Factors influencing adherence to health behavior intervention among people living with HIV
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Abstract
BACKGROUND: The development of antiretroviral therapies (ART) has been instrumental in preserving the quality of life among People Living with HIV (PLWH). However, the potential for increased life expectancy may be compromised by associated comorbidities. Research demonstrates that excessive alcohol consumption is prevalent among PLWH and can exacerbate negative health outcomes. Physical activity (PA) has become a supplementary treatment for individuals with unhealthy drinking behaviors as a positive lifestyle modification with a number of benefits for both physical and psychological health. Given the relationship between HIV and alcohol use, PLWH also stand to benefit from PA interventions. However, the current body of PA-promotion research with this population has focused on structured, supervised PA programs which tend to have high attrition rates. The ARCHER PA trial aims to increase PA engagement, decrease unhealthy drinking behaviors, and improve negative affect among PLWH through a technology-based lifestyle physical activity (LPA) intervention.
OBJECTIVE: The goal of this thesis is to use preliminary pilot study data to inform participant adherence in the ARCHER PA intervention.
METHODS: This thesis utilizes a case study approach to examine potential influences on participant adherence based upon the preliminary Project HEART pilot study. Two cases were selected on the basis of PA data collected in terms of steps per week for a total of 12 weeks and attendance at 6 biweekly phone-based counseling sessions to be classified as either low adherence or high adherence. Project HEART primary outcome variables, which include improvements in PA, alcohol use, affect scores, and cardiorespiratory fitness, were used to establish a relationship between intervention engagement and participant achievement. Participants’ self-reported mobile phone use, attitudes toward technology, perceived benefits and barriers to exercise, LPA incorporation, and alcohol use were analyzed as predictors of adherence and long-term behavior change for the ARCHER PA trial.
RESULTS: Both case study participants were successful in the achievement of short-term improvements in PA engagement, alcohol use, affect scores, and cardiorespiratory fitness. However, the participant who attended all biweekly phone-based counseling sessions and logged 12 weeks of PA data exhibited a greater degree of improvement from baseline to follow-up in survey scores for self-reported LPA incorporation and perceived barriers and benefits to exercise upon comparison between both case study participants.
CONCLUSIONS: A case study approach analyzing data from the preliminary pilot study demonstrates a positive correlation between participant adherence and the degree of improvement among PA variables, alcohol use, and affect. This suggests that participants who exhibit higher levels of adherence are more likely to develop lasting behavioral changes. Therefore, factors that may influence adherence should be carefully considered in the implementation of the ARCHER PA trial and future studies with similar sensitive target populations.
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Attribution 4.0 International