Promoting Adherence to a Yoga Intervention for Veterans With Chronic Low Back Pain

Area of Science:

• Pain Management
• Rehabilitation Medicine
• Clinical Trials

Background:

• Yoga interventions show promise for improving chronic low back pain (cLBP) in military veterans and non-veterans.
• Consistent attendance is crucial for realizing yoga's benefits, yet participation can be challenging due to resource limitations.

Purpose of the Study:

• To describe strategies implemented to enhance participant attendance in a randomized trial of yoga for cLBP.
• To investigate factors influencing attendance in this yoga intervention.

Main Methods:

• A randomized trial involving participants with cLBP assigned to yoga or delayed treatment.
• Efforts to boost attendance were implemented after the initial cohorts.
• Attendance tracking via sign-in logs and phone calls, with regression analysis to identify attendance predictors.

Main Results:

• Mean attendance increased from 42% to 59% after intervention efforts, though not statistically significant (P = 0.15).
• Primary reasons for non-attendance included transportation, financial issues, health problems, and work/school conflicts.
• Baseline living status and back pain disability significantly predicted attendance (P < .001 and P = .038, respectively).
• Yoga session attendance correlated with reduced pain severity (P = 0.01).

Conclusions:

• Strategies to improve attendance showed a positive trend but did not reach statistical significance.
• Attendance rates in later cohorts were comparable to other studies.
• Participant-reported barriers and regression findings highlight the importance of resources like transportation, stable housing, and baseline disability for in-person interventions.
• Hybrid or remotely delivered yoga interventions may mitigate barriers, with hybrid models potentially offering the best approach.