The impact of a co-created yoga program for women diagnosed with gynecologic cancer on patient-reported outcomes: a series N-of-1 trial.

[OBJECTIVE] Psychosocial oncology supportive care research has focused on adults diagnosed with breast cancer and used conventional group-based analyses that can mask meaningful individual differences. This study aimed to evaluate the effects of a co-created 12-week Hatha yoga program on patient-reported outcomes among women diagnosed with gynecologic cancer, using group- and individual-level analyses to emphasize person-centered processes.

[METHODS] A multiple baseline series N-of-1 trial design was used. Participants self-selected to enroll in a morning or evening program, attending bi-modal 60-min classes twice weekly, complemented by optional group discussions, journaling, and pre-recorded videos for at-home practice. Self-report data were collected online at 9-11 timepoints, spanning baseline (3-5 weeks), program (12 weeks), and follow-up (8 weeks) phases. Data from 20 participants (M = 62.4 years, M = 7.6) were analyzed using visual analysis and hierarchical linear modeling.

[RESULTS] Visual analysis of individual profiles and piecewise models that represent the average rate of change for the sample demonstrated similar results across most outcomes. Collectively, the analyses showed that during the program, quality of life, perceived cognitive abilities, sexual distress, and perceived stress improved (ps < .05), while follow-up fatigue and perceived stress worsened (ps < .05). However, the results of the analyses diverged for negative body image. The overall slope (fixed effect) showed improvement during the program (p < .05); yet, visual analysis of individual profiles suggested variability across participants. Individual-level analyses also revealed divergent responses for 3 participants across outcomes.

[CONCLUSIONS] This study demonstrates the potential of a co-created Hatha yoga program to improve psychosocial outcomes for women with gynecologic cancer, an often underrepresented population in the literature. Findings also highlight the added value of using individual-level analytic approaches, supporting the need for personalized approaches in supportive care. The co-created program represents a promising line of inquiry to meet a pressing need for programs that address the sequelae of gynecologic cancer.

[TRIAL REGISTRATION] ClinicalTrials.gov, no.: NCT05610982; November 3, 2022.