Feasibility of the Heart to Heart Yoga Program
Condition: Heart Failure; Caregiver Burden; Depression; Anxiety; Stress
MeSH terms: Heart Failure; Caregiver Burden
Study type: Interventional

Summary: 
      A two-group (intervention vs. usual care), randomized controlled design will be used to
      determine the feasibility and acceptability of the intervention, the Heart2Heart program, and
      determine efficacy on physical and psychological outcomes in patients with heart failure (HF)
      and caregivers. A total of 20 patients with HF and 20 caregivers (n= 40) will be randomly
      assigned to the intervention or usual care group stratified by patient and caregiver groups.
      Only participants in the intervention will be asked to attend the 12-week sessions (two
      sessions per week; a total of 24 sessions in 12 weeks) via video conferencing (i.e., ZOOM).
      The short-term intervention efficacy will be assessed following week of the completion of
      12-weeks sessions. Primary psychological outcomes include depressive symptoms, anxiety,
      stress, and quality of life. Primary physical outcomes include physical activity level, sleep
      quality, and perceived symptoms.
    

Detailed description: 
      Heart2Heart Intervention. In this study, the Heart to Heart Yoga intervention is a
      therapeutic and standardized form of yoga intervention that is adapted from MediYoga designed
      to fit the needs of patients with heart failure (HF) and family caregivers who may have
      physical limitations and to fit cultural and social norms in Kentucky. The Heart to Heart
      Yoga intervention key personnel include two primary investigators, two professional yoga
      instructors, and one PhD student who are all nurses and were certified Medi-Yoga instructor
      Level 1 by completing more than 120 hours of Medi-yoga training course for medical
      professionals. The intervention will use a gradual, physical/ psychological yoga adaptation
      approach, and it will be delivered two times per week (40 -60 minutes per session) via
      videoconference technology for 12 weeks (total 24 sessions). Real-time, face-to-face, video
      conferencing technology is used. In the recent systematic literature review, yoga has been
      delivered for 12 weeks in patients with HF. The the12-week duration was selected in this
      study by considering variations of individual adaptation and available evidence in the
      literature. Yoga sessions will be delivered by two registered nurses who were yoga
      instructors and certified MediYoga instructors.

      The 12-weeks of intervention include three structured sessions. At each session, the first
      part will focus on deep breathing (5- 11 minutes), followed by physical posture movement (3
      -11 minutes), and then meditation (6 -11 minutes), based on the structured gradual adaptation
      program. Participants will be instructed to modify movements to ensure comfort and safety.
      For example, if a participant is more comfortable seated in a chair instead of the floor, the
      instructor will demonstrate exercise modification while ensuring target muscles are utilized.
      All sessions will be delivered as group sessions using a video-conferencing program on a
      digital multimedia device. Each week, three yoga sessions are available to allow participants
      flexibility in attendance. The intervention group also receives a short-video clip each week
      (up to 10 minutes) and recommend to follow to practice yoga for 10 minutes per day, and a
      total of 50 minutes per week while not attending sessions. Participants will record practice
      time in a Yoga log booklet.

      The investigators will limit the number of participants up to 10 at each session by
      monitoring enrollment rates. Participants will also receive materials that include yoga poses
      guides and mats. Without explicit skill demonstration and training, the intervention group
      will receive the printed information and links to the AHA's Life's Simple 7 program.

      Usual Care Group. Participants in the usual care group will also receive the printed
      information and links to the AHA's Life's Simple 7 program without explicit skills and
      training, including education and stress management. Stress management will be encouraged by
      watching and practicing yoga programs by providing a yoga mat.
    

Intervention name(s): Heart to Heart Yoga
Intervention type(s): Other
Intervention description(s): The Heart to Heart Yoga intervention is a therapeutic and standardized form of yoga intervention that is adapted from MediYoga designed to fit the needs of patients with HF and family caregivers who have physical limitations and depressive symptoms and to fit cultural and social norms in Kentucky. The intervention will use a gradual, physical/ psychological yoga adaptation approach, and it will be delivered two times per week (40 -60 minutes per session) via videoconference technology for 12 weeks (total 24 sessions). Real-time, face-to-face, video conferencing technology is used.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Caregiver; Yoga