Factors influencing initial implementation of an online community-based exercise intervention with adults living with HIV: a systems approach

Introduction Online community-based exercise (CBE) is a digital health intervention and rehabilitation strategy that promotes among people living with HIV. Our aim was to describe the factors influencing initial implementation of pilot online CBE adults HIV using systems approach, as recommended by science specialists. Methods We piloted 6-month independent follow up, in partnership YMCA Toronto, Canada. recruited who identified themselves safe engage exercise. The phase included personalized sessions personal trainer; equipment; access classes; wireless physical activity monitor. Two researchers documented articulated participants team during early implementation, defined recruitment, screening, equipment distribution, technology orientation, baseline assessments. Data sources communication participants; daily communication; weekly discussions; in-person meetings. meeting minutes, recruitment screening notes, email analyzed data qualitative descriptive approach engineering method called Cognitive Work Analysis. Results Thirty-three enrolled study ( n = 33; median age: 52 years; cis-men: 22, cis-women: 10, non-binary: 1). Fifty-five spanned five layers: (i) Natural , including weather COVID-19 virus; (ii) Societal impacts (e.g. public transit risks impacting pick-ups); (iii) Organizational information dissemination tech support) logistics scheduling); (iv) Personal, setting space) device access); (v) Human episodic illness) disposition motivation). experienced heightened needs respond rapidly; sustain engagement; provide training support. Additional organizational committed fitness research skills spanning administration logistics, participant engagement, training, therapy, ethics. Conclusion multiple layers illustrate complexities Initial required dedicated, rehabilitation-centred, multi-skilled, multi-stakeholder address diverse set factors.