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.

项目摘要/摘要 抗逆转录病毒疗法的时代表明预期寿命增加并改善了与HIV相关的死亡， 导致老年人艾滋病毒的人群不断增长。然而，艾滋病毒加速了衰老过程，并增加了 造成身体和心理健康功能的许多慢性健康状况。此外，这是 上下文，在艾滋病毒（PLWH）的患者中使用不健康的饮酒很常见，也会增加患的风险 负结果。但是，在PLWH中，几乎没有干预措施可以解决不健康的酒精使用 产生了重大影响，也没有采用可能影响这些多重症状的方法。 因此，可能对PLWH中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多重症的潜力 在PLWH中常见。为解决PWLH - 物理的另一个高度普遍状况的努力 不活动性和久坐性，可能证明有益于改变不健康的饮酒以及身体和精神 健康功能。迄今为止，PLWH中的体育活动（PA）方法主要由结构化， 受到监督的，基于体育馆的干预措施，导致了积极的成果，但受到限制 触及并与该人群中的高辍学有关。在这里，我们提出了一个替代范式 - 家庭 - 具有移动健康分配的组件的基于生活方式的体育锻炼（LPA）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 指导个人在日常工作中进行综合间歇性发作。 LPA的额外强度 方法是通过提供累积物理的PLWH可能非常适合从事不健康饮酒的PLWH 以及常规，每日PA以及对负面影响的急性影响的心理健康影响（在 PLWH从事不健康的饮酒），并敦促通过个人短暂的活动来喝酒。迄今为止，LPA 干预措施尚未在PLWH中进行测试。因此，通过在线招募PLWH，我们将确定220 HIV+不健康的饮酒者，并将其随机为12周LPA+ FITBIT干预或仅fitbit 健康）状况。主要结果将包括饮料/饮酒日和客观确定的步骤/天 治疗和6个月的随访。身体健康功能的条件之间的变化， 与酒精有关的问题，应对，PA动机和PA自我效能感将被检查为次要 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 瞬间评估以获得多种每日情感措施，饮酒的冲动，饮酒和 PA参与加上PA的客观评估。如果LPA+FITBIT干预证明有效，我们 使用移动卫生技术的生活方式方法将直接影响这种高风险 PLWH的人口从事不健康的饮酒，这反过来可能会产生重大的公共卫生影响。