Promoting Adherence to a Yoga Intervention for Veterans With Chronic Low Back Pain.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
yoga | decrease | chronic low back pain (cLBP) | military veterans and non-veterans | - | effective for improving | #1 |
yoga | increase | mean attendance | participants in a randomized trial of yoga for cLBP | from 10.2/24 sessions to 13.3/24 sessions | increased | #2 |
yoga | increase | percentage attending at least half of sessions | participants in a randomized trial of yoga for cLBP | from 42% to 59% | increased | #3 |
yoga session attendance | decrease | pain severity | all participants | - | significantly associated with reduced | #4 |
BACKGROUND: Research demonstrates that yoga can be effective for improving chronic low back pain (cLBP) among military veterans and non-veterans. Attendance of yoga interventions is necessary to obtain benefits, yet yoga class attendance can be a challenge both within and outside of research, especially for persons who lack resources. OBJECTIVE: Our objective was to describe efforts to boost attendance within a randomized trial of yoga for cLBP, and to examine factors related to attendance. METHODS: A previous trial of yoga for cLBP among military veterans randomly assigned participants to 2x weekly yoga for 12 weeks, or delayed treatment. After the second of 6 intervention cohorts, efforts were made to improve participant attendance. Attendance and reasons for missing yoga sessions were tracked using sign-in logs and phone calls. Regression analysis was used to examine factors related to attendance. RESULTS: After efforts to boost attendance, mean attendance increased from 10.2/24 sessions, (42% attending at least half of sessions), to 13.3/24 sessions, (df (1,74), t = -1.44; P = 0.15) (59% attending half of the sessions). The most common reasons for non-attendance were transportation, financial problems, other health issues, and work or school conflicts. Living status and back pain-related disability at baseline were significantly associated with attendance (P= < .001 and P = .038 respectively). When including all participants, yoga session attendance was significantly associated with reduced pain severity (P = 0.01). CONCLUSIONS: Efforts to boost attendance appeared meaningful but the changes were not statistically significant. Attendance rate in later cohorts were comparable to those in other studies. Reasons provided for non-attendance by participants, and the regression results suggest that resources such as transportation, a stable living situation, and disability levels at baseline were related to attendance rates for this in-person intervention. Remotely delivered yoga may address some of these barriers but hybrid interventions that bring in-person yoga closer to participants may be the best option.