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Table 2 An overview of how the SAGE yoga program worked for participants who took part in the hybrid program

From: What helps older people persevere with yoga classes? A realist process evaluation of a COVID-19-affected yoga program for fall prevention

Program theories Intervention activities
What did we do?
Who did it work for?
How did it work?
With what process effects?
1. It’s worth the effort Program of yoga-based exercise with progressively challenging poses designed to prevent falls in older people ∙ The program attracted people who believed in the efficacy of yoga and who had interests in healthy ageing &/or tackling fall-related physical decline
∙ It best suited those with physical capabilities in the moderate range who had manageable levels of pain
∙ Value expectancy
∙ Therapeutic alliance
∙ Achievement/Mastery
∙ Engagement with SAGE: attendance (including across transition to online classes), expressed commitment and enjoyment
∙ Self-reported improvements in balance, flexibility, strength, mobility, stress reduction, sleep quality and/or wellbeing
∙ Habit formation: routine practise of yoga as part of everyday life
∙ Physical literacy: physical competence and confidence (self-efficacy), including the creation of transferable skills, and motivation to engage in physical activity
∙ Intention to continue yoga (or strength-based physical activity)
2. In expert hands Experienced instructors deliver the program, individualising it for participants’ different capabilities
3. A communal experience Group classes with a maximum of 18 people
WhatsApp forum for each group when classes moved online
∙ Group classes worked for those who valued social interaction &/or shared experiences
∙ Studio classes suited those who liked to benchmark their physical competence and/or peer-audit their poses
∙ Shared experience
∙ Social connection
∙ Social comparison
∙ Peer checking
4. Putting yoga within reach Free classes in local yoga studios...
... then online via Zoom with tech support from the SAGE team
∙ Studio classes suited those with easy access to a participating yoga studio
∙ Online classes worked for those with suitable home environments and tech confidence or with hesitancy but openness to trying online classes with support
∙ Accessibility
∙ Convenience
∙ Gratitude
5. Building yoga habits Twice-weekly classes over 12 months with:
∙ flexible ‘make up’ classes
∙ program-specific homework tools and encouragement
∙ goal-setting for mobility
∙ SAGE’s structure worked for people who prioritised and could commit to the schedule
∙ Homework suited those keenest on progression &/or their instructor’s approval
∙ Flexible classes were used by those with carer commitments, travel plans, injury or illness
∙ Goal-setting did not seem to work in SAGE
∙ Purposeful structure
∙ Momentum
∙ Accountability
∙ Continuity
6. Yoga's special properties The SAGE program utilises core Iyengar yoga practices ∙ This worked best for those who were open to yoga as an holistic practise ∙ Embodiment
∙ Mindfulness