Elizabeth Auguste is a Research Assistant; Rachel Weiskittle is an Advanced Fellow; Kelly Doherty is a Health Science Specialist; and Jennifer Moye is Associate Director for Education and Evaluation; all at US Department of Veterans Affairs (VA) New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System in Massachusetts. Stephanie Sohl is a Assistant Professor, and Suzanne Danhauer is a Professor and Director of Faculty Well-Being & Resilience, both at the Department of Social Sciences & Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine in Winston Salem, North Carolina. Aanand Naik is Chief of Implementation Science at the VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VA Medical Center and a Professor and Robert Luchi, MD Chair in Geriatric Medicine at the Baylor College of Medicine in Houston, Texas. Rachel Weiskittle is a Research Fellow and Jennifer Moye is a Professor, both at the Department of Psychiatry, Harvard Medical School.
Author disclosures
The authors report no actual or potential conflicts of interest with regard to this article.
Disclaimer
The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the US Government, or any of its agencies.
The sample of 110 military veterans was mostly male (99.1%) with a mean (SD) age of 64.9 (9.4) years (range, 41-88)(Table 1). The majority (70.9%) described their race/ethnicity as White, non-Hispanic followed by Black/African American (18.2%) and Hispanic (8.2%) persons; 50.0% had no more than a high school education. The most common cancer diagnoses were colorectal (50.9%), head and neck (39.1%), and esophageal and gastric (10.0%) and ranged from AJCC stages I to IV.
When first asked, the majority of participants (78.2%) reported that they were not interested in yoga, 16.4% reported they might be interested, and 5.5% reported they had tried a yoga class since their cancer diagnosis. In contrast, 40.9% used exercise, 32.7% used meditation, 14.5% used physical or occupational therapy, and 11.8% used massage therapy since their cancer diagnosis.
After participants were provided the brief scripted education about yoga, the level of interest shifted: 46.4% not interested, 21.8% interested, and 31.8% definitely interested, demonstrating a statistically significant shift in interest following education (χ2 = 22.25, P < .001) (Figure 1). Those with the most positive beliefs about yoga were most likely to indicate interest. Using the BAYS 3-item survey, the mean (SD) for the definitely interested, might be interested, and not interested groups was 15.1 (3.2), 14.1 (3.2), and 12.3 (2.5), respectively (F = 10.63, P < .001).
A multivariable regression was run to examine possible associations between participants’ demographic characteristics, clinical characteristics, and beliefs about yoga as measured by the 3 BAYS items (Table 2). Higher expected health benefits of yoga was associated with identifying as African American, Hispanic, or other identity and having a lower stage of cancer; lower concern for expected discomfort was associated with identifying as African American, Hispanic, or other identity and higher physical function. Lower concern about expected social norms was associated with higher education and having a higher stage of cancer. Age was not associated with any of the BAYS factors. In follow-up analysis, beliefs about yoga did not differ by age group (40-59 years: mean, 13.3, SD, 2.9; 60-69 years: mean, 13.4, SD, 3.2; 70-89 years: mean, 14.1, SD, 3.2).
Six themes were identified in qualitative analysis of semistructured interviews reflecting older veterans’ beliefs about yoga, which were grouped into the following suprathemes of positive vs negative beliefs (Figure 2). Exemplar responses appear in Table 3.
Study 2 Intervention Sample
This sample of 28 veterans was mostly male (96.4%) with a mean (SD) age of 69.2 (10.9) years (range, 57-87). The majority (89.3%) described their race as White, followed by Black/African American (10.7%); no participants self-identified in other categories for race/ethnicity. Twelve veterans (42.9%) had no more than a high school education. The most common cancer diagnosis was genitourinary (35.7%) and the AJCC stage ranged from I to IV.
