iSTEP: an mHealth Physical Activity and Diet Intervention for Persons with HIV

iSTEP：针对艾滋病毒感染者的移动健康身体活动和饮食干预

基本信息

批准号：
9330935
负责人：
Brook Henry
金额：
$ 61.41万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-08-11 至 2021-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9330935
关键词：
Accelerometer Acquired Immunodeficiency Syndrome Address Adherence Alzheimer&apos s disease risk Anti-Retroviral Agents Attention Behavior Therapy Blood Body fat Brain Car Phone Cardiovascular Diseases Cholesterol Comorbidity Consumption Control Groups Development Devices Diet Dietary History Dietary Intervention Disease Dyslipidemias Energy Metabolism Exhibits Feedback Functional disorder Grant Guidelines HIV HIV-associated neurocognitive disorder Health Health behavior Impaired cognition Impairment Incidence Individual Inferior Inflammation Interruption Intervention Juglans Lipids Lipodystrophy Measures Mediating Medical Memory Metabolic Metabolic Diseases Metabolic Marker Metabolic syndrome Methods Moderate Exercise Modification Monitor Morbidity - disease rate Neurocognition Neurocognitive Neurocognitive Deficit Participant Patient Self-Report Pattern Persons Pharmaceutical Preparations Physical activity Polypharmacy Polyunsaturated Fatty Acids Population Protocols documentation Public Health Questionnaires Randomized Reporting Research Resources Risk Factors Running Services Strenuous Exercise Testing Text Time Travel Update Virus Visit Work abdominal fat arm base cardiovascular disorder risk cardiovascular health cognitive performance design effective intervention executive function exercise intervention experience fitbit follow up assessment frailty group intervention high risk improved inflammatory marker lifestyle intervention lipid disorder mHealth medical complication medication compliance mortality neurocognitive test novel personalized approach sedentary lifestyle service intervention socioeconomics therapy design tool treadmill

项目摘要

SUMMARY/ABSTRACT People who live with HIV (PLWH) experience a high incidence of neurocognitive deficits and HIV- associated non-AIDS (HANA) disorders, including cardiovascular disease (CVD), metabolic dysfunction, and autonomic decline. While antiretroviral treatment (ART) has reduced AIDS-related morbidity, both the virus and the medications are associated with lipid disorders that also increase CVD risk, including dyslipidemia and lipodystrophy. Consequently, the development of effective lifestyle interventions to reduce the incidence of HIV-associated neurocognitive disorders (HAND) and decrease metabolic disorders is a high priority. Physical activity (PA) has been utilized as an effective tool to improve health in PLWH, but may not be sufficient by itself to improve lipid levels. Existing PA interventions in PLWH typically required strenuous PA and significant resources that limit feasibility for many people living with the disease. Recent work indicates that interrupting periods of sedentary behavior (SB), independent of PA, also has a significant beneficial effect on metabolic function, but SB has not been well-studied in PWLH. Mediterranean-style diets (MedDiet) are also effective at improving CVD risk factors in HIV-uninfected individuals and are reported to reduce cognitive decline in persons at risk for Alzheimer's disease, but have not been widely tested in PWLH. We recently developed a novel and personalized Short Message Service (SMS) mobile phone text messaging intervention (iSTEP) that is designed to increase moderate PA in PLWH (R21MH100968). Our objective is to expand upon this work and conduct an RCT examining the efficacy of iSTEP in combination with a mobile mHealth MedDiet intervention tailored to PLWH. 180 PLWH will be randomly assigned to a control group (n = 60), a 6-month iSTEP group with just a PA/SB intervention (n = 60), or a 6-month intervention with both PA/SB and MedDiet components (n = 60), where participants receive daily interactive SMS/MMS messages designed to increase moderate PA, reduce SB, and promote adherence to a MedDiet, including walnut consumption. PA/SB will be quantified by accelerometer, Fitbit step counts, and self-report, MedDiet adherence will be assessed by self-report (Diet History Questionnaire and weekly SMS feedback) and objective measures (polyunsaturated fatty acid levels - PUFA in blood), and we will quantify metabolic and inflammatory markers. We will also conduct a follow-up assessment 6 months after the end of the intervention (accelerometer, neurocognitive testing, PUFA levels) to assess PA and MedDiet adherence. We hypothesize that iSTEP (both intervention arms) will increase PA, reduce SB, and improve neurocognition compared to control; the iSTEP + MedDiet group will demonstrate improvement in CVD risk factors and neurocognition compared to the PA/SB intervention alone. Findings from this proposal will lay the groundwork for development of novel large-scale mobile PA/diet interventions dedicated to treating HAND and improving cardiovascular health for PLWH.

摘要/摘要患有艾滋病毒（PLWH）的人经历了很高的神经认知缺陷和艾滋病毒的发生率相关的非AID（HANA）疾病，包括心血管疾病（CVD），代谢功能障碍，和自主性下降。虽然抗逆转录病毒治疗（ART）降低了与AIDS相关的发病率病毒和药物与增加CVD风险的脂质疾病有关，包括血脂异常和脂肪营养不良。因此，开发有效的生活方式干预以减少与HIV相关的神经认知疾病（手）和新陈代谢疾病的发生率是优先级。体育活动（PA）已被用作改善PLWH健康的有效工具，但是本身可能不足以提高脂质水平。通常需要在PLWH中进行现有的PA干预措施艰苦的PA和大量资源限制了许多患有该疾病的人的可行性。最近的工作表明，独立于PA的中断久坐行为（SB）的中断也有对代谢功能的显着有益作用，但是SB在PWLH中尚未得到充分研究。地中海风格的饮食（Meddiet）也有效地改善了艾滋病毒未感染的CVD风险因素个人并据报道会减少患阿尔茨海默氏病风险的人的认知能力下降，但有未在PWLH中进行广泛测试。我们最近开发了一种小说和个性化的简短消息服务（SMS）手机文本消息干预（ISTEP）旨在增加中等PA PLWH（R21MH100968）。我们的目标是扩大这项工作，并进行RCT检查 ISTEP的功效与针对PLWH的移动MHealth Meddiet干预结合使用。 180 plwh 将随机分配给对照组（n = 60），这是一个只有PA/SB的6个月ISTEP组干预（n = 60），或与PA/SB和Meddiet组件（n = 60）的6个月干预参与者会收到每日互动SMS/MMS消息，旨在增加中等PA，减少SB，并促进遵守Meddiet，包括核桃消费。 PA/SB将通过加速度计，FITBIT步骤计数和自我报告，Meddiet依从性将通过自我报告评估（饮食历史问卷和每周SMS反馈）和客观措施（多不饱和脂肪酸水平 - 血液中的PUFA），我们将量化代谢和炎症标记。我们还将进行干预结束后6个月的后续评估（加速度计，神经认知测试， PUFA水平）评估PA和Meddiet依从性。我们假设ISTEP（两个干预臂）与对照相比，将增加PA，减少SB并改善神经认知； ISTEP + MEDDIET集团与PA/SB干预相比，CVD风险因素和神经认知的改善独自的。该提案的发现将为开发新型大型手机的开发奠定基础 PA/饮食干预措施致力于治疗PLWH的手和改善心血管健康。