# iSTEP: an mHealth Physical Activity and Diet Intervention for Persons with HIV

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2020 · $547,463

## Abstract

SUMMARY/ABSTRACT
People who live with HIV (PLWH) experience a high incidence of neurocognitive deficits and HIV-
associated non-AIDS (HANA) disorders, including cardiovascular disease (CVD), metabolic dysfunction,
and autonomic decline. While antiretroviral treatment (ART) has reduced AIDS-related morbidity, both the
virus and the medications are associated with lipid disorders that also increase CVD risk, including
dyslipidemia and lipodystrophy. Consequently, the development of effective lifestyle interventions to reduce
the incidence of HIV-associated neurocognitive disorders (HAND) and decrease metabolic disorders is a
high priority. Physical activity (PA) has been utilized as an effective tool to improve health in PLWH, but
may not be sufficient by itself to improve lipid levels. Existing PA interventions in PLWH typically required
strenuous PA and significant resources that limit feasibility for many people living with the disease. Recent
work indicates that interrupting periods of sedentary behavior (SB), independent of PA, also has a
significant beneficial effect on metabolic function, but SB has not been well-studied in PWLH.
Mediterranean-style diets (MedDiet) are also effective at improving CVD risk factors in HIV-uninfected
individuals and are reported to reduce cognitive decline in persons at risk for Alzheimer's disease, but have
not been widely tested in PWLH. We recently developed a novel and personalized Short Message Service
(SMS) mobile phone text messaging intervention (iSTEP) that is designed to increase moderate PA in
PLWH (R21MH100968). Our objective is to expand upon this work and conduct an RCT examining the
efficacy of iSTEP in combination with a mobile mHealth MedDiet intervention tailored to PLWH. 180 PLWH
will be randomly assigned to a control group (n = 60), a 6-month iSTEP group with just a PA/SB
intervention (n = 60), or a 6-month intervention with both PA/SB and MedDiet components (n = 60), where
participants receive daily interactive SMS/MMS messages designed to increase moderate PA, reduce SB,
and promote adherence to a MedDiet, including walnut consumption. PA/SB will be quantified by
accelerometer, Fitbit step counts, and self-report, MedDiet adherence will be assessed by self-report (Diet
History Questionnaire and weekly SMS feedback) and objective measures (polyunsaturated fatty acid
levels - PUFA in blood), and we will quantify metabolic and inflammatory markers. We will also conduct a
follow-up assessment 6 months after the end of the intervention (accelerometer, neurocognitive testing,
PUFA levels) to assess PA and MedDiet adherence. We hypothesize that iSTEP (both intervention arms)
will increase PA, reduce SB, and improve neurocognition compared to control; the iSTEP + MedDiet group
will demonstrate improvement in CVD risk factors and neurocognition compared to the PA/SB intervention
alone. Findings from this proposal will lay the groundwork for development of novel large-scale mobile
PA/diet interventi...

## Key facts

- **NIH application ID:** 9930142
- **Project number:** 5R01NR016912-05
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** Brook Henry
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $547,463
- **Award type:** 5
- **Project period:** 2016-08-11 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9930142

## Citation

> US National Institutes of Health, RePORTER application 9930142, iSTEP: an mHealth Physical Activity and Diet Intervention for Persons with HIV (5R01NR016912-05). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/9930142. Licensed CC0.

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