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: 8885625
• 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 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8885625
• 关键词: Acquired Immunodeficiency Syndrome; Adipose tissue; Adverse event; Affect; Aging; Attenuated; Behavior; Body Composition; Central obesity; Chronic; Clinical Sciences; Clinical Trials; Clinical Trials Design; Cognitive; 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; exercise adherence; 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）：作为老年医生和初级研究员，我致力于以患者为导向的研究。这个K23将为我成为一名独立研究人员奠定基础，在这里我可以领导翻译干预措施，以减轻感染HIV感染的老年人（HOA）的功能下降。除了具体的课程和教学读物外，我在艾滋病毒和衰老中的成长将从一个指导小组中增强，该小组将为我的职业发展做出贡献。职业发展计划具有强大的，建立的，多学科的指导小组，其中包括衰老，艾滋病毒疾病，行为和动机，临床试验，身体组成，身体虚弱和运动生理学专家。额外的 关键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，而且还将使我处于竞争地位，申请支持旨在减轻HOA脆弱的临床试验的NIH R01。 HOA的生存率提高在其功能状况和生活质量（QOL）方面具有重要意义。 此外，患有中央肥胖症的HOA的脆弱风险和加速功能下降的风险增加。尽管众所周知，运动可以改善一般老年人群的身体机能，但在行为改变方面，感染HIV的人群本身是一个充满挑战的队列，因此，该人群可能会发现很难启动并遵守运动计划。因此，本文研究计划的目的是1）研究基于行为改变的自我确定理论（SDT）和2）的动机咨询的单独定制的家庭运动计划的可行性和2）确定其在改善身体功能，身体组成和运动相关的心理学导体中的潜在效果，并与中央ob ob obe一起。我们建议通过一项随机对照临床试验进行试验测试干预措施。带有中央肥胖症的HOA将被随机地维护其通常的活动，或者根据行为改变的SDT结合动机咨询，以接收家庭锻炼计划。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RCT，这是潜在的R01研究。这项研究的总体目的是确定可行的干预措施，该干预措施可以转化为HOA社区，以减轻功能下降，从而改善健康和质量检查。拟议研究的研究设计和执行方面的经验对于我的职业发展以及向独立研究者的过渡非常宝贵。