Adapting an evidence-based physical activity program to reduce pain and enhance quality of life for older women living with HIV - Modified Project Summary/Abstract Section Arthritis is one of the most common debilitating chronic conditions experienced by older adults, leading to chronic pain, reduced mobility, and loss of independence. Older women living with HIV (OWWH) are disproportionately affected by arthritis, experiencing nearly twice the prevalence compared to the general population. OWWH also face unique barriers to managing arthritis, including socioeconomic challenges, HIV-related social and interpersonal challenges, and limited access to evidence-based interventions. Addressing these challenges is critical to reducing comorbidities, alleviating pain, and improving quality of life. Physical activity programs that include aerobic and strengthening exercises effectively manage arthritis by maintaining muscle strength, reducing bone loss, and controlling joint pain and stiffness. However, fewer than 16% of older adults report participating in arthritis management programs, with participation rates significantly lower among racial, ethnic, and persons with low socioeconomic status, including persons living with HIV. Guided by the NIMHD research framework, this study prioritizes individual, interpersonal, and community factors that contribute to differences in health outcomes. By applying this comprehensive approach, we aim to address multi-level challenges to physical activity participation and foster access to arthritis management for OWWH. The goal of this study is to adapt and test the Fit & Strong! (F&S) evidence-based physical activity and education intervention to address the specific physical and psychosocial needs of women, aged 50 years and older, living with HIV. The tailored intervention will integrate group-based physical activity and behavior change strategies, fostering social support and self-efficacy while addressing modifiable influences identified by OWWH. Our study aims are: 1) Collaborate with a Community Advisory Board of OWWH to tailor the F&S program using the ADAPT-ITT model and pilot test the new intervention; 2) Conduct a fully powered randomized waitlist-controlled trial with 300 participants to evaluate the intervention’s impact on participant health outcomes; and 3) Evaluate the acceptability, feasibility, and sustainability of the program at the individual, instructor, and organization levels. This project addresses a critical public health gap in an understudied population disproportionately affected by arthritis and co-morbid health challenges. By leveraging community-driven input and emphasizing an in-person, group-based approach, this study aims to increase physical activity, reduce pain, improve physical function, and enhance quality of life for OWWH.
