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Dissertation Defense: Clarity and inclusivity as precursors to disseminate, implement, and translate yoga principles for behavioral health

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Mary Frazier

Dissertation Defense: Clarity and inclusivity as precursors to disseminate, implement, and translate yoga principles for behavioral health

Mary Frazier

Graduate Student, Translational Biology, Medicine, and Health
Graduate Research Assistant, Parci Lab, Department of Human Nutrition, Foods, & Exercise
April 29, 2025, at 1 p.m.

Integrated Life Sciences Building, Room 1040

Visit the PARCI Lab
Watch via Zoom

More About the Candidate and Project

Education

Virginia Tech, Translational Biology, Medicine, and Health, Ph.D. Candidate

Virginia Tech, B.S., Microbiology

Training

Graduate Research Assistant, PARCI Lab, Department of Human Nutrition, Foods, & Exercise

Mentor

Samantha Harden, Ph.D., 500 RYT, Department of Human Nutrition, Foods, & Exercise

Committee Members

  • Shannon Armbruster, MD, MPH, Assistant Professor, Virginia Tech Carilion School of Medicine; Oncologist, Carilion Clinic
  • Julia Basso, Ph.D., CYT, Assistant Professor, Department of Human Nutrition, Foods, & Exercise
  • Broderick Turner, Ph.D., Assistant Professor, Pamplin College of Business
  • Frazier, M.C., Harden, S.M. (In preparation). Are Efficacy Trials Always Required for Implementing Health Behavior Interventions? A Perspective on Safely Shifting to Speed the Translational Gap.
  • Armbruster, S.D., Frazier, M.C., Ganjineh, B., & Harden, S.M. (In preparation). An Intervention to Improve the Lifestyle of Endometrial Cancer Survivors and Their Friends, Family, and Loved Ones: A proof-of-concept trial.
  • Frazier, M.C., Remskar, M., Harden, S.M., Barley, K.S., David, D.E., Guillen, M.Z., Olsen, D.E., Markley, K.M., Pullin, M.J., Brinsley, J. (Under review). How is yoga defined and described in the context of mental health and wellbeing interventions? A systematic review and qualitative synthesis. Systematic Reviews.
  • Frazier, M.C., Thakur, E.R., Frick, B.J., Stauffer, L.H., Osborn, T.M., Harden, S.M. (To be submitted). Disseminating Yoga Practices for Public Health: Updating the dissemination science model to include feedback from end-users to improve health equity. BMC Public Health.
  • Frazier, M.C., Pullin, M.J. Harden, S.M. (To be submitted). Patience is a Virtue: Lessons from a participatory approach to contextually tailor an employee wellness intervention for community health educators. Frontiers in Public Health.
  • Islam, M. S., Frazier, M. C., Harden, S. M., & Lim, S. (2024). Barriers and Benefits of Online Group Exercise Programs for Older Adults. Journal of applied gerontology : the official journal of the Southern Gerontological Society, 7334648241240599. Advance online publication. https://doi.org/10.1177/07334648241240599
  • Armbruster, S. D., Brow, K., Locklear, T., Frazier, M.C., & Harden, S. M. (2024). Mixed-method approach to informing a lifestyle intervention to improve the survivorship of patients with endometrial cancer. Gynecologic oncology, 180, 160–167. https://doi.org/10.1016/j.ygyno.2023.11.028
  • Frazier, M. C., Balis, L. E., Armbruster, S. D., Estabrooks, P. A., & Harden, S. M. (2023). Adaptations to a statewide walking program: Use of iterative feedback cycles between research and delivery systems improves fit for over 10 years. Translational behavioral medicine. Advance online publication. https://doi.org/10.1093/tbm/ibad052
  • Rockwell, M. S., Frazier, M. C., Stein, J. S., Dulaney, K. A., Parker, S. H., Davis, G. C., Rockwell, J. A., Castleman, B. L., Sunstein, C. R., & Epling, J. W. (2023). A "sludge audit" for health system colorectal cancer screening services. The American journal of managed care, 29(7), e222–e228. https://doi.org/10.37765/ajmc.2023.89402
  • Frazier, M. C., Tomooka, L., Foeger, N., Hagan, H. J., & Apel, P. J. (2022). Including a Vessel Loop in Wound Closure Facilitates Suture Removal Following Open Carpal Tunnel Release. Hand (New York, N.Y.), 15589447221092062. Advance online publication. https://doi.org/10.1177/15589447221092062
  • Frazier, M. C., Hackley, D. T., Locklear, T. M., Badger, A. E., & Apel, P. J. (2022). On the Road Again: Return to Driving Following Minor Hand Surgery. Hand (New York, N.Y.), 15589447221077363. Advance online publication. https://doi.org/10.1177/15589447221077363
  • Susanti, D., Frazier, M.C., & Mukhopadhyay, B. (2019) A Genetic System for Methanocaldococcus jannaschii: An Evolutionary Deeply Rooted Hyperthermophilic Methanarchaeon. Front. Microbiol. 10:1256. doi: 10.3389/fmicb.2019.01256
  • Future of Work Student Summer Research Grant, Center for Future Work Places and Practices | July 2024
  • Leadership Award, Translational Biology, Medicine, and Health Student of the Year | May 2023
  • Travel Fund Award, Graduate and Professional Student Senate | Dec 2022
  • First Place Award, Health Sciences & Technology Campus ‘Hokie Pitch’ | Dec 2021
  • Frazier, M.C., Pullin, M.J., Harden, S.M. Patience is a Virtue: Lessons from a participatory approach to contextually tailor an employee wellness intervention for community health educators. Poster presentation; 46th Annual Society of Behavioral Medicine Conference; March 26-29, 2025; San Francisco, CA.
  • Harden, S. M., Frazier, M.C., Frick, B.J., Stauffer, L.H., Osborn, T.M., Hill, H.G., Gregg, M.N. Disseminating yoga for public health: Integrating target population input into the dissemination science model. Poster presentation; 46th Annual Society of Behavioral Medicine Conference; March 26-29, 2025; San Francisco, CA.
  • Frazier, M.C., Remskar, M., Barley, K. S., David, D. E., Guillen, M. Z., Olsen, D. E., Markley, K. M., Harden, S. M., Brinsley, J.. How do mental health and wellbeing researchers define yoga? A systematic review. Poster presentation; 46th Annual Society of Behavioral Medicine Conference; March 26-29, 2025; San Francisco, CA.
  • Frazier, M. C., Harden, S.M. Perspectives on yoga principles to promote holistic well-being among community health educators. Poster presentation; 22nd Annual International Society of Behavioral Nutrition and Physical Activity Conference; June 14-17, 2023; Uppsala, Sweden.
  • Harden, S.M., Frazier, M.C., Islam, M.S., Lim, S. Translating exercise interventions online: Considerations for real-world impact. Poster presentation; 22nd Annual International Society of Behavioral Nutrition and Physical Activity Conference; June 14-17, 2023; Uppsala, Sweden.
  • Frazier, M.C., Armbruster, S.D., Ganjineh, B., Harden, S.M. Perceptions of including yoga principles in a lifestyle behavior-change program adapted for endometrial cancer survivors. Poster presentation; 44th Annual Society of Behavioral Medicine Conference; April 26-29, 2023; Phoenix, AZ.
  • Frazier, M.C., Balis, L.E., Armbruster, S.D., Estabrooks, P.A., Harden, S. M. Use of iterative feedback cycles with delivery personnel to improve an ongoing statewide walking program. Poster presentation; 15th Annual Dissemination and Implementation Conference; December 11-14, 2022; Washington, DC.
  • Frazier, M.C., Badger, A.E., Hackley, D.T., Locklear, T.M., Apel, P. J. On the road again: Return to driving following minor hand surgery. ePoster presentation; 62nd ASSH Annual Meeting and Exposition; December 5-8, 2021; Virtual
  • Frazier, M. C., Alshawkani, Y. Y., Foeger, N., Hagan, H. J., Tomooka, L. B. H., Apel, P. J. Including a Vessel Loop in Wound Closure Facilitates Suture Removal. ePoster presentation; 62nd ASSH Annual Meeting and Exposition; December 5-8, 2021; Virtual
  • Frazier, M. C., Susanti. D., Mukhopadhyay, B. Development of Methanocaldococcus jannaschii Genetics. Poster presentation. 2016 Summer Undergraduate Research Conference at Virginia Tech; July 30, 2016; Blacksburg, VA.
  • Mental Health and Wellbeing Special Interest Group; Founding Member | Apr 2024 - present
  • Student Special Interest Group for Society for Behavioral Medicine; Chair, Member | Apr 2023 - present
  • Roanoke Photography Collective; Cofounder | Apr 2023 - present
  • Peer Mentorship; Mentor to Three Students | Apr 2022 - present

  • Roanoke Graduate Student Association; Member | Sep 2021 - present

  • Society for Behavioral Medicine, Volunteer | Apr 2023, Apr 2024, Apr 2025

  • Bodies & Bites; Volunteer | Apr 2022, Mar 2023, Nov 2023, Apr 2024, Nov 2024

  • Commercialization Course; Teaching Assistant | Jun 2024 - Dec 2024

  • Roanoke STEM Goes Red; Volunteer | May 2024

  • Consultant on exergame and app development for an undergraduate class | Jan 2023 - May 2023

  • Commercialization Course; Intellectual Property Consultant | Sep 2022 – Dec 2023

  • Arts & Economic Prosperity 6; Volunteer | Sep 2022- Apr 2023

  • Roanoke Mutual Aid; Volunteer | Jul 2020 - Jul 2022

  • Blue Ridge Marathon; Volunteer | Mar 2022

  • Brain School; Co-presenter | Mar 2022

About this Dissertation

Translating health evidence is key to advance human flourishing. However, it takes 15-17 years to translate health interventions into real-world practice. Dissemination and implementation science can help bridge this gap for multiple interventions, including yoga-based ones. Yoga principles have positively impacted myriad populations and outcomes and align with scientific rigor across physiology, psychology, and neuroscience. However, several barriers to translating yoga principles exist. This dissertation presents three studies that highlight the importance of clarity and inclusivity as precursors for translation of yoga principles for behavioral health.
The first study is a systematic review that used a novel qualitative synthesis to examine how yoga is defined and described in peer-reviewed mental health and wellbeing literature. Of 5206 studies identified, we included and reviewed 129. We present a qualitative analysis of 1291 meaning units (i.e., distinct pieces of data) of yoga definitions and descriptions. Furthermore, these data are presented via a sub-analysis across five continents and three study populations (e.g., population with chronic health conditions). While no one singular yoga definition arose from the data, yoga was most prominently operationalized as a mind-body practice comprised of mental, physical, and breathing components. We recommend a findings-based comprehensive framework combined with established reporting guidelines to define and describe yoga.
The second study used a mixed methods cross-sectional survey to explore yoga end-user input for communicating and disseminating yoga benefits and yoga-based interventions. We surveyed 150 current and potential yoga end-users (mean age 36 years; 50% female; 54% people of color; 29% with higher body weight) with 28 open-ended questions. A subset of questions (n=4) was based on a dissemination model which posits that information is disseminated through various channels, messages, and sources. Using these overall themes, end-users contributed to 1133 meaning units. End-users overall preferred inclusive and clear content for yoga health messages, social media and fitness settings as channels, and health professionals and health organizations as sources. We propose an update to the dissemination model to include end-user input on health interventions, including yoga-based interventions.
The final study is a sequential pre-implementation intervention study that used participatory and co-creation methods to adapt an existing yoga-based employee wellness intervention for community health educators. In this study, we triangulated data from integrated research-practice partners and data from focus groups (n=21) and a follow-up survey (n=17) with community health educators from multiple states (90% female, 62% White). Several data-driven contextual factors provide important insights for tailoring intervention materials and scheduling. We present lessons on how to enhance fit of intervention function and form to context and also on the importance of patience and slowing down for co-creation and participatory processes.
Based on these findings, applying precursors of clarity and inclusivity to methods in dissemination and implementation science is key for translation of yoga-based interventions. Furthermore, these findings can be expanded and applied to bridge translation of other health evidence and interventions – towards meaningfully advancing human flourishing.