Comparing Home- And Group-based Physical Activity Interventions For People Living With HIV

Abstract

The transition of HIV infection from a terminal illness to a chronic disease requires a focus on lifestyle interventions to address health challenges in this vulnerable population. Social, mental and physical barriers to recruitment/retention of participants can create challenges to acquiring accurate measurements during studies. PURPOSE: The purpose of this investigation is to compare the methodologies and results of two approaches to community-based health interventions for people living with HIV (PLWH). METHODS: Data from an ongoing support group-based (SGB) intervention designed to improve health-related quality of life (HRQOL) through classes that teach and reinforce healthy lifestyle habits, like increasing physical activity (PA), for disease and symptom management was compared to that of a previously published home-based (HB) intervention by the investigators. The same accelerometer brand and psychometric questionnaires were used in each study. The SGB approach included the addition of Fitbits to help set goals and track progress. The approaches of each investigation were compared using the average changes from baseline in an independent t-test. RESULTS: The SGB study participants significantly increased daily steps from 4,326 ± 389.83 to 8,400 ± 487.58 (p=0.01), as well as mental health (p=0.03) and physical function (p=0.04) as measured by the SF-36. A decreasing trend in weight and perceived stress was also observed. The HB approach resulted in no significant change in daily step counts (p= 0.49). In comparison the HB intervention was more successful in retention rates and gathering reliable follow-up data with 57 participants. Although only 5 participants (out of 15) were retained at follow-up, the SGB study, however, did have more success increasing daily PA by 94% compared to a -5% change in the HB. CONCLUSIONS: Our results indicate that compared to an individualized HB program a SGB approach could be more effective in changing healthy behavior, like increased PA and stress reduction, to improve HRQOL in vulnerable populations. With minimal funding and no incentives offered, the SGB study encountered survival bias so it would be prudent for future investigations to find creative ways to keep participants involved in the program to determine their feasibility and effectiveness more reliably.