Psychological well-being, health behaviors, and weight loss among participants in a residential, Kripalu yoga-based weight loss program.

UNLABELLED: The increasing prevalence of overweight and obesity in humans is a growing public health concern in the United States. Concomitants include poor health behaviors and reduced psychological well-being. Preliminary evidence suggests yoga and treatment paradigms incorporating mindfulness, self-compassion (SC), acceptance, non-dieting, and intuitive eating may improve these ancillary correlates, which may promote long-term weight loss. METHODS: We explored the impact of a 5-day residential weight loss program, which was multifaceted and based on Kripalu yoga, on health behaviors, weight loss, and psychological well-being in overweight/obese individuals. Thirty-seven overweight/obese program participants (age 32-65, BMI<25) completed validated mind-fulness, SC, lifestyle behavior, and mood questionnaires at baseline, post-program, and 3-month follow-up and reported their weight 1 year after program completion. RESULTS: Significant improvements in nutrition behaviors, SC, mindfulness, stress management, and spiritual growth were observed immediately post-program (n = 31, 84% retention), with medium to large effect sizes. At 3-month follow-up (n = 18, 49% retention), most changes persisted. Physical activity and mood disturbance had improved significantly post-program but failed to reach significance at 3-month follow-up. Self-report weight loss at 1 year (n = 19, 51% retention) was significant. CONCLUSION: These findings suggest a Kripalu yoga-based, residential weight loss program may foster psychological well-being, improved nutrition behaviors, and weight loss. Given the exploratory nature of this investigation, more rigorous work in this area is warranted.

Profile of minority and under-served patients using acupuncture.

BACKGROUND: Acupuncture use remains common in the United States, yet little is known of its utilization by minority and underserved populations. Herein we report first visit data capturing patient profiles, types of conditions presented, and self-reports of their experience and satisfaction with acupuncture accessed at a free care clinic with in a large urban safety net hospital. METHODS: Sixty-one adult, English-speaking acupuncture patients were given a 20 min survey after their first visit to a free care acupuncture clinic. RESULTS: Patients were from 12 different countries. Fifty-six percent of the participants were minorities. Sixty-five percent of respondents were female. Average age was 42.1. Eighty percent were acupuncture naïve. Patients' health complaints were similar to those of other surveyed mainstream patients with 57% reporting musculoskeletal conditions. Ninety-three percent would recommend a friend or family for acupuncture, 97% rating their overall experience with the acupuncture clinic as either very good or good. CONCLUSIONS: When made available to a diverse population of patients, acupuncture is utilized and perceived to be helpful. In this survey, patients sought treatment for musculoskeletal conditions and were satisfied with their first visit. Future research is warranted.

Which patients improve: characteristics increasing sensitivity to a supportive patient-practitioner relationship.

Supportive social relationships, including a positive patient-practitioner relationship, have been associated with positive health outcomes. Using the data from a randomized controlled trial (RCT) undertaken in the Boston area of the United States, this study sought to identify baseline factors predictive of patients' response to an experimentally applied supportive patient-practitioner relationship. To sort through the hundreds of potential attributes affecting the patient-practitioner relationship, we applied a false discovery rate method borrowed from the field of genomics and bioinformatics. To our knowledge such a method has not previously been applied to generate hypotheses from clinical trial data. In a previous RCT, our team investigated the effect of the patient-practitioner relationship on symptom improvement in patients with irritable Bowel syndrome (IBS). Data were collected on a sample of 289 individuals with IBS using a three-week, single blind, three arm, randomized controlled design. We found that a supportive patient-practitioner relationship significantly improved symptomatology and quality of life. A complex, multi-level measurement package was used to prospectively measure change and identify factors associated with improvement. Using a local false discovery rate procedure, we examined the association of 452 baseline subject variables with sensitivity to treatment. Out of 452 variables, only two baseline factors, reclusiveness, and previous trial experience increased sensitivity to the supportive patient-practitioner relationship. A third variable, additional opportunity during the study for subjects to discuss their illness through experiential interview, was associated with improved outcomes among subjects who did not receive the supportive patient-practitioner relationship. The few variables associated with differential benefit suggest that a patient-centered supportive patient-practitioner relationship may be beneficial for most patients. This may be especially important for reclusive individuals. Within the context of our study, additional study attention in the form of repeated experiential interviews compensated for a lack of positive patient-practitioner support. A supportive patient-practitioner relationship may also help overcome low provider expectations for subjects with previous trial experience. These results converge with the results of the parent trial, implicating the importance of the social world in healing.