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Tailored text messages plus motivational interviewing sustain MVPA in older adults with HIVTailored text messages help people with HIV over 50 maintain physical activity

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Key Takeaway
Consider tailored text messages as a potential adjunct to MI for sustaining MVPA in older PWH, but note small sample and unknown long-term effects.

A randomized controlled trial investigated whether tailored text messages could help sustain moderate-to-vigorous physical activity (MVPA) in people with HIV (PWH) aged 50 and older. The study initially randomized 118 participants, with 92 re-randomized at 16 weeks to receive either tailored text messages (based on Two Minds Theory and daily barrier surveys) added to motivational interviewing (MI) or educational control messages added to MI. The primary outcome was sustained MVPA minutes per day, measured by ActiGraph monitor and self-report over 12 weeks of messaging (total study duration 28 weeks).

At the 28-week assessment, 22 of 29 participants in the tailored-message group and 25 of 32 in the educational-control group provided data. The tailored-message group maintained MVPA with a mean of 48.8 minutes/day (SD=45.8), while the educational-control group decreased to a mean of 40.7 minutes/day (SD=24.6). The group-by-time interaction was statistically significant (p=.01). Exploratory analyses suggested the tailored messaging effect was additive to the foundational MI. Secondary outcomes of exercise self-efficacy and perceived health were also reportedly higher in the tailored-messaging group over time, though specific numerical results were not provided.

Safety and tolerability data were not reported. The study's findings were robust to attrition in intent-to-treat analysis and were consistent across both actigraphy and self-reported MVPA measures. However, key limitations include the small sample sizes at the final 28-week time point (n=22 and n=25), the lack of reported data on long-term sustainability beyond 28 weeks, and the absence of safety or tolerability information. Funding sources and conflicts of interest were also not reported.

For clinical practice, this RCT provides preliminary evidence that a tailored text-message intervention may help sustain physical activity as an adjunct to motivational interviewing in older adults with HIV. The intervention's effect appears additive. However, clinicians should interpret these findings cautiously due to the small final cohort, unknown durability of effect, and lack of safety data. The approach represents a low-burden, scalable potential component of a broader physical activity support strategy.

Researchers wanted to see if personalized text messages could help people living with HIV who are 50 or older stay physically active. The study involved 118 people initially, with 92 continuing into the later phase. All participants received motivational interviewing, but half also got daily text messages tailored to their specific exercise barriers, while the other half received general educational messages.

After 28 weeks, the group receiving the tailored text messages maintained their level of moderate-to-vigorous physical activity, averaging about 49 minutes per day. The group receiving only educational messages saw their activity decrease, averaging about 41 minutes per day. The tailored-message group also reported feeling more confident about exercising and better about their overall health.

It's important to be cautious because the number of people who completed the full 28-week study was relatively small—only 22 in the tailored-message group and 25 in the control group. The study didn't report on safety or whether people had any problems with the messages. We also don't know if the benefits would last beyond the 28 weeks studied.

This research suggests that adding personalized text support to existing counseling might be a helpful way to encourage ongoing exercise for older adults with HIV. However, more research with larger groups and longer follow-up is needed to confirm these early findings.

What this means for you:
Personalized text messages may help older adults with HIV stay active, but more research is needed.

Study Details

Study typeRct
Sample sizen = 22
EvidenceLevel 2
PublishedMar 2026
View Original Abstract ↓
BackgroundPeople with HIV (PWH) have increased risk for cardiovascular diseases and other age-related comorbidities. These risks can be reduced through moderate to vigorous physical activity (MVPA), but MVPA can be difficult to sustain over time. PurposeWe tested tailored text messages added to motivational interviewing (MI) to sustain MVPA among PWH. Messages were created based on Two Minds Theory and matched to daily survey responses about exercise barriers. Methods118 PWH ages [≥] 50 were initially randomized to high-intensity interval training or continuous moderate-intensity exercise. After 16 weeks, 92 participants were re-randomized to receive either tailored messages plus MI, or educational control messages, for 12 weeks. Both groups completed daily barrier surveys and wore an ActiGraph monitor for 1 week/month. ResultsPWH still receiving messages at 28 weeks maintained their MVPA, ending at M = 48.8 minutes per day (SD = 45.8, n = 22/29), compared to a decrease among PWH in the educational-control group, ending at M = 40.7 (SD = 24.6, n = 25/32), p = .01 for the group-by-time interaction. Findings were similar using both actigraphy and self-reported MVPA, and were robust to attrition based on intent-to-treat analysis. PWH in the tailored-messaging group also reported higher exercise self-efficacy and better perceived health over time, relative to those in the educational-control group. ConclusionsAn automated tailored-messaging intervention led to sustained MVPA. Tailored messages were superior to non-tailored educational messages, and may help PWH maintain their long-term health. Exploratory analyses suggested these effects were additive to motivational interviewing.
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