Prevalence of the practice of physical activity and its associated factors in adult Colombian pregnant women / Prevalencia y factores asociados con la práctica de actividad física en mujeres gestantes adultas en Colombia

Introduction: Physical activity during pregnancy can be useful in the prevention of gestational complications. Objective: To estimate the prevalence of physical activity in adult Colombian pregnant women and its associated factors. Materials and methods: A secondary analysis of data from the 2015 National Nutrition Survey in Colombia was conducted. The total sample included 906 pregnant women. Leisure-time, commuting, and global physical activity were measured with the long version of the International Physical Activity Questionnaire. Factors associated with PA were evaluated through negative binomial regression models. Results: The prevalence of physical activity in pregnant women was 12.57% (95% CI=8.41-18.38), 28.66% (95% CI=23.29-34.70), and 36.33% (95% CI=30.92-42.11) in the leisuretime, commuting and global domains, respectively. Factors associated with leisure-time physical activity were living in Bogotá (prevalence ratio, PR=2.41; 95% CI=1.16-4.99), being in the third gestational trimester (PR=2.13; 95% CI=1.17-3.87), obtaining access to physical activity programs (PR=1.75; 95% CI=1.07-2.87), having a high school education (PR=0.51; 95% CI=0.29-0.91), and being in the second (PR=0.45; 95% CI=0.24-0.81), third and fourth quartiles of wealth (PR=0.43; 95% CI=0.23-0.80). Factors associated with physical activity while commuting were having at least one child (PR=1.60; 95% CI=1.14-2.24), living in Bogotá (PR=1.84; 95% CI=1.23-2.73), living with a partner (PR=0.66; 95% CI=0.49-0.89), and completing between one and four prenatal care sessions (PR=0.53; 95% CI=0.37-0.76). Conclusions: The prevalence of physical activity in pregnant Colombian women is worryingly low. Programs and projects aimed at promoting physical activity during pregnancy are needed.

Introducción. La actividad física durante el embarazo puede ser útil para la prevención de complicaciones gestacionales. Objetivo. Estimar la prevalencia de actividad física en mujeres gestantes adultas en Colombia y evaluar los factores asociados con su práctica. Materiales y métodos. Se hizo un análisis secundario de la información recolectada en la Encuesta Nacional de Situación Nutricional en Colombia del 2015. La muestra incluyó 906 mujeres gestantes. La actividad física en los dominios de tiempo libre, transporte y global se evaluó con la versión larga del International Physical Activity Questionnaire. Los factores asociados se evaluaron mediante modelos de regresión binomial negativa. Resultados. La prevalencia del cumplimiento de las recomendaciones de actividad física en las participantes fue de 12,57 % (IC95% 8,41-18,38), 28,66 % (IC95% 23,29-34,70) y 36,33 % (IC95% 30,92-42,11) en los dominios de tiempo libre, transporte y global, respectivamente. Los factores asociados con el dominio de tiempo libre fueron: residir en Bogotá (razón de prevalencia, RP=2,41; IC95% 1,16-4,99), encontrarse en el tercer trimestre de la gestación (RP=2,13; IC95% 1,17-3,87), disponer de programas de actividad física dirigida (RP=1,75; IC95% 1,07-2,87), nivel educativo de secundaria (RP=0,51; IC95% 0,29-0,91), y pertenecer a los cuartiles de riqueza dos (RP=0,45; IC95% 0,24-0,81), tres y cuatro (RP=0,43; IC95% 0,23-0,80). Los factores asociados con el transporte fueron: tener, por lo menos, un hijo (RP=1,60; IC95% 1,14-2,24), residir en Bogotá (RP=1,84; IC95% 1,23-2,73), convivir con compañero sentimental (RP=0,66: IC95% 0,49-0,89) y haber asistido a entre uno y cuatro controles prenatales (RP=0,53; IC95% 0,37-0,76). Conclusiones: La prevalencia de la actividad física en mujeres gestantes colombianas es preocupantemente baja. Se requiere la implementación de programas y proyectos orientados a la promoción de la actividad física durante el embarazo.

Prevalencia y factores asociados con la práctica de actividad física en mujeres gestantes adultas en Colombia / Prevalence of the practice of physical activity and its associated factors in adult Colombian pregnant women

Introducción. La actividad física durante el embarazo puede ser útil para la prevención de complicaciones gestacionales. Objetivo. Estimar la prevalencia de actividad física en mujeres gestantes adultas en Colombia y evaluar los factores asociados con su práctica. Materiales y métodos. Se hizo un análisis secundario de la información recolectada en la Encuesta Nacional de Situación Nutricional en Colombia del 2015. La muestra incluyó 906 mujeres gestantes. La actividad física en los dominios de tiempo libre, transporte y global se evaluó con la versión larga del International Physical Activity Questionnaire. Los factores asociados se evaluaron mediante modelos de regresión binomial negativa. Resultados. La prevalencia del cumplimiento de las recomendaciones de actividad física en las participantes fue de 12,57 % (IC95% 8,41-18,38), 28,66 % (IC95% 23,29-34,70) y 36,33 % (IC95% 30,92-42,11) en los dominios de tiempo libre, transporte y global, respectivamente. Los factores asociados con el dominio de tiempo libre fueron: residir en Bogotá (razón de prevalencia, RP=2,41; IC95% 1,16-4,99), encontrarse en el tercer trimestre de la gestación (RP=2,13; IC95% 1,17-3,87), disponer de programas de actividad física dirigida (RP=1,75; IC95% 1,07-2,87), nivel educativo de secundaria (RP=0,51; IC95% 0,29-0,91), y pertenecer a los cuartiles de riqueza dos (RP=0,45; IC95% 0,24-0,81), tres y cuatro (RP=0,43; IC95% 0,23-0,80). Los factores asociados con el transporte fueron: tener, por lo menos, un hijo (RP=1,60; IC95% 1,14-2,24), residir en Bogotá (RP=1,84; IC95% 1,23-2,73), convivir con compañero sentimental (RP=0,66: IC95% 0,49-0,89) y haber asistido a entre uno y cuatro controles prenatales (RP=0,53; IC95% 0,37-0,76). Conclusiones: La prevalencia de la actividad física en mujeres gestantes colombianas es preocupantemente baja. Se requiere la implementación de programas y proyectos orientados a la promoción de la actividad física durante el embarazo.

Introduction: Physical activity during pregnancy can be useful in the prevention of gestational complications. Objective: To estimate the prevalence of physical activity in adult Colombian pregnant women and its associated factors. Materials and methods: A secondary analysis of data from the 2015 National Nutrition Survey in Colombia was conducted. The total sample included 906 pregnant women. Leisure-time, commuting, and global physical activity were measured with the long version of the International Physical Activity Questionnaire. Factors associated with PA were evaluated through negative binomial regression models. Results: The prevalence of physical activity in pregnant women was 12.57% (95% CI=8.41- 18.38), 28.66% (95% CI=23.29-34.70), and 36.33% (95% CI=30.92-42.11) in the leisuretime, commuting and global domains, respectively. Factors associated with leisure-time physical activity were living in Bogotá (prevalence ratio, PR=2.41; 95% CI=1.16-4.99), being in the third gestational trimester (PR=2.13; 95% CI=1.17-3.87), obtaining access to physical activity programs (PR=1.75; 95% CI=1.07-2.87), having a high school education (PR=0.51; 95% CI=0.29-0.91), and being in the second (PR=0.45; 95% CI=0.24-0.81), third and fourth quartiles of wealth (PR=0.43; 95% CI=0.23-0.80). Factors associated with physical activity while commuting were having at least one child (PR=1.60; 95% CI=1.14-2.24), living in Bogotá (PR=1.84; 95% CI=1.23-2.73), living with a partner (PR=0.66; 95% CI=0.49-0.89), and completing between one and four prenatal care sessions (PR=0.53; 95% CI=0.37-0.76). Conclusions: The prevalence of physical activity in pregnant Colombian women is worryingly low. Programs and projects aimed at promoting physical activity during pregnancy are needed.

Building healthy schools through technology-enabled citizen science: The case of the our voice participatory action model in schools from Bogotá, Colombia.

The physical and social environment of school settings are important for health promotion among children and adolescents. Efforts to create supportive environments at the school level can benefit from including community engagement and empowerment processes to advocate for health promotion. The Our Voice model presents a unique opportunity for Latin American students to improve their school environments. The objective of this study was to engage and empower students (9-18 years) from five schools in Bogotá, Colombia to use the Our Voice model to assess and seek to improve their local school environments. This study employed Our Voice's 'citizen science by the people' method using a mobile application for data collection. The Our Voice initiative included the following four phases: (1) Design, planning and recruitment; (2) Data collection; (3) Community meetings for thematic analysis, priority setting and initial design of feasible solutions; and (4) Community meetings with decision-makers to advocate for changes. The citizen scientists identified and advocated for safer physical activity-supportive environments and healthier food and drinks availability. This study allowed children and adolescent citizen scientists to make their voices heard by policymakers and empowered them as agents of change in the process of building healthier schools.

Urban Transformations and Health: Methods for TrUST-a Natural Experiment Evaluating the Impacts of a Mass Transit Cable Car in Bogotá, Colombia.

Background: Cable cars provide urban mobility benefits for vulnerable populations. However, no evaluation has assessed cable cars' impact from a health perspective. TransMiCable in Bogotá, Colombia, provides a unique opportunity to (1) assess the effects of its implementation on the environmental and social determinants of health (microenvironment pollution, transport accessibility, physical environment, employment, social capital, and leisure time), physical activity, and health outcomes (health-related quality of life, respiratory diseases, and homicides); and (2) use citizen science methods to identify, prioritize, and communicate the most salient negative and positive features impacting health and quality of life in TransMiCable's area, as well as facilitate a consensus and advocacy-building change process among community members, policymakers, and academic researchers. Methods: TrUST (In Spanish: Transformaciones Urbanas y Salud: el caso de TransMiCable en Bogotá) is a quasi-experimental study using a mixed-methods approach. The intervention group includes adults from Ciudad Bolívar, the area of influence of TransMiCable. The control group includes adults from San Cristóbal, an area of future expansion for TransMiCable. A conceptual framework was developed through group-model building. Outcomes related to environmental and social determinants of health as well as health outcomes are assessed using questionnaires (health outcomes, physical activity, and perceptions), secondary data (crime and respiratory outcomes) use of portable devices (air pollution exposure and accelerometry), mobility tracking apps (for transport trajectories), and direct observation (parks). The Stanford Healthy Neighborhood Discovery Tool is being used to capture residents' perceptions of their physical and social environments as part of the citizen science component of the investigation. Discussion: TrUST is innovative in its use of a mixed-methods, and interdisciplinary research approach, and in its systematic engagement of citizens and policymakers throughout the design and evaluation process. This study will help to understand better how to maximize health benefits and minimize unintended negative consequences of TransMiCable.

Active streets for children: The case of the Bogotá Ciclovía.

INTRODUCTION: The Ciclovía is a worldwide program in which streets are temporarily closed to motorized transport to create a space for recreation and outdoor play among children and adults. The aim of this study was to assess the associations between physical activity (PA), sedentary time (SED), body mass index and Ciclovía participation among children aged 9 to 13 years. METHODS: All students in the 4th and 5th grades from the selected schools were invited to participate in the study. The study included 923 children. PA and SED were measured using waist-worn accelerometers, and height and weight were measured using standardized procedures. Ciclovía participation was self-reported. The analyses included multilevel linear, generalized mixed and generalized additive models. RESULTS: The mean age of the sample was 10.1±0.7 years, and 49.5% were boys. In the last year, 46% of the children participated in the Ciclovía, and 34% reported participating frequently (at least once per month). No differences were found in the mean minutes of moderate-to-vigorous PA on weekdays between frequent Ciclovía users and sporadic and non-Ciclovía users (72 vs 69; p = 0.09). In contrast, frequent Ciclovía users had higher moderate-to-vigorous PA on Sundays than sporadic and non-Ciclovía users (65.6 vs 59.2; p = 0.01), specifically between the hours of 12:00 and 16:00. In addition, frequent Ciclovía users did not differ from the sporadic and non-Ciclovía users in SED (515.3 vs 521.3; p = 0.19). Frequent Ciclovía users had lower SED on Sundays than the sporadic and non-Ciclovía users (437.7 vs 456.5; p = 0.005). Additionally, frequent Ciclovía users were more likely to be overweight (28.3% vs 20.4% p = 0.01). We did not find differences in participation by sex, and low-to-middle income children were more likely to participate. CONCLUSIONS: The Ciclovías offer an innovative, inclusive recreational space and consequently provide opportunities to increase moderate-to-vigorous PA and reduce SED among children.

Comparison of Health Examination Survey Methods in Brazil, Chile, Colombia, Mexico, England, Scotland, and the United States.

Comparability of population surveys across countries is key to appraising trends in population health. Achieving this requires deep understanding of the methods used in these surveys to examine the extent to which the measurements are comparable. In this study, we obtained detailed protocols of 8 nationally representative surveys from 2007-2013 from Brazil, Chile, Colombia, Mexico, the United Kingdom (England and Scotland), and the United States-countries that that differ in economic and inequity indicators. Data were collected on sampling frame, sample selection procedures, recruitment, data collection methods, content of interview and examination modules, and measurement protocols. We also assessed their adherence to the World Health Organization's "STEPwise Approach to Surveillance" framework for population health surveys. The surveys, which included half a million participants, were highly comparable on sampling methodology, survey questions, and anthropometric measurements. Heterogeneity was found for physical activity questionnaires and biological samples collection. The common age range included by the surveys was adults aged 18-64 years. The methods used in these surveys were similar enough to enable comparative analyses of the data across the 7 countries. This comparability is crucial in assessing and comparing national and subgroup population health, and to assisting the transfer of research and policy knowledge across countries.

Reclaiming the streets for people: Insights from Ciclovías Recreativas in Latin America.

The Ciclovías comprise worldwide programs in which streets are closed to motor-vehicles and open to individuals for leisure activities. Currently, 93% of the regular programs are in Latin American countries (LAC). The aims of this study were to describe the characteristics of regular Ciclovías in 7 LAC and to analyze the factors that influence the sustainability and scaling-up of five case studies. We conducted a survey of 67 Ciclovías in 2014-2015. In addition, we conducted semi-structured interviews with current and former program coordinators and reviewed policy documents from Ciclovías in 5 LAC. The greatest expansion of Ciclovías has occurred since 2000. The number of participants per event ranged from 40 to 1,500,000 (mean 41,399±193,330; median 1600), and the length ranged from 1 to 113.6km (mean 9.1±16.4; median 3). Ciclovía routes connect low-middle and high income neighborhoods (89.3%), and include the participation of minority populations (61.2%). The main complementary activity offered was physical activity (PA) classes (94.0%), and 80.0% of the programs included strategies to promote biking. All five case studies met definitions for sustainability and scaling-up. All programs shared some level of government support, alliances, community appropriation, champions, compatibility with the mission of the host organization, organizational capacity, flexibility, perceived benefits, and funding stability. However, they differed in operational conditions, political favorability, sources of funding, and number of alliances. The Ciclovías of LAC showed heterogeneity within their design and sustainability factors. Both their heterogeneity and flexibility to adjust to changes make them promising examples of socially inclusive programs to promote PA.