Action for better brain health among people living with HIV: protocol for a randomized controlled trial

Abstract

Background Lifestyle changes can protect or improve brain health in older adults. However, sustained lifestyle change is difficult for everyone and may be more difficult for those with executive dysfunction, including some people living with HIV. Thus, the key question is how we can improve adherence to the most promising interventions among people living with HIV experiencing cognitive difficulties. Goal management training is a cognitive rehabilitation program that targets executive dysfunction by teaching goal-directed behaviour and self-management. It is a promising means to improve adherence to lifestyle interventions. Objective To estimate the extent to which goal management training before a healthy lifestyle program is associated with greater adherence to health recommendations, achievement of health-related goals, and better brain health and health outcomes compared to the healthy lifestyle program alone among people living with HIV. Methods Brain Health Now cohort participants with cognitive difficulties or are not aging successfully are eligible. All participants will be given health resources, a health coach, a goal-setting digital application, and access to an online goal-setting workshop. The intervention group will participate in nine 2-h goal management training sessions and then will enter the healthy lifestyle program. Control participants will enter the healthy lifestyle program directly. A total sample of 100 participants will participate for 12 months. The main outcome is adherence to the healthy lifestyle program, defined as the number of weeks where physical activity adherence targets were met (150 min per week, measured with an activity monitor). Weekly social activities will be captured via self-report with confidential photo validation. We will send weekly health state reports to the participants. Downstream outcomes include cognitive ability, health-related quality of life, mobility, vascular risk profile, and social network size. We will analyze the data using a linear regression model. Discussion This project is the first to test whether goal management training can augment adherence to health recommendations among individuals with cognitive difficulties. If successful, behavioural interventions such as goal management training could be implemented as an adjunct to lifestyle interventions in other clinical populations. Trial registration: This trial was registered on clinicaltrials.gov (NCT04345484) on April 14, 2020, https://clinicaltrials.gov/ct2/show/NCT04345484?term=NCT04345484&draw=2&rank=1.

Wireless physical activity monitor use among adults living with HIV in a community-based exercise intervention study: a quantitative, longitudinal, observational study

“…Intensity is important as the Canadian Physical Activity Guidelines recommends adults to engage in at least 150 min of moderate to vigorous aerobic physical activity per week 55. Quigley et al are currently investigating healthy lifestyle living and goal management training among adults living with HIV using a WPAM (Garmin VivoFit 4) to record aerobic intensity to determine achievement of physical activity guidelines 56. Therefore, WPAMs that accurately measure step count and aerobic intensity may help researchers and clinicians in determining if adults living with HIV are meeting physical activity guidelines.…”

Wireless physical activity monitor use among adults living with HIV in a community-based exercise intervention study: a quantitative longitudinal observational study

“…Intensity is important as the Canadian Physical Activity Guidelines recommends adults to engage in at least 150 minutes of moderate to vigorous aerobic physical activity per week. [50] Quigley et al are currently investigating healthy lifestyle living and goal management training among PLWH[51] using a WPAM (Garmin VivoFit 4) to record aerobic intensity to determine achievement of physical activity guidelines. [51] Therefore, WPAMs that accurately measure step count and aerobic intensity may help researchers and clinicians in determining if PLWH are meeting physical activity guidelines.…”

“…PLWH[51] using a WPAM (Garmin VivoFit 4) to record aerobic intensity to determine achievement of physical activity guidelines [51]. Therefore, WPAMs that accurately measure step count and aerobic intensity may help researchers and clinicians in determining if PLWH are meeting physical activity guidelines.…”

Translocation of bacterial LPS is associated with self-reported cognitive abilities in men living with HIV receiving antiretroviral therapy

“…In a cross-sectional analysis, a total of 80 ART-treated men living with HIV (MLWH) were selected from the Positive Brain Health Now (CIHR/CTN 372) cohort. The study design and protocol of the study have been reported [ 14 , 15 ]. Samples were drawn from all participants who completed Visit 1, had available measures of cognition (performance-based and self-report) and frozen biological samples, after excluding participants (i) using anti-acids or proton pump inhibitors as those drugs modulate inflammation; and (ii) with high alcohol use (six or more drinks on one occasion more than once per month or more than 14 standard drinks/week) or cannabis use in the past 3 months.…”