Larkey, Linda

Importance Hispanic adults with type 2 diabetes (T2D) are more likely to develop complications and die from the disease than the US general population. Digital storytelling interventions are narrative-based videos elicited through a community-based participatory research approach to surface the authentic voices of participants overcoming obstacles to health-promoting behaviors that perpetuate health inequities; research on the effect of digital storytelling on T2D outcomes among Hispanic adults is lacking. Objective To assess the impact of a digital storytelling intervention on glycemic control and its acceptability among Hispanic patients with poorly controlled T2D. Design, Setting, and Participants This was a multicenter, randomized clinical trial conducted within 2 primary care networks in Minnesota and Arizona among Hispanic adults with poorly controlled T2D (hemoglobin A 1c level ≥8%). Enrollment and follow-up were conducted between February 14, 2019, and November 1, 2023. Intervention The intervention group viewed a 12-minute digital storytelling video. The video included 4 Spanish-language stories that reinforced 4 diabetes self-management behavioral goals (healthful diet for diabetes, physical activity, medication adherence, and glucose self-monitoring). The control group received printed, culturally tailored T2D education materials. Main Outcomes and Measures The primary outcome was the mean change from baseline to 3 months for hemoglobin A 1c levels, adjusting for baseline hemoglobin A 1c , age, gender, education, and income. Acceptability and narrative quality of the intervention were assessed through questionnaires. Results There were 451 study participants, with 227 (mean [SD] age, 54.3 [9.3] years; 158 [69.3%] women) randomized to the intervention group and 224 (mean [SD] age, 54.5 [9.1] years; 156 [69.3%] women) to the control group. Of these, 390 completed 3-month follow-up of the primary outcome (86% retention). There was a small improvement in the mean (SD) hemoglobin A 1c level in the intervention group compared with the control group in the adjusted model (9.1% [1.7] to 8.4% [1.6] vs 9.4% [1.8] to 8.8% [2.0]; P = .04] but not in the unadjusted model. Acceptability and narrative quality of the intervention were high. Conclusions and Relevance In this randomized clinical trial, a digital storytelling intervention developed with and for Hispanic adults with T2D was highly acceptable and feasibly implemented within primary care settings and resulted in a modest improvement of glycemic control. This was a highly scalable intervention that may be integrated into clinical practice as part of a longitudinal diabetes self-management program for Hispanic adults. Trial Registration ClinicalTrials.gov Identifier: NCT03766438

Introduction: The delivery of online interventions in cancer patients/survivors has increased. The measurement of participation in online interventions is important to consider, namely, the challenges of the remote assessment of activity. The purpose of this study was to report the measures used to assess intervention compliance and other physical activity participation in two online yoga studies, the relationship between the multimethod measures used, and the ability of cancer patients to complete these measures. Methods: The methods described are of two online yoga studies (feasibility and pilot). Cancer patients were asked to participate in 60 min/week of online yoga for 12 weeks, complete a weekly yoga log, wear a Fitbit daily for 12 weeks, and complete a weekly physical activity log. Finally, Clicky®, a web analytics software, was used to track online yoga participation. Results: Eighty-four people participated across both studies, with 63/84 participating in online yoga, averaging 57.5 ± 33.2 min/week of self-reported yoga participation compared to 41.4 ± 26.1 min/week of Clicky® yoga participation (Lin concordance = 0.28). All 84 participants averaged 95.5 ± 111.8 min/week of self-reported moderate/vigorous physical activity compared with 98.1 ± 115.9 min/week of Fitbit-determined moderate/vigorous physical activity (Lin concordance = 0.33). Across both studies, 82.9% of the yoga logs were completed, the Fitbit was worn on 75.2% of the days, and 78.7% of the physical activity logs were completed. Conclusions: Weak relationships between self-report and objective measures were demonstrated, but the compliance rates were above 75% for the study measures. Future research is needed, investigating the intricacies of self-report physical activity participation in remote interventions and the validation of a gold standard measurement for online interventions.

Abstract Purpose: The purpose of this study was to qualitatively analyze metacommunication during the digital storytelling (DST) workshop process for patients undergoing hematopoietic cell transplantation (HCT). Methods: HCT survivors who had undergone transplant within the past 2 years were recruited at a cancer center in the Phoenix Metropolitan area. Participants (M age = 51.5 years) attended a 3-day DST workshop telling and creating digital stories around their HCT experiences. Using a constructivist grounded theory approach, line by line coding and content analysis were conducted with four research team members. Results: Four themes emerged from the data: (1) communal connection; (2) expressing and processing emotions; (3) self-empowerment; and (4) multi-dimensional coping. Participants described telling and sharing their story with other HCT patients as therapeutic. Conclusion: DST shows promise as a potential coping tool and offers multiple dimensions of the role of narrative as a coping technique, in community building, and in patient-centered contexts within HCT.

Myeloproliferative neoplasms (MPNs) are rare hematological malignancies with a significant symptom burden often left unresolved despite recent advances in pharmacological therapy. Yoga is a nonpharmacological strategy that has been shown to improve symptoms in other cancers and may be effective for improving symptoms in MPN patients. Online yoga helps address many of the commonly reported barriers of cancer patients to in-person interventions and may make yoga more accessible to MPNs. An exploration of MPN patient perceptions of participation in online yoga is needed to tailor interventions to patient needs and inform future studies. The purpose of this study was to explore the perceptions of MPN patients participating in a 12-week online yoga intervention. This article represents the combined qualitative interview data from two studies. Participants were asked to complete 60 min/wk of online, home-based yoga and were asked to participate in a 15- to 20-minute phone interview postintervention. The qualitative data was coded in NVivo 11 for content analysis. The total sample included 39 MPN patients. Online yoga was well accepted and liked among these patients. They reported physical (eg, improved sleep, reduced fatigue) and mental (eg, reduced stress) health benefits and liked the convenience of being able to do yoga at home. Online yoga provides a feasible and attractive format through which to deliver a nonpharmacological intervention among MPN patients. Randomized controlled trials are needed to confirm the effects of online yoga on MPN patient symptoms. The qualitative findings presented here help inform the development of these future trials.

e21704 Background: Patients with myeloproliferative neoplasms (MPN) have difficult symptom burden (i.e. fatigue, pruritus, night sweats) not resolved by current medical therapies including jak inhibitor therapy. We hypothesize that on-line (at home) yoga might alleviate MPN symptoms and complement medical therapy. Methods: MPN patients, recruited by social media, were asked to complete 60 min/week of online yoga (designed for MPN patients) for 12 weeks and completed online self-report surveys (weeks 0,7,12 and 16) on participation (Qualtrics), disease features, and symptom burden (MPN Symptom Assessment Form; NIH PROMIS measures of pain, anxiety, depression, sleep, and sexual function). Results: Two hundred and forty-four MPN patients completed the eligibility survey, 134 were eligible, 55 completed the informed consent, and 38 MPN patients completed the 12-week intervention. The majority of participants were diagnosed with either PV (n = 16) or ET (n = 16), with MF being less common (n = 6). Approximately 37% (n = 14) of study participants averaged ≥60 min/week of yoga (i.e., demand). Yoga participation averaged 50.8±36.2 min/week. Overall, 68% of participants were satisfied with online yoga and 75% felt that is was helpful for coping with MPN-related symptoms (i.e., acceptability, practicality). Additionally, 75% of participants felt safe from injury while participating in online yoga. Only one adverse event was reported (irritated enlarged spleen). From week 0 to week 12 (n = 38), there were significant improvements in total symptom burden (effect size [ES] in standard deviation units = -0.36, p = 0.004), anxiety (ES = -0.67, p = 0.002), depression (ES = -0.41, p = 0.049), sleep (ES = -0.58, p < 0.001), and fatigue (ES = -0.33, p = 0.04). These improvements remained significant at follow-up week 16 (n = 28) for all outcome measures with a trend for maintained fatigue improvement (ES = -0.34, p = 0.06) (see Table 1). There were no significant differences in outcomes between those that averaged < 60 min/week of yoga compared to those that averaged ≥60 min/week of yoga. Conclusions: A 12-week online yoga intervention is feasible (i.e., accepted, practical) for MPN patients and merits a randomized trial as complementary therapy.