Mitigating Rural Adolescent Trauma: Remote Delivery of a Trauma-Informed Yoga Intervention During COVID-19

Abstract

Given the prevalence of childhood trauma in rural Montana, this project is intended to help mitigate stressors that may contribute to poor behavioral and mental health in high school-aged children, which may be exacerbated by the collective trauma of the COVID-19 pandemic. The immediate goal was to measure physical and mental health outcomes in adolescents resulting from a remotely delivered trauma-informed yoga intervention designed to foster positive youth development. Our study builds on the successes from an initial feasibility pilot study one year prior in order to evaluate a more robust intervention comparing experimental and control group outcomes. Students at a small, rural high school in Montana volunteered to participate in a 6-week, twice-weekly trauma-informed yoga intervention in their physical education class. Validated survey measures, including the PHQ-A, GAD-7, and ACE-Q instruments, were utilized to measure mental health outcomes pre- vs. post-intervention. Salivary cortisol levels were also measured pre-, mid-, and post-intervention. Statistically significant declines in cortisol levels and improvements in sleep duration were noted when comparing experimental vs. control groups. Noteworthy declines in depression and anxiety levels were also seen when comparing the treatment to control groups. Descriptive differences between the control and experimental groups illustrate the mental health benefits of reduced anxiety and depressive symptoms in rural adolescents resulting from a remotely delivered trauma-informed yoga intervention. Our study holds the potential for a long-term public health impact in reducing adolescent rates of anxiety and depression while mitigating trauma in geographically isolated settings. Trial Registration: ClinicalTrials.gov identifier: NCT04664855.

A systematic review of non-clinician trauma-based interventions for school-age children and young people

“…Although the study had a moderate overall quality rating, it featured a very small sample size, with n=15 at randomisation and n=9 at the one month follow up. Davis and Aylward (22) evaluated the impact of a trauma-informed mindful yoga intervention, which was delivered remotely to high school students. However, the study did not find significant differences in depression, anxiety, or resilience following the intervention.…”

“…The studies in this review either recruited the study population based on likely exposure to trauma, measured exposure to traumatic events, or measured PTSD symptoms (or a mix of these). Seven studies directly measured exposure to traumatic events (21,22,25,30,35,40,44,47). Thirteen studies directly measured PTSD symptoms (22,24,29,34,40,42), and of these, seven used PTSD score as selection criteria (29,30,(33)(34)(35)37,43).…”

“…Ten studies assessed interventions which were delivered in the school setting (24,25,(28)(29)(30)33,35,36,38,43). Three studies observed interventions delivered online (22,34,37). Eight studies looked at interventions delivered in a community setting (such as a church or charity site) (21,23,26,27,31,39,44,46), two were interventions delivered on university campuses (40,41), and one was an intervention delivered in a residential setting (32).…”

“…Three studies focussed on evaluating a mindfulness intervention (22,33,37). Ito et al (33) assessed the effects of short-term mindfulness-based group intervention delivered within a school setting for adolescents with trauma.…”

“Following the Breath”: A Trauma-Informed Intervention for Educator Wellness in Rural Montana

“…First, cortisol levels of participants fell within a normal and healthy range at each time point, so it is possible that this intervention has less impact when baseline cortisol levels are already quite low (when comparing them to previous studies involving this intervention and teenagers) [ 46 - 47 ]. Supporting this hypothesis, Galvan notes “previous work has shown that, under identical stress conditions, teens show greater cortisol release than adults” [ 48 ].…”