Feasibility of an Exercise Intervention in HIV+ Older Adults with Central Obesity

对患有中心性肥胖的艾滋病毒老年人进行运动干预的可行性

• 批准号: 8538639
• 负责人: Krupa N. Shah
• 金额: $ 15.46万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8538639
• 关键词: Acquired Immunodeficiency Syndrome; Adherence; Adipose tissue; Adverse event; Affect; Aging; Attenuated; Behavior; Body Composition; Central obesity; Chronic; Clinical Sciences; Clinical Trials; Clinical Trials Design; Cognitive; Commit; Communities; Comorbidity; Competence; Counseling; Data; Development; Development Plans; Disease; Elderly; Exercise; Exercise Physiology; Fatty acid glycerol esters; Feasibility Studies; Foundations; Future; Goals; Growth; HIV; Health; Home environment; Impairment; Informal Social Control; Institutes; Intervention; Investigation; Knowledge; Lead; Life Style; Magnetic Resonance Imaging; Measures; Mediator of activation protein; Mental disorders; Mentors; Metabolic; Motivation; Muscle; Obesity; Older Population; Patients; Physical Function; Population; Population Research; Positioning Attribute; Prevalence; Quality of life; Questionnaires; Randomized; Randomized Controlled Clinical Trials; Reading; Reporting; Research; Research Design; Research Personnel; Research Proposals; Resources; Risk; Sample Size; Self Determination; Sensory; Skeletal Muscle; Substance abuse problem; Testing; Training; Translating; Translational Research; United States National Institutes of Health; Universities; base; behavior change; career; career development; cohort; evidence based guidelines; experience; frailty; functional decline; functional status; high risk; improved; low socioeconomic status; muscle form; patient oriented research; performance tests; prevent; programs; psychologic; public health relevance; theories

DESCRIPTION (provided by applicant): As a geriatrician and a junior investigator, I am committed to an academic career in patient-oriented research. This K23 will lay the foundation for me to become an independent investigator, where I can lead translational interventions to attenuate functional decline in HIV-infected older adults (HOA). Aside from specific coursework and didactic readings, my growth in HIV and Aging will be enhanced from a mentoring panel who will contribute to my career growth. The career development plan features a strong, established, multi-disciplinary mentoring panel with experts in aging, HIV disease, behavior and motivation, clinical trials, body composition, physical frailty and exercise physiology. Additional key resources include University of Rochester's Clinical and Translational Science Institute and its Developmental Center for AIDS Research. The targeted training will not only improve my knowledge in HIV and Aging, but also will put me in a competitive position to apply for a NIH R01 that supports a clinical trial designed to ameliorate frailty in HOA. The improved survival of HOA has significant implications with respect to their functional status and quality of life (QOL). Further, HOA with central obesity are at increased risk of frailty and accelerated functional decline. While it is known that exercise can improve physical function in the general older population, the HIV-infected population, itself, is a challenging cohort with respect to behavior change, and consequently this population may find it difficult to initiate and comply with an exercise program. Consequently, the aims of the research plan herein is 1) to investigate the feasibility of an individually tailored home-based exercise program in combination with motivational counseling based on the self determination theory (SDT) of behavior change and 2) to determine its potential efficacy in improving physical function, body composition and exercise-related psychological mediators in HOA with central obesity. We propose to pilot test the intervention with a randomized controlled clinical trial. HOA with central obesity will be randomized to either maintain their usual activities or to receive the home-based exercise program in combination with motivation counseling based on SDT of behavior change. The preliminary data obtained from this feasibility study will be used to calculate the correct sample size to conduct a larger efficacy RCT, a potential R01 investigation. The overall goal of this research is to identify a feasible intervention that can be translated into the HOA community to attenuate functional decline and thereby improving health and QOL. The experience in study design and execution of the proposed research will be invaluable to my career growth and my transition to an independent investigator.

描述（由申请人提供）：作为一名老年病学家和初级研究者，我致力于以患者为导向的研究的学术生涯。 K23 将为我成为一名独立研究者奠定基础，我可以领导转化干预措施，以减轻感染 HIV 的老年人 (HOA) 的功能衰退。除了具体的课程作业和教学读物之外，我在艾滋病毒和老龄化方面的成长也将通过指导小组得到加强，他们将为我的职业发展做出贡献。该职业发展计划设有一个强大、成熟的多学科指导小组，由衰老、艾滋病毒、行为和动机、临床试验、身体成分、身体虚弱和运动生理学方面的专家组成。额外的 主要资源包括罗切斯特大学的临床和转化科学研究所及其艾滋病研究发展中心。有针对性的培训不仅会提高我在艾滋病毒和衰老方面的知识，而且还会使我在申请 NIH R01 时处于竞争地位，该 R01 支持旨在改善 HOA 虚弱的临床试验。 HOA 生存率的提高对其功能状态和生活质量 (QOL) 具有重大影响。 此外，患有中心性肥胖的 HOA 虚弱和加速功能衰退的风险增加。虽然众所周知运动可以改善一般老年人群的身体机能，但艾滋病毒感染者本身在行为改变方面是一个具有挑战性的群体，因此该人群可能会发现很难启动和遵守运动计划。因此，本文研究计划的目的是：1）研究个性化的家庭锻炼计划与基于行为改变的自我决定理论（SDT）的动机咨询相结合的可行性；2）确定其在改善中心性肥胖 HOA 的身体功能、身体成分和运动相关心理调节因素方面的潜在功效。我们建议通过随机对照临床试验对干预措施进行试点测试。患有中心性肥胖的 HOA 将被随机分配，要么维持日常活动，要么接受家庭锻炼计划，并结合基于行为改变的 SDT 的动机咨询。从这项可行性研究中获得的初步数据将用于计算正确的样本量，以进行更大的功效随机对照试验（RCT），即潜在的 R01 调查。这项研究的总体目标是确定一种可行的干预措施，可以转化为 HOA 社区，以减轻功能衰退，从而改善健康和生活质量。研究设计和执行拟议研究的经验对于我的职业发展和向独立研究者的过渡非常宝贵。