Exercise is a rehabilitation intervention that can address disability and prevent multimorbidity among adults living with HIV. Community Based Exercise (CBE) is a promising approach to improve the health of adults living with HIV within a self-management framework. CBE involves a group of individuals exercising under the assistance of an instructor with the goal of promoting regular exercise in the community. Online physical activity platforms have emerged as a way for people living with chronic conditions to engage in physical activity during the pandemic. Online tele-coaching offers a viable alternative for engaging in exercise. However, it is unclear how online physical activity interventions translate to the HIV context; the role of online approaches in addressing the complex environmental, personal, and social barriers to exercise experienced by adults living with HIV is unknown.
What is the aim of the Tele-Coaching CBE Study?
The aim is to evaluate the implementation of an online tele-coaching community-based exercise (CBE) intervention for adults living with HIV within the community with the goal of reducing disability and enhancing physical activity, health and engagement in the care cascade.
Using the RE-AIM Framework specific objectives are:
- Reach – To determine the extent to which adults living with HIV participate in the intervention;
- Effectiveness – To assess the impact of the intervention on physical activity (primary outcome), health, and engagement in the care cascade (secondary outcome);
- Maintenance – To assess engagement in exercise for adults living with HIV over time (physical activity, adherence);
- Implementation & Adoption – To evaluate the a) process (strengths, challenges, accessibility, cost, fidelity) and b) feasibility of sustainability of the implementation, from the perspective of PLWH, representatives of community-based organizations (CBOs), health and fitness centres, health providers, and policy stakeholders to build capacity, products, and considerations for broader implementation.
What are the study methods?
This is a community-based research (CBR) longitudinal mixed methods intervention study conducted in partnership with the Toronto YMCA to evaluate the implementation of an innovative online tele-coaching CBE intervention with adults living with HIV.
This study involves a 6-month tele-coaching intervention (Phase 1) followed by a 6-month follow-up phase (Phase 2) to assess sustainability.
- Phase 1 Intervention (6 months): Participants will engage in an individual tailored home-based exercise program involving aerobic, resistance, balance and flexibility training ~60min, 3X/week for 24 weeks. This phase includes biweekly personal fitness coaching sessions, online YMCA group-based exercise classes (via a YMCA virtual membership), monthly online self-care educational sessions, and a wireless physical activity monitor (WPAM) to self-monitor physical activity.
- Phase 2 Post-Intervention (6 months): Participants will be encouraged to continue with independent exercise three times per week, engage in online YMCA group-based exercise classes, and continue to track physical activity with the WPAM.
Participants complete a series of questionnaires and fitness assessments (online) bimonthly throughout to assess the impact and uptake of physical activity. We are using a qualitative longitudinal design with interviews to assess processes and outcomes at baseline (0 months), post-intervention (6 months) and post-follow-up (12 months).
Who can participate in the study?
Adults living with HIV in Toronto with access to technology to engage in the online exercise intervention and who consider themselves safe to engage in exercise.
How can I get a summary of the research study results?
Updates on the Tele-Coaching CBE study will be provided at the quarterly online HIV in Motion sessions. Results of this study will also be posted on this CIHRRC website.
Click on the links below to access the Tele-Coaching Online Self-Care Session Slide Deck Presentations:
- Session #1: Welcome to the Study and Goal Setting – Kelly O’Brien & Tizneem Jiancaro
- Session #2: Dietary Strategies for Health – Nema McGlynn
- Session #3: Sleep Health and Hygiene – Tyler Tulloch
- Session #4: Yoga, Brain Health and HIV – Adria Quigley
- Session #5: HIV and Chronic Pain – Role of Physiotherapy – Carolann Murray & Sam Morrison
- Session #6: Coaching Yourself – Tizneem Jiancaro
Videos from the Tele-Coaching Personal Training Team
In May 2022, as we transitioned from the TEx tele-coaching phase to the independent online exercise phase 2, we asked some of the YMCA Toronto Central, our excellent tele-coaches, to record their tips to stay independently engaged with the study for the participants in the TEx study. Find their short videos below.
All links to YouTube
The Tele-Coaching CBE Study Team
This study is a collaboration between the Toronto YMCA and the University of Toronto.
The Tele-Coaching CBE Study is a sub-study of the Ontario HIV Treatment Network Cohort Study (OCS).
- Kelly O’Brien, Department of Physical Therapy, University of Toronto
- Francisco Ibáñez-Carrasco, Dalla Lana School of Public Health, University of Toronto
- Ahmed Bayoumi, St. Michael’s Hospital & University of Toronto, Toronto, Ontario, Canada
- Patty Solomon, School of Rehabilitation Sciences, McMaster University
- Ada Tang, School of Rehabilitation Sciences, McMaster University
- Soo Chan Carusone, McMaster University, Toronto, Ontario, Canada
- Mona Loutfy, Maple Leaf Medical Clinic, University of Toronto
Knowledge Users and Collaborators
- Medhi Zobeiry, Ivan Illic, Zoran Pandovski, Central Toronto YMCA
- Puja Ahluwalia, Realize, Toronto, Ontario, Canada
- Shaz Islam, Toronto, Ontario
- Colleen Price, Ottawa, Ontario
- Joanne Lindsay, Toronto, Ontario
- Praney Anand, Alliance for South Asian AIDS Prevention (ASAAP), Toronto, Ontario, Canada
- Katrina Krizmancic, AIDS Committee of Toronto, Toronto, Ontario, Canada
- Chris Godi, Toronto PWA Foundation, Toronto, Ontario, Canada
- Colleen Price, Community Member, Ottawa, Ontario, Canada
- Lisa Avery, Dalla Lana School of Public Health, University of Toronto
- Darren Brown, Chelsea and Westminster Hospital, NHS Foundation Trust, London, United Kingdom
Postdoctoral Research Fellow
- Tizneem Jiancaro, PhD, Department of Physical Therapy, University of Toronto
- George Da Silva, Engagement Coordinator, University of Toronto
- Kiera McDuff, PT, Research Coordinator, University of Toronto
This study is funded by the Ontario HIV Treatment Network (OHTN) Endgame Program – Breaking New Ground.
We thank the Knowledge Users, Collaborator Organizations and YMCA in this work. Kelly O’Brien is supported by a Canada Research Chair in Episodic Disability and Rehabilitation (Canada Research Chairs Program). We thank the Tele-Coaching CBE Study participants.