Feasibility of a Yoga- and Mindfulness-Based Intervention for Resident Physicians

• Sponsor: Brigham and Women's Hospital (Other)
• Overall Status: Completed
• CT.gov ID: NCT03687450
• Collaborator: Kripalu Center for Yoga and Health (Other)
• Enrollment: 56
• Location: 1
• Arms: 2
• Actual Duration (Months): 18
• Patients Per Site Per Month: 3.1

Study Details

Study Description

Brief Summary

The investigators aim to initiate and complete the first investigation of the effect of a yoga-based program on resident physicians' psychological health using a randomized controlled trial to assess feasibility of the program in this population and measure outcomes across several domains. To meet the goals of the proposed project the investigators have identified 3 specific aims:

Specific Aim 1: Assess the acceptability and feasibility of the yoga program through measuring participation and conducting standardized interviews with a subset of yoga participants.

Specific Aim 2: Evaluate the effect of the yoga program on resident physicians' stress, burnout, resilience, mindfulness, mood, depression, anxiety, and sleep quality using quantitative self-report measures.

Specific Aim 3. Examine whether outcome measures were perceived as relevant to the participants' work environment and were not burdensome as to the length and content of the program.

Condition or Disease	Intervention/Treatment	Phase
Burnout, Professional; Anxiety; Depression; Stress	Behavioral: RISE yoga-based program	N/A

Detailed Description

The project will implement a single group mixed-methods randomized controlled trial to investigate the impact of the 6-week RISE program on psychological health in Longwood medical area residents. The RISE program is an existing standardized yoga program at Kripalu that will be adapted for residents in a 60-90-minute, once-weekly class for six weeks. Participants will be randomized to either the RISE yoga program or a no-treatment control group. Participants randomized to the RISE program will also be instructed to maintain a short 10-15-minute daily home yoga practice. Sessions will be lead by experienced instructors from Kripalu and will be held in the Longwood medical area. Self-report outcomes will be assessed at baseline, at program completion (post-program), at 2-month follow-up, and at 6-month follow-up.

Participants will include resident physicians at Longwood medical area hospitals. The only exclusion criterion is having practiced yoga, meditation, tai chi, qigong, or another mind-body practice at least 25 hours or more in the past 6 months. Participants must be willing not to practice mind-body programs other than the treatment protocol during the intervention. We plan to enroll up to 200 participants with a goal of at least 60 participants with a 2:1 ratio of participants randomized to yoga to participants randomized to control. The control group will receive one session of RISE after their participation in the trial is complete.

Study Design

• Study Type: Interventional
• Actual Enrollment: 56 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: Feasibility of a Yoga- and Mindfulness-Based Intervention for Resident Physicians
• Actual Study Start Date: Nov 1, 2018
• Actual Primary Completion Date: May 1, 2020
• Actual Study Completion Date: May 1, 2020

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Intervention (Yoga) Arm Received a weekly 60-minute yoga-based class over 6 weeks with direction for a 5-10 minute daily home practice.	Behavioral: RISE yoga-based program; The RISE program developed by Kripalu Center for Yoga and Health includes yoga postures, mindfulness practices, meditation, breathing techniques, and education sessions about mindful approaches to daily living. The RISE program will be delivered as a 6-week yoga-based program on-site at Brigham and Women's Hospital in Boston, MA. The program will consist of six 60-90-minute weekly yoga-based RISE classes. Sessions will be lead by experienced instructors from Kripalu Center for Yoga & Health. Subjects in this arm will also be asked to participate in 5-10 minutes of daily home practice with direction from the RISE curriculum.
No Intervention: No-treatment Control Arm Waitlist control-- group received one session of yoga-based class at the completion of the study.

Outcome Measures

Primary Outcome Measures

1. Feasibility of Attending the Yoga Program [Post-program]

   Participants were ask to rate the feasibility of attending the yoga program on a visual analogue scale from 0 (not at all feasible) to 100 (very feasible). Only the intervention group rated feasibility since the control group was a waitlist control group and did not attend the program. The standard deviation of the mean score was calculated.

Secondary Outcome Measures

1. Difference in Burnout [Post-program and 2-month follow-up]

   Maslach Burnout Inventory (short form, 2 items) - scores from 0-12; higher is more burnout

2. Difference in Professional Fulfillment [Baseline, post-program, and 2-month follow-up]

   Professional Fulfillment Index (PFI; 16 items) - scores from 0-4 for professional fulfillment scale; higher is more fulfillment

3. Difference in Resident Well-being [Baseline, post-program, and 2-month follow-up]

   Resident Well-Being Index (7 items) - scores from 0-7; higher is worse wellbeing

4. Difference in Resilience [Baseline, post-program, and 2-month follow-up]

   Resilience Scale (RS-14; 14 items) - scores from 14-98; higher more resilience

5. Difference in Mindfulness [Baseline, post-program, and 2-month follow-up]

   Five Facet Mindfulness Questionnaire (FFMQ; short form, 15 items) - scores from 15-75; higher score means more mindfulness

6. Difference in Stress [Baseline, post-program, and 2-month follow-up]

   Perceived Stress Scale (PSS; 10 items) - scores from 0-40; higher is more stress

7. Difference in Depression [Baseline, post-program, and 2-month follow-up]

   Patient Reported Outcomes Measurement Information System (PROMIS) Depression (short form: depression-4) - scores from 4-20, higher is more depression

8. Difference in Sleep Quality [Baseline, post-program, and 2-month follow-up]

   PROMIS Sleep Disturbance (short form, 4 items) - scores from 4-20, higher is more sleep disturbance

9. Difference in Anxiety [Baseline, post-program, and 2-month follow-up]

   Patient Reported Outcomes Measurement Information System (PROMIS) Anxiety (short form: anxiety-4) - scores from 4-20, higher is more anxiety

10. Differences in Professional Fulfillment - Burnout Sub-Item [Baseline, post-program, and 2-month follow-up]

    Professional Fulfillment Index (PFI; 16 items) - scores from 0-4 for the burnout scale; higher is more burnout

Eligibility Criteria

Criteria

• Ages Eligible for Study: 18 Years and Older
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: Yes

Inclusion Criteria:

• Individuals enrolled in residency programs at Brigham and Women's Hospital, Beth Israel Deaconess, Boston Children's Hospital, or a Harvard Combined Residency Program

• Individuals must be willing to not practice mind-body programs other than the intervention during the treatment protocol

• Must be proficient in English

Exclusion Criteria:

• Individuals who currently practice yoga, meditation, tai chi, qigong, and other mind-body practices more than 25 hours in the past 6 months

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Brigham and Women's Hospital	Boston	Massachusetts	United States	02215

Sponsors and Collaborators

• Brigham and Women's Hospital
• Kripalu Center for Yoga and Health

Investigators

• Principal Investigator: Sat Bir Khalsa, PhD, Brigham and Women's Hospital

Study Documents (Full-Text)

• Study Protocol - May 4, 2019

More Information

Publications

• Baer RA, Carmody J, Hunsinger M. Weekly change in mindfulness and perceived stress in a mindfulness-based stress reduction program. J Clin Psychol. 2012 Jul;68(7):755-65. doi: 10.1002/jclp.21865. Epub 2012 May 23.
• Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L. Using self-report assessment methods to explore facets of mindfulness. Assessment. 2006 Mar;13(1):27-45.
• Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983 Dec;24(4):385-96.
• Dyrbye LN, Satele D, Sloan J, Shanafelt TD. Ability of the physician well-being index to identify residents in distress. J Grad Med Educ. 2014 Mar;6(1):78-84. doi: 10.4300/JGME-D-13-00117.1.
• Gu J, Strauss C, Crane C, Barnhofer T, Karl A, Cavanagh K, Kuyken W. Examining the factor structure of the 39-item and 15-item versions of the Five Facet Mindfulness Questionnaire before and after mindfulness-based cognitive therapy for people with recurrent depression. Psychol Assess. 2016 Jul;28(7):791-802. doi: 10.1037/pas0000263. Epub 2016 Apr 14.
• Henry JD, Crawford JR. The short-form version of the Depression Anxiety Stress Scales (DASS-21): construct validity and normative data in a large non-clinical sample. Br J Clin Psychol. 2005 Jun;44(Pt 2):227-39.
• Pilkonis PA, Yu L, Dodds NE, Johnston KL, Maihoefer CC, Lawrence SM. Validation of the depression item bank from the Patient-Reported Outcomes Measurement Information System (PROMIS) in a three-month observational study. J Psychiatr Res. 2014 Sep;56:112-9. doi: 10.1016/j.jpsychires.2014.05.010. Epub 2014 May 29.
• Trockel M, Bohman B, Lesure E, Hamidi MS, Welle D, Roberts L, Shanafelt T. A Brief Instrument to Assess Both Burnout and Professional Fulfillment in Physicians: Reliability and Validity, Including Correlation with Self-Reported Medical Errors, in a Sample of Resident and Practicing Physicians. Acad Psychiatry. 2018 Feb;42(1):11-24. doi: 10.1007/s40596-017-0849-3. Epub 2017 Dec 1.
• Wagnild GM, Young HM. Development and psychometric evaluation of the Resilience Scale. J Nurs Meas. 1993 Winter;1(2):165-78.
• Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988 Jun;54(6):1063-70.
• West CP, Dyrbye LN, Satele DV, Sloan JA, Shanafelt TD. Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment. J Gen Intern Med. 2012 Nov;27(11):1445-52. doi: 10.1007/s11606-012-2015-7. Epub 2012 Feb 24.
• West CP, Dyrbye LN, Sloan JA, Shanafelt TD. Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals. J Gen Intern Med. 2009 Dec;24(12):1318-21. doi: 10.1007/s11606-009-1129-z. Epub 2009 Oct 3.
• Yu L, Buysse DJ, Germain A, Moul DE, Stover A, Dodds NE, Johnston KL, Pilkonis PA. Development of short forms from the PROMIS™ sleep disturbance and Sleep-Related Impairment item banks. Behav Sleep Med. 2011 Dec 28;10(1):6-24. doi: 10.1080/15402002.2012.636266.

• Responsible Party: Sat Bir Khalsa, PhD, Assistant Professor of Medicine, Brigham and Women's Hospital
• ClinicalTrials.gov Identifier: NCT03687450
• Other Study ID Numbers: 2017P002372
• First Posted: Sep 27, 2018
• Last Update Posted: Jul 23, 2020
• Last Verified: Jul 1, 2020

• Individual Participant Data (IPD) Sharing Statement: No
• Plan to Share IPD: No
• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No
• Keywords provided by Sat Bir Khalsa, PhD, Assistant Professor of Medicine, Brigham and Women's Hospital: yoga; mindfulness; meditation; resident; residency
• Additional relevant MeSH terms: Burnout, Professional

Study Results

Participant Flow

Arm/Group Title	Intervention (Yoga) Arm	No-treatment Control Arm
Arm/Group Description	This is the group that will receive a weekly 60-90minute yoga-based class for six weeks and direction for a 5-10 minute daily home practice. RISE yoga-based program: The RISE program developed by Kripalu Center for Yoga and Health includes yoga postures, mindfulness practices, meditation, breathing techniques, and education sessions about mindful approaches to daily living. The RISE program will be delivered as a 6-week yoga-based program on-site at Brigham and Women's Hospital in Boston, MA. The program will consist of six 60-90-minute weekly yoga-based RISE classes. Sessions will be lead by experienced instructors from Kripalu Center for Yoga & Health. Subjects in this arm will also be asked to participate in 5-10 minutes of daily home practice with direction from the RISE curriculum.	This group will receive no intervention during the study. At the conclusion of the study, this group will receive one free yoga-based class.
Period Title: Overall Study
STARTED	38	18
Post-Program Follow-Up	28	15
Two-month Follow-up	26	16
COMPLETED	26	16
NOT COMPLETED	12	2

Baseline Characteristics

Arm/Group Title	Intervention (Yoga) Arm	No-treatment Control Arm	Total
Arm/Group Description	This is the group that will receive a weekly 60-90minute yoga-based class for six weeks and direction for a 5-10 minute daily home practice. RISE yoga-based program: The RISE program developed by Kripalu Center for Yoga and Health includes yoga postures, mindfulness practices, meditation, breathing techniques, and education sessions about mindful approaches to daily living. The RISE program will be delivered as a 6-week yoga-based program on-site at Brigham and Women's Hospital in Boston, MA. The program will consist of six 60-90-minute weekly yoga-based RISE classes. Sessions will be lead by experienced instructors from Kripalu Center for Yoga & Health. Subjects in this arm will also be asked to participate in 5-10 minutes of daily home practice with direction from the RISE curriculum.	This group will receive no intervention during the study. At the conclusion of the study, this group will receive one free yoga-based class.	Total of all reporting groups
Overall Participants	28	16	44
Age (years) [Mean (Full Range) ]
Mean (Full Range) [years]	29.3	29.1	29.2
Sex: Female, Male (Count of Participants)
Female	21 75%	15 93.8%	36 81.8%
Male	7 25%	1 6.3%	8 18.2%
Ethnicity (NIH/OMB) (Count of Participants)
Hispanic or Latino	2 7.1%	1 6.3%	3 6.8%
Not Hispanic or Latino	26 92.9%	14 87.5%	40 90.9%
Unknown or Not Reported	0 0%	1 6.3%	1 2.3%
Race (NIH/OMB) (Count of Participants)
American Indian or Alaska Native	1 3.6%	0 0%	1 2.3%
Asian	7 25%	4 25%	11 25%
Native Hawaiian or Other Pacific Islander	0 0%	0 0%	0 0%
Black or African American	1 3.6%	0 0%	1 2.3%
White	18 64.3%	10 62.5%	28 63.6%
More than one race	0 0%	2 12.5%	2 4.5%
Unknown or Not Reported	1 3.6%	0 0%	1 2.3%
Year in Training (Count of Participants)
1st year	9 32.1%	3 18.8%	12 27.3%
2nd year	6 21.4%	5 31.3%	11 25%
3rd year	8 28.6%	3 18.8%	11 25%
4th year and above	5 17.9%	5 31.3%	10 22.7%
Specialty (Count of Participants)
Internal Medicine	12 42.9%	8 50%	20 45.5%
OB/GYN	3 10.7%	2 12.5%	5 11.4%
Diagnostic Radiology	3 10.7%	2 12.5%	5 11.4%
Emergency Medicine	2 7.1%	0 0%	2 4.5%
Psychiatry	4 14.3%	2 12.5%	6 13.6%
Medicine-Pediatrics	1 3.6%	0 0%	1 2.3%
Anesthesiology	3 10.7%	1 6.3%	4 9.1%
Physical Medicine & Rehabilitation	0 0%	1 6.3%	1 2.3%

Outcome Measures

1. Primary Outcome

Title	Feasibility of Attending the Yoga Program
Description	Participants were ask to rate the feasibility of attending the yoga program on a visual analogue scale from 0 (not at all feasible) to 100 (very feasible). Only the intervention group rated feasibility since the control group was a waitlist control group and did not attend the program. The standard deviation of the mean score was calculated.
Time Frame	Post-program

Outcome Measure Data

Analysis Population Description

Participants analyzed included those in the intervention group who completed any follow-up timepoint, including post-program and/or two-month follow-up. Since the waitlist control group did not attend the program, they were not asked to assess feasibility.

Arm/Group Title	Intervention (Yoga) Arm	No-treatment Control Arm
Arm/Group Description	This is the group that will receive a weekly 60-90minute yoga-based class for six weeks and direction for a 5-10 minute daily home practice. RISE yoga-based program: The RISE program developed by Kripalu Center for Yoga and Health includes yoga postures, mindfulness practices, meditation, breathing techniques, and education sessions about mindful approaches to daily living. The RISE program will be delivered as a 6-week yoga-based program on-site at Brigham and Women's Hospital in Boston, MA. The program will consist of six 60-90-minute weekly yoga-based RISE classes. Sessions will be lead by experienced instructors from Kripalu Center for Yoga & Health. Subjects in this arm will also be asked to participate in 5-10 minutes of daily home practice with direction from the RISE curriculum.	This group will receive no intervention during the study. At the conclusion of the study, this group will receive one free yoga-based class.
Measure Participants	28	0
Mean (Standard Deviation) [visual analogue scale, 0 to 100]	28.9 (25.6)

2. Secondary Outcome

Title	Difference in Burnout
Description	Maslach Burnout Inventory (short form, 2 items) - scores from 0-12; higher is more burnout
Time Frame	Post-program and 2-month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intervention (Yoga) Arm	No-treatment Control Arm
Arm/Group Description	This is the group that will receive a weekly 60-90minute yoga-based class for six weeks and direction for a 5-10 minute daily home practice. RISE yoga-based program: The RISE program developed by Kripalu Center for Yoga and Health includes yoga postures, mindfulness practices, meditation, breathing techniques, and education sessions about mindful approaches to daily living. The RISE program will be delivered as a 6-week yoga-based program on-site at Brigham and Women's Hospital in Boston, MA. The program will consist of six 60-90-minute weekly yoga-based RISE classes. Sessions will be lead by experienced instructors from Kripalu Center for Yoga & Health. Subjects in this arm will also be asked to participate in 5-10 minutes of daily home practice with direction from the RISE curriculum.	This group will receive no intervention during the study. At the conclusion of the study, this group will receive one free yoga-based class.
Measure Participants	28	16
Baseline	6.23 (0.52)	6.33 (0.92)
Post-program	5.65 (0.50)	6.83 (0.66)
2-month follow-up	5.72 (0.53)	6.43 (0.99)

3. Secondary Outcome

Title	Difference in Professional Fulfillment
Description	Professional Fulfillment Index (PFI; 16 items) - scores from 0-4 for professional fulfillment scale; higher is more fulfillment
Time Frame	Baseline, post-program, and 2-month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intervention (Yoga) Arm	No-treatment Control Arm
Arm/Group Description	This is the group that will receive a weekly 60-90minute yoga-based class for six weeks and direction for a 5-10 minute daily home practice. RISE yoga-based program: The RISE program developed by Kripalu Center for Yoga and Health includes yoga postures, mindfulness practices, meditation, breathing techniques, and education sessions about mindful approaches to daily living. The RISE program will be delivered as a 6-week yoga-based program on-site at Brigham and Women's Hospital in Boston, MA. The program will consist of six 60-90-minute weekly yoga-based RISE classes. Sessions will be lead by experienced instructors from Kripalu Center for Yoga & Health. Subjects in this arm will also be asked to participate in 5-10 minutes of daily home practice with direction from the RISE curriculum.	This group will receive no intervention during the study. At the conclusion of the study, this group will receive one free yoga-based class.
Measure Participants	28	16
Baseline	1.70 (0.12)	1.53 (0.18)
Post-program	1.35 (0.14)	1.48 (0.20)
2-month follow-up	1.38 (0.10)	1.56 (0.21)

4. Secondary Outcome

Title	Difference in Resident Well-being
Description	Resident Well-Being Index (7 items) - scores from 0-7; higher is worse wellbeing
Time Frame	Baseline, post-program, and 2-month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intervention (Yoga) Arm	No-treatment Control Arm
Arm/Group Description	This is the group that will receive a weekly 60-90minute yoga-based class for six weeks and direction for a 5-10 minute daily home practice. RISE yoga-based program: The RISE program developed by Kripalu Center for Yoga and Health includes yoga postures, mindfulness practices, meditation, breathing techniques, and education sessions about mindful approaches to daily living. The RISE program will be delivered as a 6-week yoga-based program on-site at Brigham and Women's Hospital in Boston, MA. The program will consist of six 60-90-minute weekly yoga-based RISE classes. Sessions will be lead by experienced instructors from Kripalu Center for Yoga & Health. Subjects in this arm will also be asked to participate in 5-10 minutes of daily home practice with direction from the RISE curriculum.	This group will receive no intervention during the study. At the conclusion of the study, this group will receive one free yoga-based class.
Measure Participants	28	16
Baseline	4.19 (0.30)	4.08 (0.58)
Post-program	3.15 (0.33)	3.62 (0.35)
2-month follow-up	3.40 (0.37)	3.25 (0.49)

5. Secondary Outcome

Title	Difference in Resilience
Description	Resilience Scale (RS-14; 14 items) - scores from 14-98; higher more resilience
Time Frame	Baseline, post-program, and 2-month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intervention (Yoga) Arm	No-treatment Control Arm
Arm/Group Description	This is the group that will receive a weekly 60-90minute yoga-based class for six weeks and direction for a 5-10 minute daily home practice. RISE yoga-based program: The RISE program developed by Kripalu Center for Yoga and Health includes yoga postures, mindfulness practices, meditation, breathing techniques, and education sessions about mindful approaches to daily living. The RISE program will be delivered as a 6-week yoga-based program on-site at Brigham and Women's Hospital in Boston, MA. The program will consist of six 60-90-minute weekly yoga-based RISE classes. Sessions will be lead by experienced instructors from Kripalu Center for Yoga & Health. Subjects in this arm will also be asked to participate in 5-10 minutes of daily home practice with direction from the RISE curriculum.	This group will receive no intervention during the study. At the conclusion of the study, this group will receive one free yoga-based class.
Measure Participants	28	15
Baseline	70.61 (2.26)	71.20 (3.14)
Post-program	76.32 (1.79)	72.07 (3.02)
2-month follow-up	72.61 (1.76)	72.43 (3.22)

6. Secondary Outcome

Title	Difference in Mindfulness
Description	Five Facet Mindfulness Questionnaire (FFMQ; short form, 15 items) - scores from 15-75; higher score means more mindfulness
Time Frame	Baseline, post-program, and 2-month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intervention (Yoga) Arm	No-treatment Control Arm
Arm/Group Description	This is the group that will receive a weekly 60-90minute yoga-based class for six weeks and direction for a 5-10 minute daily home practice. RISE yoga-based program: The RISE program developed by Kripalu Center for Yoga and Health includes yoga postures, mindfulness practices, meditation, breathing techniques, and education sessions about mindful approaches to daily living. The RISE program will be delivered as a 6-week yoga-based program on-site at Brigham and Women's Hospital in Boston, MA. The program will consist of six 60-90-minute weekly yoga-based RISE classes. Sessions will be lead by experienced instructors from Kripalu Center for Yoga & Health. Subjects in this arm will also be asked to participate in 5-10 minutes of daily home practice with direction from the RISE curriculum.	This group will receive no intervention during the study. At the conclusion of the study, this group will receive one free yoga-based class.
Measure Participants	28	16
Baseline	48.54 (1.14)	48.60 (1.92)
Post-program	54.27 (1.42)	49.73 (1.54)
2-month follow-up	51.83 (0.99)	48.56 (1.49)

7. Secondary Outcome

Title	Difference in Stress
Description	Perceived Stress Scale (PSS; 10 items) - scores from 0-40; higher is more stress
Time Frame	Baseline, post-program, and 2-month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intervention (Yoga) Arm	No-treatment Control Arm
Arm/Group Description	This is the group that will receive a weekly 60-90minute yoga-based class for six weeks and direction for a 5-10 minute daily home practice. RISE yoga-based program: The RISE program developed by Kripalu Center for Yoga and Health includes yoga postures, mindfulness practices, meditation, breathing techniques, and education sessions about mindful approaches to daily living. The RISE program will be delivered as a 6-week yoga-based program on-site at Brigham and Women's Hospital in Boston, MA. The program will consist of six 60-90-minute weekly yoga-based RISE classes. Sessions will be lead by experienced instructors from Kripalu Center for Yoga & Health. Subjects in this arm will also be asked to participate in 5-10 minutes of daily home practice with direction from the RISE curriculum.	This group will receive no intervention during the study. At the conclusion of the study, this group will receive one free yoga-based class.
Measure Participants	28	16
Baseline	19.74 (1.09)	20.69 (1.88)
Post-program	16.15 (1.38)	18.23 (1.36)
2-month follow-up	16.52 (0.85)	18.88 (1.90)

8. Secondary Outcome

Title	Difference in Depression
Description	Patient Reported Outcomes Measurement Information System (PROMIS) Depression (short form: depression-4) - scores from 4-20, higher is more depression
Time Frame	Baseline, post-program, and 2-month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intervention (Yoga) Arm	No-treatment Control Arm
Arm/Group Description	This is the group that will receive a weekly 60-90minute yoga-based class for six weeks and direction for a 5-10 minute daily home practice. RISE yoga-based program: The RISE program developed by Kripalu Center for Yoga and Health includes yoga postures, mindfulness practices, meditation, breathing techniques, and education sessions about mindful approaches to daily living. The RISE program will be delivered as a 6-week yoga-based program on-site at Brigham and Women's Hospital in Boston, MA. The program will consist of six 60-90-minute weekly yoga-based RISE classes. Sessions will be lead by experienced instructors from Kripalu Center for Yoga & Health. Subjects in this arm will also be asked to participate in 5-10 minutes of daily home practice with direction from the RISE curriculum.	This group will receive no intervention during the study. At the conclusion of the study, this group will receive one free yoga-based class.
Measure Participants	28	16
Baseline	7.56 (0.64)	7.15 (1.13)
Post-program	6.48 (0.54)	7.23 (0.75)
2-month follow-up	7.24 (0.61)	7.81 (0.94)

9. Secondary Outcome

Title	Difference in Sleep Quality
Description	PROMIS Sleep Disturbance (short form, 4 items) - scores from 4-20, higher is more sleep disturbance
Time Frame	Baseline, post-program, and 2-month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intervention (Yoga) Arm	No-treatment Control Arm
Arm/Group Description	This is the group that will receive a weekly 60-90minute yoga-based class for six weeks and direction for a 5-10 minute daily home practice. RISE yoga-based program: The RISE program developed by Kripalu Center for Yoga and Health includes yoga postures, mindfulness practices, meditation, breathing techniques, and education sessions about mindful approaches to daily living. The RISE program will be delivered as a 6-week yoga-based program on-site at Brigham and Women's Hospital in Boston, MA. The program will consist of six 60-90-minute weekly yoga-based RISE classes. Sessions will be lead by experienced instructors from Kripalu Center for Yoga & Health. Subjects in this arm will also be asked to participate in 5-10 minutes of daily home practice with direction from the RISE curriculum.	This group will receive no intervention during the study. At the conclusion of the study, this group will receive one free yoga-based class.
Measure Participants	28	16
Baseline	10.38 (0.62)	11.62 (1.28)
Post-program	8.73 (0.59)	9.92 (0.91)
2-month follow-up	8.96 (0.61)	8.50 (1.02)

10. Secondary Outcome

Title	Difference in Anxiety
Description	Patient Reported Outcomes Measurement Information System (PROMIS) Anxiety (short form: anxiety-4) - scores from 4-20, higher is more anxiety
Time Frame	Baseline, post-program, and 2-month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intervention (Yoga) Arm	No-treatment Control Arm
Arm/Group Description	This is the group that will receive a weekly 60-90minute yoga-based class for six weeks and direction for a 5-10 minute daily home practice. RISE yoga-based program: The RISE program developed by Kripalu Center for Yoga and Health includes yoga postures, mindfulness practices, meditation, breathing techniques, and education sessions about mindful approaches to daily living. The RISE program will be delivered as a 6-week yoga-based program on-site at Brigham and Women's Hospital in Boston, MA. The program will consist of six 60-90-minute weekly yoga-based RISE classes. Sessions will be lead by experienced instructors from Kripalu Center for Yoga & Health. Subjects in this arm will also be asked to participate in 5-10 minutes of daily home practice with direction from the RISE curriculum.	This group will receive no intervention during the study. At the conclusion of the study, this group will receive one free yoga-based class.
Measure Participants	28	16
Baseline	9.65 (0.60)	10.00 (1.00)
Post-program	8.54 (0.59)	9.15 (0.94)
2-month follow-up	8.96 (0.57)	7.94 (0.81)

11. Secondary Outcome

Title	Differences in Professional Fulfillment - Burnout Sub-Item
Description	Professional Fulfillment Index (PFI; 16 items) - scores from 0-4 for the burnout scale; higher is more burnout
Time Frame	Baseline, post-program, and 2-month follow-up

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intervention (Yoga) Arm	No-treatment Control Arm
Arm/Group Description	This is the group that will receive a weekly 60-90minute yoga-based class for six weeks and direction for a 5-10 minute daily home practice. RISE yoga-based program: The RISE program developed by Kripalu Center for Yoga and Health includes yoga postures, mindfulness practices, meditation, breathing techniques, and education sessions about mindful approaches to daily living. The RISE program will be delivered as a 6-week yoga-based program on-site at Brigham and Women's Hospital in Boston, MA. The program will consist of six 60-90-minute weekly yoga-based RISE classes. Sessions will be lead by experienced instructors from Kripalu Center for Yoga & Health. Subjects in this arm will also be asked to participate in 5-10 minutes of daily home practice with direction from the RISE curriculum.	This group will receive no intervention during the study. At the conclusion of the study, this group will receive one free yoga-based class.
Measure Participants	28	16
Baseline	2.26 (0.13)	1.97 (0.23)
Post-program	2.47 (0.15)	2.13 (0.19)
2-month follow-up	2.31 (0.11)	2.02 (0.22)

Adverse Events

Time Frame	2 months
Arm/Group Title	Intervention (Yoga) Arm		No-treatment Control Arm
Arm/Group Description	This is the group that will receive a weekly 60-90minute yoga-based class for six weeks and direction for a 5-10 minute daily home practice. RISE yoga-based program: The RISE program developed by Kripalu Center for Yoga and Health includes yoga postures, mindfulness practices, meditation, breathing techniques, and education sessions about mindful approaches to daily living. The RISE program will be delivered as a 6-week yoga-based program on-site at Brigham and Women's Hospital in Boston, MA. The program will consist of six 60-90-minute weekly yoga-based RISE classes. Sessions will be lead by experienced instructors from Kripalu Center for Yoga & Health. Subjects in this arm will also be asked to participate in 5-10 minutes of daily home practice with direction from the RISE curriculum.		This group will receive no intervention during the study. At the conclusion of the study, this group will receive one free yoga-based class.
All Cause Mortality
	Intervention (Yoga) Arm		No-treatment Control Arm
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/38 (0%)		0/18 (0%)
Serious Adverse Events
	Intervention (Yoga) Arm		No-treatment Control Arm
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/38 (0%)		0/18 (0%)
Other (Not Including Serious) Adverse Events
	Intervention (Yoga) Arm		No-treatment Control Arm
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/38 (0%)		0/18 (0%)

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.

There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.