Douglas Roque Andrade

Physical activity in adults from two Brazilian areas: similarities and differences

Lack of comparability has been a major limitation in studies on physical activity, due to the utilization of different methodological instruments and inconsistent cut-off points. This study aims to compare the levels of physical activity in adults from two Brazilian areas: (a) São Paulo, the richest State in the country; (b) Pelotas, a medium-sized southern Brazilian city. Both sites used cross-sectional population-based designs, with multiple-stage sampling strategies. Level of physical activity was assessed with the short version of the International Physical Activity Questionnaire. Prevalence of sedentary lifestyle was three times higher in Pelotas than in São Paulo. On the other hand, the proportion of very active subjects was significantly higher in Pelotas. The proportion of insufficiently active individuals (sedentary + irregularly active) was almost identical between the sites. Socioeconomic status was inversely related to level of physical activity in both sites. Among the insufficiently active subjects, those living in São Paulo are at least engaged in a limited amount of activity. On the other hand, among sufficiently active people, those living in Pelotas are more active.

Time Trends in Physical Activity in the State of São Paulo, Brazil: 2002-2008

PURPOSE To document time trends in physical activity in the state of São Paulo, Brazil (2002-2008). In addition, we discuss the role of Agita São Paulo at explaining such trends. METHODS Cross-sectional surveys were carried out in 2002, 2003, 2006, and 2008 in the state of São Paulo, Brazil, using comparable sampling approaches and similar sample sizes. In all surveys, physical activity was measured using the short version of the International Physical Activity Questionnaire. Separate weekly scores of walking and moderate- and vigorous-intensity physical activities were generated; cutoff points of 0 and 150 min·wk were used. Also, we created a total physical activity score by summing these three types of activity. We used logistic regression models for adjusting time trends for the different sociodemographic compositions of the samples. RESULTS The prevalence of no physical activity decreased from 9.6% in 2002 to 2.7% in 2008, whereas the proportion of subjects below the 150-min threshold decreased from 43.7% in 2002 to 11.6% in 2008. These trends were mainly explained by increases in walking and moderate-intensity physical activity. Increases in physical activity were slightly greater among females than among males. Logistic regression models confirmed that these trends were not due to the different compositions of the samples. CONCLUSIONS Physical activity levels are increasing in the state of São Paulo, Brazil. Considering that the few data available in Brazil using the same instrument indicate exactly the opposite trend and that Agita São Paulo primarily incentives the involvement in moderate-intensity physical activity and walking, it seems that at least part of the trends described here are explained by the Agita São Paulo program.

Physical Activity Promotion in Primary Health Care in Brazil: A Counseling Model Applied to Community Health Workers

BACKGROUND The aim of this study was to describe a methodology for training to provide counseling on physical activity among community health workers working within primary healthcare in Brazil. METHODS This was an intervention study conducted with 65 community health workers in the Ermelino Matarazzo district in the São Paulo, Brazil (30 in intervention group). The intervention group received a course of 12 hours (with 4 meetings of 3 hours each in 1 month) that aimed to improve their knowledge and be autonomous with regard to promoting physical activity. For data analysis, focus groups and questionnaires on knowledge and perceptions regarding physical activity were used. RESULTS The average attendance for the 4 meetings was 29 workers (93% of total). There was an improvement in knowledge on physical activity recommendations in comparison with the control (P = .03), and qualitative results revealed that the professionals appreciated the learned content, valued its application based on knowledge construction and felt secure about promoting physical activity. This was seen through high adherence levels and construction collective of proposal for home visits for physical activity promotion. CONCLUSION The training was effective in improving knowledge and attitudes toward counseling on physical activity among community health workers.

Interventions for physical activity promotion applied to the primary healthcare settings for people living in regions of low socioeconomic level: study protocol for a non-randomized controlled trial

BackgroundRegular physical activity practice has been widely recommended for promoting health, but the physical activity levels remain low in the population. Therefore, the study of interventions to promote physical activity is essential. Objective: To present the methodology of two physical activity interventions from the “Ambiente Ativo” (“Active Environment”) project.Methods12-month non-randomized controlled intervention trial. 157 healthy and physically inactive individuals were selected: health education (n = 54) supervised exercise (n = 54) and control (n = 49). Intervention based on health education: a multidisciplinary team of health professionals organized the intervention in group discussions, phone calls, SMS and educational material. Intervention based on supervised exercise program: consisted of offering an exercise program in groups supervised by physical education professionals involving strength, endurance and flexibility exercises. The physical activity level was assessed by the International Physical Activity Questionnaire (long version), physical activities recalls, pedometers and accelerometers over a seven-day period.ResultThis study described two different proposals for promoting physical activity that were applied to adults attended through the public healthcare settings. The participants were living in a region of low socioeconomic level, while respecting the characteristics and organization of the system and its professionals, and also adapting the interventions to the realities of the individuals attended.ConclusionBoth interventions are applicable in regions of low socioeconomic level, while respecting the social and economic characteristics of each region.Trial registrationClinicalTrials.gov NCT01852981

Estabilidade das variáveis de aptidão física e capacidade funcional de mulheres fisicamente ativas de 50 a 89 anos

The objective of this study was to evaluate the effect of a physical activity program and the stability of physical fitness and functional capacity in physically active adult women. Thirty-four adult women aged 50-89 years, who participated in a physical activity group at Camilo Castelo Branco University, were studied. Criteria for inclusion were attendance of at least 75% of the classes (3x/week) and undergoing at least one assessment per year between 2005 and 2007. All evaluations were conducted in June. Anthropometric (body weight, height, waist-hip ratio), neuromotor (rising from a chair in seconds, rising from a chair in 30 seconds, elbow flexion, shuttle-run, static and dynamic balance), and metabolic parameters (2-min step in place test according to the CELAFISCS standard) were evaluated. One-way ANOVA followed by the post hoc Scheffe test, delta percentage and Spearman’s rho correlation were used for data analysis, with the level of significance set at p<0.05. In the three evaluations, body weight, body mass index and waist-hip ratio indicated overweight. Analysis of functional capacity showed a significant increase in upper (42%) and lower (5.2%) limb strength and in balance (14.1%) when comparing the results from 2005 to 2007. The same was not observed for agility (2.1%). For body mass index, waist-hip ratio, strength and static balance, stability ranged from 0.26 to 0.91 (p<0.05. The physical activity program contributed to the maintenance of physical fitness and functional capacity in adult women.

Avaliação da efetividade da promoção da atividade física por agentes comunitários de saúde em visitas domiciliares

This study analyzed the effectiveness of physical activity promotion by community health workers (CHW) during home visits. This was a non-randomized controlled trial that lasted six months, with one group of CHW that received training to promote physical activity during home visits among users of the Brazilian Unified National Health System (SUS) and a control group. Physical activity and stages of behavior change were evaluated in 176 adults (n = 90 in the intervention group and n = 86 in the control group) assisted by the CHW. Associations, prevalence ratios, and generalized estimate equations were conducted to verify differences between groups. No evidence of differences in physical activity and stages of behavior change were observed between the two groups. CHW from the intervention group conducted more home visits promoting physical activity among elders, those with low schooling, unemployed, and those with chronic diseases. It is important to reassess the work and priorities of CHW to expand physical activity promotion under the SUS.Este estudo verificou a efetividade da promocao de atividade fisica realizada por agentes comunitarios de saude (ACS) em visitas domiciliares. Trata-se de um ensaio controlado nao randomizado com duracao de seis meses, com um grupo de ACS que passou por um processo educativo para promover atividade fisica nas visitas domiciliares para intervir em usuarios do Sistema Unico de Saude (SUS) e um grupo controle. Foram avaliados a pratica de atividade fisica e os estagios de mudanca de comportamento em 176 adultos (n = 90 do grupo intervencao e n = 86 do grupo controle) atendidos pelos ACS. Foram realizadas analises de associacao, razoes de prevalencia e equacoes de estimativas generalizadas para verificar diferencas entre os grupos. Nao foram observadas evidencias de diferencas nos niveis de atividade fisica e nos estagios de mudanca de comportamento entre os usuarios dos dois grupos. Os ACS do grupo intervencao realizaram mais visitas domiciliares para promover atividade fisica aos idosos, pessoas com baixa escolaridade, que nao trabalhavam e que tinham doencas cronicas. E importante que os modos de trabalho e prioridades dos ACS sejam repensados para ampliar a promocao da atividade fisica no SUS.

Evaluation of the effectiveness of home-based physical activity promotion by community health workers

This study analyzed the effectiveness of physical activity promotion by community health workers (CHW) during home visits. This was a non-randomized controlled trial that lasted six months, with one group of CHW that received training to promote physical activity during home visits among users of the Brazilian Unified National Health System (SUS) and a control group. Physical activity and stages of behavior change were evaluated in 176 adults (n = 90 in the intervention group and n = 86 in the control group) assisted by the CHW. Associations, prevalence ratios, and generalized estimate equations were conducted to verify differences between groups. No evidence of differences in physical activity and stages of behavior change were observed between the two groups. CHW from the intervention group conducted more home visits promoting physical activity among elders, those with low schooling, unemployed, and those with chronic diseases. It is important to reassess the work and priorities of CHW to expand physical activity promotion under the SUS.Este estudo verificou a efetividade da promocao de atividade fisica realizada por agentes comunitarios de saude (ACS) em visitas domiciliares. Trata-se de um ensaio controlado nao randomizado com duracao de seis meses, com um grupo de ACS que passou por um processo educativo para promover atividade fisica nas visitas domiciliares para intervir em usuarios do Sistema Unico de Saude (SUS) e um grupo controle. Foram avaliados a pratica de atividade fisica e os estagios de mudanca de comportamento em 176 adultos (n = 90 do grupo intervencao e n = 86 do grupo controle) atendidos pelos ACS. Foram realizadas analises de associacao, razoes de prevalencia e equacoes de estimativas generalizadas para verificar diferencas entre os grupos. Nao foram observadas evidencias de diferencas nos niveis de atividade fisica e nos estagios de mudanca de comportamento entre os usuarios dos dois grupos. Os ACS do grupo intervencao realizaram mais visitas domiciliares para promover atividade fisica aos idosos, pessoas com baixa escolaridade, que nao trabalhavam e que tinham doencas cronicas. E importante que os modos de trabalho e prioridades dos ACS sejam repensados para ampliar a promocao da atividade fisica no SUS.

The prevalence of physical activity and its associated effects among students in the São Paulo public school network, Brazil

The current study evaluated physical activity (PA) level and its associated effects among students in the public network of São Paulo, Brazil. A cross-sectional study was taken using a representative sample of students in São Paulo public school system. International Physical Activity Questionnaire determined PA level. Students who reported at least 300 minutes/week of PA were considered active. The independente variables were: gender, age, body mass index, education, region, recognition of the Agita São Paulo program. The prevalence of regular PA was 71.7%. Males (PR = 1.09, 95% CIs = 1.04 -1.15) at least 17 years old (PR = 1.16, 95% CIs 1.09-1.24) in their 3rd year of high school (PR = 1.20, 95% CIs = 1.12-1.29) who resided in the Midwest region (PR = 1.27, 95% CIs 1.16-1.38) were most likely to be active. Males at least 17 years old in their 3rd year of high school who lived in the Midwest and recognized the Agita São Paulo/Agita Galera program had higher levels of PA. São Paulo students presented a high level of PA. Moreover, males older than 17 years, attending their 3rd year of high school, who lived in the Midwest region, and recognized the Agita São Paulo/Agita Galera program were the most likely to be more active.

Evaluación de la efectividad de la promoción de la actividad física por agentes comunitarios de salud en visitas a domicilios

This study analyzed the effectiveness of physical activity promotion by community health workers (CHW) during home visits. This was a non-randomized controlled trial that lasted six months, with one group of CHW that received training to promote physical activity during home visits among users of the Brazilian Unified National Health System (SUS) and a control group. Physical activity and stages of behavior change were evaluated in 176 adults (n = 90 in the intervention group and n = 86 in the control group) assisted by the CHW. Associations, prevalence ratios, and generalized estimate equations were conducted to verify differences between groups. No evidence of differences in physical activity and stages of behavior change were observed between the two groups. CHW from the intervention group conducted more home visits promoting physical activity among elders, those with low schooling, unemployed, and those with chronic diseases. It is important to reassess the work and priorities of CHW to expand physical activity promotion under the SUS.Este estudo verificou a efetividade da promocao de atividade fisica realizada por agentes comunitarios de saude (ACS) em visitas domiciliares. Trata-se de um ensaio controlado nao randomizado com duracao de seis meses, com um grupo de ACS que passou por um processo educativo para promover atividade fisica nas visitas domiciliares para intervir em usuarios do Sistema Unico de Saude (SUS) e um grupo controle. Foram avaliados a pratica de atividade fisica e os estagios de mudanca de comportamento em 176 adultos (n = 90 do grupo intervencao e n = 86 do grupo controle) atendidos pelos ACS. Foram realizadas analises de associacao, razoes de prevalencia e equacoes de estimativas generalizadas para verificar diferencas entre os grupos. Nao foram observadas evidencias de diferencas nos niveis de atividade fisica e nos estagios de mudanca de comportamento entre os usuarios dos dois grupos. Os ACS do grupo intervencao realizaram mais visitas domiciliares para promover atividade fisica aos idosos, pessoas com baixa escolaridade, que nao trabalhavam e que tinham doencas cronicas. E importante que os modos de trabalho e prioridades dos ACS sejam repensados para ampliar a promocao da atividade fisica no SUS.

Stability of physical fitness and functional capacity in physically active women aged 50 to 89 years

The objective of this study was to evaluate the effect of a physical activity program and the stability of physical fitness and functional capacity in physically active adult women. Thirty-four adult women aged 50-89 years, who participated in a physical activity group at Camilo Castelo Branco University, were studied. Criteria for inclusion were attendance of at least 75% of the classes (3x/week) and undergoing at least one assessment per year between 2005 and 2007. All evaluations were conducted in June. Anthropometric (body weight, height, waist-hip ratio), neuromotor (rising from a chair in seconds, rising from a chair in 30 seconds, elbow flexion, shuttle-run, static and dynamic balance), and metabolic parameters (2-min step in place test according to the CELAFISCS standard) were evaluated. One-way ANOVA followed by the post hoc Scheffe test, delta percentage and Spearman’s rho correlation were used for data analysis, with the level of significance set at p<0.05. In the three evaluations, body weight, body mass index and waist-hip ratio indicated overweight. Analysis of functional capacity showed a significant increase in upper (42%) and lower (5.2%) limb strength and in balance (14.1%) when comparing the results from 2005 to 2007. The same was not observed for agility (2.1%). For body mass index, waist-hip ratio, strength and static balance, stability ranged from 0.26 to 0.91 (p<0.05. The physical activity program contributed to the maintenance of physical fitness and functional capacity in adult women.