Exploring Yoga Adherence, Experiences, Future Preferences and Barriers in the Medical University Community, A 6-Week Study

Exploring Yoga Adherence, Experiences, Future Preferences and Barriers in the Medical University Community, A 6-Week Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Exploring Yoga Adherence, Experiences, Future Preferences and Barriers in the Medical University Community, A 6-Week Study Fauzia Nausheen, Shazia Sheikh, Paul Lyons This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4219022/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 12 You are reading this latest preprint version Abstract Background Despite yoga's known benefits for physical and mental health, studies face challenges like small samples and high attrition, especially with medical professionals showing low adherence to yoga practices. Objectives This study aimed to assess yoga practice adherence, participant experiences, future preferences, and its impact on participants' emotional states over a 6-week period. Methods the comprehensive yoga adherence program, developed and guided by a Principal Investigator (PI), a medical doctor and a certified yoga instructor, included a 30-minute instructional video and weekly motivational messages and reminders. The video, accessible on various devices, was divided into pre-yoga stretches, yogic asanas, breathing exercises, and guided meditation. The study involved 15 participants from diverse backgrounds, including medical students, staff, and faculty members (above 18 years of age). Data collection was through three surveys, focusing on daily adherence, practice frequency, reasons for missed sessions, emotional states post-practice, and future yoga practice preferences. Results On average, participants engaged in yoga practice four days per week, with 17% practicing daily.: 20% of participants discontinued the practice during the study. The majority reported feeling relaxed and happy after sessions, and none felt tired or bored. Common barriers to adherence included lack of time, motivation, and preference for alternative workouts. Participants expressed a strong desire to continue practicing yoga in the future, with varied preferences for virtual or in-person practice formats. Conclusion The study offers insights into the implementation challenges and feasibility of a comprehensive yoga adherence program. It highlights factors influencing participants' adherence and future practice preferences, contributing to effective strategies for promoting regular yoga practice and integrating it into wellness routines. The findings emphasize the need for tailored support to address diverse barriers to adherence and preferences for yoga formats. While there was significant adherence, understanding these factors is crucial for tailoring future programs to enhance participation and adherence. Introduction Yoga, an ancient spiritual practice with its roots in Indian philosophy, has gained widespread popularity in the United States, primarily as a combination of physical postures (Asanas), controlled breathing (Pranayama), and meditation (Dhyana). Recent research indicates that approximately 14% of U.S. adults have explored the practice of yoga. Among these practitioners, the most prevalent motive for yoga participation is wellness (94%), with others seeking its potential health benefits. 1 Yoga has acquired significant attention in the medical community due to its potential health benefits. Recent research by the National Institutes of Health (NIH) and the National center of Complimentary and Integrative Health NCCIH has demonstrated its positive impact on various health conditions, including stress, anxiety, depression, sleep, physical and mental balance, low-back pain, neck pain, tension-type headaches, knee osteoarthritis, weight management, menopausal symptom relief, and smoking cessation. 1,2,3,4,5 However, many studies have faced limitations, including small sample sizes and high attrition rates. Historically, the daily practice of yoga and meditation has been recommended for achieving optimal physical and psychological benefits, making it an integral part of a healthy lifestyle. Yet, the lack of adherence to regular practice and the limited support for its widespread acceptability presents challenges to studying the impact of yoga, particularly among the medical community. Despite high initiation rates of yoga and meditation practices among medical practitioners and students, adherence remains remarkably low, with an attrition rate of nearly 90%. 6,7 We posit that the participation of medical students, clinicians, and faculty in yoga practices is particularly advantageous, given the high prevalence of burnout, depression, and anxiety within this demographic. 8 Yoga and mindfulness practices have the potential to create more resilient healthcare professionals and educators. Research also suggests that healthcare providers who practice yoga are more likely to recommend it to their patients based on their personal experiences and knowledge. 6 While historical barriers to yoga adherence included issues like laziness, procrastination, and physical and mental overexertion, contemporary barriers can be categorized into two main groups: strong and moderate barriers. The most suggested modern-day barriers include a lack of awareness about the benefits of yoga, unfamiliarity with appropriate yoga poses, irregular lifestyles, scheduling conflicts, lack of motivation, family commitments, work-related obligations, doubts about the efficacy of yoga, and a lack of social support. Less significant barriers include perceptions that yoga is physically demanding, preferring other forms of exercise, concerns about the quality of yoga instructors, and uncertainty about the type of yoga that suits their needs. 9,10,11 With the implementation of specific strategies, we believe that yoga adherence can be achieved among medical students, clinicians, and faculty. To develop these strategies, we conducted a pilot project of a virtual yoga program to investigate adherence to yoga and perceived barriers to daily yoga practice within our medical university community. Our study had three primary objectives: Develop a user-friendly yoga program, including simple poses and guided meditation, to address barriers related to a lack of awareness about the benefits, ease of yoga poses, scheduling conflicts, and access to reliable yoga instructors. Assess recruitment and attrition rates, as well as the frequency of yoga adherence and the barriers hindering consistent practice. Create effective models for promoting long-term yoga adherence within the medical university community. Institution Review Board, Approval Statement: The study received ethical approval from the Institutional Review Board (IRB) at CUSM (#HS-2023-32). Materials and Methods We designed a comprehensive yoga adherence program featuring a 30-minute video encompassing pre-yoga stretches, fundamental yogic asanas, yogic breathing exercises, and guided meditation. The Principal Investigator (PI), a medical doctor and certified yoga instructor, offered guidance throughout the program, delivering weekly motivational messages and reminders via email. Recruitment procedures involved virtual and in-person meetings, led by the PI, who also served as the yoga teacher. The 6-week study collected data through a series of three surveys. These surveys assessed participants' daily adherence to the program, frequency of practice, reasons for missed sessions, and post-practice emotional states. Additionally, participants were asked in the final survey if they wished to continue the practice in the future and, if so, which format they preferred for their yoga practice. The study received ethical approval from the Institutional Review Board (IRB) at CUSM (#HS-2023-32). The instructional video featured detailed guidance, with the yoga instructor leading the yoga session. The video was divided into three segments: the first 10 minutes comprised simple pre-yoga stretches, followed by 10 minutes of basic yogic asanas, based on the PI's training from "The Yoga Institute" an authenticated yoga training center in India. The final 10 minutes included yogic breathing exercises, calming sounds, and guided meditation, aligning with the PI's additional training from the mindfulness-based stress reduction course. The video was accessible on both phones and computers, with closed captioning and audio options available. The yoga instructor was the PI, who holds the positions of MD, professor of medical education, and assistant dean of wellness. Additionally, the yoga program featured a system for sending participants weekly motivational messages and reminders via email. Recruitment procedures involved sending invitations to potential participants via email. Initial recruitment occurred through live virtual, or in-person meetings conducted by the PI/yoga teacher to assess the suitability of participants for the yoga practice and to facilitate the signing of consent forms. Informed consent was obtained from all subjects. The study spanned six weeks and involved the collection of data through three surveys distributed during the study period. These surveys included questions to monitor daily adherence, identify reasons for missing practice sessions, and assess participants' emotional states following each session. Results Out of the initial group of 20 interested candidates(above 18 years of age), 15 individuals (75%) willingly consented to participate in the study following an initial meeting with the Principal Investigator (PI). The study cohort consisted of a diverse group, including 3 medical students, 6 staff members, and 6 faculty members. Following the introductory meeting, participants were introduced to yoga meditation through instructional videos, and the study duration of 6 weeks. However, during this period, 3 participants (20%) discontinued their yoga practice, resulting in an attrition rate of 20%. An analysis of adherence to yoga practice revealed several key findings: On average, participants engaged in yoga practice for four days per week. Notably, 2 participants (17%) demonstrated exceptional dedication, practicing yoga daily for all seven days of the week. (Fig. 1) Furthermore, 7 participants (58%) reported having sessions lasting more than 20 minutes. A majority of participants (53%) reported feeling both relaxed and happy, while 40% felt only relaxed, and 7% felt solely happy. Importantly, none of the participants reported feeling tired or bored after their practice. Among the barriers to adherence, the study identified common reasons for nonadherence to daily yoga practice, with the most frequently mentioned barriers being "No Time" (33%), "Lack of Motivation" (20%), and a preference for alternative workouts (20%). Additionally, participants provided other reasons (46.6%) through free-response comments, including concerns about not practicing the right type of yoga, dissatisfaction with online or virtual practice formats, and space constraints. Interestingly, specific trends were observed in terms of preferred days for yoga practice. Mondays were the most commonly practiced day (83%), followed by Thursdays, Fridays, and Sundays. Among the 12 participants, 3 preferred virtual yoga with instructional videos for individual practice, one participant expressed a desire for virtual yoga with instructional videos in a group setting, 8 participants favored yoga in a physical location with a yoga teacher, and 4 preferred practicing independently after initial training. Moreover, among the 12 participants, 11 expressed a desire to continue practicing yoga in the future, demonstrating a strong willingness to sustain their engagement with yoga. Discussion Our findings shed light on the nuanced aspects of adherence, preferences, and future engagement in daily yoga practice. The flexible approach to session duration, positive emotional responses, and expressed willingness to continue yoga practice among participants suggest the potential for long-term benefits and sustained engagement in yoga and meditation. Among a diverse cohort of 20 interested participants, 15 (75%) participants consented to commit to daily yoga practice. Notably, our attrition rate of 20% stood in contrast to previous studies reporting attrition rates exceeding 80%, particularly among medical students. 6,7 Analyzing adherence patterns, we observed that participants, on average, engaged in yoga practice 4–5 days per week, with a noteworthy 17% maintaining daily practice. Despite the recommended 30-minute sessions by the principal investigator (PI), participants reported engaging in sessions that averaged around 20 minutes, with a notable variability spanning 10 to 30 minutes. This outcome suggests that a flexible approach to the duration of practice sessions may contribute significantly to sustaining participant engagement. The emotional responses post-practice was overwhelmingly positive, with 53% of participants reporting feeling both relaxed and happy. This dual emotional benefit aligns with findings in previous yoga studies. 12, 13, 14,15 Importantly none of the participants reported feelings of tiredness or boredom, emphasizing a positive emotional response to yoga and meditation, as noted in related research. Participants demonstrated intriguing preferences for specific days, with Monday being the most popular choice (83%). This aligns with trends observed in many yoga studios, where Mondays tend to draw the maximum attendance. The study also uncovered diverse format preferences, ranging from virtual sessions with instructional videos to in-person classes or individual practice. This divergence in preferences echoes the broader choices made by yoga practitioners, some favoring group dynamics, while others prefer solitary practice after receiving initial training. Encouragingly, the majority of participants (11 out of 12) expressed a desire to continue practicing yoga in the future, signaling a positive outlook and the potential for sustained engagement. This aligns with previous studies emphasizing the longevity of engagement in yoga meditation. 16, 17,18 Barriers to adherence revealed common challenges, with "No Time" being the most frequently mentioned obstacle, consistent with broader survey studies highlighting time constraints as a hindrance to yoga practice. Efforts to address motivation and time issues we included weekly motivational messages and underscoring the spiritual and emotional benefits of yoga over alternative workouts. However, "Lack of Motivation" (20%) and a preference for alternative workouts (20%) persisted, despite attempts to mitigate these issues. 19,20,21 This study underscored the significance of personalized attention, highlighting the role of regular check-ins conducted by the yoga teacher or program instructor in maintaining participant engagement. Such practices are essential to guarantee that participants receive individualized guidance and support specifically tailored to their unique needs. 22, 23, 24 Furthermore, encouragement from instructors or peers has proven to be a valuable motivational throughout the practice journey. 25, 26 Our recommendation involved a flexibility of dividing the yoga practice into two distinct parts: morning stretches and pre-bedtime meditation, including specific asanas and meditation techniques. This two-step study approach aimed to elevate participant engagement in yoga programs. Notably, we did not provide a diverse range of yoga styles, which may have influenced yoga adherence. Offering a variety of yoga styles would have empowered participants to make informed choices based on their preferences and needs. 27, 28 These findings offer valuable insights into the factors influencing adherence to yoga practice and highlight the potential feelings of yoga practice for promoting relaxation and positive emotions. 29,30 Understanding the barriers and preferences of participants can guide the development of tailored yoga programs to enhance engagement and promote overall well-being. Based on the insights gained from this study, future strategies for enhancing adherence to yoga programs can be designed to address identified barriers and capitalize on positive participant experiences. Here are some key strategies that can be implemented for future yoga adherence program: (Fig. 2) Flexible Scheduling Solutions Recognizing "No Time" as a common barrier, innovative scheduling solutions will be introduced. Special videos for practices will be made available for different times—early morning, afternoon, or before bed, allowing participants to choose a practice time aligned with their daily routine. Additionally, the practice will be divided into two parts, offering flexibility for shorter sessions if needed. . Varied Practice Durations and Formats Acknowledging the importance of flexibility, future programs will offer practice durations ranging from 15–30 minutes, catering to diverse schedules. Continuous Support and Community Engagement Reflecting on past efforts, continuous support mechanisms such as regular check-ins, follow-up sessions, and virtual communities will be consistently provided. This commitment to community and accountability will contribute to long-term adherence. Enhanced Motivational Strategies Future endeavors will enhance motivational messages by incorporating personal goal setting, progress tracking, and mindfulness techniques. These additions aim to boost participants' enthusiasm and deepen their connection with yoga practice. Personalized Guidance and Support Regular check-ins conducted by yoga instructors will continue and be refined to provide personalized guidance tailored to individual needs. This approach ensures participants receive the attention necessary for a fulfilling practice. Customized Practice Plans Introducing Customized Practice Plans, participants can collaborate with instructors or use online tools to create personalized routines. This tailored approach aligns with individual needs, potentially improving adherence. Online and In-Person Hybrid Options Recognizing the need for flexibility, hybrid options will be introduced, allowing participants to choose between virtual sessions and in-person classes. This caters to varying preferences for online and in-person practice. Goal Setting for Long-Term Engagement Encouraging participants to set long-term goals will be a motivating factor, fostering a perception of yoga as a sustainable and purposeful part of their lives. Highlighting Emotional Benefits Emphasizing the emotional benefits of yoga, such as relaxation and happiness, will be a persuasive strategy to encourage continued engagement and stress management. Continuous Feedback Mechanisms To monitor and improve adherence, future programs will incorporate regular feedback mechanisms. Input from participants about experiences, preferences, and challenges will inform program adjustments, ensuring ongoing relevance and effectiveness. Coping Strategies for Life Events Future programs will integrate coping strategies for life events, providing participants with tools to navigate emotional challenges and life transitions. This inclusion aims to promote consistent engagement during challenging times. Emphasis on Supportive Community Peer encouragement and positive reinforcement from instructors will continue to be emphasized, fostering a supportive community that plays a vital role in maintaining motivation throughout the yoga journey. Availability of Variety of Yoga Styles Future programs will offer a variety of yoga styles, clearly defining each style's characteristics. Trial sessions and workshops will be provided to help participants make informed choices, addressing concerns about a style not being suitable. In summary, our commitment to providing holistic support remains steadfast. By implementing these future strategies, we aspire to create an environment where participants feel empowered, motivated, and connected throughout their yoga practice journey. Limitations: While this study provides valuable insights into yoga adherence and barriers within the medical university community, it's essential to acknowledge its limitations to be taken into consideration for planning the future research endeavors on yoga and meditation: Small Sample Size and short duration The study was conducted with a relatively small sample size, which may limit the generalizability of the findings to a broader population. The duration was 6 weeks, which may not have revealed all potential barriers to yoga adherence. Conclusion These findings shed light on the nuances of yoga adherence and provide valuable insights into the barriers and preferences of participants, which can inform future yoga programs tailored to individual needs and circumstances. In conclusion, future strategies for enhancing yoga adherence should be flexible, motivational, and adaptable to individual preferences and circumstances. By addressing the identified barriers and building on the positive aspects of participants' experiences, yoga programs can foster continued engagement and promote physical and mental well-being. Declarations Ethics approval and consent to participate: The study received ethical approval from the Institutional Review Board (IRB) at California University of Science and Medicine (CUSM) (#HS-2023-32). Consent for publication. Not Applicable Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request. Competing interests There were no competing interests. Funding No fundings were involved/used. Author contribution: FN: conceptualization, methodology, project administration, original draft SS: data curation and analysis, project administration, review and editing PL: project administration, resources, supervision, review and editing of draft Author Disclosure Statement : There are no conflicts to disclose. References Complementary, Alternative, or Integrative Health. Yoga: What You Need To Know; 2024. Available from: https://www.nccih.nih.gov/health/yoga-what-you-need-to-know Anheyer D, Klose P, Lauche R, Saha FJ, et al. Yoga for Treating Headaches: a Systematic Review and Meta-analysis. J Gen Intern Med. 2020;35(3):846-854. doi:10.1007/s11606-019-05413-9 Batrakoulis A. Psychophysiological Adaptations to Yoga Practice in Overweight and Obese Individuals: A Topical Review. Diseases. 2022;10(4):107. Published 2022 Nov 17. doi:10.3390/diseases10040107 Black LI, Barnes PM, Clarke TC, Stussman BJ, Nahin RL. 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Individual-level interventions for reducing occupational stress in healthcare workers. Cochrane Database Syst Rev. 2023;5(5):CD002892. Published 2023 May 12. doi:10.1002/14651858.CD002892.pub6 Nalbant G, Lewis S, Chattopadhyay K. Characteristics of Yoga Providers and Their Sessions and Attendees in the UK: A Cross-Sectional Survey. Int J Environ Res Public Health. 2022;19(4):2212. Published 2022 Feb 15. doi:10.3390/ijerph19042212 Telles, S., Sharma, S.K., Gupta, R.K. et al. The impact of yoga on teachers’ self-rated emotions. BMC Res Notes 12, 680 (2019). https://doi.org/10.1186/s13104-019-4737-7 Law, B. M., Siu, A. M., & Shek, D. T. (2012). Recognition for positive behavior as a critical youth development construct: conceptual bases and implications on youth service development. TheScientificWorldJournal, 2012, 809578. https://doi.org/10.1100/2012/809578 Vo TTD, Tuliao KV, Chen CW. Work Motivation: The Roles of Individual Needs and Social Conditions. Behav Sci (Basel). 2022;12(2):49. Published 2022 Feb 15. doi:10.3390/bs12020049 Cocchiara RA, Peruzzo M, Mannocci A, et al. The Use of Yoga to Manage Stress and Burnout in Healthcare Workers: A Systematic Review. J Clin Med. 2019;8(3):284. Published 2019 Feb 26. doi:10.3390/jcm8030284 Harden SM, Steketee AM, Kelliher R, et al. Using a Studio-Academic Partnership to Advance Public Health Within a Pragmatic Yoga Setting. J Prim Care Community Health. 2019;10:2150132719874621. doi:10.1177/2150132719874621 Shohani M, Badfar G, Nasirkandy MP, et al. The Effect of Yoga on Stress, Anxiety, and Depression in Women. Int J Prev Med. 2018;9:21. Published 2018 Feb 21. doi:10.4103/ijpvm.IJPVM_242_16 Dike IC, Onyishi CN, Adimora DE, et al. Yoga complemented cognitive behavioral therapy on job burnout among teachers of children with autism spectrum disorders. Medicine (Baltimore). 2021;100(22):e25801. doi:10.1097/MD.0000000000025801 Additional Declarations No competing interests reported. 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Recent research indicates that approximately 14% of U.S. adults have explored the practice of yoga. Among these practitioners, the most prevalent motive for yoga participation is wellness (94%), with others seeking its potential health benefits.\u003csup\u003e1\u003c/sup\u003e Yoga has acquired significant attention in the medical community due to its potential health benefits. Recent research by the National Institutes of Health (NIH) and the National center of Complimentary and Integrative Health NCCIH has demonstrated its positive impact on various health conditions, including stress, anxiety, depression, sleep, physical and mental balance, low-back pain, neck pain, tension-type headaches, knee osteoarthritis, weight management, menopausal symptom relief, and smoking cessation.\u003csup\u003e1,2,3,4,5\u003c/sup\u003e However, many studies have faced limitations, including small sample sizes and high attrition rates. Historically, the daily practice of yoga and meditation has been recommended for achieving optimal physical and psychological benefits, making it an integral part of a healthy lifestyle. Yet, the lack of adherence to regular practice and the limited support for its widespread acceptability presents challenges to studying the impact of yoga, particularly among the medical community. Despite high initiation rates of yoga and meditation practices among medical practitioners and students, adherence remains remarkably low, with an attrition rate of nearly 90%. \u003csup\u003e6,7\u003c/sup\u003e We posit that the participation of medical students, clinicians, and faculty in yoga practices is particularly advantageous, given the high prevalence of burnout, depression, and anxiety within this demographic.\u003csup\u003e8\u003c/sup\u003e Yoga and mindfulness practices have the potential to create more resilient healthcare professionals and educators. Research also suggests that healthcare providers who practice yoga are more likely to recommend it to their patients based on their personal experiences and knowledge.\u003csup\u003e6\u003c/sup\u003e While historical barriers to yoga adherence included issues like laziness, procrastination, and physical and mental overexertion, contemporary barriers can be categorized into two main groups: strong and moderate barriers. The most suggested modern-day barriers include a lack of awareness about the benefits of yoga, unfamiliarity with appropriate yoga poses, irregular lifestyles, scheduling conflicts, lack of motivation, family commitments, work-related obligations, doubts about the efficacy of yoga, and a lack of social support. Less significant barriers include perceptions that yoga is physically demanding, preferring other forms of exercise, concerns about the quality of yoga instructors, and uncertainty about the type of yoga that suits their needs. \u003csup\u003e9,10,11\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eWith the implementation of specific strategies, we believe that yoga adherence can be achieved among medical students, clinicians, and faculty. To develop these strategies, we conducted a pilot project of a virtual yoga program to investigate adherence to yoga and perceived barriers to daily yoga practice within our medical university community. Our study had three primary objectives:\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eDevelop a user-friendly yoga program, including simple poses and guided meditation, to address barriers related to a lack of awareness about the benefits, ease of yoga poses, scheduling conflicts, and access to reliable yoga instructors.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eAssess recruitment and attrition rates, as well as the frequency of yoga adherence and the barriers hindering consistent practice.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eCreate effective models for promoting long-term yoga adherence within the medical university community.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003cp\u003e Institution Review Board, Approval Statement: The study received ethical approval from the Institutional Review Board (IRB) at CUSM (#HS-2023-32).\u003c/p\u003e "},{"header":"Materials and Methods","content":"\u003cp\u003eWe designed a comprehensive yoga adherence program featuring a 30-minute video encompassing pre-yoga stretches, fundamental yogic asanas, yogic breathing exercises, and guided meditation. The Principal Investigator (PI), a medical doctor and certified yoga instructor, offered guidance throughout the program, delivering weekly motivational messages and reminders via email. Recruitment procedures involved virtual and in-person meetings, led by the PI, who also served as the yoga teacher. The 6-week study collected data through a series of three surveys. These surveys assessed participants' daily adherence to the program, frequency of practice, reasons for missed sessions, and post-practice emotional states. Additionally, participants were asked in the final survey if they wished to continue the practice in the future and, if so, which format they preferred for their yoga practice. The study received ethical approval from the Institutional Review Board (IRB) at CUSM (#HS-2023-32).\u003c/p\u003e\u003cp\u003eThe instructional video featured detailed guidance, with the yoga instructor leading the yoga session. The video was divided into three segments: the first 10 minutes comprised simple pre-yoga stretches, followed by 10 minutes of basic yogic asanas, based on the PI's training from \"The Yoga Institute\" an authenticated yoga training center in India. The final 10 minutes included yogic breathing exercises, calming sounds, and guided meditation, aligning with the PI's additional training from the mindfulness-based stress reduction course. The video was accessible on both phones and computers, with closed captioning and audio options available. The yoga instructor was the PI, who holds the positions of MD, professor of medical education, and assistant dean of wellness. Additionally, the yoga program featured a system for sending participants weekly motivational messages and reminders via email.\u003c/p\u003e\u003cp\u003eRecruitment procedures involved sending invitations to potential participants via email. Initial recruitment occurred through live virtual, or in-person meetings conducted by the PI/yoga teacher to assess the suitability of participants for the yoga practice and to facilitate the signing of consent forms. Informed consent was obtained from all subjects. The study spanned six weeks and involved the collection of data through three surveys distributed during the study period. These surveys included questions to monitor daily adherence, identify reasons for missing practice sessions, and assess participants' emotional states following each session.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eOut of the initial group of 20 interested candidates(above 18 years of age), 15 individuals (75%) willingly consented to participate in the study following an initial meeting with the Principal Investigator (PI). The study cohort consisted of a diverse group, including 3 medical students, 6 staff members, and 6 faculty members. Following the introductory meeting, participants were introduced to yoga meditation through instructional videos, and the study duration of 6 weeks. However, during this period, 3 participants (20%) discontinued their yoga practice, resulting in an attrition rate of 20%.\u003c/p\u003e\u003cp\u003eAn analysis of adherence to yoga practice revealed several key findings: On average, participants engaged in yoga practice for four days per week. Notably, 2 participants (17%) demonstrated exceptional dedication, practicing yoga daily for all seven days of the week. (Fig.\u0026nbsp;1) Furthermore, 7 participants (58%) reported having sessions lasting more than 20 minutes. A majority of participants (53%) reported feeling both relaxed and happy, while 40% felt only relaxed, and 7% felt solely happy. Importantly, none of the participants reported feeling tired or bored after their practice.\u003c/p\u003e\u003cp\u003eAmong the barriers to adherence, the study identified common reasons for nonadherence to daily yoga practice, with the most frequently mentioned barriers being \"No Time\" (33%), \"Lack of Motivation\" (20%), and a preference for alternative workouts (20%). Additionally, participants provided other reasons (46.6%) through free-response comments, including concerns about not practicing the right type of yoga, dissatisfaction with online or virtual practice formats, and space constraints.\u003c/p\u003e\u003cp\u003eInterestingly, specific trends were observed in terms of preferred days for yoga practice. Mondays were the most commonly practiced day (83%), followed by Thursdays, Fridays, and Sundays. Among the 12 participants, 3 preferred virtual yoga with instructional videos for individual practice, one participant expressed a desire for virtual yoga with instructional videos in a group setting, 8 participants favored yoga in a physical location with a yoga teacher, and 4 preferred practicing independently after initial training. Moreover, among the 12 participants, 11 expressed a desire to continue practicing yoga in the future, demonstrating a strong willingness to sustain their engagement with yoga.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eOur findings shed light on the nuanced aspects of adherence, preferences, and future engagement in daily yoga practice. The flexible approach to session duration, positive emotional responses, and expressed willingness to continue yoga practice among participants suggest the potential for long-term benefits and sustained engagement in yoga and meditation. Among a diverse cohort of 20 interested participants, 15 (75%) participants consented to commit to daily yoga practice. Notably, our attrition rate of 20% stood in contrast to previous studies reporting attrition rates exceeding 80%, particularly among medical students. \u003csup\u003e6,7\u003c/sup\u003e Analyzing adherence patterns, we observed that participants, on average, engaged in yoga practice 4–5 days per week, with a noteworthy 17% maintaining daily practice. Despite the recommended 30-minute sessions by the principal investigator (PI), participants reported engaging in sessions that averaged around 20 minutes, with a notable variability spanning 10 to 30 minutes. This outcome suggests that a flexible approach to the duration of practice sessions may contribute significantly to sustaining participant engagement. The emotional responses post-practice was overwhelmingly positive, with 53% of participants reporting feeling both relaxed and happy. This dual emotional benefit aligns with findings in previous yoga studies. \u003csup\u003e12, 13, 14,15\u003c/sup\u003e Importantly none of the participants reported feelings of tiredness or boredom, emphasizing a positive emotional response to yoga and meditation, as noted in related research.\u003c/p\u003e\u003cp\u003eParticipants demonstrated intriguing preferences for specific days, with Monday being the most popular choice (83%). This aligns with trends observed in many yoga studios, where Mondays tend to draw the maximum attendance. The study also uncovered diverse format preferences, ranging from virtual sessions with instructional videos to in-person classes or individual practice. This divergence in preferences echoes the broader choices made by yoga practitioners, some favoring group dynamics, while others prefer solitary practice after receiving initial training. Encouragingly, the majority of participants (11 out of 12) expressed a desire to continue practicing yoga in the future, signaling a positive outlook and the potential for sustained engagement. This aligns with previous studies emphasizing the longevity of engagement in yoga meditation.\u003csup\u003e16, 17,18\u003c/sup\u003e Barriers to adherence revealed common challenges, with \"No Time\" being the most frequently mentioned obstacle, consistent with broader survey studies highlighting time constraints as a hindrance to yoga practice. Efforts to address motivation and time issues we included weekly motivational messages and underscoring the spiritual and emotional benefits of yoga over alternative workouts. However, \"Lack of Motivation\" (20%) and a preference for alternative workouts (20%) persisted, despite attempts to mitigate these issues.\u003csup\u003e19,20,21\u003c/sup\u003e\u003c/p\u003e\u003cp\u003e This study underscored the significance of personalized attention, highlighting the role of regular check-ins conducted by the yoga teacher or program instructor in maintaining participant engagement. Such practices are essential to guarantee that participants receive individualized guidance and support specifically tailored to their unique needs.\u003csup\u003e22, 23, 24\u003c/sup\u003e Furthermore, encouragement from instructors or peers has proven to be a valuable motivational throughout the practice journey.\u003csup\u003e25, 26\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eOur recommendation involved a flexibility of dividing the yoga practice into two distinct parts: morning stretches and pre-bedtime meditation, including specific asanas and meditation techniques. This two-step study approach aimed to elevate participant engagement in yoga programs. Notably, we did not provide a diverse range of yoga styles, which may have influenced yoga adherence. Offering a variety of yoga styles would have empowered participants to make informed choices based on their preferences and needs.\u003csup\u003e27, 28\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eThese findings offer valuable insights into the factors influencing adherence to yoga practice and highlight the potential feelings of yoga practice for promoting relaxation and positive emotions.\u003csup\u003e29,30\u003c/sup\u003e Understanding the barriers and preferences of participants can guide the development of tailored yoga programs to enhance engagement and promote overall well-being.\u003c/p\u003e\u003cp\u003eBased on the insights gained from this study, future strategies for enhancing adherence to yoga programs can be designed to address identified barriers and capitalize on positive participant experiences. Here are some key strategies that can be implemented for future yoga adherence program: (Fig.\u0026nbsp;2)\u003c/p\u003e\u003cp\u003e \u003cstrong\u003eFlexible Scheduling Solutions\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eRecognizing \"No Time\" as a common barrier, innovative scheduling solutions will be introduced. Special videos for practices will be made available for different times—early morning, afternoon, or before bed, allowing participants to choose a practice time aligned with their daily routine. Additionally, the practice will be divided into two parts, offering flexibility for shorter sessions if needed. .\u003c/p\u003e\u003cp\u003e \u003cstrong\u003eVaried Practice Durations and Formats\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eAcknowledging the importance of flexibility, future programs will offer practice durations ranging from 15–30 minutes, catering to diverse schedules.\u003c/p\u003e\u003cp\u003e \u003cstrong\u003eContinuous Support and Community Engagement\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eReflecting on past efforts, continuous support mechanisms such as regular check-ins, follow-up sessions, and virtual communities will be consistently provided. This commitment to community and accountability will contribute to long-term adherence.\u003c/p\u003e\u003cp\u003e \u003cstrong\u003eEnhanced Motivational Strategies\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eFuture endeavors will enhance motivational messages by incorporating personal goal setting, progress tracking, and mindfulness techniques. These additions aim to boost participants' enthusiasm and deepen their connection with yoga practice.\u003c/p\u003e\u003cp\u003e \u003cstrong\u003ePersonalized Guidance and Support\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eRegular check-ins conducted by yoga instructors will continue and be refined to provide personalized guidance tailored to individual needs. This approach ensures participants receive the attention necessary for a fulfilling practice.\u003c/p\u003e\u003cp\u003e \u003cstrong\u003eCustomized Practice Plans\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eIntroducing Customized Practice Plans, participants can collaborate with instructors or use online tools to create personalized routines. This tailored approach aligns with individual needs, potentially improving adherence.\u003c/p\u003e\u003cp\u003e \u003cstrong\u003eOnline and In-Person Hybrid Options\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eRecognizing the need for flexibility, hybrid options will be introduced, allowing participants to choose between virtual sessions and in-person classes. This caters to varying preferences for online and in-person practice.\u003c/p\u003e\u003cp\u003e \u003cstrong\u003eGoal Setting for Long-Term Engagement\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eEncouraging participants to set long-term goals will be a motivating factor, fostering a perception of yoga as a sustainable and purposeful part of their lives.\u003c/p\u003e\u003cp\u003e \u003cstrong\u003eHighlighting Emotional Benefits\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eEmphasizing the emotional benefits of yoga, such as relaxation and happiness, will be a persuasive strategy to encourage continued engagement and stress management.\u003c/p\u003e\u003cp\u003e \u003cstrong\u003eContinuous Feedback Mechanisms\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eTo monitor and improve adherence, future programs will incorporate regular feedback mechanisms. Input from participants about experiences, preferences, and challenges will inform program adjustments, ensuring ongoing relevance and effectiveness.\u003c/p\u003e\u003cp\u003e \u003cstrong\u003eCoping Strategies for Life Events\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eFuture programs will integrate coping strategies for life events, providing participants with tools to navigate emotional challenges and life transitions. This inclusion aims to promote consistent engagement during challenging times.\u003c/p\u003e\u003cp\u003e \u003cstrong\u003eEmphasis on Supportive Community\u003c/strong\u003e \u003c/p\u003e\u003cp\u003ePeer encouragement and positive reinforcement from instructors will continue to be emphasized, fostering a supportive community that plays a vital role in maintaining motivation throughout the yoga journey.\u003c/p\u003e\u003cp\u003e \u003cstrong\u003eAvailability of Variety of Yoga Styles\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eFuture programs will offer a variety of yoga styles, clearly defining each style's characteristics. Trial sessions and workshops will be provided to help participants make informed choices, addressing concerns about a style not being suitable.\u003c/p\u003e\u003cp\u003eIn summary, our commitment to providing holistic support remains steadfast. By implementing these future strategies, we aspire to create an environment where participants feel empowered, motivated, and connected throughout their yoga practice journey.\u003c/p\u003e\u003ch2\u003eLimitations:\u003c/h2\u003e\u003cp\u003eWhile this study provides valuable insights into yoga adherence and barriers within the medical university community, it's essential to acknowledge its limitations to be taken into consideration for planning the future research endeavors on yoga and meditation:\u003c/p\u003e\u003cp\u003e \u003cstrong\u003eSmall Sample Size and short duration\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eThe study was conducted with a relatively small sample size, which may limit the generalizability of the findings to a broader population. The duration was 6 weeks, which may not have revealed all potential barriers to yoga adherence.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThese findings shed light on the nuances of yoga adherence and provide valuable insights into the barriers and preferences of participants, which can inform future yoga programs tailored to individual needs and circumstances. In conclusion, future strategies for enhancing yoga adherence should be flexible, motivational, and adaptable to individual preferences and circumstances. By addressing the identified barriers and building on the positive aspects of participants' experiences, yoga programs can foster continued engagement and promote physical and mental well-being.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthics approval and consent to participate:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study received ethical approval from the Institutional Review Board (IRB) at California University of Science and Medicine (CUSM) (#HS-2023-32).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent for publication.\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003eNot Applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAvailability of data and materials\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCompeting interests\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere were no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFunding\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo fundings were involved/used.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthor contribution:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFN: conceptualization, methodology, project administration, original draft\u003c/p\u003e\n\u003cp\u003eSS: data curation and analysis, project administration, review and editing\u003c/p\u003e\n\u003cp\u003ePL: project administration, resources, supervision, review and editing of draft\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthor Disclosure Statement\u003c/em\u003e:\u0026nbsp;\u003c/strong\u003eThere are no conflicts to disclose.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eComplementary, Alternative, or Integrative Health. 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The impact of yoga on teachers\u0026rsquo; self-rated emotions. BMC Res Notes 12, 680 (2019). https://doi.org/10.1186/s13104-019-4737-7 \u003c/li\u003e\n\u003cli\u003eLaw, B. M., Siu, A. M., \u0026amp; Shek, D. T. (2012). Recognition for positive behavior as a critical youth development construct: conceptual bases and implications on youth service development. TheScientificWorldJournal, 2012, 809578. https://doi.org/10.1100/2012/809578 \u003c/li\u003e\n\u003cli\u003eVo TTD, Tuliao KV, Chen CW. Work Motivation: The Roles of Individual Needs and Social Conditions. Behav Sci (Basel). 2022;12(2):49. Published 2022 Feb 15. doi:10.3390/bs12020049 \u003c/li\u003e\n\u003cli\u003eCocchiara RA, Peruzzo M, Mannocci A, et al. The Use of Yoga to Manage Stress and Burnout in Healthcare Workers: A Systematic Review. J Clin Med. 2019;8(3):284. Published 2019 Feb 26. doi:10.3390/jcm8030284 \u003c/li\u003e\n\u003cli\u003eHarden SM, Steketee AM, Kelliher R, et al. Using a Studio-Academic Partnership to Advance Public Health Within a Pragmatic Yoga Setting. J Prim Care Community Health. 2019;10:2150132719874621. doi:10.1177/2150132719874621 \u003c/li\u003e\n\u003cli\u003eShohani M, Badfar G, Nasirkandy MP, et al. The Effect of Yoga on Stress, Anxiety, and Depression in Women. Int J Prev Med. 2018;9:21. Published 2018 Feb 21. doi:10.4103/ijpvm.IJPVM_242_16 \u003c/li\u003e\n\u003cli\u003eDike IC, Onyishi CN, Adimora DE, et al. Yoga complemented cognitive behavioral therapy on job burnout among teachers of children with autism spectrum disorders. Medicine (Baltimore). 2021;100(22):e25801. doi:10.1097/MD.0000000000025801 \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-complementary-medicine-and-therapies","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcam","sideBox":"Learn more about [BMC Complementary Medicine and Therapies](https://bmccomplementmedtherapies.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Complementary Medicine and Therapies","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-4219022/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4219022/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eDespite yoga's known benefits for physical and mental health, studies face challenges like small samples and high attrition, especially with medical professionals showing low adherence to yoga practices.\u003c/p\u003e\u003ch2\u003eObjectives\u003c/h2\u003e \u003cp\u003eThis study aimed to assess yoga practice adherence, participant experiences, future preferences, and its impact on participants' emotional states over a 6-week period.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003ethe comprehensive yoga adherence program, developed and guided by a Principal Investigator (PI), a medical doctor and a certified yoga instructor, included a 30-minute instructional video and weekly motivational messages and reminders. The video, accessible on various devices, was divided into pre-yoga stretches, yogic asanas, breathing exercises, and guided meditation. The study involved 15 participants from diverse backgrounds, including medical students, staff, and faculty members (above 18 years of age). Data collection was through three surveys, focusing on daily adherence, practice frequency, reasons for missed sessions, emotional states post-practice, and future yoga practice preferences.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eOn average, participants engaged in yoga practice four days per week, with 17% practicing daily.: 20% of participants discontinued the practice during the study. The majority reported feeling relaxed and happy after sessions, and none felt tired or bored. Common barriers to adherence included lack of time, motivation, and preference for alternative workouts. Participants expressed a strong desire to continue practicing yoga in the future, with varied preferences for virtual or in-person practice formats.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe study offers insights into the implementation challenges and feasibility of a comprehensive yoga adherence program. It highlights factors influencing participants' adherence and future practice preferences, contributing to effective strategies for promoting regular yoga practice and integrating it into wellness routines. The findings emphasize the need for tailored support to address diverse barriers to adherence and preferences for yoga formats. While there was significant adherence, understanding these factors is crucial for tailoring future programs to enhance participation and adherence.\u003c/p\u003e","manuscriptTitle":"Exploring Yoga Adherence, Experiences, Future Preferences and Barriers in the Medical University Community, A 6-Week Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-05-10 21:17:58","doi":"10.21203/rs.3.rs-4219022/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-02-18T14:35:37+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-02-10T09:07:02+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-02-04T10:58:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"329448050821341454035484160789714503858","date":"2025-01-31T08:47:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"99224539082852049573711044647235449860","date":"2025-01-31T07:55:27+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-08-08T17:45:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"69202101462823561679477145681878649824","date":"2024-07-29T01:19:47+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-07-25T20:21:31+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-05-09T00:25:31+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-05-02T08:11:35+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-05-02T08:09:01+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Complementary Medicine and Therapies","date":"2024-04-04T16:29:39+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-complementary-medicine-and-therapies","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcam","sideBox":"Learn more about [BMC Complementary Medicine and Therapies](https://bmccomplementmedtherapies.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Complementary Medicine and Therapies","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6ffec252-2752-49bf-95b8-810c4e9f1339","owner":[],"postedDate":"May 10th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-01-16T11:16:50+00:00","versionOfRecord":[],"versionCreatedAt":"2024-05-10 21:17:58","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4219022","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4219022","identity":"rs-4219022","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}