mHealth Physical Activity Trial for Older HIV-infected Adults (mFIT)

HIV is associated with frailty, an important aging-related phenotype associated with adverse clinical outcomes. The investigators propose that personalized health coaching using a digital activity tracker with mobile health text messaging can increase physical activity in this population. The total duration of the intervention will be 12 weeks.

• Digital Activity Tracker (Other): Group wears physical activity tracker and receives physical activity feedback information informed by the tracker
• Smart Text Messaging (Other): Group receives personalized, health coaching via "smart" text messages
• Physical Activity Counseling (Other): Group receives baseline counseling on physical activity

Primary outcomes

• Change in Mean daily step count [Baseline, 12 weeks]: Mean daily step count will be assessed using a digital physical activity tracker

Secondary outcomes

• Change in Frailty as assessed by the Fried-based physical frailty phenotype [Baseline, 12 weeks]: Frailty evaluated based on the standard 5 point Fried-based frailty phenotype construct (slow gait, weakness, weight loss, exhaustion, low physical activity)
• Change in Physical Fitness as assessed by 12 minute walk [Baseline, 12 weeks]: Physical fitness of participants will be assessed by the ability to do a 12 minute walk
• Change in Muscle strength as assessed by isokinetic resistance [Baseline, 12 weeks]: Muscle strength evaluated using isokinetic resistance testing on a Biodex system measuring peak torque expressed as foot pounds (lbs)
• Percent change in fat mass [Baseline, 12 weeks]: Fat mass will be measured using the dual-energy x-ray absorptiometry (DXA) scan
• Percent change in lean mass [Baseline, 12 weeks]: Lean mass will be measured using the dual-energy x-ray absorptiometry (DXA) scan
• Change in Physical performance as assessed by the physical performance battery [Baseline, 12 weeks]: Physical performance evaluated with the short physical performance battery
• Change in Quality of Life as assessed by the Medical Outcomes Study HIV Health Survey (MOS-HIV) [Baseline, 12 weeks]: The Medical Outcomes Study HIV Health Survey (MOS-HIV) is a brief, comprehensive measure of health-related quality of life. The 35-item questionnaire includes 10 dimensions (pain, physical, role, health perceptions, social and cognitive functioning, energy, mental health, health distress and quality of life). Each dimension is scored on a 0-100 scale (a higher score indicates better health related quality of life). An overall score is obtained through a summation of z scores from each domain.
• Change in Interleukin-6 (IL-6) concentration [Baseline, 12 weeks]: Interleukin-6 concentration in pg/ml will be measured at baseline and be compared to the concentration at 12 weeks to assess any change
• Change in soluble Tumor Necrosis Factor Receptor 1 (sTNFR1) [Baseline, 12 weeks]: sTNFR1 concentration in ng/ml will be measured at baseline and be compared to the concentration at 12 weeks to assess any change

Sex: All, ages: 50 Years to any, accepts healthy volunteers

Inclusion Criteria:

* HIV-1 positive adults of any gender
* Age 50 years and older
* Frailty score of 2 or greater (at least 1 criteria is slow gait speed or decreased grip strength)
* Ability to provide informed consent

Exclusion Criteria:

* Any physical condition that would prevent or prohibit moderate physical activity
* >3 days per week of moderate or vigorous leisure time activity lasting >30 min/day

• Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA; Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56. doi: 10.1093/gerona/56.3.m146. PMID 11253156

• Damani Piggott, MD, PhD, Principal investigator, Johns Hopkins University

NIH grants: K23AI108357