NCT02925481

Brief Summary

Each year more than 26,000 pregnancies in the United States end in stillbirth (late fetal death at \>20 weeks of gestation). A 2011 issue of the Lancet, dedicated entirely to stillbirth, recognized it as a "too-often-ignored" public health problem despite occurring once in every 160 pregnancies. The death of a baby is highly traumatic and can incite negative mental, emotional, and physical health consequences lasting years after the loss. Bereaved mothers with stillbirth have a 4-fold higher risk of depression and 6-fold higher risk for post-traumatic stress disorder (PTSD). These mental health consequences are likely to negatively affect subsequent pregnancies, many of which occur within the first year after loss (50-98%). Inter-conception care is provided to women of reproductive age between pregnancies; however, few interventions focus on PTSD symptomatology and its related comorbidities in bereaved mothers. Treatment for bereaved mothers may include psychiatric medication and/or referral to support groups. Because bereaved mothers with stillbirth may have additional mental and physical health risks, pharmacological interventions are typically a first and sole line of treatment and may not sufficiently allay bereaved mothers' emotional distress. Moreover, women may be trying to conceive or may have already conceived and report reticence to taking medication. Additionally, support groups with little emphasis on coping may not be helpful for some grieving mothers. Non-pharmacological approaches, such as yoga, may be an alternative option for bereaved women with stillbirth. Yoga has been established as an effective, safe, acceptable, and cost effective approach to improving mental health in a variety of populations, including pregnant and post-partum women. Yoga has also been used as a means to cope with PTSD associated with surviving a traumatic event (i.e., interpersonal violence, military veterans). The investigators are unaware of any studies that have explored yoga to reduce PTSD in bereaved mothers with stillbirth. Furthermore, online streaming yoga (on-demand videos played in the home) has recently grown in popularity and may address the unique barriers that women experiencing stillbirth may have. To reduce PTSD symptoms and its co-morbid conditions (i.e., anxiety and depression) the investigators propose to develop and test the feasibility and acceptability of a home-based, online streamed yoga intervention (www.udaya.com) for bereaved mothers with stillbirth.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
90

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Apr 2016

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

April 1, 2016

Completed
6 months until next milestone

First Submitted

Initial submission to the registry

October 4, 2016

Completed
2 days until next milestone

First Posted

Study publicly available on registry

October 6, 2016

Completed
2.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2019

Completed
Last Updated

August 29, 2019

Status Verified

August 1, 2019

Enrollment Period

3.2 years

First QC Date

October 4, 2016

Last Update Submit

August 28, 2019

Conditions

Keywords

YogaPTSDmental healthstillbirth

Outcome Measures

Primary Outcomes (1)

  • Clinically elevated levels of PTSD (according to IES-R)

    12 weeks

Secondary Outcomes (10)

  • Impact of Events Survey (IES-R)

    12 weeks post baseline

  • State-Trait Anxiety Inventory

    12 weeks post baseline

  • Patient Health Questionnaire (PHQ-9)

    12 weeks post baseline

  • Perinatal Grief Scale (PGS)

    12 weeks post baseline

  • Self-Compassion Scale

    12 weeks post baseline

  • +5 more secondary outcomes

Study Arms (3)

Low dose Yoga

EXPERIMENTAL

12 week online yoga for 60 minutes per week

Behavioral: Low dose online yoga participation

Moderate dose Yoga

EXPERIMENTAL

12 week online yoga for 150 minutes per week

Behavioral: Moderate Online yoga participation

Stretch and toning

ACTIVE COMPARATOR

12 week online stretching, toning exercises for 60 minutes per week

Behavioral: Stretching and toning

Interventions

Phase 1: Testing yoga videos for emotional regulation and self-compassion which will inform the selected videos for Phase 2 prescription Phase 2: 150 minutes of Online streaming yoga videos completed at home. Week 1/2 introductory videos that include short video clips breaking down each pose Weeks 3-12 increase in difficulty (all videos are appropriate for beginners)

Also known as: MD
Moderate dose Yoga

Phase 1: Developing 12 week prescription for online control videos Phase 2: Online streaming stretching and toning videos completed at home which consist of a warm-up, 1 balance, 2 core, 2-3 upper body and lower body exercises, 6 stretches, cool-down

Also known as: STC
Stretch and toning

Phase 1: Testing yoga videos for emotional regulation and self-compassion which will inform the selected videos for Phase 2 prescription Phase 2: 60 minutes of Online streaming yoga videos completed at home. Week 1/2 introductory videos that include short video clips breaking down each pose Weeks 3-12 increase in difficulty (all videos are appropriate for beginners)

Also known as: LD
Low dose Yoga

Eligibility Criteria

Age18 Years+
Sexfemale
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Women who experienced stillbirth (\>20 wks gestation) within past 24 mos
  • Clinical levels posttraumatic stress symptoms (\>33 as measured by the IES-R)
  • ≥ 18 yrs of age
  • Residing in U.S.
  • Able to read/understand English
  • Underactive (≤120 mins/wk moderate intensity PA)
  • Willing to be randomized
  • Answer "no" to all items on PA Readiness Questionnaire (can participate safely), or if a woman answers "yes" to one or more questions on the PAR-Q, she will be asked to obtain medical clearance from her physician prior to participation in the study. Women will be given two options in which to demonstrate medical clearance (a) bring a form provided by the study team to their health care provider to obtain a signature from a physician and then email, fax, or mail the signed medical clearance form to the research personnel, or (b) sign and fax a release of information form to research personnel, who will then send the medical clearance form directly to their designated health care providers' office to obtain a physician signature.

You may not qualify if:

  • Unstable psychiatric condition (psychosis; suicidal ideation with plan)
  • Pregnant at time of enrollment
  • Practicing yoga at least 60 mins/wk
  • Unwilling to be randomized to a group.
  • At risk for suicide based on follow-up phone assessment by a trained contact person under supervision of Dr. Cacciatore after positive screen
  • (PHQ-9 score of 1, 2, or 3)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Arizona Biomedical Collaborative

Phoenix, Arizona, 85004, United States

Location

Related Publications (2)

  • Huberty J, Sullivan M, Green J, Kurka J, Leiferman J, Gold K, Cacciatore J. Online yoga to reduce post traumatic stress in women who have experienced stillbirth: a randomized control feasibility trial. BMC Complement Med Ther. 2020 Jun 5;20(1):173. doi: 10.1186/s12906-020-02926-3.

  • Huberty J, Matthews J, Leiferman J, Cacciatore J, Gold KJ. A study protocol of a three-group randomized feasibility trial of an online yoga intervention for mothers after stillbirth (The Mindful Health Study). Pilot Feasibility Stud. 2017 Jul 6;4:12. doi: 10.1186/s40814-017-0162-7. eCollection 2018.

MeSH Terms

Conditions

Stress Disorders, Post-TraumaticPsychological Well-BeingStillbirth

Condition Hierarchy (Ancestors)

Stress Disorders, TraumaticTrauma and Stressor Related DisordersMental DisordersPersonal SatisfactionBehaviorFetal DeathPregnancy ComplicationsFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesDeathPathologic ProcessesPathological Conditions, Signs and Symptoms

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor in the School of Nutrition and Health Promotion

Study Record Dates

First Submitted

October 4, 2016

First Posted

October 6, 2016

Study Start

April 1, 2016

Primary Completion

June 1, 2019

Study Completion

June 1, 2019

Last Updated

August 29, 2019

Record last verified: 2019-08

Locations