Long-term Effects of a Social Media–Based Intervention (Run4Love) on Depressive Symptoms of People Living With HIV: 3-Year Follow-up of a Randomized Controlled Trial

Abstract

Background Emerging studies have shown the effectiveness of mobile health (mHealth) interventions in reducing depressive symptoms among people living with HIV. Most of these studies included only short-term follow-up, with limited data on long-term effects. Objective The purpose of this study is to assess the long-term effects of a randomized controlled trial called Run4Love on depressive symptoms among people living with HIV at 1-year and 3-year follow-ups. Methods A total of 300 people living with HIV with depressive symptoms were recruited and randomized to an intervention or a control group in Guangzhou, China, from September 2017 to January 2018. The intervention group received a 3-month Run4Love program, including adapted evidence-based cognitive behavioral stress management courses and exercise promotion via WeChat (Tencent), a popular social media app. The control group received usual care and a brochure on nutrition. The primary outcome was reduction in depressive symptoms, measured using the Center for Epidemiological Studies–Depression (CES-D) scale. Data used in this study were collected at baseline and at the 1-year and 3-year follow-ups. Generalized estimating equations were used to examine the group differences at 1-year and 3-year follow-ups. Results Approximately half of the participants completed the assessment at 1-year (149/300, 49.7%) and 3-year (177/300, 59%) follow-ups. At 1-year follow-up, participants in the intervention group reported significant reduction in depressive symptoms compared with the control group (CES-D: from 23.9 to 18.1 in the intervention group vs from 24.3 to 23.3 in the control group; mean −4.79, SD 13.56; 95% CI −7.78 to −1.81; P=.002). At 3-year follow-up, between-group difference in CES-D remained statistically significant (from 23.9 to 20.5 in the intervention group vs from 24.3 to 24.4 in the control group; mean −3.63, SD 13.35; 95% CI −6.71 to −0.54; P=.02). No adverse events were reported during the 3-year follow-up period. Conclusions The mHealth intervention, Run4Love, significantly reduced depressive symptoms among people living with HIV, and the intervention effects were sustained at 1-year and 3-year follow-ups. Further research is needed to explore the mechanisms of the long-term effects of mHealth interventions such as Run4Love and to implement these effective interventions among people living with HIV. Trial Registration Chinese Clinical Trial Registry ChiCTR-IPR-17012606; https://trialsearch.who.int/Trial2.aspx?TrialID=ChiCTR-IPR-17012606 International Registered Report Identifier (IRRID) RR2-10.2196/10274

Leveraging Mobile Health to Manage Mental Health/Behavioral Health Disorders: Systematic Literature Review

“…A total of 11 themes and 2 individual observations were identified by the reviewers for a total of 48 occurrences in the literature, whereas 11 themes and 7 observations were noted for a total of 95 observations. In the 33 studies analyzed, 26 (79%) showed an improvement in symptoms of depression [25,26,[28][29][30][31][32][33][35][36][37][40][41][42][43][44][46][47][48][49][50][51][52][54][55][56], while 19 (58%) showed an improvement in anxiety [26][27][28][29][30][31][32][33]36,[38][39][40][44][45][46][53][54][55][56]. Only 11/33 (33%) reported that at least one symptom was not statistically significant when compared with results from the control group, but the improvement was still noted [25]…”

“…The following observations only occurred once in the literature: decrease in anger [26], decrease in decision conflict [30], decrease in decision regret [30], decreased digestive disturbance [26], decreased pain [26], increased medication adherence [41], and the intervention had no effect on self-efficacy [34]. [25,26,[28][29][30][31][32][33][35][36][37][40][41][42][43][44][46][47][48][49][50][51][52][54][55][56] 19 Reduced anxiety [26][27][28][29][30][31][32][33]36,[38][39][40][44][45][46][53]…”

“…Following the PRISMA checklist [20] and the Kruse protocol [21], we extracted the following data fields: participants, intervention, comparison with the control or other group, medical outcomes, and study design (PICOS; Table 1) as a way to summarize study characteristics, as required by PRISMA. Of the 33 studies analyzed over the 1-year period, 17 were from 2021 [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] and 16 were from 2022 [42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57]. All studies were RCTs involving adults, and 48% (16/33) involved an average age of 50 years or above.…”

“…Two studies reported no effects on mental health from the intervention [34,57]. [25,26,[28][29][30][31][32][33][35][36][37][40][41][42][43][44][46][47][48][49][50][51][52][54][55][56] 19 Reduced anxiety [26][27][28][29][30][31][32][33]36,[38][39][40][44][45][46][53][54][55][56] 7 Increased quality of life [36,41,44,49,…”

Outcome of Lenalidomide Treatment for Cognitive Impairment Caused by Immune Reconstitution Inflammatory Syndrome in Patients with HIV-Related Cryptococcal Meningitis

“…They all use Chinese questionnaires that have been validated for the evaluation of Chinese patients. [22][23][24] The MoCA tests eight major neurocognitive domains, including short-term memory recall (no score), visuospatial ability, naming, attention, language, conceptual thinking, working memory, and orientation of time and place. The MoCA, with a sensitivity of 90% and a specificity of 87%, 25 is used to identify patients with mild cognitive impairment.…”