Customizing Yoga for Global Diversity: A Comparative Study of Eastern and Western Practices for Effective Integration Into Complementary Healthcare.

introductionThis cross-sectional study aimed to examine differences in yoga practices to enhance the validity and comparability of yoga research findings. It addresses the "black-box" approach to yoga interventions by highlighting various delivery components that can impact the validity of outcomes. By moving away from the generalization of yoga outcomes, this study provides deeper insights into yoga practices across culturally diverse populations. These insights are crucial for improving the reliability of outcomes and facilitating the integration of yoga into global complementary healthcare.

methodsThe study included 2,619 participants, with a balanced representation from India (1,296) and the United States (1,323). The participants were diverse, with 47.5% being yoga masters, gurus, therapists, and experts. The study utilized the 14 subscales of the Essential Properties of Yoga Questionnaire (EPYQ) to assess four factors of yoga practice: region (India/United States), sex (male/female), delivery mode (remote/in-person), and participation status (instructor/practitioner). The EPYQ demonstrated strong internal consistency (Cronbach's alpha = 0.928).

resultsThe total EPYQ score was higher in India than in the United States. Significant differences (p < 0.05) were observed for the 14 subscales across all four factors: region, sex, delivery mode, and participation status. Notable observations include that, by region, the United States sample scored higher than the Indian sample on the subscales of body awareness and acceptance/compassion (mean differences of -0.06 and -0.03, respectively), while the Indian sample scored higher on the spirituality and social aspects subscales (mean differences of 0.54 and 0.57, respectively). The remote delivery mode scored higher for the subscales of yoga philosophy and health benefits (mean differences of 0.17 and 0.13, respectively), and lower for the subscales of individual attention and active postures (mean differences of -0.17 and -0.04, respectively). By sex, the scores on the subscales of social aspects and yoga philosophy were higher for men than for women (mean differences of -0.26 and -0.24, respectively), whereas women scored higher for the subscales of body awareness and restorative postures (mean differences of 0.19 and 0.17, respectively). By participation status, practitioners showed higher scores for the subscales of physicality and active postures (mean differences of -0.05 and -0.02, respectively), whereas instructors scored higher on the subscales of yoga philosophy and meditation/mindfulness (mean differences of 0.37 and 0.32, respectively).

conclusionsThis study emphasizes the importance of recognizing variations in yoga practices and highlights the need for customization to enhance its integration into healthcare. To address the challenges posed by global diversity and practice heterogeneity, the study suggests moving from "black box" evaluations of yoga interventions toward data-driven analysis of macro- and micro-level factors. These insights can guide developers, healthcare providers, and researchers in creating culturally sensitive, user-friendly solutions and inform future cross-cultural research. Further related research will help create robust standards for yoga practices and delivery, applying the same rigor as that applied to conventional healthcare practices.