Cross-Sectional Associations of Screen Time Activities With Alcohol and Tobacco Consumption Among Brazilian Adolescents.

Objectives: Little is known about the association between specific types of screen time and adolescents' substance use. Thus, this study aimed to investigate the associations between screen time for studying, working, watching movies, playing games, and using social media and frequency of alcohol and tobacco use. Methods: In this cross-sectional study, Brazilian adolescents answered survey questions related to frequency of tobacco and alcohol consumption, and reported their daily volume of five types of screen time. Multilevel ordered logistic regression models were performed. Results: Each 1-hour increase in ST for studying was associated with 26% lower odds of smoking (OR = 0.74; 95% CI: 0.61-0.90) and 17% lower odds of drinking alcohol (OR = 0.83; 95% CI: 0.76-0.91) in the past 30 days. The increase of 1 hour of social media use was associated with 10% greater odds of smoking (OR = 1.10; 95% CI: 1.02-1.18) and a 13% greater chance of consuming alcohol (OR = 1.13; 95% CI: 1.08-1.18) in the past 30 days. Conclusion: The association between screen time and substance use appears to be type-specific. Future longitudinal research is needed to explore causal relationships.

Bidirectional Daily Associations Between Accelerometer-Measured Sleep and Physical Activity in Brazilian High School Students.

PURPOSE: This study analyzed day-to-day estimates of bidirectional associations between sleep parameters and intensity-specific physical activity and assessed whether the timing of physical activity influences these relationships. METHODS: The sample was comprised of 651 high school students (51.2% female, 16.33 [1.0] y old) from southern Brazil. Physical activity and sleep were measured using accelerometers. Multilevel models were applied to test associations of nocturnal total sleep time, onset, and efficiency with moderate to vigorous and light (LPA) physical activity. RESULTS: Higher engagement in moderate to vigorous physical activity and LPA was associated with increased total sleep time, and this effect was greater when physical activity was performed in the morning. Morning and evening LPA were associated with increased sleep efficiency and reduced total sleep time, respectively. Practice of LPA in the morning leads to early sleep onset, whereas evening LPA was associated with later onset. Higher total sleep time and later sleep onset were associated with lower moderate to vigorous physical activity and LPA on the following day. However, higher sleep efficiency was associated with increased LPA. CONCLUSION: The relationship between sleep parameters and physical activity is bidirectional and dependent on physical activity intensity and timing.

Physical Activity Levels in Brazilian Adolescents: A Secular Trend Study (2007-2017/18).

Only a small proportion of Brazilian adolescents practice sufficient physical activity (PA). However, it is not clear whether this proportion has been decreasing over time. This study aimed to examine the 10-year trends of sufficient PA in adolescents and to investigate differences by sex and age. Using a standard protocol, we compared two cross-sectional cohorts of adolescents aged 15 to 18 years, recruited in 2007 (n = 1040) and in 2017/18 (n = 978). Using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the adolescents reported moderate-to-vigorous PA (MVPA) performed in the last seven days. Sufficient PA was defined as engaging in at least 60 min/day of MVPA. In the subgroups, investigated by sex or age, there was an increase in the prevalence of sufficient PA. Overall, sufficient PA declined by 28.1% from 2007 to 2017/18. Boys in 2007 were more active than their 2017/18 peers, and this was equally observed in girls in 2007 compared to those in 2017/18. The findings show decreasing secular trends in sufficient PA in the investigated adolescents. Not only are public health authorities in Brazil witnessing an escalation of insufficient PA, but they are also losing ground with the most active adolescents.

Physical Activity Guidelines for the Brazilian Population: Recommendations Report.

BACKGROUND: This article presents the recommendations from the Physical Activity Guidelines for the Brazilian Population. METHODS: A steering committee composed of a chair, 6 experts in physical activity, and representatives from the Ministry of Health/Brazil, Pan American Health Organization, Brazilian Society of Physical Activity and Health designed the guidelines, which was implemented by 8 working groups, as follows: (1) understanding physical activity, (2) children up to 5 years old, (3) children and youth from 6 to 17 years old, (4) adults, (5) older adults (60 years and above), (6) physical education at school, (7) pregnant and postpartum women, and (8) people with disabilities. The methodological steps included evidence syntheses, hearings with key stakeholders, and public consultation. RESULTS: Across 8 chapters, the guidelines provide definitions of physical activity and sedentary behavior, informing target groups on types of physical activity, dosage (frequency, intensity, and duration), benefits, and supporting network for physical activity adoption. The guidelines are openly available in Portuguese, Spanish, English, and Braille and in audio versions, with a supplementary guide for health professionals and decision makers, and a report about the preparation and references. CONCLUSIONS: The Physical Activity Guidelines for the Brazilian Population provide evidence-based recommendations, being a public-directed resource to contribute to the physical activity promotion in Brazil.

Physical Activity Guidelines for the Brazilian Population: Development and Methods.

BACKGROUND: This article describes the process and methods used in the development of the first ever Physical Activity Guidelines for the Brazilian Population. METHODS: The steering committee established 8 working groups based on other guidelines and the Brazilian agenda for public health and physical activity (PA) promotion: (1) understanding PA; (2) children up to 5 years; (3) children and youth (6-17 y); (4) adults; (5) older adults (60 years and above); (6) physical education at school; (7) pregnant and postpartum women; and (8) people with disabilities. Working groups were formed to (1) synthesize the literature on each topic; (2) conduct workshops with stakeholders, health professionals, researchers, and the public; and (3) prepare a draft chapter for open online consultation. RESULTS: The document provides guidance for the population on the benefits of being active and recommendations regarding the amount (frequency, intensity, and duration) of PA recommended across all chapters. It also includes information on supporting networks for PA. CONCLUSIONS: The PA guidelines are widely accessible in Portuguese, including versions in English, Spanish, audiobook, and Braille, and will assist policy makers and professionals from several sectors to promote PA. The ultimate goal is to increase population levels of PA in Brazil.

Clustering of Physical Activity, Sleep, Diet, and Screen-Based Device Use Associated with Self-Rated Health in Adolescents.

BACKGROUND: Little is known about how the interplay among health-related behaviors impacts self-rated health (SRH). We examined the clustering of physical activity (PA), sleep, diet, and specific screen-based device use, and the associations between the emergent clusters and SRH among Brazilian adolescents. METHOD: The data used in this cross-sectional study were from the baseline of the Movimente Program. Self-reported data were analyzed. SRH was recorded as a 5-point scale (from poor to excellent). Daily duration of exposure to the computer, the television, the cell phone, and games; PA; sleep; and weekly consumption of fruits and vegetables and ultra-processed foods were included in a Two-Step cluster analysis. Multilevel ordered logistic regressions assessed the associations between the clusters and SRH. RESULTS: The data of 750 students (girls: 52.8%, 13.1 ± 1.0 years) were analyzed. Good SRH was more prevalent (52.8%). Three clusters were identified: the Phubbers (50.53%; characterized by the longest cell phone use duration, shortest gaming and computer use, lowest PA levels, and low consumption of fruits and vegetables), the Gamers (22.80%; longest gaming and computer use duration, PA < sample average, highest intake of ultra-processed foods), and a Healthier cluster (26.67%; physically active, use of all screen-based devices < sample average, and healthier dietary patterns). For both Gamers (-0.85; 95% CI -1.24, -0.46) and Phubbers (-0.71; 95% CI -1.04, -0.38), it was found a decrease in the log-odds of being in a higher SRH category compared with the Healthier cluster. CONCLUSION: Specific clusters represent increased health-related risk. Assuming the interdependence of health-related behaviors is indispensable for accurately managing health promotion actions for distinguishable groups.

Psychometric analysis of the Brazilian-version Kidscreen-27 questionnaire.

BACKGROUND: The objective of this study was to verify the reliability, discriminatory power and construct validity of the Kidscreen-27 questionnaire in Brazilian adolescents. METHODS: Adolescents that participated of the pilot study (210 adolescents; 52.9% boys; 13.7 years old) and of the baseline (816 participants; 52.7% girls; 13.1 years old) of the Movimente Project in 2016/2017 composed the sample of the present study. This project was carried out in six public schools in the city of Florianópolis, Santa Catarina, Brazil. Test-retest reproducibility was assessed by the intraclass correlation coefficient and Gwet coefficient; internal consistency through McDonald's Omega; Hankins' Delta G coefficient verified the scale's discriminatory power and; confirmatory factor analysis to assess construct validity. RESULTS: Reproducibility values ranged from 0.71 to 0.78 for the dimensions (ICC), and ranged from 0.60 to 0.83 for the items (Gwet). McDonald's Ômega (0.82-0.91) for internal consistency measures. Discriminatory power ranging from 0.94 for the dimension Social Support and Friends to 0.98 for Psychological Well-Being. The factorial loads were > 0.40, except for item 19 (0.36). The fit quality indicators of the model were adequate (X2[df] = 1022.89 [311], p < 0.001; RMSEA = 0.053 (0.049-0.087); CFI = 0.988; TLI = 0.987), confirming the five-factor structure originally proposed. CONCLUSIONS: The Brazilian-version Kidscreen-27 achieved good levels of reproducibility, internal consistency, discriminatory power and construct validity. Its use is adequate to measure the health-related quality of life of adolescents in the Brazilian context.

Is knowledge of screen time guidelines associated with stages of behavior change for television viewing among adolescents?

It is unknown whether knowledge of guidelines for television (TV) viewing translate into behavior change for TV time among adolescents. The purpose of the present study is to verify whether knowledge of TV recommendations (spending <2 hr/day watching TV) is associated with the stages of behavior change related to TV viewing among adolescents. Schoolchildren (11-16 years) from six schools were recruited. Their knowledge of TV guidelines (correct [<2 hr/day], overestimated [<1 hr/day or never watch TV], underestimated [<3hr/day or watch TV whenever they wanted], and do not know [response option]) and stages of behavior change related to TV (precontemplation, contemplation, preparation, action, and maintenance) were assessed by a questionnaire. Multinomial logistic regression was used to test the association between knowledge and stages of behavior change. A total of 792 adolescents (53% girls) participated, of whom 45% were in the precontemplation stage, while 35% underestimated and 18% did not know the TV guidelines. Those who overestimated the guidelines had higher odds of being in the maintenance stage than did those who knew the recommendations correctly (odds ratio [OR] 2.06), while those who underestimated the guidelines had lower odds of being in the maintenance (OR 0.22) and any other stage compared to those who were aware of the recommendations (the precontemplation stage was the reference). Underestimating the guidelines was associated with being in the precontemplation stage, while overestimating them was associated with the maintenance stage. Interventions should test whether increasing knowledge can help shifting those in the precontemplation and contemplation toward action and maintenance.

Health Promoting School Interventions in Latin America: A Systematic Review Protocol on the Dimensions of the RE-AIM Framework.

Understanding the dimensions of internal and external validities (e.g., using the RE-AIM model: Reach, Effectiveness/Efficacy, Adoption, Implementation, and Maintenance) of school interventions is important to guide research and practice in this context. The aim of this systematic review protocol is to synthesize evidence on the RE-AIM dimensions in interventions based on the Health Promoting School (HPS) approach from the World Health Organization (WHO) in Latin America. Studies of interventions based on HPS-WHO that were carried out in Latin America involving the population of 5 to 18-year-olds will be eligible. Searches in nine electronic databases, a study repository, the gray literature, and the retrieved articles' reference lists will be performed, without year or publication language limits. Study selection and data extraction will be conducted by independent researchers. Data on intervention implementation will be summarized in categories of HPS-WHO actions: (1) school curriculum, (2) changes in the social and/or physical environment of schools, and (3) actions with families and the community. A previously validated tool will be used to summarize the information on the dimensions of the RE-AIM model. The strengths and limitations of the included studies will be evaluated using the Critical Appraisal Skills Program (CASP) tool, and the confidence level of evidence will be assessed according to the GRADE CERQual tool.

Food consumption and its association with leisure-time physical activity and active commuting in Brazilian workers.

BACKGROUND/OBJECTIVES: An in-depth understanding of the relationship between food consumption and physical activity is relevant since these behaviours could influence each other, while both have an effect on obesity and chronic diseases. In this context, the aim of this study was to investigate the effect of various combinations of food consumption (fruits, vegetables, sweets and snacks) on the associations with PA domains (leisure and commute) among Brazilian industrial workers. SUBJECTS/METHODS: This is part of a cross-sectional national survey developed in Brazil using data from the "Lifestyle and Leisure Habits of Industrial Workers" project. A total of 52,774 workers (response rate: 90.6%) responded to a validated questionnaire about the frequency of their consumption of fruit, vegetables, sweets and snacks, their practice of LTPA and active commuting. The answers were analysed by multilevel regression, controlled by sociodemographic behaviour and the presence of hypertension, diabetes and overweight. RESULTS: Workers with a simultaneously adequate consumption of fruit, vegetables, sweets and snacks were 2.29 (1.74; 2.99 p-value < 0.001) more likely to perform LTPA. In the full model, there was no association among any of the combinations of food consumption and active commuting. CONCLUSION: A better food consumption behaviour was reported among workers who practiced leisure physical activity when compared to those who did not.

Physical inactivity, television time and chronic diseases in Brazilian adults and older adults.

This study aimed to investigate the association between simultaneity of leisure-time physical inactivity and high television time with the presence of chronic diseases in adults and older adults in Brazil. We analyzed secondary data from Vigitel 2013 database, a cross-sectional national survey. It was included 37 947 adults (18-59 years) and 14 982 older adults (≥60 years) living in Brazilian state capitals. The association was between simultaneity of risk behaviors considering leisure-time physical inactivity (<10 min/day) and high television time (≥2 h/day), with the presence of chronic diseases (diabetes, dyslipidemia, hypertension and obesity), measured according to the age group. We performed a binary logistic regression, crude and adjusted analysis, using weighted to reflect population estimates. In adults, there was an association between leisure-time physical inactivity and television time with the presence of diseases. In practice, the simultaneity of risk behaviors when compared with those without risk behavior had higher odds for diabetes (OR = 1.83), dyslipidemia (OR = 1.17), hypertension (OR = 1.54) and obesity (OR = 1.60). In older adults, the simultaneity was associated with diabetes (OR = 1.61), hypertension (OR = 1.33) and obesity (OR = 1.81). We concluded that for adults and older adults the simultaneity of leisure-time physical inactivity and high television time increased the odds for the presence of chronic disease, especially for diabetes and obesity.

Is the availability of open public spaces associated with leisure-time physical activity in Brazilian adults?

This study aims to analyse the association between perceived presence of public spaces near residences and practice of physical activity during leisure time by adults in the state capitals of Brazil, based on sociodemographic characteristics. Participants were individuals aged ≥18 years living in the 27 state capitals of Brazil (n = 52 929, 53.9% female) who responded to a national survey called VIGITEL in 2013. Physical activity during leisure time (≥1 time/week), perception of space, population and sociodemographic variables (sex, age, years of study and geographic region) were self-reported. The adjusted binary logistic regression analysis was used. Among adults, the prevalence of physical activity during leisure was 45.1% (95% CI [44.2; 46.0]), and 71.1% (95% CI [70.2, 71.8]) perceived public space near their residence. A direct association between perceiving public space and physical activity ([OR] = 1.43; 95% CI [1.32; 1.55]) was observed. No significant difference was observed in the population groups (men and women, younger and older adults, and those with more and fewer years of study). Thus, even with the possible regional differences in Brazilian state capitals, the presence of public spaces increases the practice of physical activity during leisure time, independent of sociodemographic variables.

Are adolescents really being sedentary or inactive when at school? An analysis of sedentary behaviour and physical activity bouts.

This study analysed physical activity (PA) and sedentary behaviour (SB) performed in bouts during schooltime. Adolescents of two schools answered a questionnaire, had their height and weight measured and wore accelerometers during schooltime. Moderate-to-vigorous intensity PA was estimated in bouts of 2, 5 and 10 min, and SB in bouts of 5, 10, 30 and 60 min. Body mass index was calculated, and adolescents were classified as overweight or normal weight. Frequency, duration and volume of PA and SB were calculated for the whole sample and for those who performed at least one bout weekly. PA and SB differences between gender and weight status were tested using Mann-Whitney and t tests. A total of 415 adolescents (54% girls, 12.3 ± 1.3 years old, 34.6% overweight) performed 0.1 (± 0.2), 0.2 (± 0.5) and 0.4 (± 0.6) bouts of 10, 5 and 2 min of PA, and 10.6 (± 2.0), 6.0 (± 1.3), 1.1 (± 0.9) and 0.4 (± 0.5) bouts/day of 5, 10, 30 and 60 min of SB, respectively. Boys accumulated less SB and more PA in bouts. No differences were found for weight status.Conclusion: Adolescents hardly engaged in bouted PA and accumulated more SB in smaller bouts during schooltime. Bouted PA and SB were not associated with weight status. What is Known: • Adolescents are not engaging in enough PA and are accumulating large volumes of SB, which might negatively impact their health. • Schools play an important role in daily overall PA, with opportunities such as PE classes and recesses. But most classes are still undertaken in seated positions. What is New: • Adolescents hardly engage in bouted (> 10 m) PA when at school., and most SB is accumulated in short bouts (≤ 10m). • Weight status was not associated with bouted PA or SB at school.

Aerobic Fitness and Moderate to Vigorous Physical Activity in Children and Adolescents Living with HIV.

PURPOSE: To examine aerobic fitness, total moderate to vigorous physical activity (MVPA) and also patterns in terms of MVPA between children and adolescents with human immunodeficiency virus (HIV) and controls, and to determine whether differences, if any, are associated with HIV, sex and highly active antiretroviral therapy (HAART). METHOD: A cross-sectional analysis was carried out with 130 children and adolescents, aged between 8 and 15 years, divided into two groups (HIV group= 65 patients, control group= 65 healthy participants). Total MVPA was measured by accelerometers and 5 and 10-min bouts were estimated. The peak oxygen uptake (peak VO2) was measured by breath-by-breath respiratory exchange in an incremental cycle ergometer test. RESULTS: HIV-positive participants had lower peak VO2 (39.2 ± 6.8 vs. 44.5 ± 9.1 ml.kg-1min-1), lower bouts of MVPA of 5-min (19.7 ± 16.6 vs. 26.6 ± 23.5) and 10-min (3.6 ± 3.9 vs. 5.8 ± 7.2), but similar total MVPA (49.5 ± 28.9 vs. 49.1 ± 30.6 min.day-1). HIV infection in untreated, nonprotease inhibitors (PI)- based HAART and PI-based HAART patients was associated with lower 8.5 (95%CI= 12.5-4.6), 7.1 (95%CI= 10.6-3.6) and 4.5 (95%CI= 7.0-2.0) ml.kg-1min-1 of peak VO2. CONCLUSION: Children and adolescents with HIV demonstrated lower aerobic fitness compared with the controls and the absence of HAART may increase peak VO2 impairment. Lower bouts of MVPA were also observed in HIV group despite the similar values of total MVPA of controls.

"For whom was it effective?" Moderators of the effect of a school-based intervention on potential physical activity determinants among Brazilian students.

Knowledge about the effects of school-based interventions on modifiable physical activity (PA) determinants (e.g., social support), and whether the intervention effect differs according to students' characteristics (e.g., age and gender) are relevant PA promotion topics. This study aims to answer these topics among Brazilian students. This cluster-randomized controlled trial was conducted with 548 students in the intervention group and 537 in the control group (51.5% of boys; aged 11-18years). The four-month intervention included strategies focused on training teachers, opportunities for PA in the school environment, and health education. Potential PA determinants (attitude, self-efficacy, support of friends, parents, and teachers, perceived neighborhood environment and PA facilities in school) and moderators (gender, age, socioeconomic status (SES), and PA level at baseline) were assessed using self-reported instrument. Height and weight were measured to estimate the students' body mass index (BMI) status. Generalized linear models were used. In general, there was a significant and positive intervention effect for attitude, support of friends and teachers for PA, as well as PA facilities in school; effect size was 0.29, 0.24, 0.34, and 0.29, respectively (P<0.05). Age (support of friends, parents and teachers, and PA facilities in school), SES (support of friends and PA facilities in school), and BMI status (support of friends) were moderators of the intervention effect on some outcomes. In conclusion, the intervention improved potential PA determinants, but some changes occurred differently according to students' characteristics. These findings should be considered in PA policies in the school context. TRIAL REGISTRATION: This study is registered at Clinicaltrials.govNCT02439827.

A Physical Activity Intervention for Brazilian Students From Low Human Development Index Areas: A Cluster-Randomized Controlled Trial.

BACKGROUND: Promoting physical activity (PA) in low- and middle-income countries is an important public health topic as well as a challenge for practice. This study aimed to assess the effect of a school-based intervention on different PA-related variables among students. METHODS: This cluster-randomized-controlled trial included 548 students in the intervention group and 537 in the control group (11-18 years-old) from 6 schools in neighborhoods with low Human Development Index (0.170-0.491) in Fortaleza, Brazil. The intervention included strategies focused on training teachers, opportunities for PA in the school environment and health education. Variables measured at baseline and again at the 4-months follow-up included the weekly time in different types of moderate-to-vigorous PA (MVPA), preference for PA during leisure-time, PA behavioral change stage and active commuting to school. Generalized linear models and binary logistic regressions were used. RESULTS: An intervention effect was found by increasing the weekly time in MVPA (effect size = 0.17), popular games (effect size = 0.35), and the amount of PA per week (effect size = 0.27) among students (all P < .05). CONCLUSIONS: The intervention was effective in promoting improvements in some PA outcomes, but the changes were not sufficient to increase the proportion of those meeting PA recommendations.

Behavior change stages related to physical activity in adolescents from Santa Catarina: prevalence and associated factors. / Estágios de mudança de comportamento para atividade física em adolescentes catarinenses: prevalência e fatores associados.

OBJECTIVE: Verify the prevalence and sociodemographic and economic factors associated with behavior change stages for habitual physical activity practice in adolescents from Santa Catarina. METHODS: Secondary analysis of a study on the Behavior of Adolescents from Santa Catarina (CompAC 2). Cross-sectional school-based study of 6,529 high-school students (males, n=2,903) from the state of Santa Catarina public education system in 2011, aged 15 to 19 years. Multinomial logistic regression (crude and adjusted) was used to measure the association. RESULTS: The highest and lowest prevalence rates were found in the maintenance (43.9%) and precontemplation stages (7.0%), respectively. The stages of action, preparation and contemplation showed similar results: 16.2%; 17.0% and 15.6%; respectively. Male adolescents show higher prevalence in the maintenance stage in relation to females and these show a higher prevalence in preparation, contemplation and precontemplation. All the assessed variables (gender, age, area of residence, employment status, family income, maternal education and school grade), with the exception of school shift, were associated with at least one of the stages. CONCLUSIONS: A large proportion of adolescents are in the pre-adoption stages and most of these have the intention to start regular physical activity. With the exception of school shift, the assessed variables were associated with stages in different ways, showing different profiles in relation to sociodemographic and economic characteristics in each subgroup.

Moderating effect of gross family income on the association between demographic indicators and active commuting to work in Brazilian adults.

OBJECTIVE: To investigate the moderating effect of gross family income on the association between demographic indicators and active commuting to work in Brazilian adults. METHODS: Secondary analysis of the survey "Lifestyle and leisure habits of industry workers" (n=46,981), conducted in 24 Brazilian states (2006-2008). Self-reported information was collected with a previously tested questionnaire. Crude and adjusted logistic regression models were applied to analyze the association between sociodemographic variables (sex, age, marital status, number of children, education, country area and company size) and active commuting to work in different strata of gross family income. To test the moderating effect, an interaction analysis was applied. RESULTS: The proportion of active commuters among low-, medium- and high-income workers was 40.7% (95%CI:40.0%;41.5%), 27.0% (95%CI:26.3;27.6%) and 11.1%, (95%CI:10.5%;11.7%), respectively. The moderating effect of gross family income was confirmed. Men were more likely (OR:1.22 95%CI:1.12;1.32) to commute actively than women among low-income individuals. Active commuting was less likely among older workers in low-(OR30-39:0.90 95%CI: 0.83;0.98; OR≥40: 0.76 95%CI: 0.68;0.85) and medium-income strata (OR30-39:0.87 95%CI:0.80;0.95; OR≥40:0.84 95%CI:0.76;0.93) and among married individuals in high-income strata (OR:0.72 95%IC:0.61;0.84). Adults with lower education (ORhigh:10.80 95%CI:8.47;13.77), working in the south (ORhigh:1.93 95%CI:1.53;2.44) and in small companies (ORlow:2.50 95%CI:2.28;2.74) were more likely to commute actively; however, the magnitude of these associations differed at each income strata. CONCLUSION: There was an inverse association between gross family income and active commuting. Gross family income acts as a moderator of the association between demographic indicators and active commuting.

Clustering of Physical Inactivity in Leisure, Work, Commuting, and Household Domains: Data From 47,477 Industrial Workers in Brazil.

BACKGROUND: Physical inactivity in each domain (leisure, work, commuting, and household) is not completely independent. This study aimed to describe the clustering of physical inactivity in different domains and its association with sociodemographic factors among Brazilian industrial workers. METHODS: This was a cross-sectional, population-based study using data from 23 Brazilian states and the Federal District collected via questionnaires between 2006 and 2008. Physical inactivity in each domain was defined as nonparticipation in specific physical activities. Clustering of physical inactivity was identified using the ratio of the observed (O) and expected (E) percentages of each combination. Multinomial logistic regression was used to identify sociodemographic factors with the outcome. RESULTS: Among the 44,477 interviewees, most combinations exceeded expectations, particularly the clustering of physical inactivity in all domains among men (O/E = 1.37; 95% CI: 1.30; 1.44) and women (O/E = 1.47; 95% CI: 1.36; 1.60). Physical inactivity in 2 or more domains was observed more frequently in women, older age groups, individuals living without a partner, and those with higher education and income levels. CONCLUSIONS: Physical inactivity tends to be observed in clusters regardless of gender. Women and workers with higher income levels were the main factors associated with to be physically inactive in 2 or more domains.