Enhancing Recruitment and Retention for Black Females with HIV: Identifying Barriers, Facilitators, and the Role of Social Determinants for the Willingness to Participate in the HEALTH Study
Rongbing Xie, DrPH
University of Alabama at Birmingham
Black females with HIV are disproportionately at risk for cardiometabolic and cardiovascular diseases, including hypertension, diabetes, obesity, myocardial infarction, heart failure, and stroke. Addressing these health disparities is crucial for reducing non-AIDS-related morbidity and mortality. Despite the recognized benefits of physical activity, there is a notable lack of engagement among Black females with HIV, with a vast majority not meeting the minimal recommended exercise standards. High-Intensity Interval Exercise Training (HIIT) offers promising improvements in cardiometabolic health, including enhanced maximal oxygen uptake (VO2 max), reduced body measurements, better blood pressure control, and improved glucose levels. However, the participation of Black females in clinical trials evaluating exercise interventions like HIIT is disproportionately low. This underrepresentation limits the generalizability of research findings and hinders the development of culturally sensitive health interventions.
In response to these challenges, our study uses the Theoretical Domains Framework (TDF) to explore and address the factors and social determinants of health (SDOH) influencing Black females’ willingness to participate in or engage with clinical trials, specifically the High-Intensity Exercise Study to Attenuate Limitations and Train Habits in Older Adults With HIV (HEALTH). The HEALTH study includes a 16-week high-intensity interval exercise training (HIIT), accompanied by a 12-week tailored message biobehavioral component. This project aims to enhance recruitment and retention strategies, improve health outcomes, and reduce disparities by integrating patient perceptions and social determinants into the design and implementation of our interventions. Specifically, the goals of this project are to identify factors (barriers and facilitators) and mediating SDOH associated with the willingness to participate in the HEALTH study among eligible Black females with HIV at the University of Alabama (UAB) and the University of Mississippi Medical Center (UMMC) sites. This will be done by conducting focus groups with participants at both sites to learn more about their experiences, perspectives, and opinions. Through these strategic partnerships with UAB and UMMC, as well as community engagement, we aim to ensure our research is culturally relevant and effectively meets the needs of the community.
