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

Abstract

Objectives: Our aim was to examine Wireless Physical Activity Monitor (WPAM) use and its associations with contextual factors (age, highest education level, social support, mental health) among adults living with HIV engaged in a community-based exercise (CBE) intervention. Design: Quantitative longitudinal observational study. Setting: Toronto YMCA, Ontario, Canada. Participants: Eighty adults living with HIV who initiated the CBE intervention. Interventions: Participants received a WPAM to track physical activity during a 25-week CBE intervention involving thrice-weekly exercise, supervised weekly (Phase 1) and a 32-week follow-up involving independent thrice-weekly exercise (Phase 2). Outcome measures: Uptake was measured as participants who consented to WPAM use at intervention initiation. Usage was defined as the median proportion of days participants had great than 0 steps out of the total number of days in the study. We measured contextual factors using a baseline demographic questionnaire (age, highest education level), and median scores from the Medical Outcomes Study-Social Support Scale and Patient Health Questionnaire (mental health), where higher scores indicated greater social support and mental health concerns, respectively. We calculated Spearman correlations between WPAM usage and contextual factors defined as weak (ρ≥0.2, moderate (ρ≥0.4), strong (ρ≥0.6), or very strong (ρ≥0.8). Results: Seventy-six of 80 participants (95%) consented to WPAM use. In Phase 1, 66% of participants (n=76) used the WPAM at least one day. Median WPAM usage was 50% (25th, 75th percentile: 0%, 87%; n=76) of days enrolled in Phase 1 and 23% (0%, 76%; n=64) of days during Phase 2. Correlation coefficients ranged from weak for age (ρ=0.26) and mental health scores (ρ=-0.25) to no correlation (highest education level, social support). Conclusions: Most adults living with HIV consented to WPAM use, however, usage declined over time. Future implementation of WPAMs should consider factors to promote sustained usage by adults living with HIV. Trial Registration: NCT02794415

Research priorities in HIV, aging and rehabilitation: Building on a Framework with the Canada-International HIV and Rehabilitation Research Collaborative

“…Nevertheless, stakeholders in this consultation highlighted that online forms of rehabilitation were not a one-size-ts-all, and not always a replacement for in-person interventions. This was supported by evidence reporting variable uptake and declining use of wireless physical activity monitors (WPAMs) among adults living with HIV engaged in a community-based exercise intervention (21) and barriers and facilitators to uptake of WPAMs in the context of HIV (40). Similarly, the priorities from this Forum are supported by variability in digital health literacy documented among older adult populations during the COVID-19 pandemic (41,42).…”

“…These seven priorities spanned three content areas: A-Episodic Health and Disability Aging with HIV; B-Rehabilitation Interventions for Healthy Aging across the Lifespan and C-Outcome Measurement in HIV and Aging. Since the development of this Framework, web-based interventions, digital health technology, and tele-health and rehabilitation models of care delivery have increasingly emerged in the context of HIV and aging (17)(18)(19)(20)(21).…”