Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 22, 2020
Date Accepted: Dec 27, 2021
Positive coping as a mediator of mobile health intervention effects on quality of life among people living with HIV: secondary analysis of the randomized controlled trial Run4Love
ABSTRACT
Background:
The effectiveness of psychosocial interventions on quality of life (QOL) among people living with HIV (PLWH) have been validated, including mobile health (mHealth) interventions. However, it is unclear which components of such interventions account for the effects.
Objective:
The study aimed to examine positive coping as a potential mediator of the effects of a mobile health (mHealth) intervention on QOL among PLWH.
Methods:
The study used data from an mHealth-based randomized controlled trial, Run4Love, which was conducted to improve QOL and mental health outcomes of PLWH. A total of 300 participants were randomly assigned to the intervention group to receive the adapted cognitive-behavioral stress management courses and regular physical activity promotion, or the waitlist control group in a 1:1 ratio. Positive coping and QOL were repeatedly measured at baseline and at 3-, 6-, and 9-month follow-ups. Latent growth curve models were constructed to explore the mHealth intervention effects on QOL and the mediating role of positive coping on changes in QOL.
Results:
Positive coping served as a mediator in the effect of the mHealth intervention on QOL for up to 9 months. The mHealth intervention had a significant and positive indirect effect on the slope of QOL via the slope of positive coping (b=2.592×1.620=4.198, 95%CI=1.189-7.207, P=.006). The direct effect of the intervention was not significant (b=0.552, 95%CI=-2.154-3.258, P=.69) when controlling for the mediator.
Conclusions:
The longitudinal findings suggest that positive coping could be a crucial mediator of the mHealth intervention in enhancing QOL among PLWH. These findings underscore the importance of improving positive coping skills in mHealth interventions to improve QOL among PLWH. Clinical Trial: Chinese Clinical Trial Registry ChiCTR-IPR-17012606; http://www.chictr.org.cn/showprojen.aspx?proj=21019
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