A six week contextualised physical activity intervention for women living with HIV and AIDS of low socioeconomic status: a pilot study.
Summary (2 min read)
Introduction
- Amongst people living with HIV and AIDS , physical activity (PA) is associated with improvements in mental and physical well-being (Fillipas, Cicuttini, Holland, & Cherry, 2013; MacArthur, Levine, & Birk, 1993; Neidig, Smith, & Brashers, 2003) .
- Given the foregoing, the purpose of this study was to evaluate the effect of a six-week pilot PA intervention amongst PLWHA of low SES.
Setting and sample
- The study was conducted at a community centre caring for HIV positive Black African Xhosa-speaking women in a low-income community in the Western Cape Province, SA.
- Study participants belonged to an HIV support group who consented to participate in the study.
Eligibility/inclusion criteria
- Participants needed to be between 18 and 65 years, HIV positive, as confirmed through medical records, and cleared on the Physical Activity Readiness Questionnaire (PAR-Q).
- All participants had to be unemployed and not have attained any tertiary education.
- Additional exclusions were any history of coronary heart disease and/or diabetes, opportunistic infection, pregnancy, and orthopaedic conditions that made PA unsafe.
Protocol
- An information session and information sheets were used to inform participants about the study, and participant written informed consent was obtained.
- Height was measured with a stadiometer, and body weight using a calibrated weight scale with participants wearing minimal clothing.
- Study measurements were total moderate-to-vigorous PA by the Global Physical Activity Questionnaire (GPAQ) (World health Organisation, 2006), total weekly steps (TWS) by an Omron HJ-720IT-E2 pedometer, self-efficacy for PA using the Physical Exercise Self-efficacy scale (Schwarzer & Renner, 2008) , and the stages of motivational readiness for change (SOC) (Marcus & Simkin, 1993) .
- Two Xhosa-speaking research assistants helped the participants to complete the questionnaires.
- The standard care group received nutritional information on healthy eating (Gibney & Vorster, 2001) designed by a dietician in a once-off 2-hour session.
The contextualised physical activity intervention
- The PA intervention was developed in a previous study (Mabweazara, Leach, & Ley, 2017) and informed by Social Cognitive Theory (SCT) (Bandura, 1986 ) and the Transtheoretical model (TTM) (Prochaska & DiClemente, 1983) .
- The PA intervention was delivered in the indigenous Xhosa language, and food packs were used to promote adherence.
- The intervention employed low-cost activities of daily living (ADLs) using local resources and opportunities.
- The PA intervention was two hours each week for six weeks that comprised a combination of educational activities (60 min), home-based activities (30 min) and a 30-minute group aerobics session.
- All exercise activities were in line with the American College of Sport Medicine (ACSM) guidelines for individuals infected with HIV (ACSM, 2013).
Data analysis
- Descriptive statistics were used to summarise the participants' demographic and clinical characteristics.
- Levene's test was computed to assess equality of means.
- Independent t-tests and multivariate analysis of covariance were used to assess differences between groups, and statistical significance was set at an alpha level of < .05.
Sample characteristics
- Tables 1 and 2 show TMVPA, TWS and self-efficacy at baseline, after six weeks and post-crossover.
- The results for SOC showed two participants in the precontemplative stage, 11 in the contemplative stage, four in the preparatory stage and one in the action stage.
Discussion
- The purpose of this study was to evaluate the effects of a six week contextualised intervention aimed at increasing physical activity and self-efficacy for physical activity among HIV positive women of low SES.
- Compared to standard care, participants in the physical activity intervention, informed by SCT and TTM, had significant increases in total moderate-to-vigorous physical activity, total weekly steps and self-efficacy for physical activity.
- Theory-based behaviour change interventions are found to be effective (Sparling, Owen, Lambert, & Haskell, 2000) .
- Moreover, increased perceived enjoyment of physical activity may result in increased self-efficacy, which may lead to a greater prospect of increasing physical activity behaviour (Lewis et al., 2016) .
- Also, educating participants on where to find safe environments to walk very likely assisted them to be more physically active (Tuso, 2015) .
Study limitations
- The study sample consisted of a relatively small group.
- It was a pilot study and statistical power was not calculated at the outset.
- Furthermore, the intervention period was for six weeks only.
- The study does not report on the effect of the intervention to mental or physical health of the participants.
- Further examination of the intervention is still needed before widespread implementation of the intervention.
Conclusion
- The contextualised physical activity intervention resulted in significant increases in total moderate-to-vigorous physical activity, total weekly steps and self-efficacy for physical activity in women living with HIV and AIDS of low SES.
- Including constructs, such as selfefficacy, participant exercise preferences and social support, can help PLWHA of low SES to adopt regular physical activity, and can serve as adjunct therapy for the management of HIV and AIDS.
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"A six week contextualised physical ..." refers methods in this paper
...Both theories emphasise the enhancement of self-efficacy (Prochaska & DiClemente, 1983; Stacey, James, Chapman, Courneya, & Lubans, 2015)....
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...The intervention used in this study applied SCT and TTM....
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...Compared to standard care, participants in the physical activity intervention, informed by SCT and TTM, had significant increases in total moderate-to-vigorous physical activity, total weekly steps and self-efficacy for physical activity....
[...]
...The contextualised physical activity intervention The PA intervention was developed in a previous study (Mabweazara, Leach, & Ley, 2017) and informed by Social Cognitive Theory (SCT) (Bandura, 1986) and the Transtheoretical model (TTM) (Prochaska & DiClemente, 1983)....
[...]
6,004 citations
Additional excerpts
...Including strategies on goal-setting and educating the participants on the benefits and barriers of physical activity are reported to impact positively on health behaviour change (Bandura, 2004)....
[...]
1,158 citations
446 citations
"A six week contextualised physical ..." refers methods in this paper
...The results for SOC showed two participants in the precontemplative stage, 11 in the contemplative stage, four in the preparatory stage and one in the action stage....
[...]
...…(GPAQ) (World health Organisation, 2006), total weekly steps (TWS) by an Omron HJ-720IT-E2 pedometer, self-efficacy for PA using the Physical Exercise Self-efficacy scale (PESES) (Schwarzer & Renner, 2008), and the stages of motivational readiness for change (SOC) (Marcus & Simkin, 1993)....
[...]
...Study measurements were total moderate-to-vigorous PA (TMVPA) by the Global Physical Activity Questionnaire (GPAQ) (World health Organisation, 2006), total weekly steps (TWS) by an Omron HJ-720IT-E2 pedometer, self-efficacy for PA using the Physical Exercise Self-efficacy scale (PESES) (Schwarzer & Renner, 2008), and the stages of motivational readiness for change (SOC) (Marcus & Simkin, 1993)....
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Frequently Asked Questions (18)
Q2. What can be done to help PLWHA of low SES to be more physically active?
Including constructs, such as selfefficacy, participant exercise preferences and social support, can help PLWHA of low SES to adopt regular physical activity, and can serve as adjunct therapy for the management of HIV and AIDS.
Q3. What is the effect of the intervention on physical activity?
increased perceived enjoyment of physical activity may result in increased self-efficacy, which may lead to a greater prospect of increasing physical activity behaviour (Lewis et al., 2016).
Q4. What is the effect of exercise on the body?
Aerobic and strength training improve the profile of lymphocytes (O’Brien, Nixon, Glazier, & Tynan, 2004), body composition, muscle strength and quality of life (Spence, Galantino, Mossberg, & Zimmerman, 1990).
Q5. What is the main reason why a study was conducted?
In Africa, Murenzi (2011) reported that PLWHA, particularly women (Smit et al., 2006), engage in insufficient PA, which may be related to low socioeconomic status (SES) (Economic and Social Research Council, 2014).
Q6. What was the purpose of the study?
An information session and information sheets were used to inform participants about the study, and participant written informed consent was obtained.
Q7. What is the effect of the intervention on the health of the participants?
educating participants on where to find safe environments to walk very likely assisted them to be more physically active (Tuso, 2015).
Q8. What was the age of the participants?
Participants needed to be between 18 and 65 years, HIV positive, as confirmed through medical records, and cleared on the Physical Activity Readiness Questionnaire (PAR-Q).
Q9. What was the use of a stadiometer?
Height was measured with a stadiometer, and body weight using a calibrated weight scale with participants wearing minimal clothing.
Q10. What was the PA intervention group receiving?
The PA intervention group received logbooks for recording daily PA, and a PA manual with information on home-based exercise activities, the benefits and barriers to PA, and strategies for improving exercise self-efficacy.
Q11. What is the effect of physical activity on the health of a person with HIV?
Amongst people living with HIV and AIDS (PLWHA), physical activity (PA) is associated with improvements in mental and physical well-being (Fillipas, Cicuttini, Holland, & Cherry, 2013; MacArthur, Levine, & Birk, 1993; Neidig, Smith, & Brashers, 2003).
Q12. What was the purpose of this study?
The purpose of this study was to evaluate the effects of a six week contextualised intervention aimed at increasing physical activity and self-efficacy for physical activity among HIV positive women of low SES.
Q13. What were the main findings of the study?
Similar to this study, Webel and colleagues included PA self-monitoring, goal-setting, inclusion of physical activity into activities of daily living, social support and strategies for overcoming barriers to engaging in physical activity, such as the effective use of personal time.
Q14. What was the mean age of the participants?
The mean (±SD) age of the participants was 37.57 (8.64) years, height was 1.61 (0.06) m, weight was 84.52 (22.48) kg, and BMI was 32.21 (7.89) kg.m−2.
Q15. What were the results of the study?
Compared to standard care, participants in the physical activity intervention, informed by SCT and TTM, had significant increases in total moderate-to-vigorous physical activity, total weekly steps and self-efficacy for physical activity.
Q16. How many minutes of physical activity did the authors increase?
Moore, Hanson, and Salata (2013) reported that participants increased their physical activity by 300 MET-minutes per week compared to the standard care group.
Q17. What are the theories used in the study?
Theories assist the researcher to identify the most effective behaviour change techniques (Glanz, Burke, & Rimer, 2011) and form the base for the development of evidence-based interventions (Sparling et al., 2000).
Q18. What was the corresponding data for SOC?
http://repository.uwc.ac.za4http://repository.uwc.ac.za5The results for SOC showed two participants in the precontemplative stage, 11 in the contemplative stage, four in the preparatory stage and one in the action stage.