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O'Brien KK, Ibáñez-Carrasco F, Birtwell K, Donald G, Brown DA, Eaton AD, Kasadha B, Stanmore E, St Clair-Sullivan N, Townsend L, Vera JH, Solomon P. Research priorities in HIV, aging and rehabilitation: building on a framework with the Canada-International HIV and Rehabilitation Research Collaborative. AIDS Res Ther 2023; 20:86. [PMID: 38071351 PMCID: PMC10709904 DOI: 10.1186/s12981-023-00582-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/17/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND In 2016, the Canada-International HIV and Rehabilitation Research Collaborative established a framework of research priorities in HIV, aging and rehabilitation. Our aim was to review and identify any new emerging priorities from the perspectives of people living with HIV, clinicians, researchers, and representatives from community organizations. METHODS We conducted a multi-stakeholder international consultation with people living with HIV, researchers, clinicians and representatives of community-based organizations. Stakeholders convened for a one-day Forum in Manchester, United Kingdom (UK) to discuss research priorities via a web-based questionnaire and facilitated discussions. We analyzed data using conventional content analytical techniques and mapped emerging priorities onto the foundational framework. RESULTS Thirty-five stakeholders from the UK(n = 29), Canada(n = 5) and Ireland(n = 1) attended the Forum, representing persons living with HIV or representatives from community-based organizations(n = 12;34%), researchers or academics(n = 10;28%), service providers(n = 6;17%), clinicians(n = 4;11%); and trainees(n = 4;11%). Five priorities mapped onto the Framework of Research Priorities across three content areas: A-Episodic Health and Disability Aging with HIV (disability, frailty, social participation), B-Rehabilitation Interventions for Healthy Aging across the Lifespan (role, implementation and impact of digital and web-based rehabilitation interventions) and C-Outcome Measurement in HIV and Aging (digital and web-based rehabilitation health technology to measure physical activity). Stakeholders indicated methodological considerations for implementing digital and web-based rehabilitation interventions into research and practice and the importance of knowledge transfer and exchange among the broader community. CONCLUSION Results highlight the sustained importance of the Framework of Research Priorities and provide further depth and areas of inquiry related to digital and web-based rehabilitation interventions and technology aging with HIV.
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Affiliation(s)
- Kelly K O'Brien
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada.
- Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, 155 College Street, 4th Floor, Toronto, ON, M5T 3M7, Canada.
- Rehabilitation Sciences Institute (RSI), University of Toronto, 500 University Avenue, Room 160, Toronto, ON, M5G 1V7, Canada.
| | - Francisco Ibáñez-Carrasco
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 4th Floor, Toronto, ON, M5T 3M7, Canada
| | - Kelly Birtwell
- Centre for Primary Care and Health Services Research, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - Graeme Donald
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - Darren A Brown
- Therapies Department, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Andrew D Eaton
- Faculty of Social Work, University of Regina, Saskatoon Campus, The Concourse, 111-116 Research Drive, Saskatoon, SK, S7N 3R3, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, Toronto, ON, M5S 1V4, Canada
| | - Bakita Kasadha
- Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, United Kingdom
| | - Emma Stanmore
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom
- Healthy Ageing Research Group (HARG), University of Manchester, Manchester, United Kingdom
| | - Natalie St Clair-Sullivan
- The Lawson Unit, Royal Sussex County Hospital, Brighton and Sussex University Hospitals NHS Trust, Eastern Road, Brighton, BN2 5BE, United Kingdom
| | - Liam Townsend
- Department of Infectious Diseases, St James's Hospital, Dublin 8, Dublin, Ireland
- Department of Clinical Medicine, School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, St. James's Hospital, Dublin 8, Dublin, Ireland
| | - Jaime H Vera
- The Lawson Unit, Royal Sussex County Hospital, Brighton and Sussex University Hospitals NHS Trust, Eastern Road, Brighton, BN2 5BE, United Kingdom
- Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Brighton, BN1 9PX, East Sussex, United Kingdom
| | - Patricia Solomon
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Room 403, Hamilton, ON, L8S 1C7, Canada
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Jiancaro T, Bayoumi AM, Ibáñez-Carrasco F, Torres B, McDuff K, Brown DA, Chan Carusone S, Tang A, Loutfy M, Cobbing S, O’Brien KK. Factors influencing initial implementation of an online community-based exercise intervention with adults living with HIV: a systems approach. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1176960. [PMID: 37546578 PMCID: PMC10399961 DOI: 10.3389/fresc.2023.1176960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/05/2023] [Indexed: 08/08/2023]
Abstract
Introduction Online community-based exercise (CBE) is a digital health intervention and rehabilitation strategy that promotes health among people living with HIV. Our aim was to describe the factors influencing initial implementation of a pilot online CBE intervention with adults living with HIV using a systems approach, as recommended by implementation science specialists. Methods We piloted the implementation of a 6-month online CBE intervention and 6-month independent exercise follow up, in partnership with the YMCA in Toronto, Canada. We recruited adults living with HIV who identified themselves as safe to engage in exercise. The intervention phase included personalized exercise sessions online with a personal trainer; exercise equipment; access to online exercise classes; and a wireless physical activity monitor. Two researchers documented implementation factors articulated by participants and the implementation team during early implementation, defined as recruitment, screening, equipment distribution, technology orientation, and baseline assessments. Data sources included communication with participants; daily team communication; weekly team discussions; and in-person meetings. We documented implementation factors in meeting minutes, recruitment screening notes, and email communication; and analyzed the data using a qualitative descriptive approach using a systems engineering method called Cognitive Work Analysis. Results Thirty-three adults living with HIV enrolled in the study (n = 33; median age: 52 years; cis-men: 22, cis-women: 10, non-binary: 1). Fifty-five factors influencing implementation, spanned five layers: (i) Natural, including weather and the COVID-19 virus; (ii) Societal, including COVID-19 impacts (e.g. public transit health risks impacting equipment pick-ups); (iii) Organizational, including information dissemination (e.g. tech support) and logistics (e.g. scheduling); (iv) Personal, including physical setting (e.g. space) and digital setting (e.g. device access); and (v) Human, including health (e.g. episodic illness) and disposition (e.g. motivation). The implementation team experienced heightened needs to respond rapidly; sustain engagement; and provide training and support. Additional organizational factors included a committed fitness training and research team with skills spanning administration and logistics, participant engagement, technology training, physical therapy, and research ethics. Conclusion Fifty-five factors spanning multiple layers illustrate the complexities of online CBE with adults living with HIV. Initial implementation required a dedicated, rehabilitation-centred, multi-skilled, multi-stakeholder team to address a diverse set of factors.
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Affiliation(s)
- T. Jiancaro
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - A. M. Bayoumi
- Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- MAP Centre, St. Michael’s Hospital, Toronto, ON, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - F. Ibáñez-Carrasco
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - B. Torres
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - K. McDuff
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - D. A. Brown
- Therapies Department, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - S. Chan Carusone
- McMasterCollaborative Centre for Health and Aging, McMaster University, Hamilton, ON, Canada
| | - A. Tang
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - M. Loutfy
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Maple Leaf Medical Clinic, Toronto, ON, Canada
| | - S. Cobbing
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- The Institute of Education Research, University Health Network, Toronto, ON, Canada
- Department of Physiotherapy, University of KwaZulu-Natal, Durban, South Africa
| | - K. K. O’Brien
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, ON, Canada
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