Student Wellness Workshop Study
Condition: Stress; Stress, Psychological; Stress Reaction; Adjustment; Adjustment, Social; Adjustment, Emotional
MeSH terms: Fractures, Stress; Stress, Psychological
Study type: Interventional

Summary: 
      While efficacy of Sudarshan Kriya Yoga (SKY) has been demonstrated in a number of prior
      studies, little is known about the effects of SKY taught as part of the Your Enlightened Side
      (YESplus) workshop designed for college students. Thus, this study aims to assess the effects
      of YESplus on well-being, including sleep patterns, and physiological stress response.
    

Detailed description: 
      The transition from adolescence to adulthood, particularly for college students, is
      accompanied by several major life changes and challenges. For many individuals, this is a
      period when one moves away from home, begins interacting with different peer groups, and has
      greater financial and academic responsibilities. The emotional stress associated with these
      changes is correlated with less time devoted to sleep, increased alcohol intake reduced
      academic performance and increased rates of anxiety disorders and/or depression.

      Your Enlightened Side (plus more) (YESplus) is a life skills workshop with a strong emphasis
      on breathing practices for reducing stress and increasing well-being. Additional stress
      management tools including meditation, yoga, and interpersonal exercises that impart social
      emotional learning skills and stress reduction strategies complement the breathing
      techniques.

      The central practice taught in YESplus is a unique rhythmical breathing technique called
      Sudarshan Kriya. It is taught along with two preparatory breathing practices: an advanced
      form of Ujjayi breathing (breathing against airway resistance) and bhastrika (forceful nasal
      breathing). Collectively, these three breathing practices are referred to as Sudarshan Kriya
      Yoga (SKY).

      Prior literature has demonstrated significant improvements in psychological and physiological
      outcomes of SKY in adults, including decreases in subjective stress, clinical and subclinical
      depression and anxiety, posttraumatic stress symptoms,impulsivity, and tobacco use, as well
      as increases in calm, mental focus, emotion regulation, and overall well-being.

      However, little is known about the effects of SKY specifically taught in the YESplus workshop
      format designed for college students. One randomized controlled trial has demonstrated
      attenuated levels of subjective stress and several hematological parameters, including
      lymphocytes and platelet count, during exam periods following SKY training. These findings
      have not yet been replicated, and the extent to which the effects of YESplus generalize to
      other health-related changes such as cardiovascular function remain unclear.

      Addressing the gap in the literature described above and to provide further preliminary data
      on the specific effects of YESplus on well-being and stress physiology, this study aims to
      evaluate measures of self-reported wellness across a variety of questionnaires, in addition
      to changes in heart rate variability and salivary cortisol levels with a stress induction
      task. To control for expectancy effects, overall time spent with the workshop, social
      contact, and exposure to cognitive stress management strategies that may influence the
      observed effects of YESplus not specific to the yogic breathing and deep social connectedness
      at the core of the YESplus targets, a comparison workshop with all of these potential
      supplementary contributors will be included, titled "Wisdom On Wellness" (WOW!).

      Participation will include three laboratory visits at pre-workshop (T1), post-workshop (T2),
      and 1-2 month follow-up (T3) time points and four workshop sessions described below.

      Screening: Interested participants will first be directed to an online pre-screening survey.
      The survey will begin with a prompt describing the study and requiring understanding via
      checkbox that the survey is for screening purposes. The survey will collect information such
      as name, e-mail address, date of birth, motivation for the study, student status, prior
      contemplative practice experience, ability to meet the time commitment, panic and bipolar
      symptoms, and potential affiliation with other participants. If any of the exclusion criteria
      indicated above are met, the participant will be notified of ineligibility.

      Enrollment and randomization: Eligible participants will be first grouped in clusters with
      any other participants with known affiliations stated in the online screener, in order to
      minimize possibility of learning about material of the other workshop, then assigned a
      workshop via random number generator.

      Laboratory Visits: In-person laboratory visits will be conducted at the University of Arizona
      Respiratory Physiology Laboratory on the main UA campus. Workshops will be conducted in
      various buildings on the main UA campus depending on reservation availability.

      Actigraphy, sleep diary, online questionnaires and practice logs measures will be completely
      remotely after the instruments are provided to participants during an in-laboratory visit.

      In addition to actigraphy, sleep diary, online questionnaires, and home practice logs (for T2
      and T3 time points) the following data will be collected during each laboratory visit:
      electrocardiography (ECG) with concurrent respiratory inductance plethysmography (RIP) and
      pulse oximetry recordings, as well as salivary cortisol at baseline, post-stress induction
      task, 30-min post-stress-induction-onset, and 45-min post. ECG, RIP belts, and pulse oximetry
      will be recorded continuously, in addition to the designated resting recording periods.

      Workshop evaluations: Both workshop participants and instructors will complete a brief
      questionnaire at two time points (end of Day 1 and end of Day 4) during the workshop to
      indicate expectation of workshop benefit.

      Stress Induction. The Maastricht Acute Stress Test (MAST), a previously described and
      increasingly used stress induction task will be utilized. A research staff member in a white
      laboratory coat will explain that the session will be video-recorded to then be coded
      afterwards by trained raters, provide background information regarding performance norms, and
      express an expected ability of the participant to perform comparably. Next, the researcher
      will provide instructions for the task that will be guided by a Powerpoint presentation. The
      MAST consists of a 10 minute acute stress phase that combines elements of both the commonly
      used Cold Pressor Test and Trier Social Stress Test, adding an element of uncertainty by
      cycling between these two tests at slightly unpredictable time intervals. For the hand
      immersion trials (HIT), participants will insert their dominant hand and wrist in a bucket of
      ice water (approximately 2° C) for up to 90 seconds. Participants are instructed they may
      remove their hand at any time. Upon removal, participants will place their hand on a towel
      and immediately begin a serial subtraction task, for which participants will be instructed to
      count backwards by 13, 17, or 18 from a randomly selected number between 2013 and 2073, with
      interjections to start over from the beginning if any calculations are incorrect. Neutral or
      negative feedback will be provided throughout the task, including comments such as "That's
      wrong. Start over" and "You're going too slowly."
    

Intervention name(s): YESplus workshop; WOW! workshop
Intervention type(s): Behavioral; Behavioral
Intervention description(s): See description in "Arms" section.; See description in "Arms" section.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Other