Accepted for/Published in: JMIR Formative Research
Date Submitted: Mar 28, 2023
Date Accepted: Jul 24, 2023
Understanding Physical Activity Determinants in an HIV Self-Management Intervention: Qualitative Analysis Guided by the Theory of Planned Behavior
ABSTRACT
Background:
People living with HIV (PLWH) are living longer and are experiencing more comorbid conditions, being at an increased risk for developing cardiovascular disease (CVD) and diabetes, further exacerbated due to the HIV/inflammatory process. One effective intervention shown to decrease mortality and improve health outcomes related to CVD and diabetes in PLWH is increased regular physical activity. However, PLWH often fall short of the daily recommended physical activity levels. While studies show that mobile health (mHealth) can potentially help improve people’s daily activity levels and reduce mortality rates due to comorbid conditions, these studies do not specifically focus on PLWH. As such, it is essential to understand how mHealth interventions, like wearables, can improve PLWH’s physical activity.
Objective:
This study aimed to understand participants’ experiences wearing a fitness tracker with an app to improve their physical activity.
Methods:
Six focus groups were conducted with participants who completed the control arm of a 6-month randomized controlled trial (NCT03205982). The control arm received daily walk step reminders to walk at least 5,000 steps/day and focused on overall wellness of the individual. The analysis of the qualitative focus groups used inductive content analysis using the theory of planned behavior (TPB) as a framework to guide and organize the analysis.
Results:
Forty-one PLWH participated in the focus groups. The majority (n=26; 63.4%) of participants reported their race as Black or African American, and 31.7% (n=13) identified their ethnicity as Hispanic or Latino. Nine major themes were identified and organized following the TPB constructs. Two major themes (Positive attitude toward tracking steps; Tracking steps is motivating) related to attitudes towards the behavior, two major themes ( Social support/motivation from the fitness tracker; Encouragement from family and friends) related to participant’s subjective norms, one theme (You can adjust your daily habits) related to perceived behavioral control, two themes (Reach the step goal; Have a healthier lifestyle) related to participant’s intention, and two themes (Continuing to walk actively; Regularly wearing the fitness tracker) related to participant’s changed behavior. Participants highlighted how the mHealth interface with the avatar and daily step tracking motivated them to both begin and continue to engage in physical activity by adjusting their daily routines.
Conclusions:
Findings from this study illustrate how features of mHealth apps may motivate PLWH to start and continue sustained engagement in physical activities. This sustained increase in physical activity is crucial for reducing risk of comorbid conditions like diabetes or cardiovascular disease. Clinical Trial: NCT03205982
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