NEEDS ASSESSMENT: MOVEMENT AS MEDICINE

Needs Assessment for Holistic Health Providers using Movement as

Medicine
Miquella Young &
The Center for Mindfulness, Compassion & Resilience at Arizona State University
*This protocol has regard for the HRA guidance and order of content

Version 0.1, 6.27.2018

Aim: Exploratory research designed to assess the needs of and receptivity to mindfulness of health providers who
use movement-based healing modalities in the greater Phoenix area. This research will focus on the provider’s
personal barriers to professional success including stress levels, work environment, and patient interactions. The
resulting ethnographical assessment will be used as a basis for program development.

LIST OF CONTENTS

GENERAL INFORMATION PAGE NO.

SIGNITURE PAGE 2

KEY STUDY CONTACTS 3

STUDY SUMMARY 3

SECTION
1: BACKGROUND 3-4

2: RATIONALE 4

3: THEORETICAL FRAMEWORK 4-5

4: RESEARCH QUESTION/AIM(S) 5

5: STUDY DESIGN/METHODS 5

6: STUDY SETTING 5-6

7: SAMPLE AND RECRUITMENT 6-7

8: ETHICAL AND REGULATORY COMPLIANCE: EMOTIONAL DISTRESS 7

9: DISSEMINATION POLICY 7

10: REFERENCES 8

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SIGNATURE PAGE
The undersigned confirm that the following protocol has been agreed and accepted and that the Chief Investigator
agrees to conduct the study in compliance with the approved protocol and will adhere to the principles outlined in
the Declaration of Helsinki (World Medical Association, 2018).

I agree to ensure that the confidential information contained in this document will not be used for any other purpose
other than the evaluation or conduct of the investigation without the prior written consent of study committees and
contributors.

I also confirm that I will make the findings of the study publicly available through publication or other dissemination
tools without any unnecessary delay and that an honest accurate and transparent account of the study will be given;
and that any discrepancies from the study as planned in this protocol will be explained.

For and on behalf of the Committee/Key Contributor:

Signature: Date: ....../....../......

......................................................................................................

Name (please print):

......................................................................................................

Position: ......................................................................................................

Chief Investigator:

Signature: ...................................................................................................... Date: ....../....../......

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NEEDS ASSESSMENT: MOVEMENT AS MEDICINE

KEY STUDY CONTACTS

Chief Investigator/Study Coordinator:
Miquella Young
Key Contributors: Caryn Unterscheutz
Committees: Center for Mindfulness,
Compassion, and Resilience’s Tiara Cash
& Nika Gueci
Myoung23@asu.edu, (847)732-7983
Caryn.Unterscheutz@asu.edu, (623)451-4401
Tiara.Cash@asu.edu, (602)651-4173
Nika@asu.edu, (602)496-8602

STUDY SUMMARY
Study Title Needs assessment for holistic health providers using movement as
medicine

Study Design Exploratory Research, Phenomenological

Study Participants Virgina Nicholas, M.A., R.N., Pilates; Eileen Standley, Alexander
Technique; Aeimee Diaz, TCM; Phillip Wazny, NMD., Jessica, Podiatry

Mindfulness First, M2Wellbeing, Holistic Life Foundation, Active Minds

Planned Size of Sample 5 participants

Follow up duration At one week and one month

Planned Study Period 07.01.18-08.09.18

Research Question/Aim(s) Assess how mindfulness can best improve wellbeing and performance of
Holistic Health Professionals using current mindfulness-based approaches.

Assess levels of stress and ease associated with daily patient-interactions.

Evaluate receptivity to mindfulness practices for behavior change and

personal health deficits.

STUDY PROTOCOL
Needs assessment for holistic health providers using movement as medicine

1:BACKGROUND
This study will interview six holistic health providers with a focus on using movement as medicine. Five areas of
specialization will be assessed: Pilates, Alexander Technique, Podiatry, Naturopathic Medicine and Traditional
Chinese Medicine. Health professionals will be interviewed with reference to their satisfaction with providing patient
care, challenges of personal health deficits, and willingness to incorporate mindfulness into personal and professional
practice.

The Holistic Health Providers being assessed are uniquely trained in their area of expertise. This population of health
professionals are certified and/or licensed to care for patients within their scope of practice and may have one to four
years of post-baccalaureate education. They are all currently practicing healthcare professionals in the greater
Phoenix area. This diverse set of movement-healing techniques included in the study are Pilates, Alexander
Technique, Podiatry, Naturopathic Medicine, and Traditional Chinese Medicine. Pilates is a set of exercises designed
to build strength, flexibility, and muscular control around the pelvic and lumbar regions, which power many daily
activities (Bueno, et al., 2018). Alexander Technique is and educational, rather than therapeutic, technique which aims

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to improve everyday quality of life and performance for patients and has been praised for its ability to relieve pain in
musculoskeletal disorders of the back and neck (Lauche, et al., 2016). Podiatry is the expert care of the lower most
extremities, particularly the feet and ankles, treating patients with diabetes and disabilities until they achieve full
mobility (American Podiatric Medical Association, 2018). Naturopathic medicine is a branch of medicine focused on
the body’s natural healing capacities. Movement modalities used in this sector of medicine include lifestyle
counseling in physical activity and functional mobility and physical medicines like chiropractic care. Like
Naturopathy, Traditional Chinese Medicine is also a stand-alone branch of medicine which focuses on patient
empowered movement practices like Tai Chi, Qigong, and Yoga.

In partnership with the Center for Mindfulness, Compassion, and Resilience, health providers will be asked about
current use and receptivity to existing mindfulness techniques. Mindfulness is a practice of awareness and self-
compassion characterized by the principles of non-judgement, non-attachment, and a beginner’s mind (ASU Center
for Mindfulness, n.d.). Mindfulness-based Stress Reduction is one such technique labeled as the ‘Gold Standard’ for
this sector of contemplative practice (Greguska & Gonzales, 2018).

Mindfulness First, M2Wellbeing, and the Mind & Life Institute are a few organizations with different approaches to
mindfulness that will be suggested to practitioners as resources. Mindfulness First offers a focus on Social-Emotional
Learning with scientifically-informed mindfulness programs (Mindfulness First, 2015). M2Wellbeing envisions a
more conscious working class with a strong sense of mindfulness-based community support and culture (M2
Wellbeing LLC, 2017). The Mind & Life Institute is a resource for those seeking to learn more about the efficacy and
nature of mindfulness. Their organization is spearheaded by a trifecta of individuals: Tenzin Gyatso, the 14th Dalai
Lama, neuroscientist Francisco Varela and entrepreneur Adam Engle who seek to spread the historical wisdom of
mindfulness to all populations through Contemplative Science (Mind & Life Institute, n.d.).

2: RATIONALE
In modern healthcare, the wellbeing of the practitioner is often overlooked. When a provider’s health is depleted,
their capacity to approach patients with full vitality is diminished. Mindfulness is one way of empowering health
professionals to take control of their own health first, so that they may serve their patients with a more present and
fulfilled awareness. Movement medicine is the subject of study since the provider must be able to engage their body
and mind to serve their patient to the best of their ability.

It is predicted that there is a gap between populations who are open to receiving information and training on
mindfulness and populations that current mindfulness organizations are serving. Of these populations who are not
yet receiving mindfulness care are holistic health providers who use movement as medicine in their practice. This
population already may use many mindful practices, since this is the nature of their body work; however, the
pressures of modern healthcare may weigh too heavy for these to be brought to fruition without organizational
support.

Doctors of Allopathic Medicine are not the key subjects of study in efforts to refine the research to professionals who
are lacking in recognition for their healing services. Through consultation with these holistic practitioner, it will be
determined if mindfulness practices are useful resources for improving wellbeing and performance. Current
systematic reviews on mindfulness interventions, like mindfulness-based stress reduction (MBSR), for hospital
providers reported universal improvement of stress, anxiety, and burnout symptoms (Gilmartin, et al., 2017;
Lamothe, et al., 2016). There has not yet been research conducted for holistic practitioners.

3: THEORETICAL FRAMEWORK
A research-based exploratory approach will be supplemented with an ecological model called Salutogenic theory.
Ecological models evaluate the interaction between the person and their environment: the health provider and their
healing practice. The Salutogenic theory focuses on health-enhancing behaviors, rather than those which cause
disease (Raingruber & Haffer, 2001). Compared to other theories, the Salutogenic theory has been heavily researched
and tested (Raingruber & Haffer, 2001). Its significance in research is displayed with the Sense of Coherence Orientation

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to Life Scale, which will be used as a tool to evaluate the providers’ attitudes towards existing mindfulness approaches
and resources.

Salutogenesis is, "the process of enabling individuals, groups, organizations, and societies to emphasize the abilities,
resources, capacities, strengths, forces to create a sense of coherence and thus perceive life as manageable,
comprehensible, and meaningful" (Raingruber, 2001). The goals of the Salutogenic theory are to heighten cognitive
and behavioral engagement and empower relationships and meaningful pursuits. The goal of this model in this
research is to assess health providers’ personal needs, as well as their willingness to adopt new mindfulness
behaviors.

4: RESEARCH QUESTION/AIM(S)

 To assess how mindfulness can best improve wellbeing and performance of Holistic
Health Professionals using current mindfulness-based approaches.
 To assess levels of stress and ease associated with daily patient-interactions.
 To evaluate receptivity to mindfulness practices for behavior change and personal
health deficits.

4.1 Objectives

The primary objective of this study is to assess and analyze the personal-professional needs of holistic health
practitioners who use movement as medicine. The secondary objective is to identify and share resources on
current trends in mindfulness for greater sense of coherence, according to the Salutogenic model.

4.2 Outcome

The primary outcome for the study is analysis of needs among holistic health practitioners who focus on
movement as medicine. The secondary outcome is the foundation for workshop programming.

5: STUDY DESIGN, METHODS OF DATA COLLECTION & DATA ANALYIS

Study design is a qualitative phenomenological approach. One where the story and culture of holistic professionals
who use movement as medicine will be observed in relation to current and prospective mindfulness practices. This
design will be used in the form of a needs assessment to develop cultural awareness and sensitivity to this niche
group of professionals who may experience barriers to practice or burnout.

5.1 Data Collection

In-Depth Interviews will be prompted by the primary researcher, Miquella Young. The interview schedule
will be dependent on the health providers’ schedules and will take place in person on a one-on-one basis
between July 1st, 2018 and August 1st, 2018. The interviews will be recorded using a voice recording
application on a smart phone. Miquella Young will be the only one to complete transcription and analysis of
the data and the only one with access to the data. The data will not be transferred or accessed after
December 2019.

5.2 Data analysis

Content analysis will include coding and indexing techniques, performed using interview transcriptions,
done by hand. Deductive framework analysis will assess the utility of Salutogenic Theory to improve the
wellbeing and performance of the study population. Upon confirmation that the theory is adequate to fulfill
the primary objective, interpretive phenomenological analysis will be used to fulfill the secondary objective:
identifying themes for foundational support of Momentous Meta.Cine programming.

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6: STUDY SETTING
Data will be collected in locations at the greatest convenience of the health providers. Meetings will take place in
public spaces such as health offices, coffee shops, and restaurants. At the site, meet and greet activities will take place,
followed by documentation and consent from the health provider. Following this, interviews will be conducted using
a phone to record audio only. Interviews will last one to one and a half hours on site. Follow-up meetings may be
scheduled upon request of the provider. This informal setting is appropriate for the exploratory approach to this
project.

7: SAMPLE AND RECRUITMENT

7.1 Eligibility Criteria

To be considered as an applicant for the study, providers must have earned certification for practice of their
healing modality. One or more of their healing modalities must be focused on movement as the source of
healing provided. No previous experience with mindfulness is required.

7.1.1 Inclusion criteria

 Over 20 years of age

 Achieved bachelors level of education or higher

 Currently practicing or intending to practice movement modality in any capacity

 Located within a fifty-mile radius of downtown Phoenix

7.1.2 Exclusion criteria

 Located more than fifty miles outside downtown Phoenix

 Professionals without government accredited certification or license for practicing

7.2 Sampling

7.2.1 Size of sample

The preliminary size of the sample is five providers; however, opportunistic sampling may
give rise to a sample of seven or eight providers. This small sample size is limited by the time
of the given course dates for HCR 484, which ends on August 9th, 2018. The resources to
interview more individuals is also limited since there will only be one primary researcher
conducting interviews and no funds available for computer software to aid in the analysis
process.

A small sample size is sufficient for this ethnography since the primary goal of this research is
to develop a foundation for future programs that fulfil the needs of this population. The
research is based on an exploratory approach and may not achieve saturation.

7.2.2 Sampling technique

Maximum variation sampling, a type of purposive sampling, will be used to identify a diverse
sample of participants that best fulfills the research question. Ongoing interpretation of data
may reveal further subjects that may be approached within the data collection period. The
references for this opportunistic sampling may come from subjects being interviewed.

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This type of sampling aims to maximize the time an resources available to the primary
researcher and to understand the inherent diversity that exists within this subculture of health
professionals for ethnographical analysis.

7.3 Recruitment

Recruitment will be done via professional reference from sources at Arizona State University. Individuals
giving references to the primary researcher are employed at Arizona State University in the College of
Nursing and Health Innovation and at the Center for Mindfulness, Compassion and Resilience.

Participants will be initially contacted via e-mail and phone. Participants will be screened with internet
searches, confirmed with the reference source at Arizona State University, and by confirming participant
fulfillment with the inclusion and exclusion criteria.

7.3.1 Sample identification

The participants will be identified by the primary researcher and confirmed by the reference at
Arizona State University. These persons include, but are not limited to, Nika Gueci and Tiara Cash
at the Center for Mindfulness, Compassion and Resilience and Caryn Unterscheutz with the
College of Nursing and Health Innovation. Upon interview, health providers may refer the
primary researcher, Miquella Young, to another provider who must also be screened for
coherence to the inclusion and exclusion criteria.

Internet resources such as provider websites, workplace websites, and LinkdIn profiles will be
used as confirmation that participants follow inclusion and exclusion criterion and are adequate
representatives of the study population. The Sense of Coherence Orientation to Life Scale, will be a
preliminary assessment tool to identify participant receptivity to research questions.

7.3.2Consent

Before confirming participation in the study, participants will receive a hard copy of the study summary
and listen to a recitation of the nature of the research, its benefits, possible risks of participation, and the
methods of data collection and transcription from the primary researcher. The participant will have a chance
to ask any number of questions before affirming consent via verbal confirmation, which will be recorded by
the primary researcher preceding the interview.

8: ETHICAL AND REGULATORY COMPLIANCE

Ethical and Regulatory issues that may arise during this research for participants are emotional distress. Please refer
to the Declaration of Helsinski for more details on regulatory compliance for Medical Research with human subjects
(World Medical Association, 2018).

9: DISSEMINATION POLICY
The resulting ethnography will be disseminated to participating health providers and mindfulness organizations
upon completion. The findings will be made public through personal web and LinkdIn pages of the primary
researcher no longer than three months after the completion of the study on August 9, 2018.

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REFERENCES
American Podiatric Medical Association. (2018). What is a Podiatrist? Retrieved June 26, 2018, from
https://www.apma.org/Patients/content.cfm?ItemNumber=992

ASU Center for Mindfulness, Compassion, and Resilience. (n.d.). What is mindfulness? Retrieved from
https://mindfulnesscenter.asu.edu/what-is-mindfulness

Bueno de Souza, R. O., Faria de Arruda, A. S., Pontes Junior, F. L., Caldeira de Melo, R., & de Faria Marcon, L. (2018).
Effects of mat Pilates on physical functional performance of older adults: a meta-analysis of randomized
controlled trials. American Journal of Physical Medicine & Rehabilitation, 97(6), 414-425.
doi:10.1097/PHM.0000000000000883

Gilmartin, H., Goyal, A., Hamati, M. C., Mann, J., Saint, S., & Chopra, V. (2017). Brief mindfulness practices for
healthcare providers - A systematic literature review. American Journal of Medicine, 130(10), 1-17.
doi:10.1016/j.amjmed.2017.05.041

Greguska, E., & Gonzalez, J. (2018). Finding peace in the ER. Retrieved from https://asunow.asu.edu/20180531-
solutions-finding-peace-er

Lamothe, M., Rondeau, É., Malboeuf-Hurtubise, C., Duval, M., & Sultan, S. (2016). Outcomes of MBSR or MBSR-
based interventions in health care providers: A systematic review with a focus on empathy and emotional
competencies. Complementary therapies in medicine, 24(1), 19-28. doi:https://doi-
org.ezproxy1.lib.asu.edu/10.1016/j.ctim.2015.11.001

Lauche, R., Schuth, M., Schwickert, M., Lüdtke, R., Musial, F., Michalsen, A., Choi, K. (2016). Efficacy of the alexander
technique in treating chronic non-specific neck pain: A randomized controlled trial.Clin Rehabil,  30(3), 247-
258. doi:10.1177/0269215515578699

M2Wellbeing LLC. (2017). M2. Retrieved from https://www.m2wellbeing.com/

Mind & Life Institute. (n.d.). Mind & Life Dialogues. Retrieved from https://www.mindandlife.org/mind-and-life-
dialogues/

Mindfulness First. (2015). About Us. Retrieved from http://mindfulnessfirst.org/our-story/

Raingruber, B., & Haffer, A. (2001). Using your head to land on your feet: a beginning nurses guide to critical
thinking. Philadelphia, PA: F.A. Davis Co.

World Medical Association. (2018). Declaration of Helsinki – ethical principles for medical research involving human
subjects. Retrieved June 06, 2018, from https://www.wma.net/policies-post/wma-declaration-of-helsinki-
ethical-principles-for-medical-research-involving-human-subjects/.

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PRE-INTERVIEW DOCUMENTATION & CONSENT:

☐ Interviewee (Title and Name): ______________________________________

☐ Institutions: _____________________________________________________

☐ Interviewer: _____________________________________________________
“To facilitate our note-taking, I would like to audio tape our conversations today. Please sign the release form. For
your information, only researchers on the project will be privy to the tapes which will be eventually destroyed after
they are transcribed. In addition, you must sign a form devised to meet our human subject requirements. Essentially,
this document states that: (1) all information will be held confidential, (2) your participation is voluntary and you
may stop at any time if you feel uncomfortable, and (3) I do not intend to inflict any harm. Thank you for your
agreeing to participate.”

Documents Obtained: ___________________________________________________________________________________

Post Interview Comments or Leads:

_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________

DURING THE INTERVIEW:

☐ My research project focuses on your personal
experience with stress and illness as a
practitioner and your receptivity to current
mindfulness approaches. My study does not aim
to evaluate the quality of your techniques or
experiences. Rather, to learn about the potential
to help you reach peak wellness and performance
levels as it relates to your healing practice.
☐ Can you tell me a little about your practice and
what led you to practice healthcare in this
particular way?
☐What is the primary goal of your practice?
☐Please describe your daily work environment.
☐ How is movement used as medicine in your
practice?
☐ On a typical day, how would you rate your stress
level on a scale of 1-10?
☐ What tools do you use to compensate for acute
bouts of stress? Chronic stress?
☐ What personal health challenges do you deal
with on a daily basis?
☐ How do these challenges affect your
performance/capacity to heal?
☐ How would you describe mindfulness?
☐ How do you incorporate mindfulness into your
practice?
☐ Would you like to know more about current
mindfulness resources and practices that exist in
our community?

☐ Any words of advice for a future practitioner in

your field?

☐ Are there any material resources that you feel

would increase your capacity to provide healing
to your clients?

☐Mental resources?

☐Spiritual resources?

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POST-INTERVIEW:

“Upon completion of interviews with all five participants, data transcription, and analysis, I will send you a
comprehensive needs assessment report of my findings. Thank you so much for taking time out of your busy week to
meet with me and share your personal experience.”

-Look up resource list form Allies

INTERVIEWS

In person-

Podiatrist (Jessica, Meeting on Thursday)

-Alexander Technique (Eileen Standley, estandl1@asu.edu (310)406-7488)

-Physical Therapy (Randy, Cobalt Rlujan@cobaltrehab.com)

-Healing Movement (Serene Isabello, (818)497-3002, Serene.Isabello93@gmail.com, Walk-in Wellness 4527 N. 16th St.
Suite 101, Phoenix, AZ 85016)

 Tai Chi (Tai Chi Easy, Leslie Cook, Leslie@mindfulmove.com)

 Dance Therapy/Physical Therapy (TBD)
 Pediatrician DO (Maya Munoz, maya.munoz@gmail.com)
 Nurse (Aliria Munoz, alria.munoz@asu.edu, (480)309-1856)
 Yoga
o Nedd Freeman (602) 309-0017
o Vo Vera (928)399-0181
 Capoeira (TBD, Rex?)
 Integrative Art Therapy (Lanie Smith, (480)360-5484, info@integrativearttherapy.net,
1825 E. Northern Ave #215 Phoenix, Arizona 85028)

Phone-

-Herbalist (Chloe Bee, plantlove@rbbotanical.com)

 Chiropractor (Dr. Jon, (847) 949-0063)

 Qigong (Hug the Moon Qigong, Xie Ling or Owen (708) 218-2991)
 CBD (Entourage Clinical Sevices, Melanie Dillon, melanie@entourageclinicalservices,
Office: (847)406-0789 Cell: (847)393-5646)
 Naturopathy
o Dr. Phil Wazny, (480) 993-3331 at Health Matters, 9180 E Desert Cove Ave,
Scottsdale, AZ 85260
o Sean Scherer, (480) 244-3569
o McKenna’s Contact (TBD)

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