A feasibility (pilot) mixed methods study of an innovative non-pharmacological breath-based yoga and social-emotional intervention program in an at-risk youth sample in London, Canada.
Depression
Homeless
Mental health
Yoga
Youth at-risk
Journal
Pilot and feasibility studies
ISSN: 2055-5784
Titre abrégé: Pilot Feasibility Stud
Pays: England
ID NLM: 101676536
Informations de publication
Date de publication:
07 Feb 2024
07 Feb 2024
Historique:
received:
06
09
2022
accepted:
22
01
2024
medline:
7
2
2024
pubmed:
7
2
2024
entrez:
6
2
2024
Statut:
epublish
Résumé
Various service provision models for youth at risk of homelessness have been researched and implemented, including access to housing and physical and mental health resources. However, even with these interventions, we remain unaware of how best to manage symptoms of depression and anxiety and the rate of drug use in these populations primarily because of a lack of feasibility data. This paper presents the results of a mixed-methods study in London, Canada, that examined the feasibility of implementing a biopsychosocial intervention, SKY Schools, in at-risk youth aged between 16 and 25 (n = 49). The study also recorded qualitative responses about the program's usefulness from the perspective of the service users. The SKY Schools intervention consisted of social-emotional learning combined with Sudarshan Kriya Yoga, a standardized yoga-based breathing exercise routine. The intervention program was divided into two phases: an active learning phase and a reinforcement phase. The following feasibility outcome measures were collected: (1) the number of potential participants approached per month, (2) number (proportion) who were successfully screened, (3) the proportion of screened participants who enrolled, (4) the rate of retention in the study, (5) rate of adherence to study protocol, (6) proportion of planned ratings that were completed, (7) intervention cost per case, (8) completeness of final data for analysis, (9) length of time to collect all data, (10) quality of all collected data, (11) determining if partnering community organizations were willing to conduct the study as per study protocol, (12) determining if there were any capacity issues with partners providing intervention and investigators being able to perform the tasks that they were committed to doing, (13) determining if there were any problems of entering the data into a computer, (14) preliminary data about the safety of the intervention, and (15) preliminary estimate of treatment effects. All feasibility outcome measures were collectible. In the city of London, Canada it was feasible to conduct a pilot study in this population of youth at risk of homelessness. Foremost among the findings was a high retention rate (61.2%) and overall positive qualitative feedback with a number of potential suggestions to improve the delivery and quality of the intervention. However, we had a significantly low recruitment rate (0.27 participants per week) suggesting that multiple sites will be needed to achieve an adequate sample size for a subsequent definitive trial. Future researchers may consider the findings of this feasibility study when designing a randomized control trial to further assess the efficacy and tolerability of SKY Schools. Trial registration: Clinicaltrials.gov, identifier NCT02749240. Registered April 22, 2016, https://clinicaltrials.gov/ct2/show/NCT02749240 .
Sections du résumé
BACKGROUND
BACKGROUND
Various service provision models for youth at risk of homelessness have been researched and implemented, including access to housing and physical and mental health resources. However, even with these interventions, we remain unaware of how best to manage symptoms of depression and anxiety and the rate of drug use in these populations primarily because of a lack of feasibility data.
METHODS
METHODS
This paper presents the results of a mixed-methods study in London, Canada, that examined the feasibility of implementing a biopsychosocial intervention, SKY Schools, in at-risk youth aged between 16 and 25 (n = 49). The study also recorded qualitative responses about the program's usefulness from the perspective of the service users. The SKY Schools intervention consisted of social-emotional learning combined with Sudarshan Kriya Yoga, a standardized yoga-based breathing exercise routine. The intervention program was divided into two phases: an active learning phase and a reinforcement phase. The following feasibility outcome measures were collected: (1) the number of potential participants approached per month, (2) number (proportion) who were successfully screened, (3) the proportion of screened participants who enrolled, (4) the rate of retention in the study, (5) rate of adherence to study protocol, (6) proportion of planned ratings that were completed, (7) intervention cost per case, (8) completeness of final data for analysis, (9) length of time to collect all data, (10) quality of all collected data, (11) determining if partnering community organizations were willing to conduct the study as per study protocol, (12) determining if there were any capacity issues with partners providing intervention and investigators being able to perform the tasks that they were committed to doing, (13) determining if there were any problems of entering the data into a computer, (14) preliminary data about the safety of the intervention, and (15) preliminary estimate of treatment effects.
RESULTS
RESULTS
All feasibility outcome measures were collectible. In the city of London, Canada it was feasible to conduct a pilot study in this population of youth at risk of homelessness. Foremost among the findings was a high retention rate (61.2%) and overall positive qualitative feedback with a number of potential suggestions to improve the delivery and quality of the intervention. However, we had a significantly low recruitment rate (0.27 participants per week) suggesting that multiple sites will be needed to achieve an adequate sample size for a subsequent definitive trial.
CONCLUSIONS
CONCLUSIONS
Future researchers may consider the findings of this feasibility study when designing a randomized control trial to further assess the efficacy and tolerability of SKY Schools.
TRIAL REGISTRATION
BACKGROUND
Trial registration: Clinicaltrials.gov, identifier NCT02749240. Registered April 22, 2016, https://clinicaltrials.gov/ct2/show/NCT02749240 .
Identifiants
pubmed: 38321567
doi: 10.1186/s40814-024-01452-0
pii: 10.1186/s40814-024-01452-0
doi:
Banques de données
ClinicalTrials.gov
['NCT02749240']
Types de publication
Journal Article
Langues
eng
Pagination
26Subventions
Organisme : Lawson Health Research Institute
ID : IRF
Informations de copyright
© 2024. The Author(s).
Références
Begin P, Casavant L, Miller Chanier N, Dupuis J. (1999). Homelessness. L. o. Parliament. https://publications.gc.ca/collections/Collection-R/LoPBdP/PRB-e/PRB991-e.pdf .
Cameron KN, Racine Y, Offord DR, Cairney J. Youth at risk of homelessness in an affluent Toronto suburb. Can J Public Health. 2004;95(5):352–6. https://doi.org/10.1007/bf03405145 .
doi: 10.1007/bf03405145
pubmed: 15490924
pmcid: 6975765
Goldman-Hasbun J, Nosova E, Kerr T, Wood E, DeBeck K. Homelessness and incarceration associated with relapse into stimulant and opioid use among youth who are street-involved in Vancouver, Canada. Drug Alcohol Rev. 2019;38(4):428–34. https://doi.org/10.1111/dar.12921 .
doi: 10.1111/dar.12921
pubmed: 30896070
pmcid: 6508978
Shoemaker ES, Kendall CE, Mathew C, Crispo S, Welch V, Andermann A, . . . Pottie K. Establishing need and population priorities to improve the health of homeless and vulnerably housed women, youth, and men: a Delphi consensus study. PloS one. 2020;15(4):e0231758-e0231758.
Wiens K, Bhattarai A, Pedram P, Dores A, Williams J, Bulloch A, Patten S. A growing need for youth mental health services in Canada: examining trends in youth mental health from 2011 to 2018. Epidemiol Psychiatric Sci. 2020;29:e115–e115. https://doi.org/10.1017/S2045796020000281 .
doi: 10.1017/S2045796020000281
Gardner W, Pajer K, Cloutier P, Zemek R, Currie L, Hatcher S, . . . Lima I. Changing rates of self-harm and mental disorders by sex in youths presenting to Ontario emergency departments: repeated cross-sectional study. Can J Psychiatry. 2019;64(11):789–797. https://doi.org/10.1177/0706743719854070 .
Chiu M, Guttmann A, Kurdyak P. Mental health and addictions system performance in ontario: an updated scorecard, 2009–2017. Healthcare quarterly (Toronto, Ont). 2020;23(3):7–11. https://doi.org/10.12927/hcq.2020.26340 .
doi: 10.12927/hcq.2020.26340
pubmed: 33243359
Youth Opportunities Unlimited. (2020). About. Youth Opportunities Unlimited. https://www.you.ca/about .
Dacey JS, Fiore LB, Brion-Meisels S. (2016). Your Child's Social and Emotional Well-Being. John Wiley & Sons, Ltd.
Dowling K, Simpkin AJ, Barry MM. A Cluster randomized-controlled trial of the mindout social and emotional learning program for disadvantaged post-primary school students. J Youth Adolesc. 2019;48(7):1245–63. https://doi.org/10.1007/s10964-019-00987-3 .
doi: 10.1007/s10964-019-00987-3
pubmed: 31004264
Zope SA, Zope RA. Sudarshan kriya yoga: breathing for health. Int J Yoga. 2013;6(1):4–10. https://doi.org/10.4103/0973-6131.105935 .
doi: 10.4103/0973-6131.105935
pubmed: 23440614
pmcid: 3573542
Dhawan A, Chopra A, Jain R, Yadav D, Vedamurthachar. Effectiveness of yogic breathing intervention on quality of life of opioid dependent users. Int J Yoga. 2015;8(2):144–7. https://doi.org/10.4103/0973-6131.154075 .
Vedamurthachar A, Janakiramaiah N, Hegde JM, Shetty TK, Subbakrishna DK, Sureshbabu SV, Gangadhar BN. Antidepressant efficacy and hormonal effects of Sudarshana Kriya Yoga (SKY) in alcohol dependent individuals. J Affect Disord. 2006;94(1):249–53. https://doi.org/10.1016/j.jad.2006.04.025 .
doi: 10.1016/j.jad.2006.04.025
pubmed: 16740317
Seppälä EM, Bradley C, Moeller J, Harouni L, Nandamudi D, Brackett MA. Promoting mental health and psychological thriving in university students: a randomized controlled trial of three well-being interventions [clinical trial]. Front Psychiatry. 2020;11(590). https://doi.org/10.3389/fpsyt.2020.00590 .
Newman RI, Yim O, Shaenfield DE. Gender and ethnicity: are they associated with differential outcomes of a biopsychosocial social-emotional learning program? Int J Yoga. 2020;13(1):18.
doi: 10.4103/ijoy.IJOY_85_18
pubmed: 32030017
pmcid: 6937876
Goldstein MR, Lewis GF, Newman R, Brown JM, Bobashev G, Kilpatrick L, . . . Meleth S. Improvements in well-being and vagal tone following a yogic breathing-based life skills workshop in young adults: two open-trial pilot studies. Int J Yoga. 2016;9(1):20–26. https://doi.org/10.4103/0973-6131.171718 .
Kanchibhotla D, Subramanian S, Kaushik B. Association of yogic breathing with perceived stress and conception of strengths and difficulties in teenagers. Clin Child Psychol Psychiatry. 2021;26(2):406–17. https://doi.org/10.1177/1359104521994633 .
doi: 10.1177/1359104521994633
pubmed: 33588582
Eldridge SM, Chan CL, Campbell MJ, Bond CM, Hopewell S, Thabane L, Lancaster GA. Consort 2010 statement: extension to randomised pilot and fesibility trials. BMJ. 2016;355. https://doi.org/10.1136/bmj.i5239 .
Browne RH. On the use of a pilot sample for sample size determination. Stat Med. 1995;14(17):1933–40. https://doi.org/10.1002/sim.4780141709 .
doi: 10.1002/sim.4780141709
pubmed: 8532986
Fain JA. Reading, understanding, and applying nursing research. 2017.
Willer B, Ottenbacher KJ, Coad ML. The community integration questionnaire. A comparative examination. Am J Phys Med Rehabil. 1994;73(2):103–11. https://doi.org/10.1097/00002060-199404000-00006 .
doi: 10.1097/00002060-199404000-00006
pubmed: 8148099
Dennis M, Titus J, White M, Unsicker J, Hodgkins D. Global appraisal of individual needs (GAIN): Administration Guide for the GAIN and related measures. Bloomington, IL: Chestnut Health Systems; 2002.
Boothroyd RA, Chen HJ. The psychometric properties of the Colorado Symptom Index. Adm Policy Ment Health. 2008;35(5):370–8. https://doi.org/10.1007/s10488-008-0179-6 .
doi: 10.1007/s10488-008-0179-6
pubmed: 18561020
Forchuk C, Turner K, Hall B, Wiktorowicz M, Hoch JS, Schofield R, . . . Speechley M. (2001). Research Report. Partnerships in capacity building: Housing, community economic development, and psychiatric survivors. In: University of Western Ontario.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101. https://doi.org/10.1191/1478088706qp063oa .
doi: 10.1191/1478088706qp063oa
Patton MQ. Enhancing the quality and credibility of qualitative analysis. Health Serv Res. 1999;34(5 Part II):1189–208. Avaialble at: https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC1089059&blobtype=pdf .
Preston V, Murdie R, Wedlock J, Agrawal S, Anucha U, D'Addario S, . . . Murnaghan AM. Immigrants and homelessness—at risk in Canada's outer suburbs. The Canadian Geographer / Le Géographe canadien. 2009;53(3):288–304. https://doi.org/10.1111/j.1541-0064.2009.00264.x .
Hough RL, Tarke H, Renker V, Shields P, Glatstein J. Recruitment and retention of homeless mentally ill participants in research. J Consult Clin Psychol. 1996;64(5):881–91. https://doi.org/10.1037//0022-006x.64.5.881 .
doi: 10.1037//0022-006x.64.5.881
pubmed: 8916615
Newcombe D. (2021). How London avoided return of large homeless encampments this summer. CTV News London. https://london.ctvnews.ca/how-london-avoided-return-of-large-homeless-encampments-this-summer-1.5512501 .
Gaetz S, Gulliver T, Richter T. The State of Homelessness in Canada 2014. Toronto: The Homeless Hub Press; 2014.
Efraimsson E, Höglund I, Sandman P. The everlasting trial of strength and patience’: transitions in home care nursing as narrated by patients and family members. J Clin Nurs. 2001;10(6):813–9. https://doi.org/10.1046/j.1365-2702.2001.00539.x .
doi: 10.1046/j.1365-2702.2001.00539.x
pubmed: 11822854
Gentil-Gutiérrez A, Cuesta-Gómez JL, Rodríguez-Fernández P, González-Bernal JJ. Implication of the sensory environment in children with autism spectrum disorder: perspectives from school. Int J Environ Res Public Health. 2021;18(14):7670.
doi: 10.3390/ijerph18147670
pubmed: 34300120
pmcid: 8306690
Gerhart B, Ledford GE. Negative Effects of Extrinsic Rewards on Intrinsic Motivation: More Smoke Than Fire. 2013.