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Mabweazara SZ, Manne-Goehler J, Bibangambah P, Kim JH, Ruth S, Hemphill LC, Okello S, Hamer M, Siedner MJ. Correlates of physical activity among people living with and without HIV in rural Uganda. FRONTIERS IN REPRODUCTIVE HEALTH 2023; 5:1093298. [PMID: 37547804 PMCID: PMC10398393 DOI: 10.3389/frph.2023.1093298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 06/07/2023] [Indexed: 08/08/2023] Open
Abstract
Background Antiretroviral therapy (ART) has led to diminishing AIDS-related mortality but a concomitant increase in non-communicable diseases (NCDs) for people with HIV (PWH). Whereas physical activity (PA) has been shown to help prevent NCDs and NCD outcomes in other settings, there are few data on PA and its correlates among PWH in high-endemic settings. We aimed to compare PA by HIV serostatus in rural Uganda. Methods We analysed data from the UGANDAC study, an observational cohort including PWH in ambulatory HIV care in Mbarara, Uganda, and age- and gender-matched people without HIV (PWOH). Our primary outcome of interest was PA, which we assessed using the International Physical Activity Questionnaire and considered as a continuous measure of metabolic equivalents in minutes/week (MET-min/week). Our primary exposure of interest was HIV serostatus. We fit univariable and multivariable linear regression models to estimate the relationship between HIV and PA levels, with and without addition of sociodemographic and clinical correlates of PA (MET-min/week). In secondary analyses, we explored relationships restricted to rural residents, and interactions between gender and serostatus. Results We enrolled 309 participants, evenly divided by serostatus and gender. The mean age of PWH was 52 [standard deviation (SD) 7.2] and 52.6 (SD 7.3) for PWOH. In general, participants engaged in high levels of PA regardless of serostatus, with 81.2% (251/309) meeting criteria for high PA. However, PWOH reported higher mean levels of PA met-minutes/week than PWH (9,128 vs 7,152, p ≤ 0.001), and a greater proportion of PWOH (88.3%; 136/154) met the criteria for high PA compared to PWH (74.2%; 115/155). In adjusted models, lower levels of PA persisted among PWH (β = -1,734, 95% CI: -2,645, -824, p ≤ 0.001). Results were similar in a sensitivity analysis limited to people living in rural areas. Conclusion In a rural Ugandan cohort, PWOH had higher levels of PA than PWH. Interventions that encourage PA among PWH may have a role in improving NCD risk profiles among PWH in the region.
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Affiliation(s)
- Smart Z. Mabweazara
- Clinical Research Department, Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Jennifer Manne-Goehler
- Department of Medicine, Harvard Medical School, Boston MA, United States
- Department of Medicine Brigham and Women's Hospital Boston, MA, United States
| | - Prossy Bibangambah
- Faculties of Medicine and Radiology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - June-Ho Kim
- Department of Medicine, Harvard Medical School, Boston MA, United States
- Ariadne Labs, Brigham and Women's Hospital, Boston, MA, United States
| | - Sentongo Ruth
- Faculties of Medicine and Radiology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Linda C. Hemphill
- Department of Medicine, Harvard Medical School, Boston MA, United States
| | - Samson Okello
- Faculties of Medicine and Radiology, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, United States
| | - Mark Hamer
- Division of Surgery & Interventional Science, University College London, London, United Kingdom
| | - Mark J. Siedner
- Clinical Research Department, Africa Health Research Institute, KwaZulu-Natal, South Africa
- Department of Medicine, Harvard Medical School, Boston MA, United States
- Faculties of Medicine and Radiology, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
- Faculty of Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
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2
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Chetty L, Cobbing S, Chetty V. The perceptions of older people living with hiv/aids towards physical activity and exercise. AIDS Res Ther 2022; 19:67. [PMID: 36575436 PMCID: PMC9795653 DOI: 10.1186/s12981-022-00500-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 12/19/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Older people living with HIV (OPLWH) require significant levels of support, including healthcare and rehabilitation interventions. People living with HIV are living longer, but still experience health-related impairments that affect functional activity, participation in day-to-day interactions, livelihoods and overall quality of life. Physical activity and exercise should be included as part of the comprehensive medical management for OPLWH but the investigation of prior studies reveal a gap in understanding and prescription. Our study aimed to explore the perceptions of OPLWH about physical activity and exercise. METHODS The study adopted a phenomenological, qualitative design, using in-depth interviews, to understand OPLWH perceptions of physical activity and exercise, and their need for, and access to, physical activity and exercise programmes in a community in South Africa. Nine [9] males and seven [7] females participated in the study. RESULTS Sixteen individuals voluntarily participated in face-to-face, semi-structured interviews which took place at the healthcare facility where they received regular treatment. All participants were 50 years and older. Personal gratification and the ability to perform activities of daily living as well as participate in community activities were believed to be strong motivators for exercise participation, while barriers to exercise were attributed to physical health issues; lack of proper instruction as well as stigma associated with HIV status within their communities. Participants also favored a combination of aerobic, flexibility and strength activities, as well as proper supervision and instruction within a group exercise setting. CONCLUSION The qualitative nature of our study provided an in-depth understanding of the perceptions of OPLWH towards physical activity and exercise. Our study highlighted the factors that hinder adherence to physical activity and exercise in this population. Many indicated that they would love to engage in structured physical activity programmes, but did not know where, when or how to begin. Creating a suitable environment with proper supervision and instruction by suitably qualified health professionals are essential when developing a community-based exercise programme for OPLWH.
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Affiliation(s)
- Levin Chetty
- grid.16463.360000 0001 0723 4123Discipline of Physiotherapy, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000 Westville South Africa
| | - Saul Cobbing
- grid.16463.360000 0001 0723 4123Discipline of Physiotherapy, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000 Westville South Africa
| | - Verusia Chetty
- grid.16463.360000 0001 0723 4123Discipline of Physiotherapy, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000 Westville South Africa
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Ramos SR, O’Hare OM, Colon AH, Jacobs SK, Campbell B, Kershaw T, Vorderstrasse A, Reynolds HR. Purely Behavioral: A Scoping Review of Nonpharmacological Behavioral and Lifestyle Interventions to Prevent Cardiovascular Disease in Persons Living With HIV. J Assoc Nurses AIDS Care 2021; 32:536-547. [PMID: 33481464 PMCID: PMC8289919 DOI: 10.1097/jnc.0000000000000230] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Cardiovascular disease (CVD) is the leading cause of death in the United States, accounting for 900,000 deaths annually. People living with HIV are at a higher risk of developing CVD. We conducted a scoping review guided by the Joanna Briggs Institute Manual for Evidence Synthesis. In July 2020, six databases were searched: PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Web of Science, Embase, and The Cochrane Central Register of Controlled Trials, as well as reference lists of relevant studies and key journals. Our review identified 18 studies that addressed nonpharmacological behavioral interventions into the following: physical activity (n = 6), weight loss (n = 2), dietary interventions (n = 1), and multicomponent interventions (n = 9). In the past 10 years, there has been an increased emphasis on nonpharmacological behavioral approaches, including the incorporation of multicomponent interventions, to reduce cardiovascular risk in people living with HIV. The extant literature is limited by underrepresentation of geographic regions and populations that disproportionately experience CVD.
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Affiliation(s)
- S. Raquel Ramos
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Olivia M. O’Hare
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | | | - Susan Kaplan Jacobs
- Health Sciences Librarian/Curator, New York University, New York, New York, USA
| | - Brynne Campbell
- Health Sciences Reference Associate, New York University, New York, New York, USA
| | - Trace Kershaw
- Department of Social and Behavioral Sciences, and Director, P30 Center for Interdisciplinary Research on AIDS and R25 REIDS HIV Training Programs, School of Public Health, Yale, University, New Haven, Connecticut, USA
| | | | - Harmony R. Reynolds
- Sarah Ross, Soter Center for Women’s Cardiovascular Research, Leon H. Charney Division of Cardiology, and Associate Professor, Department of Medicine, NYU School of Medicine, NYU LangoneHealth, New York, New York, USA
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Odukoya OO, Ohazurike C, Akanbi M, O'Dwyer LC, Isikekpei B, Kuteyi E, Ameh IO, Osadiaye O, Adebayo K, Usinoma A, Adewole A, Odunukwe N, Okuyemi K, Kengne AP. mHealth Interventions for Treatment Adherence and Outcomes of Care for Cardiometabolic Disease Among Adults Living With HIV: Systematic Review. JMIR Mhealth Uhealth 2021; 9:e20330. [PMID: 34106075 PMCID: PMC8409010 DOI: 10.2196/20330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 08/13/2020] [Accepted: 04/16/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The success of antiretroviral therapy has led to an increase in life expectancy and an associated rise in the risk of cardiometabolic diseases (CMDs) among people living with HIV. OBJECTIVE Our aim was to conduct a systematic review to synthesize the existing literature on the patterns of use and effects of mobile health (mHealth) interventions for improving treatment adherence and outcomes of care for CMD among people living with HIV. METHODS A systematic search of multiple databases, including PubMed-MEDLINE, Embase, CINAHL, Scopus, Web of Science, African Journals online, ClinicalTrials.gov, and the World Health Organization Global Index Medicus of peer-reviewed articles, was conducted with no date or language restrictions. Unpublished reports on mHealth interventions for treatment adherence and outcomes of care for CMD among adults living with HIV were also included in this review. Studies were included if they had at least 1 component that used an mHealth intervention to address treatment adherence or 1 or more of the stated outcomes of care for CMD among people living with HIV. RESULTS Our search strategy yielded 1148 unique records. In total, 10 articles met the inclusion criteria and were included in this review. Of the 10 studies, only 4 had published results. The categories of mHealth interventions ranged from short messaging, telephone calls, and wearable devices to smartphone and desktop web-based mobile apps. Across the different categories of interventions, there were no clear patterns in terms of consistency in the use of a particular intervention, as most studies (9/10, 90%) assessed a combination of mHealth interventions. Short messaging and telephone calls were however the most common interventions. Half of the studies (5/10, 50%) reported on outcomes that were indirectly linked to CMD, and none of them provided reliable evidence for evaluating the effectiveness of mHealth interventions for treatment adherence and outcomes of care for CMD among people living with HIV. CONCLUSIONS Due to the limited number of studies and the heterogeneity of interventions and outcome measures in the studies, no definitive conclusions could be drawn on the patterns of use and effects of mHealth interventions for treatment adherence and outcomes of care for CMD among people living with HIV. We therefore recommend that future trials should focus on standardized outcomes for CMD. We also suggest that future studies should consider having a longer follow-up period in order to determine the long-term effects of mHealth interventions on CMD outcomes for people living with HIV. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42018086940; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018086940.
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Affiliation(s)
- Oluwakemi Ololade Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Chidumga Ohazurike
- Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Maxwell Akanbi
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Linda C O'Dwyer
- Galter Health Sciences Library and Learning Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Brenda Isikekpei
- Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Ewemade Kuteyi
- Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Idaomeh O Ameh
- Division of Nephrology, Zenith Medical and Kidney Center, Abuja, Nigeria
| | - Olanlesi Osadiaye
- Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Khadijat Adebayo
- Department of Clinical Medicine, All Saints University School of Medicine, Roseau, Dominica
| | - Adewunmi Usinoma
- Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Ajoke Adewole
- Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Nkiruka Odunukwe
- Non-Communicable Disease Research Group, Nigeria Institute of Medical Research, Lagos, Nigeria
| | - Kola Okuyemi
- Department of Family and Preventive Medicine, University of Utah School Of Medicine, Salt Lake City, UT, United States
| | - Andre Pascal Kengne
- Non-Communicable Disease Research Unit, Medical Research Council, Cape Town, South Africa
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Effects of Aerobic and Resistance Exercise on Cardiovascular Parameters for People Living With HIV: A Meta-analysis. J Assoc Nurses AIDS Care 2020; 30:186-205. [PMID: 30822291 DOI: 10.1097/jnc.0000000000000006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
People living with HIV (PLWH) have limited exercise capacity because of anemia, neuromuscular disorders, and pulmonary limitations. We used a meta-analysis to examine the effect of aerobic and resistance exercise alone and in combination on cardiovascular parameters. Subgroup meta-analyses were conducted and long-term effects of exercise were investigated. A systematic literature search was conducted up to July/August 2017. The Physiotherapy Evidence Database-scale was used to rate quality and assess the risk of bias on the papers. Standardized mean differences (SMDs) were calculated to assess the effect of exercise. Posttreatment comparison between the exercise and control groups revealed moderate and large effect sizes in favor of the intervention group for VO2max (SMD = 0.66, p < .0001) and the 6-minute walk test (SMD = 1.11, p = .0001). Exercise had a positive effect on cardiovascular parameters in PLWH. Exercise can be a prevention factor for PLWH dealing with multiple comorbidities.
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Mabweazara SZ, Ley C, Leach LL. Physical activity, social support and socio-economic status amongst persons living with HIV and AIDS: a review. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2019; 17:203-212. [PMID: 30003848 DOI: 10.2989/16085906.2018.1475400] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Physical activity can be used for the effective and comprehensive management of HIV and AIDS. Social support and socio-economic status (SES) are two factors that shape physical activity behaviours. Individuals of low SES carry a disproportionate burden of the HIV and AIDS epidemic. In addition, limited resources constitute socio-ecological barriers predisposing such individuals to physical inactivity. The purpose of this narrative review is to examine the available literature on physical activity, social support and SES and to generate recommendations for designing and implementing physical activity interventions targeting people living with HIV and AIDS (PLWHA) of low SES. The review used literature from Google, Google Scholar and PubMed on physical activity of PLWHA, social support for physical activity, and SES and physical activity. Qualitative and quantitative studies in English were included from 1970 to 2016. The results show that social support plays a major role in promoting physical activity and counteracting the barriers to PA in PLWHA of low SES. The results on the role of social support and the influence of SES are integrated to help design appropriate physical activity interventions for PLWHA of low SES. Well-designed interventions should utilise social support and be contextualised for PLWHA of low SES, whose living conditions present multiple barriers to physical activity.
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Affiliation(s)
- Smart Z Mabweazara
- a Department of Sport Recreation and Exercise Science , University of the Western Cape , Bellville , South Africa
| | - Clemens Ley
- b Institute of Sport Science , University of Vienna , Vienna , Austria
| | - Lloyd L Leach
- a Department of Sport Recreation and Exercise Science , University of the Western Cape , Bellville , South Africa
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7
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Abstract
Evidence would suggest that regardless of disease status, people living with human immunodeficiency virus (HIV)/AIDS can obtain similar health benefits from routine physical activity reported within general populations. Research has shown significant improvements among psychological and physiologic variables within the first 5 to 6 weeks of beginning a routine physical activity program. Daily activity has shown promising results in other clinical populations, but there is still a paucity of research that limits evidence among the HIV population. Additional research is needed to examine the long-term benefits of physical activity, and to discover more practical ways to achieve this lifestyle change.
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Affiliation(s)
- Jason R Jaggers
- Department of Health and Sport Sciences, University of Louisville, 2100 South Floyd Street SAC East 104, Louisville, KY 40208, USA.
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8
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Wireless Physical Activity Monitor Use Among Adults Living With HIV: A Scoping Review. REHABILITATION ONCOLOGY 2019. [DOI: 10.1097/01.reo.0000000000000153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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9
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Lambert SD, Beatty L, McElduff P, Levesque JV, Lawsin C, Jacobsen P, Turner J, Girgis A. A systematic review and meta-analysis of written self-administered psychosocial interventions among adults with a physical illness. PATIENT EDUCATION AND COUNSELING 2017; 100:2200-2217. [PMID: 28734559 DOI: 10.1016/j.pec.2017.06.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/19/2017] [Accepted: 06/30/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The cost of implementing professionally-led psychosocial interventions has limited their integration into routine care. To enhance the translation of effective psychosocial interventions in routine care, a self-administered format is sometimes used. The meta-analysis examined the efficacy of written self-administered, psychosocial interventions to improve outcomes among individuals with a physical illness. METHODS Studies comparing a written self-administered intervention to a control group were identified through electronic databases searching. Pooled effect sizes were calculated across follow-up time points using random-effects models. Studies were also categorised according to three levels of guidance (self-administered, minimal contact, or guided) to examine the effect of this variable on outcomes. RESULTS Forty manuscripts were retained for the descriptive review and 28 for the meta-analysis. Findings were significant for anxiety, depression, distress, and self-efficacy. Results were not significant for quality of life and related domains as well as coping. Purely self-administered interventions were efficacious for depression, distress, and self-efficacy; only guided interventions had an impact on anxiety. CONCLUSIONS Findings showed that written self-administered interventions show promise across a number of outcomes. PRACTICE IMPLICATIONS Self-administered interventions are a potentially efficacious and cost-effective approach to address some of the most common needs of patients with a physical illness.
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Affiliation(s)
- Sylvie D Lambert
- Ingram School of Nursing, McGill University, Wilson Hall, 3506 University Street, Montreal, H3A 2A7, Canada; Psycho-Oncology Research Group, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Sydney, The University of New South Wales, Liverpool, Australia(1); St. Mary's Research Centre.
| | - Lisa Beatty
- School of Psychology, Flinders University, Adelaide, Australia
| | - Patrick McElduff
- School of Medicine and Public Health, The University of Newcastle, HMRI building, John Hunter Hospital Campus, New Lambton Heights, Australia
| | - Janelle V Levesque
- Psycho-Oncology Research Group, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Sydney, The University of New South Wales, Liverpool, Australia(1)
| | - Catalina Lawsin
- School of Psychology, The University of Sydney, Sydney, Australia
| | - Paul Jacobsen
- Division of Population Science, Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Jane Turner
- Mental Health Centre, The University of Queensland, Herston, Australia
| | - Afaf Girgis
- Psycho-Oncology Research Group, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Sydney, The University of New South Wales, Liverpool, Australia(1)
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Improving Health and Reducing Comorbidity Associated with HIV: The Development of TAVIE en santé, a Web-Based Tailored Intervention to Support the Adoption of Health Promoting Behaviors among People Living with HIV. BIOMED RESEARCH INTERNATIONAL 2017; 2017:4092304. [PMID: 28393077 PMCID: PMC5368366 DOI: 10.1155/2017/4092304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 01/30/2017] [Indexed: 01/14/2023]
Abstract
Background. In the domain of health behavior change, the deployment and utilization of information and communications technologies as a way to deliver interventions appear to be promising. This article describes the development of a web-based tailored intervention, TAVIE en santé, to support people living with HIV in the adoption of healthy behaviors. Methods. This intervention was developed through an Intervention Mapping (IM) framework and is based on the theory of planned behavior. Results. Crucial steps of IM are the selection of key determinants of behavior and the selection of useful theory-based intervention methods to change the targeted determinants (active ingredients). The content and the sequence of the intervention are then created based on these parameters. TAVIE en santé is composed of 7 interactive web sessions hosted by a virtual nurse. It aims to develop and strengthen skills required for behavior change. Based on an algorithm using individual cognitive data (attitude, perceived behavioral control, and intention), the number of sessions, theory-based intervention methods, and messages contents are tailored to each user. Conclusion. TAVIE en santé is currently being evaluated. The use of IM allows developing intervention with a systematic approach based on theory, empirical evidence, and clinical and experiential knowledge.
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Côté J, Cossette S, Ramirez-Garcia P, De Pokomandy A, Worthington C, Gagnon MP, Auger P, Boudreau F, Miranda J, Guéhéneuc YG, Tremblay C. Evaluation of a Web-based tailored intervention (TAVIE en santé) to support people living with HIV in the adoption of health promoting behaviours: an online randomized controlled trial protocol. BMC Public Health 2015; 15:1042. [PMID: 26458508 PMCID: PMC4603806 DOI: 10.1186/s12889-015-2310-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 09/22/2015] [Indexed: 11/19/2022] Open
Abstract
Background Long-term use of antiretroviral therapy, normal aging, and presence of certain risk factors are associated with metabolic disorders that predispose persons living with HIV to diabetes and cardiovascular diseases. The emergence and progression of these disorders can be prevented by adopting healthy behaviours. Based on the theory of planned behaviour, the Web-based tailored intervention TAVIE en santé was developed. The aim of this study is to evaluate the effectiveness of TAVIE en santé in order to support people living with HIV in the adoption of health promoting behaviours. Methods/Design An online randomized controlled trial with parallel-groups will be conducted across Canada. To participate in this study, people living with HIV must be: ≥ 18 years, able to read/understand French or English, have access to the Internet. A convenience sample of 750 participants will be randomly assigned either to an experimental group (TAVIE en santé, n = 375) or to a control group (websites, n = 375) (1:1 allocation ratio). The TAVIE en santé intervention is composed of seven interactive computer sessions, lasting between 5 and 10 min. The sessions, hosted by a virtual nurse, aim to develop and strengthen skills required for behaviour change. The control group will receive a validated list of five predetermined conventional health-related Websites. The adoption of health behaviour (smoking cessation or physical activity or healthy eating) is the principal outcome. Cognitions (intention, attitude, perceived behavioral control) are the secondary outcomes. Health indicators will also be assessed. All outcomes will be measured with a self-administered online questionnaire and collected three times: at baseline, 3 and 6 months after. The principal analyses will focus on differences between the two trial groups using Intention-to-Treat analysis. Discussion This study will yield new results about the efficacy of Web-based tailored health behaviours change interventions in the context of chronic disease. The TAVIE en santé intervention could constitute an accessible complementary service in support of existing specialized services to support people living with HIV adopt health behaviors. Trial registration NCT02378766, assigned on March 3th 2015.
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Affiliation(s)
- José Côté
- Research Centre of the Centre Hospitalier de l'Université de Montréal, 900 Saint Denis Street, Montreal, H2X 0A9, QC, Canada. .,Research Chair in Innovative Nursing Practices, 900 Saint Denis Street, Montreal, H2X 0A9, QC, Canada. .,Faculty of Nursing, Université de Montréal, 2375, chemin de la Côte-Ste-Catherine, Montréal, H3T 1A8, QC, Canada.
| | - Sylvie Cossette
- Faculty of Nursing, Université de Montréal, 2375, chemin de la Côte-Ste-Catherine, Montréal, H3T 1A8, QC, Canada. .,Research Center of the Montreal Heart Institute, 5000, Bélanger Street, Montréal, H1T 1C8, QC, Canada.
| | - Pilar Ramirez-Garcia
- Faculty of Nursing, Université de Montréal, 2375, chemin de la Côte-Ste-Catherine, Montréal, H3T 1A8, QC, Canada.
| | - Alexandra De Pokomandy
- Faculty of Medecine, McGill University, 3655 Sir William Osler, Montreal, H3G 1Y6, QC, Canada.
| | - Catherine Worthington
- Faculty of Human and Social Development, University of Victoria, 3800 Finnerty Road, Victoria, V8P 5C2, BC, Canada.
| | - Marie-Pierre Gagnon
- Research Centre of the Centre Hospitalier Universitaire de Québec, 2705, boulevard Laurier, Québec, G1V 4G2, QC, Canada. .,Faculty of Nursing Sciences, Université Laval, 1050, avenue de la Médecine Local 3645, Québec, G1V 0A6, QC, Canada.
| | - Patricia Auger
- Research Centre of the Centre Hospitalier de l'Université de Montréal, 900 Saint Denis Street, Montreal, H2X 0A9, QC, Canada. .,Research Chair in Innovative Nursing Practices, 900 Saint Denis Street, Montreal, H2X 0A9, QC, Canada.
| | - François Boudreau
- Faculty of Nursing, Université du Québec à Trois-Rivièves, 3351, boul. des Forges, CP 500, Trois-Rivières, G9A 5H7, QC, Canada.
| | - Joyal Miranda
- Ryerson University, 350 Victoria Street, Toronto, M5B 2K3, ON, Canada.
| | - Yann-Gaël Guéhéneuc
- Canada Research Chair on Software Patterns and Patterns of Software, 2500, chemin de Polytechnique, Montréal, H3T 1J4, QC, Canada. .,Department of Computer Engineering, Polytechnique Montréal, 2500, chemin de Polytechnique, Montréal, H3T 1J4, QC, Canada.
| | - Cécile Tremblay
- Research Centre of the Centre Hospitalier de l'Université de Montréal, 900 Saint Denis Street, Montreal, H2X 0A9, QC, Canada. .,Quebec Public Health Laboratory, Sainte-Marie Rd, Sainte-Anne-de-Bellevue, H9X 3R5, QC, Canada. .,Faculty of Medecine, Université de Montréal, 2900, boulevard Édouard-Montpetit, Montréal, H3T 1J4, QC, Canada.
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Wirth MD, Jaggers JR, Dudgeon WD, Hébert JR, Youngstedt SD, Blair SN, Hand GA. Association of Markers of Inflammation with Sleep and Physical Activity Among People Living with HIV or AIDS. AIDS Behav 2015; 19:1098-107. [PMID: 25399034 DOI: 10.1007/s10461-014-0949-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This study examined associations of sleep and minutes spent in moderate-vigorous physical activity (MVPA) with C-reactive protein (CRP) and interleukin (IL)-6 among persons living with HIV. Cross-sectional analyses (n = 45) focused on associations of inflammatory outcomes (i.e., CRP and IL-6) with actigraph-derived sleep duration, latency, and efficiency; sleep onset; wake time; and wake-after-sleep-onset; as well as MVPA. Least square means for CRP and IL-6 by levels of sleep and MVPA were computed from general linear models. Individuals below the median of sleep duration, above the median for sleep onset, and below the median of MVPA minutes had higher CRP or IL-6 levels. Generally, individuals with both low MVPA and poor sleep characteristics had higher inflammation levels than those with more MVPA and worse sleep. Understanding the combined impact of multiple lifestyle/behavioral factors on inflammation could inform intervention strategies to reduce inflammation and therefore, chronic disease risk.
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Affiliation(s)
- Michael D Wirth
- The South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Room 233, Columbia, SC, 29208, USA,
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Jaggers JR, Prasad VK, Dudgeon WD, Blair SN, Sui X, Burgess S, Hand GA. Associations between physical activity and sedentary time on components of metabolic syndrome among adults with HIV. AIDS Care 2014; 26:1387-92. [PMID: 24861098 DOI: 10.1080/09540121.2014.920075] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Recent data show that people living with HIV/AIDS (PLWHA) are at a greater risk of cardiovascular disease (CVD), which could possibly be explained by an increased prevalence of metabolic syndrome (MetSyn) due to the known toxicities associated with antiretroviral therapy (ART). The purpose of this study is to examine the relationships between physical activity (PA) and components of MetSyn in a sample of PLWHA taking ART. A total of 31 males and 32 females living with HIV and currently taking ART were enrolled in a home-based PA intervention aimed to reduce risk factors for CVD. Clinical assessments included measures of resting blood pressure (BP), waist circumference, height, weight, PA levels via accelerometer, and a fasted blood draw. Components of MetSyn were divided into three clusters (1 = 0-1; 2 = 2; 3 = 3 or more). A one-way analysis of variance was used to determine differences between clusters. Multiple linear regressions were used to identify significant associations between moderate intensity PA (MPA) and sedentary time among components of MetSyn. MPA was significantly lower across MetSyn clusters (p < 0.001), whereas sedentary time was significantly higher (p = 0.01). A multiple linear regression showed MPA to be a significant predictor of waist circumference after controlling for age, race, gender, and sedentary time. Routine PA can be beneficial in helping PLWHA reduce waist circumference ultimately leading to metabolic improvements. This in turn would help PLWHA self-manage known components of MetSyn, thus reducing their risk of CVD and mortality.
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Affiliation(s)
- Jason R Jaggers
- a Department of Applied Health Sciences , Murray State University , Murray , KY , USA
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