Fidelity of an Online Telecoaching Community-Based Exercise Intervention Among Adults Living With HIV in Toronto, Ontario, Canada: Observational Longitudinal Study.
Marfy Abousifein, Julia Nathanson, Tizneem Jiancaro and 14 others
PMID 42691484WHAT IT FOUND
83% of the 18 participants assessed at month 6 attended at least 80% of online personal training sessions, but only 50% met the independent exercise target and 33% attended group classes.
The only part delivered as planned was supervised attendance.
Key findings
01Among participants who completed the intervention and month 6 assessment, 83% attended at least 80% of their 13 online personal training sessions.
02The independent exercise, month 6 participant-reported fidelity, and all four exercise types criteria were not met. Among participants who completed the intervention and month 6 assessment, 50% met the independent exercise criterion, 44% met the participant-reported fidelity criterion, and 22% met the all four exercise types criterion.
03Participants reported illness, pain, injury, scheduling, lack of interest, technology problems, and Fitbit discomfort as barriers; they valued exercise demonstration, adaptation, and feedback.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 18 of 32 participants completed the intervention and month 6 assessment, so fidelity results may be overestimated among those who stayed. In sensitivity analysis assuming participants who withdrew did not meet criteria, none of the four fidelity criteria were met. Participants reported fidelity only for their most recent coaching session, while trainers logged all sessions, so the two perspectives were not directly comparable. The fidelity threshold was set before analysis and all four criteria were weighted equally, though some components may matter more than others. Most participants were men, so findings may not transfer to women or gender diverse adults living with HIV. The study did not report physical activity measured by the Fitbit or assess income, stigma, or discrimination as factors.
Declared interests
No conflicts of interest were declared.
The easy way to misread this
Do not read the 83% attendance rate as evidence that the intervention was delivered as intended overall. It applies only to participants who completed the intervention, and the other fidelity criteria were not met. If participants who withdrew are assumed not to have met the criteria, none of the four fidelity criteria were met.