Online Program

Factors associated with treatment adherence in a predominantly minority population in a yoga study for chronic low back pain

Monday, November 4, 2013

Shayna Egan, MPH, Back to Health Study, Boston Medical Center Department of Family Medicine, Boston, MA
Chelsey Lemaster, BS, Department of Family Medicine, Program for Integrative Medicine and Health Care Disparities, Boston, MA
Julia Keosaian, MPH, Program for Integrative Medicine and Health Disparities, Department of Family Medicine, Boston Medical Center, Boston, MA
Robert Saper, MD, MPH, Department of Family Medicine, Boston University School of Medicine, Boston, MA
The Back to Health study is a 12-week comparative effectiveness randomized controlled trial for cLBP. We are recruiting 320 adults with cLBP from community health centers in racially diverse neighborhoods of Boston, MA. They are randomized in a 2:2:1 ratio to yoga, physical therapy, and education treatment arms. During the 12-week intervention period, yoga participants engage in a standardized once per week hatha yoga protocol delivered in a class format and supplemented by home practice. Activities to enhance adherence include flexible yoga class schedules, small class sizes (<10), weekly reminder phone calls, assistance with child care or transportation, make-up classes, attendance based raffles, staggered distribution of honoraria, and yoga take home practice supplies. Pain-related disability is measured using the Modified Roland Morris Disability Questionnaire (RMDQ) (0-23 scale). Treatment adherence is measured by class attendance and was defined as at least 75% class attedance. We will compare mean RMDQ scores for those adherent and non-adherent using a T-test. We will determine if the RMDQ score is independently associated with adherence using a logistic regression, controlling for possible confounders. For the first cohort (n=34), the overall attendance rate was 76% and 25 participants (74%) were compliant, attending at least 9 classes in the 12-week study period. Analysis of further cohorts is ongoing. An analysis will be conducted to determine if self-reported disability predicts treatment adherence. Results will determine the effects of cLBP-related disability on treatment adherence. Overall, results will highlight the feasibility of attaining treatment adherence for cLBP sufferers participating in a yoga research trial.

Learning Areas:

Chronic disease management and prevention
Clinical medicine applied in public health
Implementation of health education strategies, interventions and programs

Learning Objectives:
Analyze the relationship between self-reported back pain related disability on treatment adherence in participants engaged in the yoga treatment arm of a research study for chronic low back pain (cLBP).

Keyword(s): Minority Research, Community Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the yoga coordinator for the Back to Health study, a study comparing yoga, physical therapy and education for chronic low back pain in predominantly low-income minority populations. Among my specific interests has been working with minority populations and alternative treatments for chronic low back pain.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.