A Restorative Yoga Intervention for African-American Breast Cancer Survivors: a Pilot Study

  • Teletia R. TaylorEmail author
  • Judith Barrow
  • Kepher Makambi
  • Vanessa Sheppard
  • Sherrie Flynt Wallington
  • Chloe Martin
  • Danyella Greene
  • Sri Lakshmi Hyndavi Yeruva
  • Sara Horton



Data show that yoga is effective for improving health-related outcomes in breast cancer survivors. While breast cancer is the most commonly diagnosed cancer among African-American women (AAW), AAW are less likely to engage in yoga compared to other ethnic groups. The goals of the current study were to assess the feasibility of an 8-week restorative yoga program among African-American breast cancer survivors (AA BCS). Specifically, study aims were to (1) measure changes in study outcomes in a restorative yoga (RY) group compared to a wait list control group, (2) assess adherence to the RY program, and (3) assess program satisfaction among study participants.


Thirty-three AA BCS were randomly assigned to either the RY intervention (n = 18) or wait list control group (n = 15). RY classes met once per week for 8 weeks. Pre- and post-testing assessments were measured at 0 and 8 weeks (immediately post-intervention).


Depression scores at follow-up were significantly lower in the yoga group (M = 4.78, SD = 3.56) compared to the control group (M = 6.91, SD = 5.86). No significant group differences were observed for sleep quality, fatigue, or perceived stress. Yoga program participants completing baseline assessments demonstrated 61% adherence to the yoga classes. Average rating of the yoga program was “very useful.” Recommendations for future yoga programs were provided.


This study suggests that yoga has a beneficial effect on depression in AA BCS. There is, however, a need to further explore the benefits of yoga among minority breast cancer survivors using a study with larger sample sizes.


African-American Breast cancer survivors Yoga 



This project has been funded in whole or in part with Federal funds (UL1TR001409 previously UL1TR000101) from the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, through the Clinical and Translational Science Awards Program (CTSA), a trademark of DHHS, part of the Roadmap Initiative, “Re-Engineering the Clinical Research Enterprise.”

Compliance with Ethical Standards

Human Subjects Statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all participants included in this study. The Georgetown-Howard Universities Center for Clinical and Translational Science Institutional Review Board approved the study that this manuscript is based on (Dr. Teletia R. Taylor, Principal Investigator).

Conflict of Interest

The authors declare that they have no conflict of interest.


  1. 1.
    American Cancer Society. Cancer facts and figures for African Americans 2013–2014. American Cancer Society 2013.Google Scholar
  2. 2.
    Courneya KS, Friedenreich CM. Physical exercise and quality of life following cancer diagnosis: a literature review. Ann Behav Med. 1999;21:171–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Courneya KS. Exercise in cancer survivors: an overview of research. Med Sci Sports Exerc. 2003;35:1846–52.CrossRefPubMedGoogle Scholar
  4. 4.
    Buffart LM, van Uffelen JG, Riphagen II, Brug J, van Mechelen W, Brown WJ, Chinapaw MJ. Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials. BMC Cancer. 2012;12:559. 2407-12-559CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Courneya KS, McKenzie DC, Reid RD, Mackey JR, Gelmon K, Friedenreich CM, Ladha AB, Proulx C, Lane K, Vallance JK, Segal RJ. Barriers to supervised exercise training in a randomized controlled trial of breast cancer patients receiving chemotherapy. Ann Behav Med. 2008;35:116–22.CrossRefPubMedGoogle Scholar
  6. 6.
    Rogers LQ, Courneya KS, Verhulst S, Markwell SJ, McAuley E. Factors associated with exercise counseling and program preferences among breast cancer survivors. J Phys Act Health. 2008;5:688–705.CrossRefPubMedGoogle Scholar
  7. 7.
    Whitehead S, Lavelle K. Older breast cancer survivors’ views and preferences for physical activity. Qual Health Res. 2009;19:894–906.CrossRefPubMedGoogle Scholar
  8. 8.
    Perna FM, Craft L, Carver CS, Antoni MH. Negative affect and barriers to exercise among early stage breast cancer patients. Health Psychol. 2008;27:275–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Courneya KS, Friedenreich CM, Quinney HA, Fields AL, Jones LW, Fairey AS. Predictors of adherence and contamination in a randomized trial of exercise in colorectal cancer survivors. Psychooncology. 2004;13:857–66.CrossRefPubMedGoogle Scholar
  10. 10.
    National Center for Health Statistics. National Health Interview Survey, 2000, 2013, and 2014. Public-use data file and documentationGoogle Scholar
  11. 11.
    Lipton L. Using yoga to treat disease: an evidence-based review. JAAPA. 2008;21:34–6. 38, 41PubMedGoogle Scholar
  12. 12.
    Ross A, Thomas S. The health benefits of yoga and exercise: a review of comparison studies. J Altern Complement Med. 2010;16:3–12.CrossRefPubMedGoogle Scholar
  13. 13.
    Cramer H, Lange S, Klose P, Paul A, Dobos G. Yoga for breast cancer patients and survivors: a systematic review and meta-analysis. BMC Cancer. 2012;12:412. 2407-12-412CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Harder H, Parlour L, Jenkins V. Randomised controlled trials of yoga interventions for women with breast cancer: a systematic literature review. Support Care Cancer. 2012;20:3055–64.CrossRefPubMedGoogle Scholar
  15. 15.
    Danhauer SC, Mihalko SL, Russell GB, Campbell CR, Felder L, Daley K, Levine EA. Restorative yoga for women with breast cancer: findings from a randomized pilot study. Psychooncology. 2009;18:360–8.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Birdee GS, Legedza AT, Saper RB, Bertisch SM, Eisenberg DM, Phillips RS. Characteristics of yoga users: results of a national survey. J Gen Intern Med. 2008;23:1653–8.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Moadel AB, Shah C, Wylie-Rosett J, Harris MS, Patel SR, Hall CB, Sparano JA. Randomized controlled trial of yoga among a multiethnic sample of breast cancer patients: effects on quality of life. J Clin Oncol. 2007;25:4387–95.CrossRefPubMedGoogle Scholar
  18. 18.
    American College of Sports Medicine. Guidelines for graded exercise testing and prescription. 4th ed. Philadelphia: Lea & Febiger; 1991.Google Scholar
  19. 19.
    Godin G, Shephard RJ. Godin Leisure-Time Exercise Questionnaire. Medicine and science in sports and exercise 1997; 29 June Supplement: S36–8.Google Scholar
  20. 20.
    Amireault S, Godin G, Lacombe J, Sabiston CM. The use of the Godin-Shephard Leisure-Time Physical Activity Questionnaire in oncology research: a systematic review. BMC Med Res Methodol. 2015;15:60. 015-0045-7CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Mendoza TR, Wang XS, Cleeland CS, Morrissey M, Johnson BA, Wendt JK, Huber SL. The rapid assessment of fatigue severity in cancer patients: use of the Brief Fatigue Inventory. Cancer. 1999;85:1186–96.CrossRefPubMedGoogle Scholar
  22. 22.
    Taylor TR, Huntley ED, Makambi K, Sween J, Adams-Campbell LL, Frederick W, Mellman TA. Understanding sleep disturbances in African-American breast cancer survivors: a pilot study. Psychooncology. 2012;21:896–902.CrossRefPubMedGoogle Scholar
  23. 23.
    Bastien CH, Vallieres A, Morin CM. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med. 2001;2:297–307.CrossRefPubMedGoogle Scholar
  24. 24.
    Radloff LS. CES-D scale: a self-report depression scale for research in the general populations. Appl Psychol Meas. 1977;1:385–401.CrossRefGoogle Scholar
  25. 25.
    Makambi KH, Williams CD, Taylor TR, Rosenberg L, Adams-Campbell LL. An assessment of the CES-D scale factor structure in black women: The Black Women’s Health Study. Psychiatry Res. 2009;168:163–70.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24:385–96.CrossRefPubMedGoogle Scholar
  27. 27.
    Lee EH. Review of the psychometric evidence of the perceived stress scale. Asian Nurs Res (Korean Soc Nurs Sci). 2012;6:121–7.CrossRefGoogle Scholar
  28. 28.
    Hofman M, Ryan JL, Figueroa-Moseley CD, Jean-Pierre P, Morrow GR. Cancer-related fatigue: the scale of the problem. Oncologist. 2007;12(Suppl 1):4–10.CrossRefPubMedGoogle Scholar
  29. 29.
    Ancoli-Israel S, Moore PJ, Jones V. The relationship between fatigue and sleep in cancer patients: a review. Eur J Cancer Care (Engl). 2001;10:245–55.CrossRefGoogle Scholar
  30. 30.
    Berger AM, Parker KP, Young-McCaughan S, Mallory GA, Barsevick AM, Beck SL, Carpenter JS, Carter PA, Farr LA, Hinds PS, Lee KA, Miaskowski C, Mock V, Payne JK, Hall M. Sleep wake disturbances in people with cancer and their caregivers: state of the science. Oncol Nurs Forum. 2005;32:E98–126.CrossRefPubMedGoogle Scholar
  31. 31.
    Lewis PE, Sheng M, Rhodes MM, Jackson KE, Schover LR. Psychosocial concerns of young African American breast cancer survivors. J Psychosoc Oncol. 2012;30:168–84.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Von Ah DM, Russell KM, Carpenter J, Monahan PO, Qianqian Z, Tallman E, Ziner KW, Storniolo AM, Miller KD, Giesler RB, Haase J, Otte J, Champion VL. Health-related quality of life of African American breast cancer survivors compared with healthy African American women. Cancer Nurs. 2012;35:337–46.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Bower JE, Greendale G, Crosswell AD, Garet D, Sternlieb B, Ganz PA, Irwin MR, Olmstead R, Arevalo J, Cole SW. Yoga reduces inflammatory signaling in fatigued breast cancer survivors: a randomized controlled trial. Psychoneuroendocrinology. 2014;43:20–9.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Bower JE, Ganz PA, Irwin MR, Arevalo JM, Cole SW. Fatigue and gene expression in human leukocytes: increased NF-kappaB and decreased glucocorticoid signaling in breast cancer survivors with persistent fatigue. Brain Behav Immun. 2011;25:147–50.CrossRefPubMedGoogle Scholar
  35. 35.
    Banasik J, Williams H, Haberman M, Blank SE, Bendel R. Effect of Iyengar yoga practice on fatigue and diurnal salivary cortisol concentration in breast cancer survivors. J Am Acad Nurse Pract. 2011;23:135–42.CrossRefPubMedGoogle Scholar
  36. 36.
    Antonova L, Aronson K, Mueller CR. Stress and breast cancer: from epidemiology to molecular biology. Breast Cancer Res. 2011;13:208.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Theobald DE. Cancer pain, fatigue, distress, and insomnia in cancer patients. Clin Cornerstone. 2004;6(Suppl 1D):S15–21.CrossRefPubMedGoogle Scholar
  38. 38.
    Culos-Reed SN, Carlson LE, Daroux LM, Hately-Aldous S. A pilot study of yoga for breast cancer survivors: physical and psychological benefits. Psychooncology. 2006;15:891–7.CrossRefPubMedGoogle Scholar
  39. 39.
    Joseph RP, Keller C, Affuso O, Ainsworth BE. Designing culturally relevant physical activity programs for African-American women: a framework for intervention development. J Racial Ethn Health Disparities 2016.Google Scholar

Copyright information

© W. Montague Cobb-NMA Health Institute 2017

Authors and Affiliations

  • Teletia R. Taylor
    • 1
    Email author
  • Judith Barrow
    • 2
  • Kepher Makambi
    • 3
  • Vanessa Sheppard
    • 4
  • Sherrie Flynt Wallington
    • 4
  • Chloe Martin
    • 5
  • Danyella Greene
    • 5
  • Sri Lakshmi Hyndavi Yeruva
    • 1
  • Sara Horton
    • 1
  1. 1.College of MedicineHoward UniversityWashingtonUSA
  2. 2.Community Outreach AssociatesWashingtonUSA
  3. 3.Department of Biostatistics, Bioinformatics, and BiomathematicsGeorgetown UniversityWashingtonUSA
  4. 4.Georgetown-Lombardi Comprehensive Cancer CenterWashingtonUSA
  5. 5.Department of PsychologyHoward UniversityWashingtonUSA

Personalised recommendations