Perceptions of Participants on Trial Participation and Adherence to Tai Chi: A Qualitative Study

Author: Guoyan Yang,1 Xun Li,2 Nicole Peel,3 Nerida Klupp,1,3 Jian-Ping Liu,2 Alan Bensoussan,1 Hosen Kiat,1,4– 6 Dennis Chang1
1NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia; 2Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China; 3School of Health and Sciences, Western Sydney University, Penrith, NSW, 2751, Australia; 4Faculty of Medicine, Human and Health Sciences, Macquarie University, Macquarie, NSW, 2109, Australia; 5ANU College of Health and Medicine, Australian National University, Canberra, ACT, 2600, Australia; 6Cardiac Health Institute, Sydney, NSW, 2122, Australia

Correspondence: Dennis Chang; Guoyan Yang, NICM Health Research Institute, Western Sydney University, Locked Bag, 1797, Penrith, NSW, 2751, Australia, Tel +61 2 9685 4725, Fax +61 2 9685 4760, Email;
Conference/Journal: Dovepress
Date published: 28 Sep 2022
Other: Special Notes: DOI , Word Count: 287

Purpose: Trial participation and adherence to interventions can directly influence the evaluation of outcomes in clinical trials for real world applications. The factors that influence trial participation and adherence to Tai Chi interventions in people with cardiovascular diseases remains unknown. This study aimed to explore participants’ perceptions of influential factors on their trial participation and adherence to a Tai Chi intervention within a trial setting.
Patients and Methods: Participants had coronary heart disease and/or hypertension in a randomized controlled trial comparing Tai Chi with a waitlist control. Data were collected via face-to-face, semi-structured interviews and analyzed using thematic analysis.
Results: Thirty-four participants from the Tai Chi group who completed the randomized trial were interviewed. Six dominating themes and four sub-themes are discussed under the facilitators of internal and external motivation, positive feelings, benefits of Tai Chi and future practice with an overall internal motivation to improve health. Positive feelings had three sub-themes: positive feelings toward Tai Chi, the project, and the learning experience. The Tai Chi instructor(s) was found to be a crucial element in motivating participants’ adherence to Tai Chi.
Conclusion: From the perception of participants, the facilitators to their trial participation and adherence to a Tai Chi intervention included internal and external motivation, positive feelings towards Tai Chi, the project and the learning experience, and perceived benefits of Tai Chi. Perceived barriers included concerns about the safety and complexity of Tai Chi practice, lack of group atmosphere outside of class, and scheduling conflicts. Future researchers can address these factors to improve trial recruitment and implementation of Tai Chi and other mind-body interventions in research and for real world applications.

Keywords: Tai Chi, trial participation, adherence, cardiovascular disease, interview