How would you feel about being in a class with teens of different ages? • What would make you feel more comfortable in such a diverse group? • What do you think about mixed gender in one class?
o What could be done to make a mixed gender class feel more comfortable? • How long do you think the optimal class length is? • What time of day is the best time to have a yoga class? • What about group size?
o What do you think the best group size is? • How often would you be willing and able to attend? • Would you be willing to practice yoga in between sessions at home?
o What are the barriers to practicing at home? o What could make it easier for you to practice yoga at home?
• How would you get to class? What kinds of transportation would you use? • What kinds of barriers do you think would keep you or other teens from getting to
L.A. Uebelacker et al.
Complementary Therapies in Medicine 59 (2021) 102723
Responses included basic elements of yoga: stretching, postures, bal- ance, flexibility, relaxation, and meditation. Two teens mentioned thinking of their mothers (who practiced yoga). Some teens commented that yoga may be difficult or not easily accessible because it requires strength, flexibility, time, effort, or patience. Teens reflected on who does yoga. By far the largest group was “moms” (n = 7). Some teens specified middle-aged women; others talked about young adults (but not teenagers). Participants largely identified women as people who did yoga. Some teens (n = 5) talked about people with “alternative” life- styles – i.e., “hippies,” “vegans,” “people who are into astrology or essential oils,” or people who “want their chakras to be aligned” (ID#8, Focus Group [hereafter FG] 2). Other characteristics of people who do yoga included people with money and time, who want to improve themselves or cope with stress, or who are “super flexible.” (ID#5, FG2). Only one teen noted that “pretty much anyone” can do yoga (ID#16, Interview).
We asked participants what their friends or peers think about yoga. Several teens thought yoga is or would be acceptable to peers, and knew of peers who had positive experiences with yoga (n = 6). Two teens talked about yoga being viewed as a workout of insufficient intensity, i. e., “the easy way out’” (ID#14, FG3). Two teens talked about negative experiences doing yoga with peers, describing yoga as this “tedious thing you have to do” (ID#3, FG1) or having been to a class where peers were “giggling and talking the whole time” (ID#14, FG3). Participants also stated that yoga may be seen as only for women or girls, with a male teen stating that he has been criticized for doing yoga and it is “frowned upon for boys of my age” (ID#11, FG3). One teen with some experience practicing yoga stated “my friends think I’m insane” (ID#6, FG2) but did not explain why. Three teens stated that their peers did not think or talk about yoga.
We learned about teens’ prior experience with yoga. Many, but not all, had tried yoga at school (n = 7), with friends outside of school (n = 4), with a parent at home (n = 3) in a studio as part of an adult class (n = 4), or as part of an outpatient program (n = 2). Many previous experi- ences had been positive (n = 8): they found yoga to be calming and relaxing; to provide relief from stress; and even to be fun. One teen said,
“yoga is definitely something that always calms me down and I think it’s really helpful for stress” (#14, FG2). However, two teens noted that they would be less likely to do yoga if they were feeling stressed at the time. Some reported feeling self-conscious in class (n = 3), not feeling it was enough of a workout (n = 2), and difficulty sitting still (n = 2). One discussed a negative first-time experience doing yoga in gym class, in which the teacher encouraged them to push themselves beyond their comfort zone when doing postures.
We asked about attitudinal or emotional barriers and facilitators of yoga class attendance. Self-consciousness was a major concern (n = 15). Self-consciousness could be related to not being able to do yoga “right” (n = 10), and included worry about others being judgmental even though “You might think the other people think you’re bad, but… like, at least from what I’ve noticed, nobody really cares” (ID#6, FG2). Other contributors to self-consciousness included having a larger body and/or wearing tight clothes. Finally, two people were concerned that quiet in class could lead to others hearing noises their body might make, including breathing. Other barriers reflected characteristics of the in- dividual, including not being flexible, not having good balance, not wanting to meet new people, being anxious about coming to a new place, and low motivation. Yoga was perceived as being for others: older people, or girls/women. Finally, one person mentioned yoga being boring and another mentioned physical discomfort with breathing ex- ercises (felt like hyperventilating).
Facilitators included being in class with others who were similar (n = 5), i.e., yoga beginners, friends, nice people, and people doing yoga for similar reasons. Teaching style was important (n = 5), with preference for teachers who were non-judgmental, welcoming, and gave partici- pants alternate choices for postures. Teens mentioned aspects of the class environment, preferring low lights (to minimize self- consciousness), being allowed to bring a friend, and calming aroma- therapy. One teen stated that sending a fact sheet ahead of time, with a class description and suggestions for clothing, would be helpful. Another said it was important to make class “open to anyone who wants to do it” and “something they don’t have to do” (ID#10, FG3).
We asked teens about benefits of yoga for stressed or depressed teens. Many said that it could be calming or relaxing (n = 7), or helpful (n = 8). Four noted that yoga might give a teen something to focus on besides feeling stressed or down: “Yoga can really help me … just be focused on something else other than what I’m feeling and just like help me feel really calm” (ID#18, Interview). Others commented that yoga might be helpful because it guided one to focus on oneself (n = 3), or allowed a teen to be with others (n = 2). Individual teens also noted each of the following: yoga could give one a sense of accomplishment, increased patience, more flexibility, and increased ability to cope with problems. One teen commented on a potential pitfall: “When you tell a teen who… has a lot going on in their head to just try to like clear their head, it’s even more frustrating” (ID#21, interview).
Teens told us about desired features of yoga classes. Two teens thought it would be important to start with slower movements and have the class beco
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