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de Oliveira AB, Katzmarzyk PT, Dantas WS, Benseñor IJM, Goulart ADC, Ekelund U. Profile of leisure-time physical activity and sedentary behavior in adults in Brazil: a nationwide survey, 2019. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2023; 32:e2023168. [PMID: 37585879 PMCID: PMC10421589 DOI: 10.1590/s2237-96222023000200016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/06/2023] [Indexed: 08/18/2023] Open
Abstract
OBJECTIVES to estimate the prevalence of leisure-time physical activity and sedentary behavior in adults in Brazil. METHODS this was a cross-sectional, population-based study carried out in a sample of 88,531 Brazilians, using data from the 2019 National Health Survey; leisure-time physical activity (overall and aerobic exercise) was measured according to the World Health Organization guidelines; the weighted prevalence and respective 95% confidence intervals (95%CI) of physical activity, physical inactivity and sedentary behavior were estimated. RESULTS according to the selected sample, 26.4% (95%CI 25.9;27.1) of Brazilian adults were physically active, 14.0% (95%CI 13.5;14.4) were insufficiently physically active and 59.5% (95%CI 58.8;60.2) were physically inactive; sedentary behavior ≥ 6 hours was reported by 30.1% (95%CI 29.5;30.8) of the population; only 8.6% (95%CI 8.2;8.9) met the recommendations for muscle-strengthening activities. CONCLUSION most Brazilian adults were physically inactive and did not meet international recommendations for leisure-time physical activity and reduction in sedentary behavior.
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Affiliation(s)
- Arão Belitardo de Oliveira
- Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
| | - Peter T. Katzmarzyk
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Estados Unidos da América
| | - Wagner Silva Dantas
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Estados Unidos da América
| | | | | | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Noruega
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Papini CB, Campos LD, Nakamura PM, Brito BTGD, Kokubun E. Cost-analysis and cost-effectiveness of physical activity interventions in Brazilian primary health care: a randomised feasibility study. CIENCIA & SAUDE COLETIVA 2021; 26:5711-5726. [PMID: 34852103 DOI: 10.1590/1413-812320212611.27142020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 09/08/2020] [Indexed: 11/22/2022] Open
Abstract
Physical exercise programs have been carried out in primary health care in Brazil and have provided good results in terms of effectiveness, their economic contribution has not been investigated yet. The aim of the study is to verify the feasibility of brief counseling physical activity intervention and to compare its economic cost and cost-effectiveness with supervised physical exercise intervention in primary care. A multi-arm parallel feasibility trial, with equal randomization [1:1:1] was conducted in Basic Health Units in Brazil. 61 participants were randomized in Brief Counseling Intervention (BCI), Supervised Physical Exercise Intervention (SPEI) and Control Group (CG). Interventions lasted one year. The BCI is more economical than the SPEI, costing around 50% less in the economic comparisons (session cost, annual cost and cost per participant annually). At leisure time, the cost to move one person to the physically active category at 12 months is estimated in R$369.00 for BCI and R$426.21 for the SPEI. The Incremental Cost-effectiveness Ratio (ICER) is R$310.32. The BCI is feasible and more economic, however, the cost effective is not that different. Thus, it is strongly recommended that the two interventions be offered at primary care in Brazil.
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Affiliation(s)
- Camila Bosquiero Papini
- Departamento de Ciências do Esporte, Universidade Federal do Triângulo Mineiro (UFTM). Av. do Tutunas 490, Vila Celeste. 38061-500 Uberaba MG Brasil.
| | - Leonardo de Campos
- Programa de Pós-Graduação em Educação Física, Universidade Estadual Paulista (UNESP). Rio Claro SP Brasil
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Szwarcwald CL, Stopa SR, Damacena GN, Almeida WDSD, Souza Júnior PRBD, Vieira MLFP, Pereira CA, Sardinha LMV, Macário EM. Changes in the pattern of health services use in Brazil between 2013 and 2019. CIENCIA & SAUDE COLETIVA 2021; 26:2515-2528. [PMID: 34133631 DOI: 10.1590/1413-81232021266.1.43482020] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 12/01/2020] [Indexed: 11/22/2022] Open
Abstract
This study aimed to investigate changes in the health service use pattern based on information from the 2013 and 2019 National Health Surveys (PNS). The two outcomes, "Seeking health-related care in the past two weeks" and "Medical visit in the last twelve months", were analyzed according to socioeconomic, geographic and health conditions characteristics. Multivariate Poisson regression models were used to investigate the factors associated with seeking care due to a health problem or prevention. The prevalence of chronic diseases increased from 15.0% to 22.5% between 2013 and 2019. The proportion of seeking care increased from 15.3 to 18.6%, and medical visits from 71.2% to 76.2%, ranging from 61.4 to 75.8% and 68.0 to 80.6% between the North and Southeast regions. There was no significant association of seeking care due to a health problem with per capita income, after controlling for the other covariates. We conclude by saying that, despite the expanded coverage of health service use, the persistent regional inequalities indicate unmet health needs among residents of the less developed regions. Health care models focused on prevention and health promotion are required.
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Affiliation(s)
- Célia Landmann Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fiocruz. Av. Brasil 4365, Manguinhos. 21040-360 Rio de Janeiro RJ Brasil.
| | - Sheila Rizzato Stopa
- Departamento de Análise em Saúde e Vigilância de Doenças Não Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde. Brasília DF Brasil
| | - Giseli Nogueira Damacena
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fiocruz. Av. Brasil 4365, Manguinhos. 21040-360 Rio de Janeiro RJ Brasil.
| | - Wanessa da Silva de Almeida
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fiocruz. Av. Brasil 4365, Manguinhos. 21040-360 Rio de Janeiro RJ Brasil.
| | - Paulo Roberto Borges de Souza Júnior
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fiocruz. Av. Brasil 4365, Manguinhos. 21040-360 Rio de Janeiro RJ Brasil.
| | | | - Cimar Azeredo Pereira
- Diretoria de Pesquisas, Instituto Brasileiro de Geografia e Estatística. Rio de Janeiro RJ Brasil
| | - Luciana Monteiro Vasconcelos Sardinha
- Departamento de Análise em Saúde e Vigilância de Doenças Não Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde. Brasília DF Brasil
| | - Eduardo Marques Macário
- Departamento de Análise em Saúde e Vigilância de Doenças Não Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde. Brasília DF Brasil
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dos Santos LP, da Silva AT, Rech CR, Fermino RC. Physical Activity Counseling among Adults in Primary Health Care Centers in Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5079. [PMID: 34064953 PMCID: PMC8151541 DOI: 10.3390/ijerph18105079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/22/2021] [Accepted: 05/03/2021] [Indexed: 11/16/2022]
Abstract
Physical activity (PA) counseling by health professionals has promising results in behavior change. However, few studies have evaluated its prevalence in Primary Health Care in Latin American countries. This study aimed to describe the prevalence and analyze the associated factors of PA counseling in adults in Primary Health Care in Brazil. This is a cross-sectional study with a representative sample of 779 adults (70% women). Counseling was identified among those who reported having received PA counseling during a health professional consultation in the last 12 months. Sociodemographic factors, health conditions, and leisure-time PA were analyzed with Poisson regression. The prevalence of counseling was 43% (95% Confidence Interval [CI]: 39.5-46.4%), higher in people aged ≥40 years (Prevalence Ratio [PR]: 1.44; 95% CI: 1.19-1.75], who are married (PR: 1.27; 95% CI: 1.07-1.59), obese (PR: 1.53; 95% CI: 1.23-1.90), take prescription medication (PR: 1.83; 95% CI: 1.47-2.27), and walk for leisure (PR: 1.28; 95% CI: 1.06-1.54). People with more education were less likely to receive PA counseling (PR: 0.82; 95% CI: 0.68-0.99). In conclusion, 4 out of 10 users reported receiving PA counseling and this was associated with sociodemographic factors, health conditions, and walking for leisure. These results can guide PA promotion in Primary Health Care.
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Affiliation(s)
- Letícia Pechnicki dos Santos
- Research Group in Environment, Physical Activity and Health, Federal University of Technology—Parana, Curitiba 81310-900, Brazil; (L.P.S.); (A.T.S.)
| | - Alice Tatiane da Silva
- Research Group in Environment, Physical Activity and Health, Federal University of Technology—Parana, Curitiba 81310-900, Brazil; (L.P.S.); (A.T.S.)
- Postgraduate Program in Physical Education, Federal University of Parana, Curitiba 81531-980, Brazil
| | - Cassiano Ricardo Rech
- Physical Education Department, Federal University of Santa Catarina, Florianopolis 88040-900, Brazil;
| | - Rogério César Fermino
- Research Group in Environment, Physical Activity and Health, Federal University of Technology—Parana, Curitiba 81310-900, Brazil; (L.P.S.); (A.T.S.)
- Postgraduate Program in Physical Education, Federal University of Parana, Curitiba 81531-980, Brazil
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Bortolini GA, Pereira TN, Nilson EAF, Pires ACL, Moratori MF, Ramos MKP, Silva SAD, Carvalho MDFCCD, Bressan LÂ, Faller LDA. Evolução das ações de nutrição na atenção primária à saúde nos 20 anos da Política Nacional de Alimentação e Nutrição do Brasil. CAD SAUDE PUBLICA 2021; 37Suppl 1:e00152620. [DOI: 10.1590/0102-311x00152620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 02/01/2021] [Indexed: 11/21/2022] Open
Abstract
O objetivo do estudo é sistematizar as ações de alimentação e nutrição desenvolvidas na atenção primária à saúde (APS), de 1999 a 2019, identificando os avanços no período e perspectivas atuais. É uma pesquisa qualitativa realizada baseando-se na análise de documentos publicados entre 1999 e 2020, disponíveis em bases de dados científicos e na literatura cinza. Adicionalmente, realizou-se análise quantitativa valendo-se de sistemas de informação do Ministério da Saúde, como o Sistema de Vigilância Alimentar e Nutricional e o Sistema de Informação em Saúde para a Atenção Básica e dos microdados do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB). As ações e marcos normativos identificados foram categorizados em gestão, vigilância alimentar e nutricional, promoção da alimentação adequada e saudável, atenção nutricional - múltipla carga de má nutrição e formação. Os resultados revelam que as ações de alimentação e nutrição acompanharam o cenário epidemiológico, considerando-se a múltipla carga da má nutrição, estando a primeira década mais direcionada ao enfrentamento da fome, da desnutrição e carências de micronutrientes e; a partir de 2006, passou a dar ênfase à prevenção e cuidado de pessoas com obesidade e outras doenças crônicas não transmissíveis, além da promoção da alimentação adequada e saudável, desenvolvendo, durante todo o período, ações com forte caráter intersetorial e compreendendo o lócus da APS como campo prioritário de atuação no Sistema Único de Saúde. A universalização das ações de alimentação e nutrição na APS, contudo, é ainda um desafio atual.
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Alves KCG, Guimarães RA, de Souza MR, de Morais Neto OL. Performance of family health teams for tackling chronic diseases in a state of the Amazon. PLoS One 2020; 15:e0241765. [PMID: 33156831 PMCID: PMC7647065 DOI: 10.1371/journal.pone.0241765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 10/20/2020] [Indexed: 11/21/2022] Open
Abstract
The most common cause of death worldwide is noncommunicable diseases. A cross-sectional study was conducted to evaluate the adequacy of the work process among family health teams and compare differences in regional adequacy in the state of Tocantins, in the Amazonian Region, Brazil. Categorical principal components analysis was used, and scores of each principal component extracted in the analysis were compared among health regions in Tocantins. A post hoc analysis was performed to compare the heath region pairs. The adequacy of family health teams’ work process was evaluated with respect to the Strategic Action Plan to Tackle NCDs. The results showed that the family health teams performed actions according to the Strategic Action Plan to Tackle NCDs. However, overall, the adequacy percentages of these actions according to the axes of the Plan are very uneven in Tocantins, with large variations among health regions. The family health teams in the Bico do Papagaio (Region 1), Médio Norte Araguaia (Region 2), Cantão (Region 4) and Capim Dourado (Region 5) regions have adequacy percentages ≥ 50% with the Strategic Action Plan to Tackle NCDs, whereas all other regions have percentages <50%. Health teams perform surveillance actions, health promotion, and comprehensive care for NCDs in accordance with the guidelines of the Strategic Action Plan to Tackle NCDs. The challenge of NCDs in primary care requires a care model that is tailored to users’ needs and has the power to reduce premature mortality and its determinants.
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Affiliation(s)
| | - Rafael Alves Guimarães
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Marta Rovery de Souza
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil
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Bispo JP, Morais MB. Democracy and Health: reflections and challenges before the 16th Brazilian National Health Conference. Rev Saude Publica 2020; 54:16. [PMID: 32022144 PMCID: PMC6986867 DOI: 10.11606/s1518-8787.2020054001713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 06/26/2019] [Indexed: 11/24/2022] Open
Abstract
This text aimed to analyze characteristics and challenges of the 16th Brazilian National Health Conference based on the conference three thematic axes: Health as a right; Consolidation of the Brazilian Unified Health System (SUS) principles; Adequate and enough funding for SUS. Given the initiatives to dismantle the social security model and the setbacks of social protection policies, to delimitate health in an expanded sense is essential to defend the SUS project. We analyzed the proposal of Universal Health Coverage as an alternative to universal systems. We then presented the restrictions of universal coverage and how the restrictions can threaten the SUS principles. We also discussed insufficient SUS funding and possible worsening in the face of fiscal austerity policies. To strengthen social participation and to monitor the proposals approved at the conference are necessary.
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Affiliation(s)
- José Patrício Bispo
- Universidade Federal da BahiaInstituto Multidisciplinar em SaúdeVitória da ConquistaBABrasil Universidade Federal da Bahia. Instituto Multidisciplinar em Saúde. Vitória da Conquista, BA, Brasil
| | - Marciglei Brito Morais
- Faculdade PitágorasVitória da ConquistaBABrasil Faculdade Pitágoras. Vitória da Conquista, BA, Brasil
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Oliveira JHD, Souza MRD, Morais Neto OLD. Addressing chronic noncommunicable diseases in primary health care in Goiás, Brazil: a descriptive study, 2012 and 2014. ACTA ACUST UNITED AC 2020; 29:e2020121. [PMID: 33174902 DOI: 10.1590/s1679-49742020000500016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 08/17/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To compare primary health care (PHC) actions taken to care for chronic non-communicable diseases (NCDs) in the state of Goiás, Brazil, between 2012 and 2014. METHODS This was a descriptive study using secondary data from the National Program for Improving Primary Care Access and Quality (PMAQ-AB). The proportions of teams performing actions to address NCDs were compared between PMAQ-AB cycles I and II using the McNemar test for paired samples. RESULTS Seventeen of the 20 variables studied showed a proportional increase between the two cycles: from 16.0% to 32.1% of teams that practiced all care management actions, from 21.5% to 35.2% of those that practiced all health promotion actions and from 22.2% to 39.8% of teams that practiced all activities at school. CONCLUSION PHC actions to address NCDs in Goiás were strengthened between the two PMAQ-AB cycles.
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Affiliation(s)
| | - Marta Rovery de Souza
- Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde Pública, Goiânia, GO, Brasil
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"I Did Not Believe You Could Get Better"-Reversal of Diabetes Risk Through Dietary Changes in Older Persons with Prediabetes in Region Stockholm. Nutrients 2019; 11:nu11112658. [PMID: 31690003 PMCID: PMC6893725 DOI: 10.3390/nu11112658] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/21/2019] [Accepted: 10/31/2019] [Indexed: 11/17/2022] Open
Abstract
Diabetes risk can be controlled and even reversed by making dietary changes. The aim of this study was to improve the understanding of how older persons with a high risk of developing Type 2 diabetes manage and relate to information about diabetes risk over a ten-year period. Fifteen qualitative interviews were conducted among participants from the Stockholm Diabetes Prevention Program (SDPP). The participants were asked to recall the health examinations conducted by the SDPP related to their prediabetes and to describe their experiences and potential changes related to diet and physical activity. Data were analyzed using qualitative content analysis. The main theme found was that T2D (type 2 diabetes) risk is not perceived as concrete enough to motivate lifestyle modifications, such as changing dietary patterns, without other external triggers. Diagnosis was recognized as a reason to modify diet, and social interactions were found to be important for managing behavior change. Diagnosis was also a contributing factor to lifestyle modification, while prognosis of risk was not associated with efforts to change habits. The results from this study suggest that the potential of reversing prediabetes needs to be highlighted and more clearly defined for older persons to serve as motivators for lifestyle modification.
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Randomized Controlled Trial of Primary Health Care Strategies for the Promotion of Leisure-Time Physical Activity Among Older Brazilians. J Phys Act Health 2019; 16:706-714. [PMID: 31310991 DOI: 10.1123/jpah.2017-0502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 02/22/2019] [Accepted: 04/20/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Physical activity promotion within primary health care is in the spotlight. However, few studies have evaluated the long-term effectiveness of possible interventions. This study aimed to compare the effectiveness of 3 primary health care interventions in increasing leisure-time physical activity among older Brazilians. METHODS Experimental study with 142 older residents of an ongoing urban cohort in São Paulo (Brazil). Participants were randomized into 3 groups: minimal intervention group, physician-based counseling group, and individual counseling and referral for physical activity programs group (CRG). We used the long version of the International Physical Activity Questionnaire to assess leisure-time physical activity at baseline, 4 years after baseline without any intervention, 3 months after intervention, and 6 months after intervention. Statistical analysis included repeated analysis of variance. RESULTS At baseline, 31% of the individuals were active, and this figure remained stable for a period of 4 years. Three months after the interventions, there was a significant increase in leisure-time physical activity for CRG compared with the minimal intervention (P < .001) and physician-based counseling (P < .02) groups, and these differences persisted after 6 months (P < .001 and P < .05, respectively). CONCLUSION Results indicate that interventions with CRG are effective in producing sustained changes in physical activity among older Brazilians.
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Santos MDDV, Santos SV, Caccia-Bava MDCGG. [The prevalence of strategies for cessation of tobacco use in primary health care: an integrative review]. CIENCIA & SAUDE COLETIVA 2019; 24:563-572. [PMID: 30726388 DOI: 10.1590/1413-81232018242.27712016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 03/23/2017] [Indexed: 11/22/2022] Open
Abstract
The habit of tobacco use/smoking, which is a major concern of Primary Health Care (PHC), is a serious public health problem and the main avoidable cause of death in the world. The relevance of actions, whose focus is to facilitate the cessation of this habit, motivates the discussion of studies that have different approaches to tackle this issue by seeking to train PHC professionals accordingly. A search was conducted in the Lilacs, MEDLINE and Web of Science databases for recent scientific publications (2010-2015). The key words were combined with Boolean operators and, after analysis of the articles found, 75 are discussed in this article since they have strategies with a higher prevalence in PHC. The conclusion drawn is that the brief or intense individual approach using the 5A method (Transtheoretical Model) is the most widely adopted, as well as bupropion and nicotine replacement patches. The increasing use of hard technology requires new studies that examine their impact on the treatment of smokers. It was clearly revealed that there is a need for health professionals to be better prepared to address the issue with the users, in addition to a lack of stimulus and proper conditions to work in the PHC team directly reflecting scientific advances in clinical practice.
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Affiliation(s)
- Meire de Deus Vieira Santos
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Av. Bandeirantes 3900, Monte Alegre. 14048-900 Ribeirão Preto SP Brasil.
| | - Stella Vieira Santos
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Av. Bandeirantes 3900, Monte Alegre. 14048-900 Ribeirão Preto SP Brasil.
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de Almeida ML, Casemiro FG, Baba CT, Monteiro D, Fornazieri M, Cerri N, Fernandes DFM, de Oliveira Gomes GA. Studies About Physical Activity Interventions Including Follow-Up Analysis: A Systematic Review. J Phys Act Health 2018; 15:462-467. [PMID: 29542365 DOI: 10.1123/jpah.2016-0580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Some studies have used the follow-up method to analyze real behavioral changes in research involving physical activity (PA) interventions. This has great scientific value; however, it is hard to apply without satisfactory resources and research funding. Little is known about how many studies have used this method to analyze PA interventions in low-income and middle-income countries, especially Brazil. PURPOSE To describe Brazilian studies using follow-up analysis after PA interventions. METHODS A systematic review was performed including Brazilian studies with follow-up analysis after PA interventions; the analyzed papers were from the previous 10 years. The search was carried out in Portuguese, English, and Spanish in the following databases: SciELO, Latin American and Caribbean Health Science Literature, PubMed, and Scopus. The Preferred Reporting Items for Systematic Review and Meta-Analysis method was used. RESULTS In total, 6 of the 7 studies analyzed were from the southeast region, with the intervention time ranging from 2 to 12 months, carrying out follow-up every 5.3 months with 2.2 observations on average. The interventions had a behavioral approach and were generally carried out in universities, hospitals, and ambulatory care. CONCLUSION Studies on PA interventions using follow-up analysis are scarce. Considering the relevance of follow-up studies to measure behavior changes, the results suggest that more studies about this topic are essential in Brazil.
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Florindo AA, Andrade DR, Guerra PH, Mota J, Crone D, Mafra AC, Bracco MM. Physical activity promotion by health practitioners: a distance-learning training component to improve knowledge and counseling. Prim Health Care Res Dev 2018; 19:140-150. [PMID: 29122043 PMCID: PMC6452955 DOI: 10.1017/s1463423617000676] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 07/14/2017] [Accepted: 09/17/2017] [Indexed: 02/01/2023] Open
Abstract
Aim To report an evaluation of health professionals' participation in a distance-learning physical activity training course developed in a low socio-economic region of São Paulo city, Brazil. BACKGROUND In countries with public universal health systems, physical activity promotion in primary health care settings can reap results, particularly given that such interventions have the potential to reach a large percentage of the population. However, few studies proposed physical activity training for health professionals in low- and middle-income countries. Brazil is a continental country and has the Unified Health System which incorporates family health teams in over 85% of Brazilian cities. METHODS The physical activity training was part of the fifth module of an educational intervention throughout a distance-learning course focusing on health professionals at M'Boi Mirim district in São Paulo city. The training totaled 3 h and had five themes of physical activity: (1) concepts, definitions benefits; (2) evaluation; (3) recommendation; (4) interventions; (5) physical activity counseling. The opinion of health professionals was evaluated after training by two open questions. Findings Out of 106 professionals who took part of the course, only 22.6% (n=24) had accessed the fifth module. These professionals were predominantly female (79.2%), nurses (66.7%) and aged 30 years or older. Responses highlighted the course approach focused on physical activity for improving patient's quality of life and well-being, disease prevention and health improvements. Regarding the themes for improvement, the health professionals identified that there was a need to experience physical activity classes first-hand, and the need to link physical activity counseling to the local venues that provide structured physical activity programs. We recommend that further training courses can be conducted based on this model for health professionals to promote physical activity to the community in Brazil.
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Affiliation(s)
- Alex A. Florindo
- Associate Professor, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Douglas R. Andrade
- Professor, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Paulo H. Guerra
- Professor, Federal University of Fronteira Sul, Santa Catarina, Brazil
| | - Jorge Mota
- Professor, University of Porto, Porto, Portugal
| | - Diane Crone
- Professor, University of Gloucestershire, Cheltenham, England
| | - Ana C.C.N. Mafra
- Statistician, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Mario M. Bracco
- Physician Researcher, Centro de Estudos e Pesquisas Dr. João Amorim; 8 Former Research Coordinator Hospital Municipal Dr. Moyses Deutsch, São Paulo, Brazil
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Wittkowski L, Dias CRS. Avaliação dos resultados obtidos nos grupos de controle do tabagismo realizados numa unidade de saúde de Curitiba-PR. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2018. [DOI: 10.5712/rbmfc12(39)1463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introdução: O tabagismo é fator de risco para diversas doenças, sendo responsável por seis óbitos a cada segundo. No Brasil, sua prevalência é de 14,7%. A terapia cognitivo comportamental é alicerce principal para esta abordagem. Objetivo: Avaliar os resultados obtidos nos grupos do programa nacional de controle do tabagismo (PNCT) desenvolvidos numa unidade municipal de saúde (UMS) de Curitiba – Paraná (PR), com ênfase na avaliação da taxa de cessação da dependência nicotínica e análise do perfil clínico epidemiológico dos pacientes. Métodos: Trata-se de um estudo descritivo, observacional e retrospectivo. Foram analisados dados da população participantes dos grupos do PNCT através das fichas da avaliação inicial e das planilhas de consolidação de informações do Ministério da Saúde. Resultados: Foram realizados 8 grupos, totalizando 160 tabagistas. 68% eram do sexo feminino, 38% eram casados e 32,5% tinham ensino fundamental incompleto. A média de idade foi de 47,2 anos e de início do tabagismo, de 15 anos. A porcentagem de cessação do uso do tabaco variou de 12,5 até 72,7 ao final do primeiro mês. A taxa de desistência do tratamento chegou a 62,5% nos grupos. Conclusão: Os Grupos do Programa de Controle ao Tabagismo apresentam resultados a curto prazo, porém alto índice de abandono do tratamento. Houve baixa adesão à manutenção da abstinêcia no decorrer do tempo. Maiores esforços devem ser destinados visando uma abstinência duradoura.
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Baba CT, Oliveira IM, Silva AEF, Vieira LM, Cerri NC, Florindo AA, de Oliveira Gomes GA. Evaluating the impact of a walking program in a disadvantaged area: using the RE-AIM framework by mixed methods. BMC Public Health 2017; 17:709. [PMID: 28915827 PMCID: PMC5603090 DOI: 10.1186/s12889-017-4698-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 08/29/2017] [Indexed: 11/13/2022] Open
Abstract
Background The positive health impact of physical activity (PA) is well known, yet a large proportion of the world’s population remains sedentary. General PA programs are common as health promotion initiatives. However, effectiveness evaluations of such PA programs on individual and organizational aspects, which could inform the decision-making process of public health bodies are still lacking, particularly in the most socially disadvantaged areas, where health promotion schemes are particularly needed. The aim of this study was to assess the effectiveness of a Guided Walking Program in a high social vulnerability context. Methods A quasi-experimental, mixed methods study was conducted. The program had a duration of 6 months and a 6-month follow-up period after the intervention. Session frequency was five times a week, where sessions consisted of supervised PA combined with educational sessions. The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework was followed to assess the program. The International Physical Activity Questionnaire (IPAQ) and accelerometers were used to measure levels of PA. Focus groups were conducted to gain a comprehensive insight on the implementation domain. Results Most subjects in the intervention (IG) (n = 74) and control (CG) (n = 74) groups were female (IG:90.5%; CG:95.9%), aged 18–49 years (IG:44.6%; CG:43.2%), received less than 1 minimum wage (IG:74.3%; CG:83.7%) and had 0–4 years of formal education (IG:52.1%; CG:46.1%). The reach of the intervention was 0.3%. The IG showed increased levels of PA at post-intervention and 6-month follow-up. However, the difference between groups was not statistically significant. Adoption data revealed that 89.5% of the professionals in the Primary Health Care Center (health center) team perceived the benefits of the program for the population. The program was independently promoted by the health center team for a further 4 months post-intervention. The qualitative data revealed that the program was discontinued due to participants’ low adherence and human resource limitations in the unit’s operational dynamics. Conclusions A health promotion intervention in a socially deprived setting faces challenges but can be effective and feasible to implement. The present study informs the development of future health promotion initiatives in this context. Trial registration NCT02857127. Registered: 30 July 2016 (retrospectively registered).
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Affiliation(s)
- Camila Tiome Baba
- Federal University of São Carlos, Washington Luís Highway, 235 km, São Carlos, São Paulo, 13565-905, Brazil.
| | | | | | - Leonardo Moreira Vieira
- Federal University of São Carlos, Washington Luís Highway, 235 km, São Carlos, São Paulo, 13565-905, Brazil
| | - Natalia Caroline Cerri
- Federal University of São Carlos, Washington Luís Highway, 235 km, São Carlos, São Paulo, 13565-905, Brazil
| | - Alex Antonio Florindo
- University of São Paulo, Arlindo Bettio Street, 1000, São Paulo, São Paulo, 03828-000, Brazil
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Szwarcwald CL, Damacena GN, de Souza Júnior PRB, de Almeida WDS, de Lima LTM, Malta DC, Stopa SR, Vieira MLFP, Pereira CA. Determinants of self-rated health and the influence of healthy behaviors: results from the National Health Survey, 2013. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2017; 18 Suppl 2:33-44. [PMID: 27008601 DOI: 10.1590/1980-5497201500060004] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 07/13/2015] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To investigate the determinants of self-rated health in Brazil and the influence of healthy lifestyles. METHODS We used data from the National Health Survey (PNS), 2013. The self-rated health was categorized as very good/good, fair, and poor/very poor. Differences in the distribution of self-rated health according to the age group and sex were tested. Logistic regression models were used to test the effects of educational level, race/skin color, and the presence of at least one noncommunicable chronic disease on poor/very poor health perception. In addition, the influence of healthy behaviors was tested controlling for the effects of sociodemographic factors and the presence of at least one chronic disease. RESULTS We analyzed 60,202 individuals; about 66.1% rated their health as very good/good and 5.9% as poor/very poor; about 47.1% reported the diagnosis of at least one noncommunicable chronic disease; and only 9.3% reported a "healthy lifestyle" (do not use tobacco products, consume fruits and vegetables properly, and do physical activity during leisure time). Among the sociodemographic factors, age, sex, educational level, and race were significantly associated with self-rated health and the presence of at least one chronic disease. The effects of all healthy behaviors were statistically significant even after controlling for the other determinants. CONCLUSION Although the adoption of healthy lifestyles in Brazil is still insufficient, the association of healthy practices with self-perception of health found in this study is an indication that the Brazilian population is beginning to relate healthy behaviors to their well-being and better health evaluation.
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Affiliation(s)
- Celia Landmann Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Giseli Nogueira Damacena
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | | | - Wanessa da Silva de Almeida
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | | | - Deborah Carvalho Malta
- Departamento de Vigilância de Doenças e Agravos não Transmissíveis e Promoção da Saúde, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, DF, Brazil
| | - Sheila Rizzato Stopa
- Departamento de Vigilância de Doenças e Agravos não Transmissíveis e Promoção da Saúde, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, DF, Brazil
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Szwarcwald CL, de Souza Júnior PRB, Damacena GN, de Almeida WDS, Malta DC, Stopa SR, Vieira MLFP, Pereira CA. Recommendations and practice of healthy behaviors among patients with diagnosis and diabetes in Brazil: National Health Survey (PNS), 2013. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2017; 18 Suppl 2:132-45. [PMID: 27008609 DOI: 10.1590/1980-5497201500060012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 06/23/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze healthy life style recommendations given in health care and the adoption of healthy behaviors among hypertension and diabetes patients. METHODS We analyzed the recommendations according to the place of the last health care visit (primary health care, other public facilities, and private health care facilities). The effects of having a diagnosis of hypertension or diabetes on the adoption of healthy practices were analyzed by multivariate logistic regression models, using sex, age, and educational level as control variables, and the following outcomes: current use of tobacco products; regular physical activity during leisure time; recommended intake of fruits and vegetables; perception of low salt intake; frequent consumption of sweets; and excessive alcohol consumption. RESULTS Approximately 88% of hypertension patients received recommendations to have a healthy diet, 91% to eat less salt, 83% to practice regular physical activity, and 76% to not to smoke. Among diabetic patients, all recommendations related to nutrition were very frequent, reaching 95% for the habit of having fruits and vegetables regularly. The effect of having a diagnosis of hypertension was significant for non-use of tobacco products and perception of low salt intake. The diagnosis of diabetes mainly influenced the habit of not consuming sweets often. CONCLUSION Results evidenced that people with diagnosis of hypertension and diabetes give priority to not use (stop) harmful health behaviors than to adopt practices that will bring benefits to their health. It is necessary to promote not only the adverse effects of harmful habits, but also the benefits of healthy behaviors to aging well.
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Affiliation(s)
- Celia Landmann Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | | | - Giseli Nogueira Damacena
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Wanessa da Silva de Almeida
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Deborah Carvalho Malta
- Departamento de Vigilância de Doenças e Agravos não Transmissíveis e Promoção da Saúde, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, DF, Brazil
| | - Sheila Rizzato Stopa
- Departamento de Vigilância de Doenças e Agravos não Transmissíveis e Promoção da Saúde, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, DF, Brazil
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Lin X, Alvim SM, Simoes EJ, Bensenor IM, Barreto SM, Schmidt MI, Ribeiro AL, Pitanga F, Almeida MCC, Liu S, Lotufo PA. Leisure Time Physical Activity and Cardio-Metabolic Health: Results From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). J Am Heart Assoc 2016; 5:JAHA.116.003337. [PMID: 27412901 PMCID: PMC4937275 DOI: 10.1161/jaha.116.003337] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background Although increasing effort has been devoted to the promotion of a healthy lifestyle such as leisure time physical activity for cardio‐metabolic health, specific evidence supporting health policy remains sparse, particularly in those ethnically diverse populations where cardio‐metabolic diseases are reaching epidemic proportion and yet are grossly understudied. Methods and Results We conducted a cross‐sectional analysis of the baseline data from 10 585 participants aged 35 to 74 free of cardiovascular diseases in the Brazilian Longitudinal Study of Adult Health. Leisure time physical activity status was defined by the American Heart Association and the World Health Organization recommendations (≥150 min/week moderate activities or 75 min/week vigorous activities). In total, 1183 (21%) women and 1387 (29%) men were active. After accounting for covariates, the favorable effects of leisure time physical activity on cardio‐metabolic parameters were evident. Specifically, the average blood pressure, heart rate, and Framingham Risk Score for cardiovascular diseases of the active were significantly lower within each sex. The ORs comparing the active versus the inactive women were 0.78 (95% CI: 0.66–0.92) for hypertension and 0.78 (95% CI: 0.65–0.93) for cardiovascular diseases in 10 years. Among men, the ORs were 0.75 (95% CI: 0.65–0.87) for hypertension and 0.73 (95% CI: 0.61–0.87) for diabetes. The 10‐year risk of cardiovascular diseases was significantly lower among the active men with a 33% reduction (OR=0.67, 95% CI: 0.57–0.78). Conclusions We observed beneficial effects of leisure time physical activity on cardio‐metabolic health in this large Brazilian population that are consistent with studies in North America and Europe.
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Affiliation(s)
- Xiaochen Lin
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI
| | - Sheila M Alvim
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Eduardo J Simoes
- Department of Health Management and Informatics, University of Missouri School of Medicine, Columbia, MO
| | - Isabela M Bensenor
- Center for Clinical and Epidemiological Research, University of São Paulo, Brazil
| | - Sandhi M Barreto
- Faculty of Medicine and Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maria I Schmidt
- Hospital de Clínicas and Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, Brazil
| | - Antonio L Ribeiro
- Hospital das Clínicas and Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Francisco Pitanga
- Departamento de Educação Física, Faculdade de Educação, Universidade Federal da Bahia, Salvador, Brazil
| | | | - Simin Liu
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI Center for Global Cardio-metabolic Health, Brown University, Providence, RI Division of Endocrinology, Department of Medicine, Alpert School of Medicine and Rhode Island Hospital, Providence, RI
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, University of São Paulo, Brazil
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Yamaguchi MU, Bernuci MP, Pavanelli GC. Scientific research about the National Policy for Health Promotion. CIENCIA & SAUDE COLETIVA 2016; 21:1727-36. [PMID: 27281659 DOI: 10.1590/1413-81232015216.07462016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 03/05/2016] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivou-se avaliar o nível do conhecimento e sistematização da produção científica vinculada à Política Nacional da Promoção da Saúde (PNPS) após dez anos de sua implementação. Estudo cienciométrico da literatura científica nacional e internacional sobre a PNPS nas bases PubMed e SciELO. A pesquisa foi realizada no mês de dezembro de 2015, utilizando o termo “política nacional de promoção da saúde”, que resultou na identificação de 88 publicações relacionadas à PNPS. Os anos de 2012 e 2013 detiveram o maior número de artigos publicados, identificando a Política Nacional de Alimentação e Nutrição e a temática Saúde Bucal como objetos mais estudados. Os estados de São Paulo, Rio de Janeiro e o Distrito Federal destacaram-se pela quantidade e qualidade da produção científica, os quais foram em sua maioria divulgados em periódicos internacionais classificados nos estratos Qualis A2. As políticas de Atenção às Urgências, Saúde Materno-Infantil e Adolescência figuraram como temas pouco explorados. Embora as produções científicas tenham contribuído para aplicação do conhecimento técnico e científico na promoção da saúde, os setores pouco explorados poderão dificultar o dimensionamento e a reformulação de ações estratégicas para o enfrentamento das iniquidades em saúde nas próximas décadas.
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Affiliation(s)
- Mirian Ueda Yamaguchi
- Centro Universitário de Maringá, Centro Universitário de Maringá, Maringá PR , Brasil, Programa de Pós-Graduação em Promoção da Saúde, Centro Universitário de Maringá. Av. Guedner 1610, Aclimação. 87050-900 Maringá PR Brasil. mirian.yamaguchi@ unicesumar.edu.br
| | - Marcelo Picinin Bernuci
- Centro Universitário de Maringá, Centro Universitário de Maringá, Maringá PR , Brasil, Programa de Pós-Graduação em Promoção da Saúde, Centro Universitário de Maringá. Av. Guedner 1610, Aclimação. 87050-900 Maringá PR Brasil. mirian.yamaguchi@ unicesumar.edu.br
| | - Gilberto Cezar Pavanelli
- Centro Universitário de Maringá, Centro Universitário de Maringá, Maringá PR , Brasil, Programa de Pós-Graduação em Promoção da Saúde, Centro Universitário de Maringá. Av. Guedner 1610, Aclimação. 87050-900 Maringá PR Brasil. mirian.yamaguchi@ unicesumar.edu.br
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Mpofu JJ, de Moura L, Farr SL, Malta DC, Iser BM, Ivata Bernal RT, Robbins CL, Lobelo F. Associations between noncommunicable disease risk factors, race, education, and health insurance status among women of reproductive age in Brazil - 2011. Prev Med Rep 2016; 3:333-7. [PMID: 27419033 PMCID: PMC4929178 DOI: 10.1016/j.pmedr.2016.03.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 03/25/2016] [Accepted: 03/28/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Noncommunicable disease (NCD) risk factors increase the risk of adverse reproductive health outcomes and are becoming increasingly common in Brazil. METHODS We analyzed VIGITEL 2011 telephone survey data for 13,745 Brazilian women aged 18-44 years in a probabilistic sample from 26 Brazilian state capitals and the Federal District. We examined associations between NCD risk factors (fruit and vegetable intake, leisure time physical activity, alcohol consumption, smoking status, BMI and hypertension status) and race, education, and insurance using chi-square tests and multivariable logistic regression models, estimating the average marginal effects to produce adjusted relative risk ratios (aRRs). Analyses were conducted using SAS 9.3 survey procedures and weighted to reflect population estimates. RESULTS Women with less than a college education were more likely to report physical inactivity (adjusted relative risk (aRR) and 95% confidence interval = 1.1 (1.1-1.2)), smoking (aRR = 1.7 (1.3-2.2)), and self-reported diagnoses of hypertension (aRR = 2.0 (1.6-2.5)) compared to women with a college education or greater. Similarly, women without health insurance were more likely to report physical inactivity (aRR = 1.1 (1.1-1.2)), smoking (aRR = 1.4 (1.1-1.8)), and self-reported diagnoses of hypertension aRR = 1.4 (1.1-1.7)) compared to women with health insurance. Less variation was found by race and NCD risk factors. CONCLUSION Targeted public health strategies and policies are needed to increase healthcare access and decrease educational and racial disparities in NCD risk factors among women of reproductive age in Brazil.
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Affiliation(s)
- Jonetta Johnson Mpofu
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-F-74, Atlanta, GA 30341, United States
- U.S. Public Health Service Commissioned Corps, 1101 Wooten Parkway, Rockville, MD 20852, United States
| | - Lenildo de Moura
- Pan-Americana Health Organization, Brasilia, Distrito Federal, Brazil
| | - Sherry L. Farr
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-F-74, Atlanta, GA 30341, United States
| | - Deborah Carvalho Malta
- Ministry of Health of Brazil, Section 2, Lots 05/06, Premium Building, Block F, Tower 1, Brasilia, DF, Brazil
| | - Betine Moehlecke Iser
- Ministry of Health of Brazil, Section 2, Lots 05/06, Premium Building, Block F, Tower 1, Brasilia, DF, Brazil
| | - Regina Tomie Ivata Bernal
- Ministry of Health of Brazil, Section 2, Lots 05/06, Premium Building, Block F, Tower 1, Brasilia, DF, Brazil
| | - Cheryl L. Robbins
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-F-74, Atlanta, GA 30341, United States
| | - Felipe Lobelo
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, Mailstop 1518-002-7BB, Atlanta, GA 30322, United States
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Mielke GI, Malta DC, Sá GBARD, Reis RS, Hallal PC. Diferenças regionais e fatores associados à prática de atividade física no lazer no Brasil: resultados da Pesquisa Nacional de Saúde-2013. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2015; 18 Suppl 2:158-69. [DOI: 10.1590/1980-5497201500060014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 06/03/2015] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Objetivo: Analisar as diferenças regionais e os fatores associados à prática de atividade física no lazer em adultos participantes da Pesquisa Nacional de Saúde, de 2013. Métodos: Este estudo foi realizado com os dados da Pesquisa Nacional de Saúde, realizada em 2013 com uma amostra aproximada de 63.000 adultos (18+ anos). Para cada uma das cinco regiões do Brasil foi calculada a prevalência de adultos ativos no lazer, sendo classificados como ativos aqueles participantes que praticaram pelo menos 150 minutos por semana de atividades físicas no lazer. Resultados: A prevalência de ativos no lazer variou de 21,9% no Sul a 24,4% no Centro-Oeste. Homens foram 1,48 (IC95% 1,40 - 1,57) vezes mais ativos que as mulheres, sendo a região Norte aquela que apresentou maior diferença entre sexos. A prevalência de ativos foi 67% menor entre aqueles com 75+ anos quando comparado ao grupo de 18-24 anos, sendo que esta diferença foi mais acentuada na região Norte. Aqueles com maior grau de instrução foram, em média, três vezes mais ativos que os participantes com menor grau de instrução. Em termos de grau de instrução, a menor diferença observada ocorreu no Nordeste. Conclusões: Apesar das pequenas variações na prevalência de prática de atividade física no lazer entre as regiões, quando são considerados subgrupos populacionais, diferenças importantes são observadas. Estes resultados sugerem a necessidade de ações de promoção de atividade física com diferentes abordagens em cada uma das cinco regiões do Brasil.
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Affiliation(s)
- Grégore Iven Mielke
- Universidade Federal de Pelotas, Brazil; Ministério da Saúde, Brazil; Universidade Federal de Pelotas, Brazil
| | | | | | | | - Pedro Curi Hallal
- Universidade Federal de Pelotas, Brazil; Universidade Federal de Pelotas, Brazil; Universidade Federal de Pelotas, Brazil
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Galaviz KI, Lee RE, Bergeron K, Lévesque L. Assessing the physical activity environment in Mexican healthcare settings. SALUD PUBLICA DE MEXICO 2015; 57:403-11. [PMID: 26545001 DOI: 10.21149/spm.v57i5.7620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 07/23/2015] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To assess the informational, educational and instrumental environments among Mexican healthcare settings for their potential to promote physical activity (PA). MATERIALS AND METHODS The Environmental Physical Activity Assessment Tool for Healthcare Settings (EPATHS) was developed to assess the PA environments of 40 clinics/hospitals representing the three Mexican healthcare systems in Guadalajara. The EPATHS assessed the presence and quality of PA enhancing features in the informational (e.g. signage), educational (e.g. pamphlets), and instrumental (e.g. stairs) environments of included clinics/hospitals. RESULTS 28 (70%) clinics/hospitals had more than one floor with stairs; 60% of these had elevators. Nearly 90% of stairs were visible, accessible and clean compared to fewer than 30% of elevators. Outdoor spaces were observed in just over half (55%) of clinics/hospitals, and most (70%) were of good quality. Only 25% clinics/hospitals had educational PA materials. CONCLUSIONS The PA instrumental environment of Mexican healthcare settings is encouraging. The informational and educational environments could improve.
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Affiliation(s)
- Karla I Galaviz
- Hubert Department of Global Health, Emory University, Atlanta, Georgia, Estados Unidos de América
| | - Rebecca E Lee
- College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, Estados Unidos de América
| | - Kim Bergeron
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canadá
| | - Lucie Lévesque
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canadá
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Florindo AA, Brownson RC, Mielke GI, Gomes GA, Parra DC, Siqueira FV, Lobelo F, Simoes EJ, Ramos LR, Bracco MM, Hallal PC. Association of knowledge, preventive counseling and personal health behaviors on physical activity and consumption of fruits or vegetables in community health workers. BMC Public Health 2015; 15:344. [PMID: 25885709 PMCID: PMC4410462 DOI: 10.1186/s12889-015-1643-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 03/16/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND There is evidence that if a health professional is active and has a healthy diet, he/she is more likely to advise patients about the benefits of physical activity and healthy eating The aims of this study were to: (1) describe the personal physical activity, consumption of fruits and vegetables behaviors and nutritional status of community health workers; (2) evaluate the association between knowledge, delivery of preventive counseling and personal behaviors among community health workers. METHODS This was a cross-sectional study conducted in a nationally sample of health professionals working in primary health care settings in Brazil in 2011. This survey was part of the second phase of the Guide for Useful Interventions for Activity in Brazil and Latin America project, and data were collected through telephone interviews of 269 community health workers from the Unified Health Care system of Brazil. We applied questionnaires about personal reported behaviors, knowledge and preventive counseling in physical activity and consumption of fruits and vegetables. We calculated the prevalence and associations between the variables with logistic regression. RESULTS The proportion of community health workers that practiced 150 minutes per week of physical activity in leisure time or transportation was high (64.9%). Half of community health workers were overweight and only 26.2% reported consuming five portions/day of fruits or vegetables. Most community health workers reported counseling about physical activity for more than six months (59.7%), and most were not knowledgeable of the fruits and vegetables and physical activity recommendations. Meeting the fruits and vegetables recommendations was associated with correct knowledge (OR = 4.5; CI95% 1.03;19.7), with reporting 150 minutes or more of physical activity per week (OR = 2.0; CI95% 1.03;3.7) and with reporting physical activity in leisure time (OR = 2.0; CI95% 1.05;3.6). Regular physical activity counseling was associated with reporting 10-149 minutes per week (OR = 3.8; CI95% 1.1;13.3) and with more than 150 minutes of physical activity per week (OR = 4.9; CI95% 1.5;16.5). CONCLUSION Actions to promote physical activity and healthy eating and to improve knowledge among community health workers within the health care system of Brazil could have a potential positive influence on delivery of preventive counseling to patients on this topic.
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Affiliation(s)
- Alex A Florindo
- School of Arts, Sciences and Humanities, University of São Paulo, Rua Arlindo Bettio, 1.000, CEP: 03828-000, São Paulo, SP, Brazil.
| | - Ross C Brownson
- Prevention Research Center in St. Louis, Brown School, Division of Public Health Sciences and Alvin J. Siteman Cancer Center - Washington University in St. Louis, Missouri, USA.
| | - Gregore I Mielke
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil.
| | - Grace Ao Gomes
- Department of Gerontology, Federal University of São Carlos, São Carlos, SP, Brazil.
| | - Diana C Parra
- Program in Physical Therapy Surgery (Prevention and Control), School of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
| | - Fernando V Siqueira
- School of Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil.
| | - Felipe Lobelo
- Hubert Department of Global Health, Emory University - Rollins School of Public Health, Atlanta, USA.
| | - Eduardo J Simoes
- Department of Health Management and Informatics, School of Medicine, University of Missouri, Missouri, USA.
| | - Luiz R Ramos
- Department of Preventive Medicine, Federal University of Sao Paulo, São Paulo, SP, Brazil.
| | - Mário M Bracco
- Hospital Israelita Albert Einstein; Hospital Municipal Dr. Moysés Deutsch - M'Boi Mirim, São Paulo, SP, Brazil.
| | - Pedro C Hallal
- School of Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil.
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