Boosting Health by Changing Activity

‌Background

People living with HIV are at high risk for developing cardiovascular disease (CVD). Improving diet and exercise are evidence-based treatments which when performed in a regular and sustained fashion, can help prevent and/or mitigate the severity of CVD. Yet, to achieve these benefits one must, over the long term, regularly eat a healthy diet and exercise in his or her home setting; but subject-initiated, home-based diet and exercise interventions have rarely been studied in PLHIV.An innovative approach to improving and maintaining healthy living behaviors such as diet, exercise, and medication adherence is the SystemCHANGE intervention. SystemCHANGE draws on social-ecological theories and focuses on system redesign of the environment (daily routines) linked to health behavior.

Specific Aims

  • Evaluate the short-term (3-month) and maintenance (6-month) effects of SystemCHANGE-HIV on the amount and intensity of free living exercise
  • To describe the impact of SystemCHANGE-HIV on fitness and cardiometabolic health.
  • To evaluate the moderating impact of demographics, medical history, depression, social support, environment, HIV medication history, and diet composition on the association between the intervention, exercise, fitness, and cardiometabolic risk. 

Research Design

A two-group (n = 53/52), randomized, repeated measures design will be employed using an intent-to-treat approach.Enrolled participants will be randomized to receive one of two conditions: (1) SystemCHANGE intervention, or (2) enhanced usual care.  Subjects in both groups will continue to receive usual care. Subjects will complete measures at baseline, 3, 6 (primary endpoints), 12 and 24 months. 

 

 

Substudies

Effect of SystemCHANGE on Cognitive Processing & Cardiac Health in HIV+ adults

  • Evaluate the impact of cognitive mediators on the association between the SystemCHANGE exercise, diet, and markers of cardiovascular health.
  • Describe the neural activity processes that are associated with increased self-management (exercise and diet).

Exploring the Relationship between Fitness, Mitochondrial Dysfunction, and Myokines in HIV+ Adults Participating in an Exercise Intervention (co-PI Trevor Jenkins, MD)

  • Describe the relationship between changes in fitness, mitochondrial dysfunction, and myokines in 20 HIV-infected adults and well-matched HIV-uninfected controls who are participating in a standardized exercise intervention.
  • Compare differences in changes in fitness, mitochondrial dysfunction, and myokines between HIV-infected adults and well-matched HIV-uninfected control group.

Results

This study is closed to new enrollment. All primary endpoints have been collected and are being analyzed. Follow up data collection at 12 and 24 months is ongoing. 

We’re finishing up or primary data analyses. Please plan to attend our following presentations to hear about our exciting results.

8th Workshop on HIV & Aging
October 1-2, 2017

American Heart Association Scientific Session
November 11-15, 2017

HIV and Aging: From Mitochondria to the Metropolis
November 16-17, 2017

Midwest Nursing Research Society Annual Conference
April 12-15, 2018


 

Research Team

Principal Investigator:

  • Allison R. Webel, RN, PhD, Frances Payne Bolton School of Nursing, Case Western Reserve University

Co-Investigators:

  • Rich Josephson, MAS, MD, Harrington Heart and Vascular Institute, Cleveland Medical Center
  • Chris Longenecker, MD, Harrington Heart and Vascular Institute, Cleveland Medical Center
  • Shirley M. Moore, PhD. FAAN, Frances Payne Bolton School of Nursing, Case Western Reserve University
  • Grace McComsey, MD, FIDSA, University Hospitals Cleveland Medical Center
  • Ann K. Avery, MD MetroHealth System
  • Abdus Sattar, PhD, Case Western Reserve University School of Medicine
  • Robert A. Salata, MD, University Hospitals Cleveland Medical Center

Support:

This project was funded by grants from the American Heart Association (14CRP20380259) and a developmental grant from the University Hospitals/Case Western Reserve University Center for AIDS Research (National Institutes of Health Grant # P30 AI036219) and as a pilot study from the SMART Center (National Institute of Nursing Research  #P30NR015326).