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

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; 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.