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.
Randomized Controlled Trial of Primary Health Care Strategies for the Promotion of Leisure-Time Physical Activity Among Older Brazilians
Francini Vilela Novais, Eduardo J. Simoes, Chester Schmaltz, and Luiz R. Ramos
Cross-Sectional Associations of Health-Related Quality of Life Measures With Selected Factors: A Population-Based Sample in Recife, Brazil
Jesus Soares, Eduardo J. Simões, Luiz Roberto Ramos, Michael Pratt, and Ross C. Brownson
We used data from a random telephone survey of 2045 adults in Recife, Brazil to investigate the associations of health-related quality of life (HRQoL) with selected factors.
We generated odds ratios of 4 HRQoL measures (perception of overall health, mentally unhealthy days, physically unhealthy days, and physically and mentally unhealthy days impeding usual activities) by levels of environmental factors (number of destinations, neighborhood aesthetics, neighborhood crime safety, neighborhood traffic interference, and neighborhood walkability), physical activity behavior, and participation in the Academia da Cidade Program (ACP).
Perception of overall health was associated with age, gender, education, body mass index (BMI) level, chronic disease, and having heard or seen an ACP activity. Mentally unhealthy days were associated with age, sex, BMI level, neighborhood aesthetics, and neighborhood crime safety. Physically unhealthy days were associated with age, sex, chronic diseases, leisure time physical activity, and neighborhood crime safety, and neighborhood traffic interference. Physically and mentally unhealthy days impeding usual activities were associated with chronic disease neighborhood crime safety, and traffic interference.
The associations of HRQoL with environmental factors and health promoting programs may have public health policy implications and highlight the need for additional research into HRQoL in Brazil.
Odds of Getting Adequate Physical Activity by Dog Walking
Jesus Soares, Jacqueline N. Epping, Chantelle J. Owens, David R. Brown, Tina J. Lankford, Eduardo J. Simoes, and Carl J. Caspersen
We aimed to determine the likelihood that adult dog owners who walk their dogs will achieve a healthy level of moderate-intensity (MI) physical activity (PA), defined as at least 150 mins/wk.
We conducted a systematic search of 6 databases with data from 1990–2012 on dog owners’ PA, to identify those who achieved MIPA. To compare dog-walkers’ performance with non-dog walkers, we used a random effects model to estimate the unadjusted odds ratio (OR) and corresponding 95% confidence interval (CI).
We retrieved 9 studies that met our inclusion criterion and allowed OR calculations. These yielded data on 6980 dog owners aged 18 to 81 years (41% men). Among them, 4463 (63.9%) walked their dogs. Based on total weekly PA, 2710 (60.7%) dog walkers, and 950 (37.7%) non-dog walkers achieved at least MIPA. The estimated OR was 2.74 (95% CI 2.09–3.60).
Across 9 published studies, almost 2 in 3 dog owners reported walking their dogs, and the walkers are more than 2.5 times more likely to achieve at least MIPA. These findings suggest that dog walking may be a viable strategy for dog owners to help achieve levels of PA that may enhance their health.
Association Between Perceived Environmental Attributes and Physical Activity Among Adults in Recife, Brazil
Pedro C. Hallal, Rodrigo S. Reis, Diana C. Parra, Christine Hoehner, Ross C. Brownson, and Eduardo J. Simões
To evaluate the association between perceived environmental factors and leisure-time and transport-related physical activity.
A random-digit-dialing telephone cross-sectional survey in Recife, Brazil, was conducted among individuals aged 16 years or older (n = 2046). Leisure-time and transport-related physical activity were measured using the long version of the International Physical Activity Questionnaire. Three outcome variables were used: leisure-time physical activity (min/wk), transport-related physical activity (min/wk), and walking for leisure (min/wk). A cutoff of 150 min/wk was used for all outcome variables. The environmental module of the questionnaire was based on the short version of the Neighborhood Environment Walkability Scale (A-NEWS), and included 12 environmental items.
The proportions of subjects reaching the 150-minutes per week threshold were 30.6% for leisure-time physical activity, 26.6% for transport-related physical activity and 18.2% for walking for leisure. Lack of sidewalks and low access to recreational facilities were associated with a lower likelihood of performing 150 minutes per week or more of leisure-time physical activity. Lack of sidewalks was associated with low levels of walking for leisure. Neighborhood aesthetics was inversely associated with transport-related physical activity.
Lack of sidewalks and low access to recreational facilities were predictors of low levels of leisure-time physical activity, suggesting that policy strategies aimed at improving these environmental features may be warranted.
Project GUIA: A Model for Understanding and Promoting Physical Activity in Brazil and Latin America
Michael Pratt, Ross C. Brownson, Luiz Roberto Ramos, Deborah Carvalho Malta, Pedro C. Hallal, Rodrigo S. Reis, Diana C. Parra, and Eduardo J. Simões
Using Logic Models as Iterative Tools for Planning and Evaluating Physical Activity Promotion Programs in Curitiba, Brazil
Isabela C. Ribeiro, Andrea Torres, Diana C. Parra, Rodrigo Reis, Christine Hoehner, Thomas L. Schmid, Michael Pratt, Luiz R. Ramos, Eduardo J. Simões, and Ross C. Brownson
The Guide for Useful Interventions for Activity in Brazil and Latin America (GUIA), a systematic review of community-based physical activity (PA) interventions in Latin American literature, selected the CuritibAtiva program for a comprehensive evaluation. We describe the process of developing logic models (LM) of PA community interventions from Curitiba, Brazil, and discuss influential factors.
The year-long process included engaging stakeholders involved in the promotion of PA in Curitiba, working with stakeholders to describe the programs and their goals, and developing LMs for the 2 main secretaries promoting PA in the city.
Results & Conclusions:
As a result of stakeholder interviews and discussion and the development of the LMs, local officials are coordinating programming efforts and considering ways the programs can be more complementary. The process has prompted program managers to identify overlapping programs, refine program goals, and identify gaps in programming. It also helped to frame evaluation questions, identify data sources, describe realistic outcomes, and reinforce the importance of intersectoral alliances for public health impact. Developing LMs proved to be feasible in the Latin American context, therefore adaptable and useful for other PA promotion programs in the region.
Description of the Countrywide Physical Activity Network Coordinated by the Brazilian Ministry of Health: 2005−2008
Alan G. Knuth, Deborah C. Malta, Danielle K. Cruz, Adriana M. Castro, Janaína Fagundes, Luciana M. Sardinha, Cristiane Scolari Gosch, Eduardo J. Simões, and Pedro C. Hallal
Based on the Brazilian National Health Promotion Policy (PNPS), the Ministry of Health (MoH) started stimulating and funding physical activity interventions in 2005, leading to the establishment of a countrywide network. The aim of the present article is to geographically describe this network (2005−2008) and to present structure and process evaluation indicators of interventions funded in 2006 and 2007.
In 2005, the 27 state capitals received funding for carrying out physical activity-related interventions. From 2006 onwards, public calls for proposals were announced, and cities were selected through a competitive basis. Coordinators of interventions in cities who got funding in 2006 and 2007 answered to survey questions on structure and process aspects of the interventions.
The network currently comprises 469 projects, out of which over 60% are carried out in small cities (<30,000 inhabitants). The most frequently used public spaces for the interventions are squares and indoor sports courts. The main physical activity-related topic of the PNPS prioritized in the projects is healthy diet. The main partnerships developed are between City's Health and Education Secretariats.
Expanding the network to 1000 cities by 2010 and continuing the evaluation efforts are the next goals of the Brazilian MoH.