Table 3 Selected representative quotes from participants

For the most part, expectations were met and exceeded.

This category captures when participants shared if (and how) their expectations of the yoga intervention, as a whole, were met, changed, or exceeded. Within this category, participants shared how their expectations changed over time. For example, participants did not initially expect there to be reflection/journaling yet came to expect and value this aspect of the intervention. As another example, participants shared that they had expectations about the intensity of the intervention, initially feeling as though it would be more challenging, but came to value the lighter intensity. Regardless of the initial expectations for the yoga intervention (as a whole), participants were of similar perspective that any expectations they did have were met and surpassed. Of note, there was one aspect of the intervention that did not meet the participants’ expectations: the group-based format. Participants shared that they expected to feel more connected with the other young adults affected by cancer who were taking part. Participants acknowledged that the lack of connection they felt may have been influenced by the nature of the online classes wherein only the instructor was visible throughout the class and participants had the option to practice with their cameras on or off. Participants offered some suggestions to try to improve feelings of connection, which are shared below in the category: More could be done to promote connection in this group-based intervention.

“I didn’t necessarily feel connected. It’s so hard to, and you don’t really know the other people, so I just felt like I was doing it myself, on my own, with the instructor there as a third party. So, I don’t necessarily feel connected to the group, but I did look forward to it.” YA1

“With the reflection piece after and the [journal prompts], it sparked that in me a little bit, it changed the expectations a bit about not just being a yoga class but being something to take throughout my week too.” YA3

“I don’t really go into things with much expectation. I knew it was going to be good. I didn’t know it was going to be great. Like, it was awesome. I go into things without much expectation, but it would have exceeded the little expectation I had. I just wanted to be a part of it, and it was really awesome.” YA10

“I don’t know if it’s a good thing or not, everybody having their cameras off. […] I always turn my camera off, pretty much because most other people did it, and also because it’s kind of nice. Especially for me working from home, I’m on a screen all day long. So it’s kind of nice to have that option. But then at the same time I felt like you don’t really get to connect with the other people.” YA24

“I was hoping for more of a workout, and maybe I didn’t come in thinking it was what it was intended to be. But anyways it was super beneficial. Whatever the intention was, it was beneficial for that. I just would happily [like to see the classes] a step up in hardness if you will.” YA28

“I didn’t really feel like the sense of community [was something] that I wanted with the other participants. [Since] it was optional to have the camera on, and also I just had my screen on like speaker mode […]. Also, it’s not about everyone else. Like, it did feel like I wasn’t alone, but I didn’t feel like that sense of like there’s someone right here besides me that’s like breathing with me, that kind of thing. […] I know it’s not mandatory and you can’t force people, and has nothing to do with you guys or the program, but it would have been nice to hear more from the rest of the participants because not everyone wanted to share or felt comfortable or sometimes I didn’t have time to read through [the chat] instead of listen, and myself I also hadn’t spoke sometimes too so that might be my fault too.” YA34

“It’s been a great experience. There are a lot of things I really appreciated about it. I got more out of it than I expected, which was great. […] I did not expect to do the journaling, reflective bit at the end. I was like ‘no, I’ll just do the yoga and go’. [I was like] ‘yeah, yeah, uh huh, sure cool’, but some of the reflective questions were very, very important to me. So, I found myself writing them down and I still have them.” YA36

The videoconference-based delivery style enhanced accessibility.

This category captures when participants shared their appreciation for the videoconference-based delivery style of the yoga intervention. Within this category, participants shared how the videoconference-based delivery style reduced, and in some cases eliminated, barriers to attending (e.g., low/no cost, driving time). They also described how it offered them access to an intervention that they might not otherwise have (i.e., living in different cities/provinces, residing in rural and remote areas) and appreciated being able to do it from the comfort of their own home. Within this category, participants also shared how they liked having the option to choose from various times of classes when they signed up.

“I liked the Zoom access, I liked that I could be [at home] and you guys were running this in Calgary. I never would have [been able to participate otherwise].” YA1

“[The fact that it] was online that you could it from home, it made it easy and accessible, it was at a very good time too.” YA3

“I’m in the middle of nowhere. We’re a long way from a lot of places so, it’s nice to be able to do something again, and it’s nice to have similar aged people [to practice with].” YA11

“I think you guys made it very accessible. Having it multiple times throughout different times of day was [also] really nice.” YA13

“[Having access to online] free classes [like yoga] rather than in-person were [something] I was considering for a while. […] [These classes] are nicer than [doing them from] YouTube.” YA22

“The fact that it was free was a huge incentive.” YA24

“[I liked that it was] in your own house and you didn’t have to drive somewhere. It was handy because it was just in your house and you did just have to [go out and buy equipment/props], it wasn’t like it was anything crazy. I did feel like it was very accessible to anybody so that was really probably made it a better option honestly for cancer people.” YA33

The personnel fostered feelings of inclusivity and safety.

This category captures when participants expressed feelings of gratitude towards the personnel delivering the yoga intervention. The personnel were viewed by participants as fostering a safe space that was welcoming of individuals with different cancer diagnoses and abilities. The instructors were described kindly and as important to promote a sense of relaxation and ease. Although some participants did not interact directly with the moderators, their presence and availability were viewed favorably. Participants saw the instructor and moderators as dynamically and effectively managing class needs and offering a safe and inclusive space.

“I think just the personality of the instructor, they just created a safe and easy space [to practice yoga], it felt comfortable right away and non-threatening and there was never any pressure.” YA3

“[The yoga instructor] offered this safe space […] for myself to recuperate and regenerate and reset my day and take the time to relax.” YA6

“I think it was probably good to have [the moderators] there because I think you need to have someone [else other than the instructor] there. I never realized them but it was probably nice to have someone there if you did have a question or if you needed to get something it was probably nice to have that extra support as well for [the instructor as well].” YA12

“You’re going to have three people [one instructor and two moderators] assigned to the class for, [however many] people that would attend—but actually, you need those three people there because of [various reasons]. […] I’m sure they’re also allowing people to enter [the class]. So, no, definitely the number was appropriate, and all their roles were very appropriate.” YA21

“[The yoga instructor was] very personable, very easy to connect to. Whenever you arrived [to class], she had a big smile. She was very good at pulling everybody in. I think [she] did a really good job of just making it feel like, I think there were 18 people or something in my class, so she did a good job with just making it feel like she was talking to us.” YA28

“I think with the combination of the three of you working there behind the scenes, whether it’s like answering questions in the chat or um showing options while the instructor was teaching I think like I thought it was awesome. Like, all grounds were covered.” YA31

“[The yoga instructor was] so empathetic and gentle. […] She seemed very genuine and kind, and it made it a lot easier to just kind of relax and do what I was there to do.” YA36

The modifiable and personalized nature of the intervention was appreciated.

This category captures when participants expressed satisfaction with the modifiable and personalized nature of the yoga intervention. Participants appreciated being provided options within each posture to support their needs and abilities (whether looking for more/less challenging postures). Participants also described how they appreciated the verbal cues and variety of pose demonstrations, including seated and chair options (though many did not utilize the chair modifications, they recognized other participants may have needed them).

“I really liked how the instructor was offering different variations of the poses we were doing. So, if there were some days when I was not feeling well and could not do everything, I could do something else. […] Normally if you do yoga with a group, everybody is like okay now we do this, and then everybody does this, that’s not super practical in this situation. So, having that opportunity to be like okay, it’s okay if you can’t do this, if you are not feeling it, you can do this instead, I think that really helps to keep the feeling like you are part of the group and feeling like being engaged in, I can do something as well, even If I can’t do like the hardest thing.” YA6

“I [really] liked being introduced to movements that I could do comfortably.” YA9

“I liked that [the poses were] easy to do. And that [the instructor] did the modifications, saying ‘OK, if you can do this, then you can try doing this as it’s a little further’ so, I really liked the modifications, and that kind of is the baseline and if you can do more here, do more. So, I felt that was nice and it kind of gave you an option.” YA11

“I feel like the instructor […] tailored things when necessary. The approach was very inclusive to varying and different skill levels or abilities or even just the kind of day somebody was having.” YA15

“I really enjoyed going to [the] classes. I wouldn’t use the other seated [modifications] and I didn’t use those but I thought it was cool that they were there [for others to potentially use].” YA29

“… I liked that [I was] introduced to movements that I could do very comfortably. […] Having access to things that you can do you comfortably, that aren’t too tiring, that you’re like ‘OK, this isn’t going to hurt me,’ and that add movement to your day [was valuable].” YA39

The additional class components were highly valued.

This category captures participants’ thoughts on the additional class components (e.g., class theme, poses, music, journaling, and reflection). Participants expressed satisfaction and deemed additional class components to be acceptable in general. Specifically, participants enjoyed the class themes (physical focus and energetic intention), which were embedded throughout the physical poses, behavior change components, music, and journaling and reflection. However, participants were of mixed minds about the journal prompts. Though all appreciated the opportunity to reflect and (in some cases) discuss the prompts within the 1-h class, others desired this aspect of class to be shorter or outside of the 1-h class time. This feedback was provided by participants to optimize delivery and allocate more time to practice yoga.

“It was a good program. Again, I feel like it was a really good mix of restoration and more strength stuff. I liked the mix of that. I liked the journaling aspect at the end of each practice. I loved that they sent the Spotify playlist, I felt that was really fantastic and it took me a few weeks to be like, “Oh yeah the Spotify!” and figure out how to run that in the background while also doing the program but once I did I was like, oh this is a really nice touch, I really like that.” YA1

“I loved the combination of [the behaviour change support, the mindfulness meditation, and the physical postures], I think they did a very good job of putting that together too like as I said, [I liked how] themes each week would go together with the readings, and the music, those practices we did too.” YA6

“I think setting an intention before the practice was really helpful cause for me to set the intention before the practice I could decide what my goal was and I would preemptively pick something that wasn’t particularly physical and just about re-connecting with myself or whatever that prompt was, it allowed me to remember what I was practicing that day.” YA13

“I loved the playlist actually I think that that was a really unique way for everybody to experience the same thing but not necessarily like directly from the instructor. So if there was a particular piece of music that didn’t quite resonate with you or didn’t quite resonate with the movement that you were doing at the time it was very easy to kind of move to the next song. I just thought that that was unusual compared to some of the other yoga experiences that I’ve had.” YA15

“[I would suggest] a shorter amount of time to interact with the prompts, because I think the prompts and reflection was super helpful, but it was like 15 minutes, and I think that was maybe too long.” YA38

Access to a greater frequency of classes per week was desired.

This category captures participants’ desire for more yoga classes to be offered throughout the week. Participants shared that although they appreciated having access to one class each week; if they had to miss class that week, they missed their opportunity to practice yoga, which they did not like. Suggestions were made to have the intervention include two classes per week. Although recognizing that offering classes twice per week may present more scheduling challenges, participants felt that increasing the frequency of classes would allow them to accumulate more benefits from a regular and consistent practice.

“[The yoga intervention] was run really great, if [classes were] offered a few times a week I would be up for that too.” YA3

“I think personally I would have enjoyed like twice a week, I think that would be super helpful not just taking the time once a week to slow it down but If I could do it twice a week, I could re-orient myself earlier in the week and work towards the goals I need.” YA6

“I think anything more would just—I mean I would love to go twice a week, but I think that would just be a lot of work for you guys.” YA10

“I’d like to do it twice a week, but I don’t know in terms of scheduling for me personally how that would work but it’s something for me that like twice a week would be helpful.” YA11

“I think once a week was good, but I think twice a week would probably make a bigger difference for me. Personally, just I think with increased frequency I would probably notice a little bit more differences in some of the other some of the aspects that we talked about.” YA15

“I think twice [a week] is better. One time was fine, but I do think twice a week would be really beneficial. […] I think you just get yourself into even more of a groove [with 2 times a week], because if you missed one yoga class, like that’s huge, but if you miss one [out of 2] classes it is not quite so huge.” YA28

“I think in order for yoga to be really beneficial, you need to be doing it more often. So, I think twice a week would be even better. Once a week was good and it was like oh feel so good to stretch out and then if you don’t make a conscious effort to do it again on your own, it feels like you’re not seeing many bigger improvements, right? I think that you’d see more [improvements], or for me at least, I’d see more flexibility and like stuff like that if I did it more regularly.” YA38

More could be done to promote connection in this group-based intervention.

This category captures when participants shared their suggestions to improve the group-based nature of the intervention. While participants commented that the young adult-specific nature of the intervention was appreciated and they liked being around similar others, they did not feel connected. Though this lack of connection was described as inconsequential and having minimal impact on their enjoyment of the yoga intervention, participants felt the intervention could be optimized by leveraging the social aspect and offered some suggestions to do so (e.g., introductions and icebreakers during the first few classes).

“I have really enjoyed that hour of my day once a week. I don’t necessarily feel connected [to other participants] because it’s so hard to and you don’t really know the other people so I just kind of feel like I’m doing it myself on my own with the instructor there as a third party so, I don’t necessarily feel connected to the group, but I do look forward to it.” YA1

“Our group did most of the communication over chat, and I guess it would have been nice if we did more conversation, which is kind of hard to do over Zoom when you don’t know people. But yeah, if we could have created a bit more of that.” YA3

“I do wonder what the options would be for other interactions whether it’s adding in a more official sense, adding an additional 10 or 15 minutes at the beginning or something like that, the expectation is that you show up, not just like you have the option, but all show up at this time, we’re going to start with a grounding exercise and a quick go round or something like that, and then get into the program as a way of facilitating that sense of belonging and mutual support.” YA8

“I would have liked to see a bit more of an introduction to the group members to create a bit more of a relationship between the members. […] It might be nice to connect on a slightly different level. So you know a kind of ice breaker, maybe a session that’s not yoga, and then the following week you move into a yoga piece. […] I really enjoy being able to share something with other cancer survivors or other cancer patients that are very similar and even though we were, you know from across the country. It was this one period of time where we got to kind of all be together.” YA15

“I don’t really feel like I know people on a super personal level, but it has been nice to see the same people every week and everyone is quite friendly and supportive. So, I guess it feels like there’s just sort of a nice place that you can join once or twice a week. Even if you don’t really know anyone, I feel welcome and that it’s gonna be nice activity to do that there’s a good, positive attitude coming out from everyone.” YA39