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

Author: Guoyan Yang1, Xun Li2, Nicole Peel3, Nerida Klupp1,3, Jian-Ping Liu2, Alan Bensoussan1, Hosen Kiat1,4,5,6, Dennis Chang1
1 NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia.
2 Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China.
3 School of Health and Sciences, Western Sydney University, Penrith, NSW, 2751, Australia.
4 Faculty of Medicine, Human and Health Sciences, Macquarie University, Macquarie, NSW, 2109, Australia.
5 ANU College of Health and Medicine, Australian National University, Canberra, ACT, 2600, Australia.
6 Cardiac Health Institute, Sydney, NSW, 2122, Australia.
Conference/Journal: Patient Prefer Adherence
Date published: 2022 Sep 28
Other: Volume ID: 16 , Pages: 2695-2707 , Special Notes: doi: 10.2147/PPA.S380780. , Word Count: 288

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.

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.

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; adherence; cardiovascular disease; interview; trial participation.

PMID: 36196067 PMCID: PMC9527000 DOI: 10.2147/PPA.S380780