Abstract 17252: A Randomized Controlled Trial of the System CHANGE Intervention on Lifestyle Behaviors in HIV+ Adults
Introduction: HIV+ adults are twice as likely to develop cardiovascular disease (CVD) and approximately four times more likely to have a stroke than HIV-uninfected adults. Lifestyle behaviors (e.g., diet and exercise) help prevent CVD and stroke but targeted interventions to improve these behaviors are lacking. The SystemCHANGE intervention is an approach to behavioral counselling based on a systems re-design model and proposes that the individual’s daily routines are composed of a set of habits (behaviors) that can be changed. By helping to integrate small, measurable changes into one’s daily routine, the SystemCHANGE intervention can improve diet and exercise in HIV+ adults.
Hypothesis: Subjects in the SystemCHANGE intervention will have improved exercise (i.e., moderate-to-vigorous physical activity and steps per day) and diet (i.e., Healthy Eating Index and daily salt consumption), compared with those in the control group.
Methods: One-hundred and six HIV+ adults were randomized to either the intervention (six, in-person, standardized group sessions focusing on improving lifestyle behaviors) or a control condition (general advice on AHA diet and exercise guidelines). All subjects wore an ActiGraph accelerometer and completed 24-hour dietary recalls at baseline, three, and six months. Generalized estimating equations were used to examine the effects of the intervention on lifestyle behaviors.
Results: Subjects were approximately 53 years old, 65% male (n=70), 86% African American (n=93). Approximately 90% attended half of the sessions and 60% attended 5 sessions. Controlling for age, gender, race, and season enrolled, the intervention did not significantly improve lifestyle behaviors (p ≥ 0.05). Post-intervention interviews found that subjects reported that adverse weather, symptom burden, and a lack of financial resources were barriers to enacting the lifestyle recommendations.
Conclusion: The SystemCHANGE intervention did not improve exercise or diet composition in HIV+ adults at risk for developing CVD. This population faces unique medical and structural challenges to engaging in healthy behaviors. More research is needed to understand how to develop targeted interventions to improve these important behaviors in HIV+ adults.
Author Disclosures: A.R. Webel: Consultant/Advisory Board; Significant; Association of Nurses in AIDS Care. Other; Modest; Bull Publishing. S.M. Moore: None. A. Sattar: None. C.T. Longenecker: Research Grant; Significant; Medtronic Foundation. Honoraria; Modest; Gilead Sciences. J. Currie: None. C. Horvat Davey: None. J. Perazzo: Consultant/Advisory Board; Modest; Association of Nurses in AIDS Care. R. Josephson: None.
This research has received full or partial funding support from the American Heart Association, Yes.
- © 2017 by American Heart Association, Inc.