From implementation to sustainability? A 5-year follow-up on a physical activity counseling program in Uganda for people with HIV and mental health conditions
Bibliographic Data
| ID | 19443397 |
|---|---|
| Authors | Davy Vancampfort (0000-0002-4592-8625, KU Leuven, corresponding author), James Mugisha (0000-0003-2084-8693, Kyambogo University) |
| Year | 2025 |
| Volume | 37 |
| Issue | 10 |
| Pages | 1652-1666 |
| Publication date | 2025-10-03 |
| Open Access | No |
| Type | ARTICLE |
| Venue | AIDS Care (JOURNAL) |
| Journal identifiers | ISSN: 0954-0121 • E-ISSN: 1360-0451 |
| Publisher | Informa UK Limited (PUBLISHER • GB) |
| DOI | 10.1080/09540121.2025.2550343 |
| PMID | 40889160 |
| OpenAlex | W4413883800 |
| Language | EN |
| References cited | 30 |
Physical activity (PA) interventions benefit people living with HIV and co-morbid mental health conditions, but sustaining them in low-resource settings remains difficult. This study explored the long-term sustainability of a multi-stakeholder PA counseling program in a rural Ugandan fishing community, five years post-implementation. The program integrated a PA counseling into routine HIV care, combining motivational interviewing and self-determination theory. It began with sessions led by health care providers and later transitioned to lay-led group sessions that focused on goal-setting, identifying barriers, and fostering community support. Using a context–mechanism–outcome (CMO) framework and Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis, a focus group (n = 10) involving patients, lay health workers, and staff identified key influencing factors. Although the program ended, PA awareness and some brief counseling persisted. Lay health workers remained partially active despite unpaid roles and limited supervision. Early success was supported by family involvement, and stakeholder enthusiasm, while long-term delivery was hindered by funding gaps and persistent stigma. Sustainability was supported by co-creation, community engagement, and task-shifting, but depended on material support and health system integration. Future efforts should prioritize early financial planning, integration into existing systems, and strengthening of lay roles through stable funding and supportive policy
Environmental health · Family medicine · Mental health · Physical health · Psychiatry · Sustainability · HIV-related health complications and treatments · HIV/AIDS Impact and Responses · Interprofessional Education and Collaboration · Medicine · Psychology · Gerontology
Applied Thematic Analysis
Self-Determination Theory
What is a resilient health system? Lessons from Ebola
Exploring SWOT analysis – where are we now?
Organizational Memory
Stakeholder perceptions of mental health stigma and poverty in Uganda
Home-based interventions to promote physical activity for people living with HIV – a systematic review
The efficacy of physical activity counseling in Ugandan patients with HIV and a co-morbid mental disorder
The efficacy of a lay health workers – led physical activity counselling program in patients with HIV and mental health problems
A sport-for-protection program reduces suicidal ideation in youth affected by displacement
Alcohol consumption and risky sexual behaviour in the fishing communities
Prevalence and Correlates of Substance Use Among Youth Living with HIV in Fishing Communities in Uganda
Barriers to Linkage to HIV Care in Ugandan Fisherfolk Communities
Codebook Development for Team-Based Qualitative Analysis
| Highly cited | No |
|---|