Use of pragmatic community-based interventions to enhance recruitment and adherence in a randomized trial of Tai Chi for women with osteopenia: insights from a qualitative substudy.
Use of pragmatic community-based interventions to enhance recruitment and adherence in a randomized trial of Tai Chi for women with osteopenia: insights from a qualitative substudy.
复制标题
DOI：
10.1097/gme.0000000000000257
复制
发表时间：
2014-11
期刊：
影响因子：
--
通讯作者：
Wayne PM
中科院分区：
文献类型：
--
作者：
Fischer M;Fugate-Woods N;Wayne PM
定性评估利用社区太极学校的实用网络为骨质疏松症女性提供9个月运动干预的可行性，并探索这种设计特征对试验招募和参与者在试验期间和试验后坚持的促进者和障碍的影响。在一项随机试验中，比较了9个月的太极加常规护理与仅常规护理对中度低骨量的绝经后妇女的影响，对43名随机接受太极干预的参与者进行了退出访谈。将转录本数字化记录、转录并导入计算机辅助定性数据分析软件NVivo。定性内容分析被用来编码的数据。对守则中出现的模式作了进一步审查，并将其归类为主题。分析显示，实用交付太极计划的功能，既促进和阻碍研究参与和/或试验后的依从性。直接协助者包括：上课地点和时间的便利性、替代性学习方式、教学质量、社区和社会支持以及预期的健康益处。障碍主要包括与时间有关的问题。还确定了一个可能的因果机制-自我效能。与使用实用的干预措施相关的因素有利于促进研究参与和试验后坚持太极计划。定性的子研究是有价值的，以确定这些因素和可能的因果机制。这些发现将有助于设计和进行未来的研究，探索太极拳在预防骨折和健康相关的生活质量在绝经后妇女的使用。
To qualitatively evaluate the feasibility of utilizing a pragmatic network of community-based Tai Chi schools to deliver 9-month exercise interventions to osteopenic women and to explore the impact of this design feature on facilitators and barriers to trial recruitment and participant adherence during and following the trial. Within a randomized trial comparing 9 months of Tai Chi plus usual care to usual care alone for post-menopausal women with moderately low bone mass, exit interviews were conducted with 43 participants randomized to the pragmatically-delivered Tai Chi intervention. Transcripts were digitially recorded, transcribed and imported into NVivo, a computer-assisted qualitative data analysis software. Qualitative content analysis was used to code the data. Patterns emerging from among the codes were further examined and clustered into themes. Analyses revealed features of pragmatically-delivered Tai Chi programs that both facilitated and impeded study participation and/or post trial adherence. Direct facilitators included: convenience of class locations and times, alternative learning modalities, quality of teaching, community and social support and perceived health benefits. Barriers consisted primarily of time-related issues. A possible causal mechanism--self-efficacy--was also identified. Factors related to using pragmatically-delivered intervention were beneficial in fostering both study participation and post-trial adherence to the Tai Chi programs. The qualitative sub-study was valuable for identifying these factors and a possible causal mechanism. These findings will assist in the design and conduct of future studies exploring the use of Tai Chi in fracture prevention and health-related quality of life in post-menopausal women.