Evelyn Fabiana Costa

Percepção do ambiente e prática de atividade física no lazer entre idosos

OBJETIVO: Analisar a associacao da pratica de atividades fisicas no lazer com a percepcao do ambiente por idosos. METODOS: Estudo transversal realizado com 385 idosos com 60 anos ou mais residentes do distrito de Ermelino Matarazzo no municipio de Sao Paulo, SP, em 2007. Para a avaliacao das atividades fisicas no lazer foi utilizado o Questionario Internacional de Atividades Fisicas versao longa, acrescida de questoes especificas para o estudo. A avaliacao do ambiente foi realizada por meio de escala de percepcao adaptada do instrumento Neighborhood Environmental Walkability Scale. Para a analise estatistica, modelos de analise de regressao logistica multipla foram estratificados segundo sexo, controlados por escolaridade. Para a classificacao de ativo no lazer, foi utilizado o ponto de corte de 150 min semanais de atividade fisica. RESULTADOS: A proporcao de idosos fisicamente ativos no lazer foi de 15,2% (19,1% e 12,5%, para homens e mulheres, respectivamente). A presenca de quadras (OR=2,95), agencias bancarias (OR=3,82) e postos de saude (OR=3,60), boa percepcao de seguranca durante o dia (OR=4,21) e receber convite de amigos para fazer atividade fisica (OR=3,13) tiveram associacao com a pratica de atividade fisica no lazer nos homens. Presenca de igrejas ou templos religiosos (OR=5,73), academias (OR=2,49) e pracas (OR=3,63) tiveram associacao com a pratica de atividade fisica no lazer em mulheres. CONCLUSOES: Programas de promocao de atividades fisicas para a populacao idosa devem considerar as variaveis relacionadas as estruturas publicas e privadas (academias, pracas, quadras, postos de saude e bancos), locais que congregam reunioes sociais (igrejas), ao suporte social (ser convidado por amigos para praticar atividade fisica) e percepcao de seguranca.OBJECTIVE To analyze the association between leisure-time physical activity and perception of the environment in the elderly. METHODS Cross-sectional study performed with 385 elderly individuals aged 60 years or older, living in the district of Ermelino Matarazzo, in the city of São Paulo, Southeastern Brazil, in 2007. The long version of the International Physical Activity Questionnaire, in addition to specific questions for the study, was used to assess leisure-time physical activity. Assessment of the environment was performed using a perception scale adapted from the Neighborhood Environment Walkability Scale. For statistical analysis, multiple logistic regression models were stratified by sex and controlled by level of education. The cut-off point of 150 minutes of physical activity per week was used to classify individuals who were active during leisure time. RESULTS The proportion of elderly individuals active during leisure time was 15.2% (19.1% and 12.5% for men and women, respectively). Presence of sports courts (OR=2.95), banks (OR=3.82) and health clinics (OR=3.60), good perception of safety during the day (OR=4.21) and invitation from friends to exercise (OR=3.13) were associated with leisure-time physical activity in men. Presence of churches or religious temples (OR=5.73), gyms (OR=2.49) and squares (OR=3.63) were associated with leisure-time physical activity in women. CONCLUSIONS Programs to promote physical activities for the elderly population must consider the variables associated with public and private structures (gyms, squares, sports courts, health clinics and banks), places where there are social gatherings (churches), social support (invitation from friends to exercise) and perception of safety.

Perception of the environment and leisure-time physical activity in the elderly.

OBJETIVO: Analisar a associacao da pratica de atividades fisicas no lazer com a percepcao do ambiente por idosos. METODOS: Estudo transversal realizado com 385 idosos com 60 anos ou mais residentes do distrito de Ermelino Matarazzo no municipio de Sao Paulo, SP, em 2007. Para a avaliacao das atividades fisicas no lazer foi utilizado o Questionario Internacional de Atividades Fisicas versao longa, acrescida de questoes especificas para o estudo. A avaliacao do ambiente foi realizada por meio de escala de percepcao adaptada do instrumento Neighborhood Environmental Walkability Scale. Para a analise estatistica, modelos de analise de regressao logistica multipla foram estratificados segundo sexo, controlados por escolaridade. Para a classificacao de ativo no lazer, foi utilizado o ponto de corte de 150 min semanais de atividade fisica. RESULTADOS: A proporcao de idosos fisicamente ativos no lazer foi de 15,2% (19,1% e 12,5%, para homens e mulheres, respectivamente). A presenca de quadras (OR=2,95), agencias bancarias (OR=3,82) e postos de saude (OR=3,60), boa percepcao de seguranca durante o dia (OR=4,21) e receber convite de amigos para fazer atividade fisica (OR=3,13) tiveram associacao com a pratica de atividade fisica no lazer nos homens. Presenca de igrejas ou templos religiosos (OR=5,73), academias (OR=2,49) e pracas (OR=3,63) tiveram associacao com a pratica de atividade fisica no lazer em mulheres. CONCLUSOES: Programas de promocao de atividades fisicas para a populacao idosa devem considerar as variaveis relacionadas as estruturas publicas e privadas (academias, pracas, quadras, postos de saude e bancos), locais que congregam reunioes sociais (igrejas), ao suporte social (ser convidado por amigos para praticar atividade fisica) e percepcao de seguranca.OBJECTIVE To analyze the association between leisure-time physical activity and perception of the environment in the elderly. METHODS Cross-sectional study performed with 385 elderly individuals aged 60 years or older, living in the district of Ermelino Matarazzo, in the city of São Paulo, Southeastern Brazil, in 2007. The long version of the International Physical Activity Questionnaire, in addition to specific questions for the study, was used to assess leisure-time physical activity. Assessment of the environment was performed using a perception scale adapted from the Neighborhood Environment Walkability Scale. For statistical analysis, multiple logistic regression models were stratified by sex and controlled by level of education. The cut-off point of 150 minutes of physical activity per week was used to classify individuals who were active during leisure time. RESULTS The proportion of elderly individuals active during leisure time was 15.2% (19.1% and 12.5% for men and women, respectively). Presence of sports courts (OR=2.95), banks (OR=3.82) and health clinics (OR=3.60), good perception of safety during the day (OR=4.21) and invitation from friends to exercise (OR=3.13) were associated with leisure-time physical activity in men. Presence of churches or religious temples (OR=5.73), gyms (OR=2.49) and squares (OR=3.63) were associated with leisure-time physical activity in women. CONCLUSIONS Programs to promote physical activities for the elderly population must consider the variables associated with public and private structures (gyms, squares, sports courts, health clinics and banks), places where there are social gatherings (churches), social support (invitation from friends to exercise) and perception of safety.

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.

Systematic review of physical activity promotion by community health workers

OBJECTIVE To assess the physical activity promotion in interventions conducted by community health workers. METHODS Systematic searches in five electronic databases (LILACS, PubMed, Scopus, Web of Science and SportDiscus) and manual searches in reference lists were conducted for papers published up until May 2014. The inclusion criteria were interventions delivered in adults by community health workers that had physical activity promotion as an objective (primary or secondary). RESULTS Of the 950 references initially retrieved, 26 were included in the descriptive synthesis. At the operational level, action strategies were predominantly based on the model of health education grounded in counseling, and delivered in populations at risk or diagnosed with chronic non-communicable diseases. Only five studies had the primary outcome of physical activity promotion and twenty-five studies used self-report methods for evaluation. The majority of studies (72.4%) were classified as having low or moderate risk of bias. Sixteen studies (61.5%) reported positive results for different parameters of physical activity. Most studies were carried out in the United States. The successful interventions were conducted over a period averaging 6.5 months and targeted mainly women, individuals older than thirty, specific ethnic groups, and syndromic or at-risk individuals. CONCLUSIONS The community health workers were important for physical activity promotion, but further interventions should be carried out in different countries and less specific samples, that include physical activity as a primary outcome and employ direct methods for assessing physical activity.

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.

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.

Percepción del ambiente y práctica de actividad física en el ocio entre ancianos

OBJETIVO: Analisar a associacao da pratica de atividades fisicas no lazer com a percepcao do ambiente por idosos. METODOS: Estudo transversal realizado com 385 idosos com 60 anos ou mais residentes do distrito de Ermelino Matarazzo no municipio de Sao Paulo, SP, em 2007. Para a avaliacao das atividades fisicas no lazer foi utilizado o Questionario Internacional de Atividades Fisicas versao longa, acrescida de questoes especificas para o estudo. A avaliacao do ambiente foi realizada por meio de escala de percepcao adaptada do instrumento Neighborhood Environmental Walkability Scale. Para a analise estatistica, modelos de analise de regressao logistica multipla foram estratificados segundo sexo, controlados por escolaridade. Para a classificacao de ativo no lazer, foi utilizado o ponto de corte de 150 min semanais de atividade fisica. RESULTADOS: A proporcao de idosos fisicamente ativos no lazer foi de 15,2% (19,1% e 12,5%, para homens e mulheres, respectivamente). A presenca de quadras (OR=2,95), agencias bancarias (OR=3,82) e postos de saude (OR=3,60), boa percepcao de seguranca durante o dia (OR=4,21) e receber convite de amigos para fazer atividade fisica (OR=3,13) tiveram associacao com a pratica de atividade fisica no lazer nos homens. Presenca de igrejas ou templos religiosos (OR=5,73), academias (OR=2,49) e pracas (OR=3,63) tiveram associacao com a pratica de atividade fisica no lazer em mulheres. CONCLUSOES: Programas de promocao de atividades fisicas para a populacao idosa devem considerar as variaveis relacionadas as estruturas publicas e privadas (academias, pracas, quadras, postos de saude e bancos), locais que congregam reunioes sociais (igrejas), ao suporte social (ser convidado por amigos para praticar atividade fisica) e percepcao de seguranca.OBJECTIVE To analyze the association between leisure-time physical activity and perception of the environment in the elderly. METHODS Cross-sectional study performed with 385 elderly individuals aged 60 years or older, living in the district of Ermelino Matarazzo, in the city of São Paulo, Southeastern Brazil, in 2007. The long version of the International Physical Activity Questionnaire, in addition to specific questions for the study, was used to assess leisure-time physical activity. Assessment of the environment was performed using a perception scale adapted from the Neighborhood Environment Walkability Scale. For statistical analysis, multiple logistic regression models were stratified by sex and controlled by level of education. The cut-off point of 150 minutes of physical activity per week was used to classify individuals who were active during leisure time. RESULTS The proportion of elderly individuals active during leisure time was 15.2% (19.1% and 12.5% for men and women, respectively). Presence of sports courts (OR=2.95), banks (OR=3.82) and health clinics (OR=3.60), good perception of safety during the day (OR=4.21) and invitation from friends to exercise (OR=3.13) were associated with leisure-time physical activity in men. Presence of churches or religious temples (OR=5.73), gyms (OR=2.49) and squares (OR=3.63) were associated with leisure-time physical activity in women. CONCLUSIONS Programs to promote physical activities for the elderly population must consider the variables associated with public and private structures (gyms, squares, sports courts, health clinics and banks), places where there are social gatherings (churches), social support (invitation from friends to exercise) and perception of safety.