How yoga interventions are operationalized and reported in the context of mental health and wellbeing RCTs: a systematic review and qualitative synthesis

Mary C. Frazier; Masha Remskar; Samantha M. Harden; Karsen S. Barley; Danielle E. David; Marina Z. Guillen; Daryn E. Olsen; Kayla M. Markley; Megan J. Pullin; Jacinta Brinsley

doi:10.1186/s12906-025-05162-9

How yoga interventions are operationalized and reported in the context of mental health and wellbeing RCTs: a systematic review and qualitative synthesis

Mary C. Frazier, Masha Remskar, Samantha M. Harden, Karsen S. Barley, Danielle E. David, Marina Z. Guillen, Daryn E. Olsen, Kayla M. Markley, Megan J. Pullin, Jacinta Brinsley

Research output: Contribution to journal › Review article › peer-review

Abstract

Background: Yoga is a popular intervention demonstrating promising impacts for mental health and wellbeing. Despite growing research interest, yoga remains poorly operationalized and inconsistently described in scientific literature, hindering dissemination, rigorous evaluation, and replication. This systematic review aims to address this critical knowledge gap by examining how yoga is operationalized in recent mental health and wellbeing research. Methods: We conducted a systematic review of literature from January 2013 to August 2024. Terms relating to yoga, mental health, wellbeing, and interventions were used to search MEDLINE, CINAHL, Embase, Emcare, PsycINFO, and Scopus. Randomized controlled trials that included yoga as the primary intervention and reported a validated measure of mental ill-health, mental wellbeing, or quality of life, were included. Inductive qualitative analyses of yoga definitions and descriptions were conducted. Results: Of 5206 studies identified, 129 were included with exclusion primarily due to study design. Qualitative analysis resulted in a total of 1291 meaning units (MU). Yoga definitions suggest that yoga is operationalized as a practice, complementary and alternative medicine, or system (e.g., encompassing philosophy and practices) with mind-body or mind-body-spirit aspects. Components of yoga included physical such as postures, mental such as meditation, and breath. Conclusions: This is the first systematic review to comprehensively analyze how yoga is operationalised and reported in recent experimental mental health and wellbeing research. Generally, yoga is operationalized as a mind-body or mind-body-spirit practice comprising mental, physical, and breathing components. We provide recommendations to improve the translation and implementation of yoga interventions. Trial registration: This study was prospectively registered with PROSPERO (CRD42023455373). Clinical trial number: not applicable.

Original language	English
Article number	55
Journal	BMC Complementary Medicine and Therapies
Volume	26
Issue number	1
Early online date	22 Dec 2025
DOIs	https://doi.org/10.1186/s12906-025-05162-9
Publication status	Published - 10 Feb 2026

Data Availability Statement

All data analyzed were extracted from previously published studies. Datasets may be accessed in Supplementary File 1 (qualitative information and codes, including meaning units, keywords, subcategories, categories, subthemes, and themes) and Supplementary File 2 (characteristics of included studies).

Acknowledgements

The authors would like to warmly thank Rachel Kaplan and Julia Bauer for their contributions to screening and data extraction for this systematic review. The authors would also like to thank Michael Stamper for his assistance in improving resolution and layout for specific supplementary figures.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Holistic
Intervention
Mental health
Physical activity
Review
Wellbeing
Yoga

ASJC Scopus subject areas

Complementary and alternative medicine

Access to Document

10.1186/s12906-025-05162-9Licence: CC BY-NC-ND

Cite this

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. (2026). How yoga interventions are operationalized and reported in the context of mental health and wellbeing RCTs: a systematic review and qualitative synthesis. BMC Complementary Medicine and Therapies, 26(1), Article 55. https://doi.org/10.1186/s12906-025-05162-9

How yoga interventions are operationalized and reported in the context of mental health and wellbeing RCTs: a systematic review and qualitative synthesis. / Frazier, Mary C.; Remskar, Masha; Harden, Samantha M. et al.
In: BMC Complementary Medicine and Therapies, Vol. 26, No. 1, 55, 10.02.2026.

Research output: Contribution to journal › Review article › peer-review

Frazier, MC, Remskar, M, Harden, SM, Barley, KS, David, DE, Guillen, MZ, Olsen, DE, Markley, KM, Pullin, MJ & Brinsley, J 2026, 'How yoga interventions are operationalized and reported in the context of mental health and wellbeing RCTs: a systematic review and qualitative synthesis', BMC Complementary Medicine and Therapies, vol. 26, no. 1, 55. https://doi.org/10.1186/s12906-025-05162-9

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abstract = "Background: Yoga is a popular intervention demonstrating promising impacts for mental health and wellbeing. Despite growing research interest, yoga remains poorly operationalized and inconsistently described in scientific literature, hindering dissemination, rigorous evaluation, and replication. This systematic review aims to address this critical knowledge gap by examining how yoga is operationalized in recent mental health and wellbeing research. Methods: We conducted a systematic review of literature from January 2013 to August 2024. Terms relating to yoga, mental health, wellbeing, and interventions were used to search MEDLINE, CINAHL, Embase, Emcare, PsycINFO, and Scopus. Randomized controlled trials that included yoga as the primary intervention and reported a validated measure of mental ill-health, mental wellbeing, or quality of life, were included. Inductive qualitative analyses of yoga definitions and descriptions were conducted. Results: Of 5206 studies identified, 129 were included with exclusion primarily due to study design. Qualitative analysis resulted in a total of 1291 meaning units (MU). Yoga definitions suggest that yoga is operationalized as a practice, complementary and alternative medicine, or system (e.g., encompassing philosophy and practices) with mind-body or mind-body-spirit aspects. Components of yoga included physical such as postures, mental such as meditation, and breath. Conclusions: This is the first systematic review to comprehensively analyze how yoga is operationalised and reported in recent experimental mental health and wellbeing research. Generally, yoga is operationalized as a mind-body or mind-body-spirit practice comprising mental, physical, and breathing components. We provide recommendations to improve the translation and implementation of yoga interventions. Trial registration: This study was prospectively registered with PROSPERO (CRD42023455373). Clinical trial number: not applicable.",

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AU - Barley, Karsen S.

AU - David, Danielle E.

AU - Guillen, Marina Z.

AU - Olsen, Daryn E.

AU - Markley, Kayla M.

AU - Pullin, Megan J.

AU - Brinsley, Jacinta

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How yoga interventions are operationalized and reported in the context of mental health and wellbeing RCTs: a systematic review and qualitative synthesis

Abstract

Data Availability Statement

Acknowledgements

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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