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Evaluating a community-based exercise intervention with adults living with HIV: protocol for an interrupted time series study
  1. Kelly K O'Brien1,2,3,
  2. Ahmed M Bayoumi3,4,5,
  3. Patricia Solomon6,
  4. Ada Tang6,
  5. Kate Murzin7,
  6. Soo Chan Carusone8,
  7. Mehdi Zobeiry9,
  8. Ayesha Nayar1,
  9. Aileen M Davis1,2,3,10
  1. 1Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
  2. 2Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, Ontario, Canada
  3. 3Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
  4. 4Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
  5. 5Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  6. 6School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
  7. 7Realize (formally known as the Canadian Working Group on HIV and Rehabilitation (CWGHR)), Toronto, Ontario, Canada
  8. 8Casey House, Toronto, Ontario, Canada
  9. 9Toronto Central Grosvenor Street YMCA, Toronto, Ontario, Canada
  10. 10Division of Health Care and Outcomes, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
  1. Correspondence to Dr Kelly K O'Brien; kelly.obrien{at}


Introduction Our aim was to evaluate a community-based exercise (CBE) intervention with the goal of reducing disability and enhancing health for community-dwelling people living with HIV (PLWH).

Methods and analysis We will use a mixed-methods implementation science study design, including a prospective longitudinal interrupted time series study, to evaluate a CBE intervention with PLWH in Toronto, Canada. We will recruit PLWH who consider themselves medically stable and safe to participate in exercise. In the baseline phase (0–8 months), participants will be monitored bimonthly. In the intervention phase (8–14 months), participants will take part in a 24-week CBE intervention that includes aerobic, resistance, balance and flexibility exercise at the YMCA 3 times per week, with weekly supervision by a fitness instructor, and monthly educational sessions. In the follow-up phase (14–22 months), participants will be encouraged to continue to engage in unsupervised exercise 3 times per week. Quantitative assessment: We will assess cardiopulmonary fitness, strength, weight, body composition and flexibility outcomes followed by the administration of self-reported questionnaires to assess disability and contextual factor outcomes (coping, mastery, stigma, social support) bimonthly. We will use time series regression analysis to determine the level and trend of outcomes across each phase in relation to the intervention. Qualitative assessment: We will conduct a series of face-to-face interviews with a subsample of participants and recreation providers at initiation, midpoint and completion of the 24-week CBE intervention. We will explore experiences and anticipated benefits with exercise, perceived impact of CBE for PLWH and the strengths and challenges of implementing a CBE intervention. Interviews will be audio recorded and analysed thematically.

Ethics and dissemination Protocol approved by the University of Toronto HIV/AIDS Research Ethics Board. Knowledge translation will occur with stakeholders in the form of presentations and publications in open access peer-reviewed journals.

Trial registration number NCT02794415; Pre-results.

  • Exercise
  • community-based exercise
  • physical activity

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  • Contributors KKO led the conceptualisation of the study objectives, and drafted the protocol and is the lead investigator on the study. AMD, PS, AMB, AN and AT are members of the research team, were involved in the pilot work, conceptualisation of the study design and development of the protocol. KM is a knowledge user and member of the Community Advisory Committee. She is involved in the recruitment of participants and provision of training for the YMCA fitness instructors through the realize (formally CWGHR) online interprofessional learning module. SCC is a collaborator and member of the Community Advisory Committee. She is involved in recruitment of participants. MZ is the principal knowledge user in this study in collaboration with the YMCA (see acknowledgements) involved in developing the protocol as it relates to the physical assessments, fitness instruction and CBE intervention at the YMCA. All authors have read and approved the final protocol manuscript.

  • Funding This study is supported by the Canadian Institutes of Health Research (CIHR) HIV/AIDS Community-Based Research (CBR) Program (Funding Reference Number #CBR-139685; 160 Elgin Street, Ottawa, Ontario, Canada K1A 0W9). KKO is supported by a New Investigator Award from the Canadian Institutes of Health Research (CIHR). AMB is supported by the Foundation Baxter and Alma Ricard Chair in Inner City Health at St. Michael's Hospital and the University of Toronto. AT is supported by a personnel award from the Heart and Stroke Foundation, Ontario Provincial Office (CS I 7468).

  • Disclaimer The CIHR had no role in the design of this study and will not have any role during its execution, analyses, interpretation of the data or decision to submit results.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data collected during and/or analysed during the study are not publicly available in accordance with our study protocol that was approved by the University of Toronto HIV/AIDS Research Ethics Board. Data may be available on reasonable request by contacting the corresponding author.