This Mentored Patient-Oriented Research Career Development Award (K23) will prepare the candidate to conduct and advance clinical research focusing on the effectiveness and mechanisms of mind-body practices for patients with chronic disease. Utilizing patients with end-stage renal disease (ESRD) on maintenance hemodialysis (MHD) as a model of chronic disease, the candidate will develop clinical research skills through advanced training and mentorship to conduct clinical research of the therapeutic application of yoga practice during MHD. MHD is a life-sustaining treatment for many patients with ESRD. Despite treatment, patients receiving MHD have significantly decreased quality of life, poor physical function and mood disorders. The ESRD population has a high mortality due to cardiovascular risk factors including hypertension, diabetes, sedentary behavior, autonomic dysfunction, endothelial dysfunction and arterial stiffness. Mind-body practices, such as yoga, may provide a novel therapeutic intervention for patients with ESRD to improve quality of life, symptoms associated with disease, and reduce cardiovascular risk factors. The candidate's short term goals are to gain: 1) methodological skills and experience in clinical research;2) knowledge to measure and interpret cardiovascular and autonomic physiology and behavioral outcomes in clinical studies to characterized mind-body practices and elucidate potential mechanisms of action;3) experience in the implementation of mind-body practices in a chronic disease population i.e. adaptation of yoga therapeutically for patients with ESRD. The candidate has proposed a career development plan which will be guided by mentors and collaborators with expertise in clinical trials, chronic disease, health behavior, physiology, and mind-body practices. Through focused didactics in clinical research methodology and laboratory training to measure relevant cardiovascular physiology, the candidate will acquire the necessary skills to conduct proposed and future research. The proposed research will implement an intra-dialysis yoga protocol and determine feasibility by measuring adherence to practice and fidelity of the intervention in a pilot study (n=12) of yoga among patients on MHD (Specific Aim 1). The candidate will then design and conduct a clinical trial (n=60) of intra-dialysis yoga (IDY) to measure the effect of the practice on health related outcomes including quality of life, physical function, self-efficacy, blood pressure, and mood (Specific Aim 2a). As a sub- study to the clinical trial (n=20), the candidate will investigate potential cardiovascular mechanisms of yoga practice through measurement of endothelial function, arterial stiffness, and autonomic tone among patients on MHD (Specific Aim 2b). MHD provides an innovative setting to apply the mind-body practices, by facilitating access to this chronic disease population, quantification of yoga dose, and collection of outcome variables. These projects will inform and advance implementation of MBP for patients with chronic disease. Importantly, the proposed research will provide the candidate with hands-on clinical research experience to develop into a successful independent investigator trained to implement and evaluate mind-body practices for patients with chronic disease.

Public Health Relevance

While mind-body practices, including yoga, are frequently used by individuals for health prevention and treatment of disease, rigorous research on translation of these practices into a therapeutic context is lacking. This application will inform future research on development, implementation, and mechanisms of mind-body practices for patients with chronic disease.

National Institute of Health (NIH)
National Center for Complementary & Alternative Medicine (NCCAM)
Mentored Patient-Oriented Research Career Development Award (K23)
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Special Emphasis Panel (ZAT1)
Program Officer
Khalsa, Partap Singh
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Vanderbilt University Medical Center
Internal Medicine/Medicine
Schools of Medicine
United States
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Birdee, Gurjeet S; Ayala, Sujata G; Wallston, Kenneth A (2017) Cross-sectional analysis of health-related quality of life and elements of yoga practice. BMC Complement Altern Med 17:83
Sohl, Stephanie J; Danhauer, Suzanne C; Birdee, Gurjeet S et al. (2016) A brief yoga intervention implemented during chemotherapy: A randomized controlled pilot study. Complement Ther Med 25:139-42
Sohl, Stephanie J; Wallston, Kenneth A; Watkins, Keiana et al. (2016) Yoga for Risk Reduction of Metabolic Syndrome: Patient-Reported Outcomes from a Randomized Controlled Pilot Study. Evid Based Complement Alternat Med 2016:3094589
Sohl, Stephanie J; Birdee, Gurjeet S; Ridner, Sheila H et al. (2016) Intervention Protocol for Investigating Yoga Implemented During Chemotherapy. Int J Yoga Therap 26:103-111
Sohl, Stephanie Jean; Birdee, Gurjeet; Elam, Roy (2016) Complementary Tools to Empower and Sustain Behavior Change: Motivational Interviewing and Mindfulness. Am J Lifestyle Med 10:429-436
Birdee, Gurjeet S; Sohl, Stephanie J; Wallston, Ken (2016) Development and Psychometric Properties of the Yoga Self-Efficacy Scale (YSES). BMC Complement Altern Med 16:3
Birdee, Gurjeet S; Rothman, Russell L; Sohl, Stephanie J et al. (2015) Feasibility and Safety of Intradialysis Yoga and Education in Maintenance Hemodialysis Patients. J Ren Nutr 25:445-53
Birdee, Gurjeet S; Kemper, Kathi J; Rothman, Russell et al. (2014) Use of complementary and alternative medicine during pregnancy and the postpartum period: an analysis of the National Health Interview Survey. J Womens Health (Larchmt) 23:824-9
Sohl, Stephanie J; Weaver, Kathryn E; Birdee, Gurjeet et al. (2014) Characteristics associated with the use of complementary health approaches among long-term cancer survivors. Support Care Cancer 22:927-36
Birdee, Gurjeet S; Byrne, Daniel W; McGown, Paula W et al. (2013) Relationship between physical inactivity and health characteristics among participants in an employee-wellness program. J Occup Environ Med 55:514-9

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