Evaluating a community-based exercise intervention with adults living with HIV: protocol for an interrupted time series study

Abstract

IntroductionOur aim was to evaluate a community-based exercise (CBE) intervention with the goal of reducing disability and enhancing health for community-dwelling people living with HIV (PLWH).Methods and analysisWe will use a mixed-methods implementation science study design, including a prospective longitudinal interrupted time series study, to evaluate a CBE intervention with PLWH in Toronto, Canada. We will recruit PLWH who consider themselves medically stable and safe to participate in exercise. In the baseline phase (0–8 months), participants will be monitored bimonthly. In the intervention phase (8–14 months), participants will take part in a 24-week CBE intervention that includes aerobic, resistance, balance and flexibility exercise at the YMCA 3 times per week, with weekly supervision by a fitness instructor, and monthly educational sessions. In the follow-up phase (14–22 months), participants will be encouraged to continue to engage in unsupervised exercise 3 times per week. Quantitative assessment: We will assess cardiopulmonary fitness, strength, weight, body composition and flexibility outcomes followed by the administration of self-reported questionnaires to assess disability and contextual factor outcomes (coping, mastery, stigma, social support) bimonthly. We will use time series regression analysis to determine the level and trend of outcomes across each phase in relation to the intervention. Qualitative assessment: We will conduct a series of face-to-face interviews with a subsample of participants and recreation providers at initiation, midpoint and completion of the 24-week CBE intervention. We will explore experiences and anticipated benefits with exercise, perceived impact of CBE for PLWH and the strengths and challenges of implementing a CBE intervention. Interviews will be audio recorded and analysed thematically.Ethics and disseminationProtocol approved by the University of Toronto HIV/AIDS Research Ethics Board. Knowledge translation will occur with stakeholders in the form of presentations and publications in open access peer-reviewed journals.Trial registration numberNCT02794415; Pre-results.

Research priorities for rehabilitation and aging with HIV: a framework from the Canada-International HIV and Rehabilitation Research Collaborative (CIHRRC)

“…Given the barriers to accessing formalized rehabilitation services, strategies promoting resilience and self-management have an increasing role for empowering individuals to maximize their own health and well-being while aging with HIV [85,93]. For instance, exercise is a widely accepted rehabilitation intervention to improve physical and mental health outcomes among adults living with HIV [94][95][96][97] and implementation science approaches are underway to examine the effectiveness of communitybased exercise for adults with HIV in Canada [98] and South Africa [77]. Evidence examining the effectiveness of yoga interventions also is emerging in the context of HIV [38,99]; however, data comparing level of engagement in and response to these physical activity interventions among older versus younger adults living is limited.…”

Research priorities for rehabilitation and aging with HIV: a framework from the Canada-International HIV and Rehabilitation Research Collaborative (CIHRRC)

“…Given the barriers to accessing formalized rehabilitation services, strategies promoting resilience and selfmanagement have an increasing role for empowering individuals to maximize their own health and well-being while aging with HIV (85,93). For instance, exercise is a widely accepted rehabilitation intervention to improve physical and mental health outcomes among adults living with HIV (94-97) and implementation science approaches are underway to examine the effectiveness of community-based exercise for adults with HIV in Canada (98) and South Africa (77). Evidence examining the effectiveness of yoga interventions also is emerging in the context of HIV (38,99); however, data comparing level of engagement in and response to these physical activity interventions among older versus younger adults living is limited.…”

Research priorities for rehabilitation and aging with HIV: a framework from the Canada-International HIV and Rehabilitation Research Collaborative (CIHRRC)

“…Examining the prevalence and impact of uncertainty, and determining how rehabilitation interventions can address worrying about the future and mental-emotional health challenges will be critical as adults age with HIV. implementation science approaches are underway to examine the effectiveness of community-based exercise for adults with HIV in Canada (94) and South Africa (73). Evidence examining the effectiveness of yoga interventions also is emerging in the context of HIV (35,95); however, data comparing level of engagement in and response to these physical activity interventions among older versus younger adults living is limited.…”