LoveYourBrain Mindset: Feasibility, Usability, and Acceptability of an Online Yoga, Mindfulness, and Psychoeducation Intervention for Traumatic Brain Injury

ABSTRACT

Objective: Despite the rapid growth of virtual health services in response to COVID-19, people affected by traumatic brain injury (TBI) experience symptoms that can undermine their ability to access and benefit from such services. This study assessed the feasibility, usability, and acceptability of LoveYourBrain Mindset, a manualized, 6-week yoga, mindfulness, and psychoeducation program delivered online to people with TBI and caregivers. To enhance accessibility, participants choose between two interactive tracks, either a weekly 75-min gentle yoga class or a 45-min group discussion on Zoom. Participants also receive weekly pre-recorded tools by email (1-min psychoeducational videos, 45-min yoga classes, 10-min meditations, 25-min yoga nidra meditations). Methods: LoveYourBrain Foundation recruited prospective participants from October 2020-March 2021 through clinical, advocacy, and social media outreach. People were eligible if they were a TBI survivor or caregiver, age 15 to 70, able to participate in gentle exercise and/or group discussion, and consented for their data to be used for research. Self-reported survey data were collected electronically in eligibility and feedback forms. We assessed feasibility by describing the number of people enrolled, number of programs successfully offered, and mean attendance;usability by examining use of the tools;and acceptability by analyzing satisfaction measures. Results: A total of 62 programs were offered by LoveYourBraintrained Facilitators during the study period. No programs were canceled from low enrollment. Eight hundred and nine eligible people enrolled, including 733 people with TBI and 76 caregivers. Participants were majority white (n = 654, 80.8%), non- Hispanic (n = 690, 85.3%), female (n = 640, 79.1%), educated (college graduate/equivalent or higher) (n = 657, 81.2%), and had a median age of 43 years (range 18-80 years). TBI severity ranged from mild (n = 272, 38.1%), moderate (n = 247, 34.6%), to severe (n = 195, 27.3%). Participants were located mostly in 47 states in the US (n = 601, 74.1%) or 8 Canadian provinces (n = 192, 23.7%). A majority (n = 584, 72.2%) attended ≥1 interactive classes, while 26.8% were 'no-shows' (n = 217) and 1.0% withdrew (n = 8). Mean attendance in the interactive classes was 7 (SD 1) people per program. Most participants (n = 263, 74.0%) completed some tools in 5 or all 6 weeks of their program, most often the videos (n = 256, 72.1%), meditations (n = 142, 40.0%), yoga classes (n = 133, 37.5%), and yoga nidras (n = 105, 29.6%). Participants reported high satisfaction (M = 9.1 out of 10, SD 1.4) and a majority (n = 308, 86.7%) would 'Definitely, yes' recommend it to a friend or family. Conclusion: High attendance, engagement, and satisfaction with LoveYourBrain Mindset suggests that online delivery of yoga, mindfulness, and psychoeducation is feasible and acceptable for people with TBI and caregivers. The program's scalability has implications on expanding access to holistic health services for this marginalized community, yet greater efforts are needed to reach minority groups with disproportionately worse access to care, particularly Black, Indigenous and People of Color.