BOosting health By Changing AcTivity: A Clinical Trial of SystemCHANGE to Improve Exercise, Diet and Health in HIV-Infected Adults

Years: 2015-2018

Background

People living with HIV are at high risk for developing cardiovascular disease (CVD). Improving physical activity is an evidence-based strategy which, when performed in a regular and sustained fashion, can help prevent and mitigate the severity of CVD. Yet to achieve these benefits, one must, over the long term, be physically active and regularly eat a healthy diet. An innovative approach to improving and maintaining healthy living behaviors such as physical activity and eating a healthy diet is the SystemCHANGE-HIV intervention. The BOBCAT Study aimed to:

• Evaluate the short-term and maintenance effects of SystemCHANGE-HIV on the amount and intensity of exercise
• To describe the impact of SystemCHANGE-HIV on cardiorespiratory fitness and cardiometabolic health

Research Design

A two-group, randomized, repeated measures design was used to test the 3 and 6 month effects of SystemCHANGE-HIV. Participants were randomized to receive one of two conditions: (1) SystemCHANGE-HIV intervention, or (2) enhanced usual care. Subjects completed measures at baseline, 3, 6 (primary endpoints), 12, and 24 months. This study was registered at ClinicalTrials.gov #NCT02553291

Results

This study is closed to new enrollment. All primary endpoints have been collected and are being analyzed. 

• Oliveira, VHF; Currie, J; Horvat Davey, C; Josephson, RA; Silva, DRP; Deminice, R; Webel, AR. (2020). Weekday and weekend physical activity and stationary behavior patterns of people living with HIV. Journal of the Association of Nurses in AIDS Care
• Currie, J., Perazzo, J., Schreiner, N., & Webel, A.R. (2020). Association Between Magnesium Intake and Depressive Symptoms in People Living with HIV Infection. Journal of the Association of Nurses in AIDS Care.
• Chen M, Hung CL, Yun CH, Webel AR, Longenecker CT.   (2019) Sex differences in the association of fat and inflammation among people with treated HIV infection. Pathogens and Immunity. 4(1) 163-179
• Perazzo, J. D., Currie, J., Horvat Davey, C., Lambert, J., & Webel, A. R. (In Press). Depression and social capital in people living with HIV. Journal of Psychiatric and Mental Health Nursing. Accepted 7/29/2019
• Webel, A.R., Schreiner, N., Salata, R.A., Friedman, J., Jack, A.I., Sattar, A., Fresco, D.M., Rodriguez, M., Moore, S.M. (In press) The Effect of an HIV Self-Management Intervention on Neurocognitive Behavioral Processing. Western Journal of Nursing Research.
• Webel, A.R, Jenkins, T., Vest, M., Longenecker, C.T., de Oliveria V., Liu, J., Currie, J., Sattar, A., & Josephson, R. (2019). Cardiorespiratory fitness is associated with inflammation and physical activity in HIV+ adults. AIDS. 33(6) 1023-1030.
• Webel, A.R., Jenkins, T., Longenecker, C.T., Vest, M., Horvat Davey, C., Currie, J., Darrah, R., Litman, P., de Oliveria, V., & Josephson, R. (In Press). Relationship of HIV status and fatigue, cardiorespiratory fitness, muscle strength and physical activity. Journal of Association of Nurses in AIDS Care.
• Oliveria, V.H.F, Perazzo, J.D., Josephson, R.A., Deminice, R., Webel, A.R.. (In Press). The association between the 6-minute walk test distance and peak cardiorespiratory fitness among people living with HIV varies by fitness level. Journal of the Association of Nurses in AIDS Care. PMID: 29910102
• A.R., Moore, S.M., Longenecker, C.T., Currie, J., Horvat Davey, C., Perazzo, J., Sattar, A., & Josephson, R. (2018). A Randomized Controlled Trial of the SystemCHANGE Intervention on Lifestyle Behaviors in HIV+ Adults. JAIDS: Journal of Acquired Immune Deficiency Syndromes. 78(1) 23-33 PMID: 29373392
• Webel, A.R. Perazzo, J.Longenecker, C.T., Jenkins, T., Sattar, A., Rodriguez, M., Schreiner, N. & Josephson, R. (2018). The Influence of Lifestyle Exercise on the Cardiovascular Health of HIV+ Adults. Journal of Cardiovascular Nursing. 33(3) 239-247. PMID: 29189426

• Perazzo, J. D., Rodriguez, M., Currie, J., Salata, R., & Webel, A. R. (In Press). Creation of data repositories to advance nursing science. Research in Nursing and Health. Accepted on November 3, 2017 PMID 29277149

Research Team

Principal Investigator

• Allison R. Webel, RN, PhD, FAAN, University of Washington School of Nursing

Co-Investigators

• Rich Josephson, MAS, MD, Harrington Heart and Vascular Institute, Cleveland Medical Center
• Chris Longenecker, MD, University of Washington, Department of Global Health | Division of Cardiology
• Shirley M. Moore, PhD, RN, FAAN, Frances Payne Bolton School of Nursing, Case Western Reserve University
• 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).