Online Yoga Pilot Intervention for Black Women at High Cardiovascular Risk: Internet-Based Recruitment and Engagement

Disproportionately adverse heart health outcomes in Black women, characterized by high metabolic syndrome prevalence, underscore the need for innovative, accessible interventions. Digital health strategies, particularly web-based yoga videos, show promise for engaging this high-risk group in health-promoting behaviors.

This study aimed to evaluate the feasibility and acceptability of a web-based yoga intervention for community-dwelling Black women, providing preliminary data to inform a larger, mixed methods study on reducing cardiometabolic risks.

In this 4-week pilot study, grounded in Pender's Health Promotion Model, 28 participants engaged in daily online health education and yoga activities through YouTube videos. Using Fitbit trackers, electronic blood pressure monitors, and web-based logs, the study measured metabolic syndrome risk factors and sedentary behavior. Participant experiences were further explored through postintervention focus groups aiming to contextualize the intervention's impact.

We enrolled 28 women, with a completion rate of 79% (22/28), demonstrating successful recruitment and retention. Participants were an average age of 43.3 years with a mean BMI of 40.9 kg/m², indicating a high-risk group for metabolic syndrome. Engagement with 2 or more intervention components were significantly correlated with study completion (χ²₁=7.14, P=.008). Specifically, viewing over one-half of the instructional videos (χ²₁=4.39, P=.04) and daily blood pressure monitoring (χ²₁=5.67, P=.02) were key to participant adherence. The intervention was well-received, with 95% (19/20) of survey respondents finding it satisfactory and suitable. Technology use was high, with all participants having access to the internet, 96% (27/28) owning smartphones, and 53% (15/28) having a YouTube account prior to the study. Recruitment was effectively conducted online, primarily via Facebook and a university newsletter, each accounting for 39.3% (11/28) of participants. The qualitative focus group data unveiled 4 major themes: (1) accountability, emphasizing the shift toward self-prioritization and collective health responsibility; (2) increased awareness, highlighting enhanced understanding of health behaviors and metabolic syndrome risks; (3) health benefits, noting observed improvements in blood pressure and stress levels; and (4) unanticipated stressors, identifying external factors that challenged engagement. These insights underscore the intervention's multifaceted impact, from fostering health awareness to navigating external stressors.

This pilot study demonstrated the feasibility and acceptability of a culturally tailored, online yoga intervention among community-based, Black women at high risk for metabolic syndrome, showing promising engagement and potential health benefits. The high rates of participation and completion highlight the intervention's acceptability and the potential for digital platforms to facilitate health behavior changes in high-risk populations. The qualitative findings reveal critical insights into the psychological and social dynamics influencing health behavior change, suggesting the importance of addressing both individual and communal barriers to improve intervention efficacy. Future research should further explore these dynamics in larger, more diverse cohorts to substantiate the intervention's potential in reducing cardiometabolic risks.