Learning Yoga Through Interactive Online Classes: Perspectives From Midlife and Older Women Enrolled in the LILA Trial for Urinary Incontinence

Objective To explore experiences with learning yoga through synchronous, online instruction among midlife and older women participating in a trial of therapeutic yoga for urinary incontinence. Methods We conducted an embedded qualitative study and assessed process outcomes within a multi-site randomized controlled trial of a group-based therapeutic pelvic floor yoga program vs physical conditioning program for midlife and older women with urinary incontinence. Participants were recruited from the San Francisco Bay Area from 2019 to 2022. The trial included twice-weekly small group instruction delivered via telehealth using the videoconference platform Zoom. Questionnaires and semi-structured interviews were used to assess satisfaction and explore experiences of learning yoga in an online format. Data were analyzed using descriptive statistics and a hybrid deductive/inductive qualitative thematic analysis approach. Results Questionnaire results showed 96% of respondents (n = 51) rated their overall experience with online yoga as “good to excellent.’’ Interview participants (n = 24) identified key challenges including navigating technology, configuring home environments, limited social connection, and not being in the physical presence of the yoga teacher. However, these challenges were offset by facilitators such as convenience, privacy, and perceived mind-body benefits, including improved incontinence symptoms. Effective teaching strategies contributing to a positive experience included detailed verbal instructions, visual demonstrations, solicitation of questions, and individualized feedback. Conclusion Synchronous, videoconference-based yoga instruction was effective at engaging midlife and older women in managing urinary incontinence. The online format provided convenience and privacy, making therapeutic yoga more accessible. Tailored teaching strategies and technical support significantly enhanced learning and satisfaction. This study suggests the potential for broader application of online therapeutic yoga programs for specific health conditions.