Cultural Adaptation and Feasibility of an Inpatient Yoga Intervention for Patients Undergoing Hematopoietic Stem Cell Transplantation in Tanzania, India, and the United States: A Study Protocol

Background: Cancer is a global health challenge that continues to rise worldwide. People with cancer in low- and middle-income countries (LMIC) have less access to integrative oncology programs than their counterparts in high-income countries. This is especially true of countries on the African continent, such as Tanzania. LMICs have a disproportionately higher cancer burden than their counterparts. Hematopoietic Stem Cell Transplantation (HSCT) requires extended hospitalization, including social isolation. While yoga is often recommended to help manage symptoms in oncology patients, its use has not been systematically evaluated among hospitalized patients or those undergoing HSCT. To address this gap, we designed a pilot study to culturally tailor and implement a yoga program for HSCT inpatients across diverse settings in Tanzania, India, and the United States. Methods: Five patients with hematological malignancy who underwent HSCT within the past year from each of the 3 centers will participate in semi-structured interviews to explore cultural norms, culturally appropriate language, and factors specific to yoga and psychosocial support. After any modifications to the program, 15 patients from each center will participate in the yoga program 2 weeks before HSCT and for the first 30 days after HSCT via in-person, telehealth (Zoom), or in combination. We will declare the intervention feasible if (a) at least 50% of patients complete a minimum of 6 of the 12 YT sessions and (b) at least 60% of patients complete follow-up measures at 2 months after transplant. Conclusion: This trial will provide important information regarding the cultural sensitivity and feasibility of an inpatient yoga program provided during hospitalization for 3 different centers. This data is necessary before embarking on a multicenter randomized clinical trial.