Text Message Physical Activity Intervention to Treat Cognitive Deficits in HIV

描述（由申请人提供）：HIV感染的特征通常是神经认知缺陷，统称为HIV相关神经认知障碍（HAND）。虽然联合抗逆转录病毒疗法（CART）的使用大大降低了艾滋病相关的发病率，但HAND仍然是一个重大的公共卫生问题，与艾滋病毒阳性（HIV+）个体的日常功能受损和生活质量差有关。尽管在CART时代HAND持续流行，但在该人群中没有经验验证的有效治疗神经认知功能障碍的策略。身体活动（PA）已被用作 有效非药物方法来改善痴呆和精神障碍患者的认知能力。据报道，PA干预HIV+受试者可改善心肺功能，但PA对HAND的影响尚未得到很好的表征。以前的HIV PA干预措施还涉及严格的PA（在跑步机上跑步）和重要的参与者资源（每周多次前往健身房），这可能不适合或不适用于许多HIV+个体。我们建议进行一项随机对照试验，以管理个性化的交互式移动的手机短信干预，以增加中度PA和改善认知功能的HIV+参与者与手。本研究将利用加州电信和信息技术研究所（Calit 2）开发的短消息服务/多媒体消息服务（SMS/MMS）平台，该平台使用移动的电子设备进行最先进的健康宣传。50名HIV阳性受试者将被随机分配到对照组或为期4个月的干预组，干预组将每天接收旨在增加PA的SMS/MMS移动的电话信息。干预条件，基于控制理论，通过使用短信文本提示和MMS图像来监测PA，提供目标提醒，促进目标策略，并提供目标进展的反馈，从而促进目标设定。我们将进行焦点小组，以确定艾滋病毒特异性PA限制（例如，药物副作用，神经病变），并确定克服这些障碍的方法。短信将针对每个人，包括他们的社会联系和环境。我们假设，与对照组相比，接受这种干预的HIV+参与者将表现出PA的显著增加，这是通过计步器步数、加速度计活动和7天体力活动回忆（PAR）自我报告的PA进行评估的。此外，我们建议，干预措施将改善认知能力和日常功能相比，控制条件量化的全面的神经心理电池和自我报告和基于性能的日常生活活动的措施。该提案的结果将为开发新的大规模个性化移动的PA干预措施奠定基础，这些干预措施致力于治疗HAND并改善HIV+个体的生活质量。

DESCRIPTION (provided by applicant): HIV infection is frequently characterized by neurocognitive deficits collectively labeled as HIV-associated neurocognitive disorders (HAND). While the use of combination antiretroviral therapies (CART) have dramatically reduced AIDS-related morbidity, HAND remains a significant public health concern linked to impaired everyday functioning and poor quality of life in HIV-positive (HIV+) individuals. Despite the continued prevalence of HAND in the CART era, there are no empirically validated strategies to effectively treat neurocognitive dysfunction in this population. Physical activity (PA) has been utilized as an effective non- pharmacological method to improve cognitive performance in individuals with dementia and psychiatric disorders. PA interventions in HIV+ subjects are reported to improve cardiopulmonary fitness, but the effects of PA on HAND have not been well characterized. Previous HIV PA interventions also involve rigorous PA (running on a treadmill) and significant participant resources (traveling to a gym multiple times per week) that may not be suitable or practical for many HIV+ individuals. We propose to conduct a randomized controlled trial to administer a personalized interactive mobile phone text messaging intervention to increase moderate PA and improve cognitive function in HIV+ participants with HAND. This study will utilize a Short Message Service/Multimedia Message Service (SMS/MMS) platform developed by the California Institute for Telecommunications and Information Technology (Calit2), which conducts state-of-art health promotions using mobile electronic devices. 50 HIV+ participants will be randomly assigned to a control group or a 4-month intervention group that will receive daily SMS/MMS mobile phone messages designed to increase PA. The intervention condition, based on control theory, is structured to promote goal-setting by using SMS text prompts and MMS images to monitor PA, provide goal reminders, promote goal strategies, and deliver feedback on goal progress. We will conduct focus groups to identify HIV-specific PA limitations (e.g., medication side effects, neuropathy) and identify ways to overcome these barriers. Text messages will be tailored to each individual, including their social contacts and environment. We hypothesize that HIV+ participants administered this intervention will exhibit a significant increase in PA compared to a control group as assessed by pedometer step counts, accelerometer activity, and self-reported PA on the 7-Day Physical Activity Recall (PAR). Further, we propose that the intervention will improve cognitive performance and everyday functioning compared to the control condition as quantified by a comprehensive neuropsychological battery and self-report and performance-based measures of daily living activities. Findings from this proposal will lay the groundwork for development of novel large-scale personalized mobile PA interventions dedicated to treating HAND and improving the quality of life for HIV+ individuals.