Document Type


Publication Date



Maine Medical Center, Medical Education, Maine Medical Center Research Institute

MeSH Headings

Humans, Female, Yoga, Meditation, Primary Health Care, Emigrants and Immigrants, Recreation


Purpose/ Background Maine Medical Center’s immigrant population has a high need for mental health care and resources. Our program is a referral-based community trauma-informed yoga class for immigrant women. We sought to eliminate common barriers such as cost, childcare, and transportation, as well as providing group-based wellness options that differ from the traditional referral-based model to limit social isolation and build community.

Methods The yoga program is a weekly trauma-sensitive yoga program at the YMCA taught by Sea Change Yoga. Cost is free with transportation included. Women are self- referred from the primary care clinics. Criteria for referral include female gender, history of immigration, and current depression, pain, trauma, or the discretion of their primary care provider. Participants are reminded about the class weekly by resident volunteers. Transportation to the YMCA is provided via taxi on request. Approach Initial pilot class survey results were presented at the 2019 Costas Lambrew Retreat. Participants were surveyed in October 2019 and March 2020 (results ongoing). These patients did not overlap with the pilot study. Inclusion criteria includes women over age 18, immigrants, living in Maine, and participation in at least one class. The survey focused on demographics (age, language, ethnicity), barriers to class attendance, perceived generalized pain, as well as any open- ended feedback for class improvement. These were administered with a phone interpreter at the time of a weekly reminder call.

Results 81 women were referred to the program over an 11 month period. 48 women participated in at least one session. Languages represented included Arabic, Somali, Lingala, Kinyarwanda, Dari, Khmer, Spanish, and French. Average attendance per participant was 3.2 classes, ranging from one class to eleven classes. Nine participants participated in telephone survey in October 2019. On average women reported they had attended five classes. 67% reported they utilized childcare or transportation. 89% reported they had pain prior to the class. 100% had been referred by their doctor or social worker. 89% reported they planned on attending more classes. 89% reported they preferred text message reminders to calls. Results of feedback in March 2020 are ongoing.

Conclusions Implementation of a community-based intervention addresses a gap in trauma-based care: the power of community and social interaction. The practice of yoga is a low barrier intervention requiring little equipment, has few side effects, and allows social integration with exercise. Through better access to community resources, immigrant women may be empowered to build their own communities, reduce social isolation, which in turn reduces somatic pain and depression. We expect these findings may help guide similar programs for primary care providers, mental health providers, and immigrant health groups on how to integrate community-based health resources into the primary care setting.


2020 Costas T. Lambrew Research Retreat