A Qualitative Study of Fitness Coaches’ Experiences in Community Based Exercise with People Living with HIV

Abstract

Fitness coaches need to understand the needs of people living with HIV engaged in community-based exercise (CBE) to be competent in developing exercises programs with this population. Our aim was to understand coaches’ experiences engaging in a CBE intervention with PLWH in an urban center in Canada. As part of a broader study, coaches supervised weekly hour-long individualized exercise sessions with PLWH over a six-month period. Using qualitative longitudinal methods, we interviewed coaches up to three times over six months. Transcribed interviews were analyzed cross-sectionally and longitudinally. Seven coaches participated in 15 interviews. Developing confidence, improving health and experiencing a sense of community were viewed as key benefits to PLWH by the coaches. Challenges included accommodating the episodic nature of HIV and ensuring they felt prepared to work with PLWH. Understanding the experiences of coaches engaged in CBE can assist in tailoring exercise programs to meet the needs of PLWH.

Piloting an online telecoaching community-based exercise intervention with adults living with HIV: protocol for a mixed-methods implementation science study

“…Our prior work suggests this number will enable us to achieve our objectives related to the strengths and challenges of implementing CBE. 37 38 …”

“…This research involves a community-academic-clinical partnership derived from foundational work on CBE in the context of HIV with the Toronto Central YMCA, Toronto, Ontario, Canada 29 30 37–39. Collaborating partners include the Toronto Central YMCA, community-based organisations, community HIV clinic in collaboration with the Ontario HIV Treatment Network Cohort Study (OCS), and Realize, a national organisation focused on advancing education, practice and policy on HIV and rehabilitation.…”

“…We will recruit ≥30% cisgender and transgender women to achieve proportional gender and geographical representation in the study 60. As a result, we will approach women from our in-person CBE study who were interested but unable to participate due to geographical or childcare reasons 36–38…”

“…Our online telecoaching intervention builds on lessons learnt from our in-person CBE study,39 the American College of Sports Medicine guidelines,67 qualitative consultation with community (adults living with HIV and fitness instructors),30 37 and qualitative work that identified factors to consider in developing and implementing online CBE with the HIV community, specifically (1) person-specific considerations (episodic nature of disability, stigma, HIV disclosure), (2) accessibility (physical space to exercise, reliable internet, access to devices, digital literacy), (3) programme delivery and technology (live vs prerecorded online classes, multiple online platforms for delivery, physical activity tracking, troubleshooting technology), (4) attributes of CBE personnel (working with CBOs, relatable instructors, diverse staff), (5) programme content and design (tailored exercise classes, educational sessions) and (6) building community (shared experiences, peer support, social opportunities) 68…”

“…CBE can foster social interaction, peer support, encouragement to exercise, and can promote emotional, cognitive and behavioural self-management strategies to help independently manage chronic health challenges 33 35. In earlier work, we evaluated a CBE intervention in which adults living with HIV were expected to engage in thrice weekly exercise for 6 months, with weekly in-person supervised personal training at the YMCA in Toronto, Canada 36–39. Few women (<10%) and even fewer from the trans community participated in the study,36 citing barriers including geographical and childcare barriers, and social and interpersonal barriers to exercise in traditional cisnormative gym settings 38.…”