Methods to assess ambivalence towards food and diet: a scoping review.

BACKGROUND: Ambivalence towards food and diet, which favours behavioural inertia, might be a barrier to adopting healthier eating behaviours. Measuring it can help researchers to better understand its relationship with behaviour change and design interventions aimed at resolving it. In this scoping review, we map and describe methods and tools employed in studies to assess, measure or classify the ambivalence of participants towards food- and diet-related attitude objects. METHODS: In accordance with Joanna Briggs Institute guidance for conducting scoping reviews, we retrieved peer-reviewed studies from MEDLINE, CINAHL, PsycINFO, Web of Science, FSTA and Food Science Source and preprints from PsyArXiv and MedRxiv. Two independent reviewers screened the articles. We considered for inclusion peer-reviewed studies and preprints that assessed the ambivalence of participants of any age, sex or sociodemographic group towards food and diet. RESULTS: We included 45 studies published between 1992 and 2022, which included participants from 17 countries. Eighteen methods were employed across the included studies to assess different types of ambivalence (felt, potential or cognitive-affective), the most frequent of which were the Griffin Index, the Subjective Ambivalence Questionnaire, the MouseTracker Paradigm and the Orientation to Chocolate Questionnaire. CONCLUSION: This scoping review identified several methods and tools to assess different types of ambivalence towards food- and diet-related objects, providing an array of options for future studies.

What methods have been used to estimate salt intake? A systematic review.

The relationship between salt intake and cardiovascular diseases is a contemporary scientific controversy, which has been attributed to the limits of the measures of salt intake used in the studies. Thus, this article sought to systematically review the literature on the methods used to estimate salt intake in different study designs. Of the 124 articles, 60.5% used only biochemical measures, 26.6% only self-report measures and 12.9% reported the combined use of both methods. The 24-hour urinary sodium excretion was the predominant biochemical method (79.1%) and the Food Frequency Questionnaire was the predominant self-report measure (36.4%). Interventional studies used mostly 24-hour urinary sodium excretion; while longitudinal studies used self-report measures. The question guiding the study and its design, as well as constraints related to costs, sample size and feasibility seems to influence the choice of the type of measurement.

Dietary sources of salt intake in adults and older people: a population-based study in a Brazilian town.

OBJECTIVE: To assess salt intake and its dietary sources using biochemical and self-report methods and to characterize salt intake according to sociodemographic and disease-related variables in a sample of the Brazilian population. DESIGN: Population-based cross-sectional survey. SETTING: Salt intake was assessed by biochemical (24 h urinary Na excretion) and self-report methods (sodium FFQ, 24 h dietary recall, seasoned-salt questionnaire, discretionary-salt questionnaire and total reported salt intake).ParticipantsAdults and older people (n 517) aged 20-80 years, living in Artur Nogueira, São Paulo, Brazil. RESULTS: Mean salt intake based on 24 h urinary Na excretion and total reported salt intake was 10·5 and 11·0 g/d, respectively; both measures were significantly correlated. Discretionary salt and seasoned salt were the most important sources of salt intake (68·2 %). Men in the study consumed more salt than women as estimated by 24 h urinary Na excretion (11·7 v. 9·6 g salt/d; P<0·0001). Participants known to be hypertensive added more salt to their meals but consumed less salty ultra-processed foods. Waist circumference in both sexes and BMI were positively correlated with salt intake estimated by 24 h urinary Na excretion. In addition, regression analysis revealed that being a young male or having a high waist circumference was a predictor of higher salt intake. CONCLUSIONS: Salt intake in this population was well above the recommended amount. The main source of salt intake came from salt added during cooking. Salt intake varied according to sex and waist circumference.

A randomized controlled trial of the effectiveness of planning strategies in the adherence to medication for coronary artery disease.

AIM: To examine the effect of action and coping planning strategies in the adherence to medication among outpatients with coronary artery disease. BACKGROUND: Action and coping planning strategies are based on implementation intention, which requires self-regulation by the individual, to prioritize intentionally planned responses over learned or habitual ones, from daily routines to stressful situations. DESIGN: Randomized controlled trial. METHODS: Participants (n = 115) were randomized into intervention (use of action and coping planning strategies, n = 59) or control (usual care, n = 56) groups. The study was conducted between June 2010-May 2011 in two in-person visits: baseline and 2-month follow-up. Participants in the intervention group received telephone reinforcement between baseline and 2-month follow-up. Adherence to medication for cardioprotection and symptoms relief was evaluated by proportion of adherence, global measure of adherence evaluation and Morisky Self-Reported Measure of Medication Adherence Scale at both baseline and 2-month follow-up. FINDINGS: When using the measure of global measure of adherence, participants in the intervention group reported adherence to therapy more often than controls (odds ratio = 5.3), but no statistically significant change was observed in the other two outcome measures. CONCLUSION: This study has shown that individuals who use action and coping planning report higher adherence to drug treatment, when measured by the global adherence evaluation. Further studies with longer follow-ups are needed to assess if the effect of planning strategies has long-term duration.

[Measuring instruments in cardiology adapted into Portuguese language of Brazil: a systematic review]. / Instrumentos de medida em cardiologia adaptados para a língua portuguesa do Brasil: uma revisão sistemática.

This was a systematic review aimed at identifying and characterizing measuring instruments, developed in the context of cardiology, which were adapted into Portuguese language of Brazil. Systematic searches were performed in six databases. Information extracted included cultural adaptation process and measurement properties. To assess the methodological quality of studies, criteria based on international guidelines for cultural adaptation of instruments were used. Among the 114 articles found, 14 were eligible for review. Of these, most evaluated quality of life (35.7%) and health knowledge/learning (28.6%). Most studies followed all stages of the adaptation process recommended in the literature. With respect to measurement properties, internal consistency, verified by Cronbach's alpha, was the property reported in the majority of the studies, as well as construct and criterion validity. This study is expected to provide to the scientific community a critical evaluation of adapted questionnaires available in the context of cardiology.

A Mobile Phone App Intervention to Promote Healthy Salt Intake Among Adults: Protocol for a Randomized Controlled Study.

BACKGROUND: There is sound evidence associating high salt intake and a greater risk of cardiovascular and noncardiovascular diseases. High salt intake has been observed in several populations worldwide. Therefore, promoting healthier salt consumption has been encouraged as a low-cost strategy to reduce this risk factor. However, these strategies need to be sound, built on theoretical and methodological bases, and consider the target population's context. OBJECTIVE: This protocol aims to describe a mobile phone app intervention to promote healthy salt intake among adults. METHODS: This is an experimental and longitudinal study protocol conducted in three modules. Module 1 refers to the planning of the intervention based on the Behaviour Change Wheel framework. Module 2 is the development of the mobile phone app intervention based on the date of module 1. In module 3, the intervention will be evaluated using a randomized controlled study, with three steps of data collection in a 2-month follow-up in a sample of 86 adults (43 participants for each group: the control group and intervention group) recruited from the primary health care centers of a Brazilian town. The discretionary salt intake questionnaire will assess salt consumption, the app usability will be assessed using the System Usability Scale, and psychosocial variables (habit, intention, and self-efficacy) will also be measured. RESULTS: Recruitment began in October 2021, and the follow-up will end in August 2022. The results of this study are expected to be published in 2023. CONCLUSIONS: Results from this study will help people to control salt intake when cooking at home, will stimulate self-care, will work as an alternative or supportive method in the relationship between health care professionals and patients, and will contribute to implementing the app intervention to promote healthy salt intake on a large scale. TRIAL REGISTRATION: The Brazilian Clinical Trials Registry RBR-4s8qyyq; https://ensaiosclinicos.gov.br/rg/RBR-4s8qyyq. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/37853.

Content Validity of a Questionnaire Based on the Theory of Planned Behavior to Assess the Psychosocial Determinants of Insulin Adherence.

OBJECTIVES: To verify the content validity of questions of an insulin adherence questionnaire based on the Theory Planned Behavior in outpatients with type 2 diabetes mellitus. METHODS: The instrument was derived from a tool created to evaluate psychosocial determinants of adherence to oral antidiabetics medications in the Brazilian context, and was submitted for evaluation by a committee of experts and members of the target population. The item-level content validity index, the scale-level content validity index averaging calculation method, and the modified kappa coefficient were used to evaluate agreement among specialists. The comprehensibility of the instrument by members of the target population was qualitatively analyzed. RESULTS: The item-level content validity index was found to be lower than desired in 6 of the 20 items analyzed. Of these, one item was modified and 5 were excluded after the comprehensibility evaluation by members of the target population; one item from the perceived control scale was excluded. Content validation resulted in an instrument with 14 items, distributed in the domains intention (4 items), attitude (3 items), perceived norm (4 items), and perceived control (4 items) scales. CONCLUSIONS: The findings support good evidence of the content validity of the instrument for use among people with type 2 diabetes mellitus receiving insulin therapy.

Musculoskeletal symptoms and work ability in a context of electronic judicial process.

INTRODUCTION: The recent transformations undergone by Brazilian labor court, especially with the introduction of electronic process of law (processo judicial eletrônico [PJe]), had a significant influence on how people work. OBJECTIVES: This study aimed to evaluate the occurrence of musculoskeletal symptoms and work ability in public sector employees working in a specialized labor court body. METHODS: A cross-sectional study was conducted with 449 workers, who provided demographic and occupational information and completed the Nordic Musculoskeletal Questionnaire (NMQ) and the Work Ability Index (WAI). RESULTS: Symptoms occurred more frequently in wrists/hands (62.4%), shoulders (62.1%), and neck (60.4%) in the past 12 months, and in the neck (29.8%), shoulders (29.4%), and wrists/hands (29.2%) in the past 7 days. The mean WAI score was 38.7 (6.4), and 31.4% of participants had poor or moderate work ability. WAI scores were poorer when participants had previous problems, and the number of body segments involved in complaints was greater among those with inadequate work ability. CONCLUSIONS: Higher frequency of musculoskeletal symptoms in wrists/hands, shoulders, and neck may be related to using PJe for work and is associated with poorer work ability scores, highlighting the importance of preventive interventions for work-related musculoskeletal disorders.

Musculoskeletal symptoms, psychosocial factors and work ability in Brazilian labor justice workers.

BACKGROUND: The implementation of the electronic judicial process (PJe) in recent years is associated with an increase in workload and stricter control through productivity targets in the Brazilian labor judiciary. OBJECTIVES: To evaluate the relations between musculoskeletal symptoms, psychosocial factors and work ability in civil servants of a labor justice body in the context of the PJe. METHODS: A cross-sectional exploratory study with a quantitative approach involving 449 workers. Sociodemographic, occupational and related data were collected through questionnaires validated in the Brazilian context. Data analysis was conducted by descriptive and inferential statistics: Mann-Whitney test, Spearman's correlation coefficient and multiple linear regression. RESULTS: There was a correlation between musculoskeletal symptoms and psychosocial factors (p < 0.05), as well as between both musculoskeletal symptoms and psychosocial factors with reduced work ability (p < 0.05). The multiple linear regression model pointed to the female gender and the dimensions "demands", "control" and "peer support" as related to the musculoskeletal symptoms. CONCLUSION: We highlight the importance of a broader approach, involving psychosocial factors in preventive actions related to musculoskeletal disorders considering the important relationship with work ability.

[Development of an instrument to measure psychosocial determinants of physical activity behavior among coronary heart disease patients]. / Desenvolvimento de instrumento para medida dos fatores psicossociais determinantes do comportamento de atividade física em coronariopatas.

The aim of this study was to report the development and the analysis of content validity and reliability of the Psychosocial Determinants of Physical Activity among Coronary Heart Disease Patients Questionnaire, based on an extension of the Theory of Planned Behavior. In the content validity step, three experts evaluated the instrument which was, afterwards, pre-tested with five subjects in order to obtain a conceptually appropriate and easily understood instrument. Fifty-one patients participated in the evaluation of internal consistency of the reviewed instrument. Cronbach's alpha coefficients above 0.75 were observed for the constructs: Intention, Attitude, Subjective Norm, Self-efficacy and Habit. The new instrument demonstrated acceptable evidence of content validity and reliability.

Effect of implementation intention on walking in people with diabetes: an experimental approach.

OBJECTIVE: To evaluate the effect of implementation intentions as an intervention strategy to promote walking in adults with type 2 diabetes mellitus (T2DM). METHODS: We conducted a controlled and randomized trial, with 12 months of follow-up, involving 65 people with T2DM recruited from primary health care units and allocated them in the control group (CG, n = 32) and intervention group (IG, n = 33). The IG received the implementation intention strategy to promote walking and the CG remained in follow-up for conventional treatment in primary health care. The researchers were blinded by anthropometric measurements and the filling of the instruments. RESULTS: After twelve months of follow up, the IG presented a statistically significant increase in the leisure time physical activity when compared with the CG (p = 0.0413) and showed a significant decrease in waist circumference (p = 0.0061). No significant difference was observed regarding body mass index and glycated hemoglobin among groups. CONCLUSIONS: Implementation intention was effective in promoting walking and improving clinical indicators in adults with T2DM.

Development and reliability of an instrument to measure psychosocial determinants of salt consumption among hypertensive patients.

This study aimed to present the content validity and reliability analyses of an instrument to study the determinant factors of salt consumption among hypertensive subjects, based on an extension of the Theory of Planned Behavior. Content validity was assessed by 3 experts and a pre-test was carried out with 5 subjects. The final tool, comprising 3 different behaviors related to salt consumption and corresponding psychosocial variables, was applied to 32 subjects for internal consistency and temporal stability (15-day interval) analysis. Cronbach's alpha coefficients > 0.70 and significant intra-class correlation coefficients were observed for most variables, indicating the temporal stability of the measured concepts. The developed instrument exhibited evidence of both content validity and reliability.

Sociodemographic, clinical, and dietary characteristics of overweight adults: a secondary analysis of a population study / Caracterização sociodemográfica, clínica e da alimentação de adultos com excesso de peso: análise secundária de um estudo populacional

ABSTRACT Objective: To estimate the prevalence of overweight among Brazilian adults aged 20 to 59, according to sociodemographic characteristics, health-related behaviors, and food consumption. Methods: A cross-sectional study based on data from a population-based survey in a major metropolitan city in the state of São Paulo, Brazil, conducted between 2015-2016. Prevalences and prevalence ratios were estimated using Poisson regression; food consumption means were estimated using linear regression. Results: We analyzed data from 855 adults, 61% of whom were overweight. The prevalence of overweight was significantly higher among males, those aged 30 or older, with 8 to 11 years of education, and those who reported eating more than they should. The body mass index was significantly associated with hypertension, diabetes, high cholesterol, waist-to-height ratio, taking weight-loss medications, overeating, and the habit of checking labels. Overweight adults reported eating meat with visible fat and drinking soda more frequently than those not overweight. Overweight adults reported eating significantly more grams of food daily and had a higher intake of energy, total fat, saturated fats, trans fats, carbohydrates, protein, insoluble dietary fiber, sodium, and potassium. Their diets had a higher glycemic load when compared to participants who were not overweight. Conclusion: Adults with and without overweight differed in their sociodemographic, dietary, and clinical characteristics. Diet quality was similar between both groups, suggesting a need for improving dietary habits in this population regardless of body weight.

RESUMO Objetivo: Estimar a prevalência de excesso de peso entre adultos brasileiros, de 20 a 59 anos, segundo características sociodemográficas, de comportamentos relacionados à saúde e quanto ao consumo alimentar. Métodos: Estudo transversal, de pesquisa de base populacional, em uma cidade metropolitana de São Paulo - Brasil, conduzida entre os anos de 2015 e 2016. Foram estimadas as prevalências e as razões de prevalência por meio da regressão de Poisson, e as médias de consumo alimentar pelo uso da regressão linear. Resultados: Foram analisados dados referentes à 855 adultos, 61% destes apresentavam sobrepeso. A prevalência de excesso de peso foi significativamente maior entre: homens, com 30 anos ou mais, pessoas que possuíam entre 8 e 11 anos de estudo e entre aqueles que acreditavam comer mais do que deveriam. O índice de massa corporal foi significativamente associado à hipertensão, diabetes, colesterol alto, razão cintura-estatura, uso de medicamentos, comer mais do que deveria e o hábito de checar rótulos. Adultos com excesso de peso ingeriam carnes com gordura e refrigerantes em maior frequência quando comparados à adultos com peso saudável. Adultos com excesso de peso consumiam, significativamente, mais gramas de alimentos por dia e apresentaram maior ingestão de calorias, gorduras totais, saturadas e trans, carboidratos, proteína, fibras insolúveis, sódio e potássio. A dieta deles continha uma maior carga glicêmica quando comparada àqueles com peso saudável. Conclusão: Adultos com e sem excesso de peso, diferiram quanto às características sociodemográficas, dietéticas e clínicas. A qualidade da dieta foi similar em ambos os grupos, o que sugere a necessidade de melhora dos hábitos alimentares da população, independentemente do peso corporal.

Impact of the COVID-19 pandemic isolation concerning physical activity and cardiovascular health / Impacto do isolamento da pandemia de COVID-19 na atividade física e na saúde cardiovascular

Background: Regular physical activity (PA) is essential for health maintenance and disease prevention. COV-ID-19 and its social isolation affected patients with cardiovascular (CV) disease. This is a scoping review aiming to map, analyze, and summarize the impacts caused by the isolation of the COVID-19 pandemic concerning PA and CV health in adults. Methods: The review was based on PRISMA-ScR. PubMed, PubMed Central, BVS/BIREME, Scopus, Web of Science, CINAHL, Brazilian Digital Library of Theses and Dissertations, and SciELO databases were selected to search. Two search phases were performed: May 2021 and March 2022. English-language full-text papers were included. Initially, the titles and abstracts of the retrieved documents were read and screened based on the research question. A third reviewer resolved disagreement through consensus meetings. An assessment form was adapted for data extraction. The study was registered in the Open Science Framework platform under the DOI https://doi.org/10.17605/OSF.IO/AH6P8. Results: 11 papers were included and demonstrated that regular PA could be challenging in social isolation environments. Most participants were moderately active and performed low-intensity PA. Confinement led to the limitation of everyday activities, nutritional disorders, and reduced PA, contributing to weight gain. Quarantine was associated with stress and depression, leading to an unhealthy diet (AU).

Introdução: A prática regular de atividade física (AF) é essencial para a manutenção da saúde e prevenção de doenças. A COVID-19 e seu isolamento social afetaram pacientes com doenças cardiovasculares (CV) na prática dessas atividades. Desta forma, realizou-se uma revisão de escopo com o objetivo de mapear, analisar e sintetizar os impactos causados pelo isolamento da pandemia de COVID-19 na realização de AF e na saúde CV em adultos. Métodos: A revisão foi baseada no PRISMA-ScR. Foram selecionadas para a pesquisa a PubMed, PubMed Central, BVS/BIREME, Scopus, Web of Science, CINAHL, Biblioteca Digital Brasileira de Teses e Dissertações e bases de dados SciELO. Duas fases de busca foram realizadas: maio de 2021 e março de 2022. Foram incluídos artigos que possuíam texto completo em inglês. Inicialmente, os títulos e resumos dos documentos recuperados foram lidos e triados com base na questão de pesquisa. Um terceiro revisor foi utilizado para avaliar os desacordos por meio de reuniões de consenso. Um formulário de avaliação foi adaptado para extração de dados. O estudo foi registrado na plataforma Open Science Framework sob o DOI https://doi.org/10.17605/OSF.IO/AH6P8. Resultados: 11 artigos foram incluídos neste estudo e demonstraram que a AF regular pode ser desafiadora em ambientes de isolamento social. A maioria dos participantes era moderadamente ativa e praticava AF de baixa intensidade. O confinamento levou à limitação das atividades cotidianas, distúrbios nutricionais e diminuição da AF, contribuindo para o ganho de peso. A quarentena foi associada ao estresse e à depressão, levando a uma dieta pouco saudável. Possíveis soluções apontam para a realização de AF domiciliar, considerando a saúde basal e o estado CV. Conclusão: A era pós-COVID-19 e suas consequências apontam para a necessidade de planejamento de estratégias que aumentem e mantenham a AF domiciliar como medida protetora para a população em geral, considerando saúde CV, recursos e espaço domiciliar (AU).

Autocuidado e risco cardiometabólico em pessoas com hipertensão arterial em seguimento na atenção primária / Self-care and cardiometabolic risk in people with high arterial pressure following primary care

O objetivo deste estudo foi avaliar o autocuidado e o risco cardiometabólico em pessoas com hipertensão arterial (HA) em seguimento clínico regular na atenção primária à saúde. Estudo analítico e transversal conduzido entre 86 pessoas com HA no interior do Estado de São Paulo, por meio da aplicação das versões brasileiras da Escala de Autocuidado de Hipertensão e do Escore de Risco Cardiometabólico de Framingham. Os participantes demonstraram níveis satisfatórios de confiança (71,3(14,7)), níveis insatisfatórios para manutenção (59,2(14,5)) e manejo (55,1(20,3)) do autocuidado na Escala de Autocuidado e 34,6% de chance de desenvolver infarto agudo do miocárdio nos próximos dez anos. Os indivíduos com menor idade apresentaram níveis de confiança satisfatórios em relação ao manejo do autocuidado, e observou-se maior risco cardiometabólico entre pessoas com diabetes e angina. Os indivíduos possuem confiança, mas demonstram inadequados manejo e manutenção do comportamento de autocuidado, e quanto menor a idade, melhor o manejo do autocuidado.

This study aimed evaluate self-care and cardiometabolic risk in people with arterial hypertension undergoing regular clinical follow-up in primary health care. Exploratory study conducted among people with hypertension in the interior of the State of São Paulo, through the application of the Brazilian versions of the Hypertension Self-Care Scale and the Framingham Cardiometabolic Risk Score. Participants demonstrated satisfactory levels of confidence (71.3 (14.7)) and unsatisfactory levels for Self-Care maintenance (59.2 (14.5)) and management (55.1 (20.3)), domains of the Scale Self-care; and a 34.6% chance of developing acute myocardial infarction in the next 10 years. The youngest individuals had satisfactory levels of confidence in relation to the management of self-care; and higher cardiometabolic risk was observed among people with diabetes and angina. No significant associations were found between the other variables. Individuals have confidence, but demonstrate inadequate Self-Care management and maintenance and the younger the better self-care management.

Linguistic validation of the Diabetic foot ulcer scale short form (DFS-SF): a methodological approach

Objective: to presenting the linguistic validation of the Diabetic Foot Ulcer Scale Short-Form (DFS-SF) among pa-tients with ulcer diabetic foot (DFU) to Brazilian Portuguese and evaluate its content, practicability and acceptability. Methods and casuistry: a cross-sectional, methodological research, was conducted among 30 outpatients in follow--up for DF, assessed regarding QoL, sociodemographic and clinical data. International recommendations provided by the Mapi Research Trust on adaptation procedures were followed: the stages of Forward translation, Backward trans-lation and the Cognitive interview were carried out. The Content Validity Index was calculated and a pre-test were gathered to produce a pre-final version. Practicability and acceptability were also assessed. Results: the semantic, idiomatic, cultural and conceptual equivalences between the linguistic validated and the original version were obtai-ned. The DFS-SF was practical, well accepted and easy to understand. Conclusion: the linguistic validation process of the Brazilian version of the DFS-SF has been completed in accordance with internationally recommended standards. The instrument was easy to apply, to understand and presented short time for administration. (AU)

Objetivo: apresentar a validação linguística do DFS-SF entre pacientes com DFU para o português do Brasil e avaliar seu conteúdo, praticabilidade e aceitabilidade. Metodologia e casuística: foi realizada uma pesquisa metodológica de corte transversal entre 30 pacientes ambulatoriais em acompanhamento para DFU. Seguiram-se recomendações internacionais fornecidas pelo Mapi Research Trust sobre procedimentos de adaptação: tradução direta, tradução reversa e entrevista cognitiva. O Índice de Validade de Conteúdo foi calculado e um pré-teste foi coletado para produzir uma versão pré-final. A praticidade e aceitabilidade também foram avaliadas. Resultados:foram obtidas as equivalências semântica, idiomática, cultural e conceitual entre a versão linguística validada e a versão original. O DFS-SF foi prático, bem aceito e fácil de entender. Conclusão: O DFS-SF da versão brasileira foi concluído de acordo com os padrões internacionalmente recomendados, foi fácil de aplicar, entender e apresentou pouco tempo para administração. (AU)

Effect of implementation intention on walking in people with diabetes: an experimental approach

ABSTRACT OBJECTIVE To evaluate the effect of implementation intentions as an intervention strategy to promote walking in adults with type 2 diabetes mellitus (T2DM). METHODS We conducted a controlled and randomized trial, with 12 months of follow-up, involving 65 people with T2DM recruited from primary health care units and allocated them in the control group (CG, n = 32) and intervention group (IG, n = 33). The IG received the implementation intention strategy to promote walking and the CG remained in follow-up for conventional treatment in primary health care. The researchers were blinded by anthropometric measurements and the filling of the instruments. RESULTS After twelve months of follow up, the IG presented a statistically significant increase in the leisure time physical activity when compared with the CG (p = 0.0413) and showed a significant decrease in waist circumference (p = 0.0061). No significant difference was observed regarding body mass index and glycated hemoglobin among groups. CONCLUSIONS Implementation intention was effective in promoting walking and improving clinical indicators in adults with T2DM.

Quality of life of coronary artery disease patients after the implementation of planning strategies for medication adherence.

OBJECTIVE: to compare the general and specific health-related quality of life (HRQoL) between the Intervention (IG) and Control (CG) groups of coronary artery disease patients after the implementation of Action Planning and Coping Planning strategies for medication adherence and to verify the relationship between adherence and HRQoL. METHOD: this was a controlled and randomized study. RESULTS: the sample (n=115) was randomized into two groups, IG (n=59) and CG (n=56). Measures of medication adherence and general and specific HRQoL were obtained in the baseline and after two months of monitoring. CONCLUSION: the findings showed that the combination of intervention strategies - Action Planning and Coping Planning for medication adherence did not affect the HRQoL of coronary artery disease patients in outpatient monitoring.

Implementation Intentions on the Effect of Salt Intake among Hypertensive Women: A Pilot Study.

This experimental study was aimed at assessing the potential effect of a theory-driven intervention-implementation intentions-on reducing salt intake among hypertensive Brazilian women. Ninety-eight participants were randomly assigned to participate in an implementation intentions intervention aimed at promoting lower salt intake through decreased addition of salt and salty spices to meals (intervention group, n = 49; group, n = 49). Endpoints were assessed at baseline and at the 2-month follow-up. Primary endpoints were a self-reporting measure of salt intake given by salt addition to meals (discretionary salt + salty spices = total added salt) and the 24 h urinary-sodium excretion. Secondary endpoints included intention, self-efficacy, and habit related to adding salt to meals. Patients in the intervention group showed a significant reduction in salt intake as assessed by 24 h urinary-sodium excretion. A significant reduction in the measure of habit was observed for both groups. No differences were observed for intention and self-efficacy. The results of this pilot study suggest the efficacy of planning strategies to help hypertensive women reduce their salt intake.

Beliefs related to adherence to oral antidiabetic treatment according to the Theory of Planned Behavior.

OBJECTIVE: to identify salient behavioral, normative, control and self-efficacy beliefs related to the behavior of adherence to oral antidiabetic agents, using the Theory of Planned Behavior. METHOD: cross-sectional, exploratory study with 17 diabetic patients in chronic use of oral antidiabetic medication and in outpatient follow-up. Individual interviews were recorded, transcribed and content-analyzed using pre-established categories. RESULTS: behavioral beliefs concerning advantages and disadvantages of adhering to medication emerged, such as the possibility of avoiding complications from diabetes, preventing or delaying the use of insulin, and a perception of side effects. The children of patients and physicians are seen as important social references who influence medication adherence. The factors that facilitate adherence include access to free-of-cost medication and taking medications associated with temporal markers. On the other hand, a complex therapeutic regimen was considered a factor that hinders adherence. Understanding how to use medication and forgetfulness impact the perception of patients regarding their ability to adhere to oral antidiabetic agents. CONCLUSION: medication adherence is a complex behavior permeated by behavioral, normative, control and self-efficacy beliefs that should be taken into account when assessing determinants of behavior.