Increasing physical activity among persons living with HIV engaged in unhealthy drinking

增加从事不健康饮酒的艾滋病毒感染者的体力活动

• 批准号: 10304669
• 负责人: Lisa M. Quintiliani
• 金额: $ 42.15万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-22 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10304669
• 关键词: AIDS/HIV problem; Acute; Address; Affect; Aging; Alcohol consumption; Behavioral; Boston; Cessation of life; Chronic; Collaborations; Counseling; Coupled; Data; Dropout; Ecological momentary assessment; Elderly; Female; General Population; Goals; HIV; Health; Health Technology; Health education; Heavy Drinking; Home; Individual; Intervention; Life Expectancy; Life Style; Measures; Mediating; Mental Depression; Mental Health; Monitor; Motivation; Outcome; Participant; Persons; Physical activity; Physical assessment; Population; Populations at Risk; Process; Public Health; Quality of life; Randomized; Randomized Controlled Trials; Recording of previous events; Risk; Self Efficacy; Structure; Supervision; Testing; Time; Work; acceptability and feasibility; alcohol abstinence; alcohol misuse; alcohol related problem; alcohol research; alcohol use disorder; antiretroviral therapy; base; comorbidity; coping; drinking; efficacy testing; exercise intervention; fitbit; fitness; follow-up; hazardous drinking; intervention effect; mHealth; male; mental function; mobile application; multiple chronic conditions; negative affect; physical conditioning; physical inactivity; primary outcome; recruit; secondary outcome; sedentary; sedentary lifestyle

PROJECT SUMMARY/ABSTRACT The era of antiretroviral therapy has shown increasing life expectancy and decreased HIV-related deaths, leading to a growing older adult HIV population. Yet, HIV accelerates the aging process and increases risk for numerous chronic health conditions that compromise physical and mental health functioning. Further, in this context, unhealthy alcohol use is common among persons living with HIV (PLWH) and also increases risk for negative outcomes. Yet, there are few interventions to address unhealthy alcohol use in PLWH that have resulted in significant effects nor have they employed approaches that could impact these multimorbidities. Therefore, intervention approaches that may have significant impact on unhealthy drinking in PLWH are necessary, particularly if they also have the potential to affect the physical and mental health multimorbidities common in PLWH. Efforts toward addressing another highly prevalent condition among PWLH – physical inactivity and sedentariness, may prove beneficial for changing unhealthy drinking and physical and mental health functioning. To date, physical activity (PA) approaches in PLWH have primarily consisted of structured, supervised, gym-based interventions that have resulted in positive outcomes but have been limited in their reach and associated with high drop-out in this population. Here we propose an alternate paradigm – home- based, lifestyle physical activity (LPA) with mobile health-delivered components that have the potential to address existing limitations of previous approaches. LPA interventions consist of behavioral strategies that guide individuals to integrate intermittent bouts of PA in their daily routines. An added strength of the LPA approach is it may be well-suited for PLWH engaged in unhealthy drinking by providing cumulative physical and mental health effects from regular, daily PA as well as acute effects on negative affect (common among PLWH engaged in unhealthy drinking) and urges to drink via individual, brief bouts of activity. To date, LPA interventions have not been tested in PLWH. As such, through online recruitment of PLWH, we will identify 220 HIV+ unhealthy drinkers and randomize them to the 12-week LPA+Fitbit intervention or to a Fitbit Only condition. Primary outcomes will include drinks/drinking day and objectively-determined steps/day at end of treatment and 6-month follow-ups. Changes between conditions on physical and mental health functioning, alcohol-related problems, coping, PA motivation, and PA self-efficacy will be examined as secondary outcomes. In addition, to elucidate mechanisms of intervention effects, we will employ two bursts of ecological momentary assessment to obtain multiple daily measures of affect, urges to drink, alcohol consumption, and PA engagement coupled with objective assessment of PA. If the LPA+Fitbit intervention proves efficacious, our lifestyle approach using mobile health technology will directly affect the significant multimorbidity in this at-risk population of PLWH engaged in unhealthy drinking, which in turn may have significant public health impact.

项目概要/摘要 抗逆转录病毒治疗时代显示出预期寿命的延长和艾滋病毒相关死亡的减少， 导致老年人艾滋病毒感染者人数不断增加。然而，艾滋病毒会加速衰老过程并增加患病风险 许多损害身心健康功能的慢性健康问题。此外，在这个 在这种背景下，不健康的饮酒在艾滋病毒感染者 (PLWH) 中很常见，并且还增加了患病的风险 负面结果。然而，针对感染者不健康饮酒问题的干预措施却很少。 导致了重大影响，也没有采用可能影响这些多重疾病的方法。 因此，可能对艾滋病病毒感染者不健康饮酒产生重大影响的干预方法是 必要的，特别是如果它们也有可能影响身心健康的多种疾病 常见于感染者。努力解决 PWLH 中另一个非常普遍的状况——身体状况 不活动和久坐，可能有助于改变不健康的饮酒和身心健康 健康运转。迄今为止，艾滋病毒感染者的体力活动 (PA) 方法主要包括结​​构化、 有监督的、以健身房为基础的干预措施取得了积极成果，但效果有限 达到并与该人群的高辍学率相关。在这里，我们提出了另一种范式——home- 基于生活方式的身体活动 (LPA) 以及移动健康交付的组件，这些组件有可能 解决以前方法的现有局限性。 LPA 干预措施包括行为策略， 指导个人将间歇性 PA 纳入日常生活中。 LPA 的额外优势 方法是，它可能非常适合从事不健康饮酒的艾滋病病毒感染者，通过提供累积的物理量 定期、日常 PA 以及对负面情绪的急性影响（常见于 PLWH 从事不健康饮酒）并通过个人、短暂的活动来敦促饮酒。迄今为止，LPA 干预措施尚未在 PLWH 中进行过测试。因此，通过网上招募感染者，我们将确定220名感染者。 HIV+ 不健康饮酒者，并将他们随机分配至 12 周 LPA+Fitbit 干预组或仅使用 Fitbit 健康）状况。主要结果将包括饮酒/饮酒日以及每天结束时客观确定的步数 治疗和6个月的随访。身体和心理健康功能状况之间的变化， 与酒精相关的问题、应对方式、PA 动机和 PA 自我效能将作为次要因素进行检查 结果。此外，为了阐明干预效果的机制，我们将采用两次生态爆发 进行瞬时评估，以获得多种每日情绪、饮酒冲动、饮酒量和 PA 参与以及对 PA 的客观评估。如果 LPA+Fitbit 干预被证明有效，我们的 使用移动健康技术的生活方式将直接影响这一高危人群的显着多重发病率 艾滋病毒感染者群体从事不健康饮酒，这反过来可能对公共健康产生重大影响。