Text Message Physical Activity Intervention to Treat Cognitive Deficits in HIV

描述(由申请人提供)：HIV感染通常以神经认知缺陷为特征，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+)患者的日常功能受损和生活质量低下有关。尽管手部疾病在CART时代持续流行，但在这一人群中，还没有经过经验验证的有效治疗神经认知功能障碍的策略。体力活动(PA)已被用作 有效的非药物方法，以改善痴呆症和精神障碍患者的认知表现。据报道，对HIV阳性的受试者进行PA干预可以改善心肺健康，但PA对手部的影响尚未得到很好的表征。以前的HIV PA干预还涉及严格的PA(在跑步机上跑步)和大量的参与者资源(每周多次前往健身房)，这些可能不适合或不实用于许多HIV+患者。我们建议进行一项随机对照试验，以实施个性化的互动手机短信干预，以增加适度的PA，并改善HIV+手部参与者的认知功能。这项研究将利用加州电信和信息技术研究所(Calit2)开发的短消息服务/多媒体消息服务(SMS/MMS)平台，该平台使用移动电子设备进行最先进的健康促进。50名HIV+参与者将被随机分配到对照组或为期4个月的干预组，干预组每天将收到旨在增加PA的短信/彩信手机短信。干预条件以控制理论为基础，通过使用短信短信提示和彩信图像来监控PA，提供目标提醒，促进目标策略，并就目标进展提供反馈，从而促进目标设定。我们将领导焦点小组，以确定艾滋病毒特有的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。短信将为每个人量身定做，包括他们的社交联系人和环境。我们假设，与对照组相比，实施这项干预的HIV+参与者将显示出显著的PA增加，这是通过计步器步数、加速计活动和7天体力活动回忆(PAR)中自我报告的PA来评估的。此外，我们认为，与控制条件相比，干预将改善认知表现和日常功能，控制条件通过综合神经心理组合和自我报告以及基于日常生活活动的绩效测量来量化。这项提议的发现将为开发新型大规模个性化移动PA干预措施奠定基础，该干预措施致力于治疗手部疾病并改善HIV+患者的生活质量。

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.