Effectiveness of the 5A Counseling Model-Based Interventions on Physical Activity Indicators in Adults: A Systematic Review.

BACKGROUND: To identify and appraise the effectiveness of the 5A-counseling-model-based interventions on indicators of physical activity in adults. METHODS: A systematic review was conducted from systematic searches in Embase, Lilacs, Pubmed, Scielo, Scopus, Sportdiscus and Web of Science, involving studies published from its inception until May 2022. To avoid potential losses, searches also were made in Google Scholar and in reference lists. The assessment of studies, data extraction, and synthesis were carried out independently by two researchers. RESULTS: Four studies composed the synthesis, which involved people with an average age between 40 and 55 years, most of the samples being women. It was observed that counseling was carried out in conjunction with other strategies, such as drawing up an action plan, sending text messages, and offering educational material. Only one study showed a statistically significant difference between the intervention and control groups in the "daily number of steps" indicator. CONCLUSIONS: Based on available studies, 5A-counseling-model-based interventions did not reflect significant findings in relation to physical activity. However, given the potential of the model, future studies are recommended with a better description of the strategies, as well as a more robust methodology, to strengthen the evidence.

Atuação da Educação Física em um hospital universitário da rede pública: uso do método AMPARO / Proceeding of Physical Education in the public university hospital: use of the AMPARO method

A atuação do Profissional de Educação Física (PEF) na "Atenção intra-hospitalar" ainda é recente, não havendo evidências e informações padronizadas na assistência aos pacientes. Objetivou-se apresentar e promover o método "AMPARO" no Programa de Recondicionamento Físico (PRF) do Hospital de Clínicas das Universidade Federal do Triângulo Mineiro. AMPARO significa Avaliação Multidimensional, Planejamento, Atuação, Reavaliação e Orientação de atividades e exercícios físicos, visando aprimoramento das capacidades físicas relacionadas à saúde. Mais de 1600 atendimentos (avaliações e exercícios físicos) foram realizados. Completaram as 36 sessões do PRF, 31 pacientes, média de idade de 46,12 ± 13,58, sendo 25 (80,6%) do sexo feminino. Houve melhora na aptidão cardiovascular (p < 0,001), aumento da massa magra (p = 0,025) e aumento do tempo de atividade física moderada (p = 0,030). Conclui-se que o "PRF-Método AMPARO" vem se mostrando eficiente na assistência integral à saúde de pacientes atendidos por PEF em um hospital universitário da rede pública

The performance of the Physical Education Professional (PEP) in "Intra-hospital care" is still recent, with no evidence and standardized information on patient care. The objective was to present and promote the "AMPARO-method" in the Physical Reconditioning Program (PRP) of the Clinical Hospital of the Federal University of Triângulo Mineiro. AMPARO means Multidimensional As-sessment, Planning, Performance, Reassessment, and Orientation of activities and physical exercises, aiming at improving physical capacities related to health. More than 1600 consultations (assessments and physical exercises) were carried out. Completed the 36 PRP sessions, 31 patients, average age 46.12 ± 13.58, 25 (80.6%) female. There was an improvement in cardiovascular fitness (p < 0.001), an increase in lean mass (p = 0.025), and an increase in moderate physical activity time (p = 0.030). It is concluded that the "PRP-AMPARO Method" has been proven to be efficient in the comprehensive health care of patients assisted by PE professionals in the public university hospital

Evaluation of the effect of physical exercise interventions in Primary Health Care in Brazil on cardiometabolic risk factors: a systematic review / Avaliação do efeito de intervenções de exercícios físicos na Atenção Primária à Saúde no Brasil sobre fatores de risco cardiometabólicos: uma revisão sistemática

Abstract The objective was to systematically search and synthesize the evidence available in the literature about the effect of physical exercise interventions Primary Health Care (PHC), carried out in Brazil, on cardiometabolic risk factors. The search was performed in the PubMed, Virtual Health Library and Web of Science databases. The inclusion criteria were: studies with physical activity (PA) interventions or exercise in PHC; carried out in Brazil; population aged >18 years; at least one cardiometabolic risk factor assessed pre and post-intervention. The "Health Sciences Descriptors" were used to define the search descriptors: "physical activity" OR "exercise" OR "motor activity" AND "primary health care" OR "health centers" OR "primary care" AND "Brazil". The selection phases were performed by pairs of blinded researchers and the conflicts were decided by a third evaluator. Jadad scale was used to assess the methodological quality of the articles included. In total, 1,817 articles were found and 26 duplicates excluded, leaving 1,791 for reading of titles. The abstracts of 105 articles were read, and 53 articles were read in full. Finally, 06 articles were considered eligible and included in the review. The cardiometabolic risk factors evaluated in the included studies were body mass index (4 studies), waist-hip ratio (1 study), fat percentage (1 study), blood pressure (2 studies), lipid profile (1 study), inflammatory profile (1 study), and aerobic capacity (3 studies). It is concluded that there is insufficient evidence in the literature about the effect of exercise interventions in PHC with a focus on cardiometabolic risk factors.

Resumo O objetivo foi buscar sistematicamente e sintetizar as evidências disponíveis na literatura acerca do efeito de intervenções com exercício físico na Atenção Primária à Saúde (APS), realizadas no Brasil, sobre os fatores de risco cardiometabólicos. A busca sistemática foi realizada nas bases de dados PubMed, Biblioteca Virtual em Saúde e Web of Science. Foram incluídos estudos com intervenção de AF ou exercício na APS; realizadas no Brasil; com população >18 anos de idade; pelo menos um fator de risco cardiometabólico avaliado pré e pós intervenção. Utilizou-se o Descritores em Ciências da Saúde para definir os descritores de busca: "physical activity" OR "exercise" OR "motor activity" AND "primary health care" OR "health centers" OR "primary care" AND "Brazil". As fases de seleção foram realizadas por pares e com cegamento e os conflitos decididos por um terceiro avaliador. Utilizou-se a escala de Jadad para avaliar a qualidade metodológica dos artigos incluídos. Foram encontrados 1.817 artigos e excluídas 26 duplicatas, restando 1.791 para leitura dos títulos. Foram lidos 105 resumos e 53 artigos na íntegra. Por fim, 06 artigos foram considerados elegíveis e incluídos na revisão. Os fatores de risco cardiometabólicos avaliados nos estudos incluídos foram índice de massa corporal (4 estudos), razão cintura quadril (1 estudo), percentual de gordura (1 estudo), pressão arterial (2 estudos), perfil lipídico (1 estudo), perfil inflamatório (1 estudo) e capacidade aeróbica (3 estudos). Conclui-se que não há evidências suficientes na literatura sobre o efeito das intervenções de exercícios na APS com foco nos fatores de risco cardiometabólicos.

Barriers and facilitators of domain-specific physical activity: a systematic review of reviews.

BACKGROUND: Knowing what facilitates and hinders physical activity behaviour across domains (leisure, travel, work or education, and household) is central for the development of actions for more active lifestyles. Thus, the aim of this systematic review of reviews was to summarize the evidence on barriers and facilitators of domain-specific physical activity. METHODS: We included systematic reviews with or without meta-analysis that investigated the association between modifiable barriers and facilitators and levels of domain-specific physical activity. Reviews published until September 2020 were retrieved from PubMed, ISI Web of Science, Scopus, Regional Library of Medicine (BIREME), and PsycNET, and from the reference list of selected articles. Each review was screened by two independent reviewers for eligibility. Data extracted from selected papers included methodological aspects (number of primary studies, study designs, and age groups); physical activity domains and barriers and facilitators investigated; and direction of association. For each pair of barrier/facilitator and domain-specific physical activity, we recorded the number of positive, negative, and null associations reported across reviews. Quality assessment of each systematic review was performed using the AMSTAR-2 tool. RESULTS: Forty-four systematic reviews were selected. The evidence base was largest for leisure-time followed by travel-related physical activity. A very small number of reviews included physical activity in work, educational and domestic settings. Across all physical activity domains, factors related to the built environment were more abundant in the reviews than intra and interpersonal factors. Very consistent positive associations were observed between a range of intrapersonal factors and leisure-time physical activity, as well as moderately consistent evidence of positive association for general social support and support from family members. Evidence of moderate consistency was found for the positive association between transport-related physical activity and positive beliefs about consequences, walkability, and existence of facilities that support active travel. Evidence on barriers and facilitators for physical activity at work, educational, and domestic settings was limited in volume and consistency. CONCLUSIONS: Efforts and resources are required to diversify and strength the evidence base on barriers and facilitators of domain-specific physical activity, as it is still limited and biased towards the leisure domain and built environment factors. TRIAL REGISTRATION: PROSPERO CRD42020209710.

Barreiras e facilitadores para a prática de atividade física em diferentes domínios no Brasil: uma revisão sistemática / Barriers and facilitators for physical activity domains in Brazil: a systematic review

Resumo O objetivo foi revisar sistematicamente as evidências científicas sobre as barreiras e os facilitadores para a prática de atividade física (AF) na população brasileira, considerando os diferentes domínios (lazer, deslocamento, trabalho/estudo e tarefas domésticas). A busca foi conduzida nas bases de dados MEDLINE/PubMed, ISI Web of Science, Scopus, BIREME/LILACS e APA PsycNET, considerando o período de 2010 a 2020. Posteriormente, foi incluída a busca na Revista Brasileira de Atividade Física e Saúde. O processo de seleção consistiu na leitura de títulos e resumos, seguida de textos na íntegra. A avaliação foi realizada por pares e, mediante discrepância, um terceiro revisor era consultado. O domínio do lazer e as barreiras e os facilitadores ambientais foram os mais investigados nos 78 artigos incluídos. Houve consistência nas associações positivas de seis diferentes facilitadores pessoais e sociais para o lazer e um fator ambiental para o deslocamento. Encontrou-se um número reduzido de investigações sobre os domínios de trabalho/estudo e tarefas domésticas, sendo importante o incentivo a futuras investigações acerca das barreiras e dos facilitadores pessoais e sociais relacionados à AF de deslocamento.

Abstract This study aimed to systematically review scientific evidence on the barriers and facilitators of physical activity (PA) among the Brazilian population, considering different domains (leisure, travel, work/study, and household). The search was conducted in the MEDLINE/PubMed, ISI Web of Science, SCOPUS, BIREME/LILACS, and APA PsycNET databases and was limited to papers published between 2010 and 2020. A manual search of the Brazilian Journal of Physical Activity & Health was also conducted. The selection process consisted of screening titles and abstracts, followed by the analysis of full texts. Each paper was assessed by two independent reviewers, and when discrepancies arose, a third reviewer was consulted. Leisure, environmental barriers and facilitators were the most investigated domains in the 78 included studies. There was consistency in the positive associations between six different intrapersonal and social facilitators for leisure PA and one environmental factor for travel. There have been a small number of investigations on the work/study and household domains, and future investigations on intrapersonal and social barriers and facilitators in the travel domain are important.

Barriers and facilitators for physical activity domains in Brazil: a systematic review. / Barreiras e facilitadores para a prática de atividade física em diferentes domínios no Brasil: uma revisão sistemática.

This study aimed to systematically review scientific evidence on the barriers and facilitators of physical activity (PA) among the Brazilian population, considering different domains (leisure, travel, work/study, and household). The search was conducted in the MEDLINE/PubMed, ISI Web of Science, SCOPUS, BIREME/LILACS, and APA PsycNET databases and was limited to papers published between 2010 and 2020. A manual search of the Brazilian Journal of Physical Activity & Health was also conducted. The selection process consisted of screening titles and abstracts, followed by the analysis of full texts. Each paper was assessed by two independent reviewers, and when discrepancies arose, a third reviewer was consulted. Leisure, environmental barriers and facilitators were the most investigated domains in the 78 included studies. There was consistency in the positive associations between six different intrapersonal and social facilitators for leisure PA and one environmental factor for travel. There have been a small number of investigations on the work/study and household domains, and future investigations on intrapersonal and social barriers and facilitators in the travel domain are important.

O objetivo foi revisar sistematicamente as evidências científicas sobre as barreiras e os facilitadores para a prática de atividade física (AF) na população brasileira, considerando os diferentes domínios (lazer, deslocamento, trabalho/estudo e tarefas domésticas). A busca foi conduzida nas bases de dados MEDLINE/PubMed, ISI Web of Science, Scopus, BIREME/LILACS e APA PsycNET, considerando o período de 2010 a 2020. Posteriormente, foi incluída a busca na Revista Brasileira de Atividade Física e Saúde. O processo de seleção consistiu na leitura de títulos e resumos, seguida de textos na íntegra. A avaliação foi realizada por pares e, mediante discrepância, um terceiro revisor era consultado. O domínio do lazer e as barreiras e os facilitadores ambientais foram os mais investigados nos 78 artigos incluídos. Houve consistência nas associações positivas de seis diferentes facilitadores pessoais e sociais para o lazer e um fator ambiental para o deslocamento. Encontrou-se um número reduzido de investigações sobre os domínios de trabalho/estudo e tarefas domésticas, sendo importante o incentivo a futuras investigações acerca das barreiras e dos facilitadores pessoais e sociais relacionados à AF de deslocamento.

Effect of volume of participation in exercise programs on biochemical parameters of women / Efeito do volume de participação em programas de exercícios nos parâmetros bioquímicos de mulheres

The aim of the study was to evaluate the effect of the volume of participation in exercise programs offered in Primary Health Care (PHC), for 24 weeks on blood biochemical parameters of adult women. Three Basic Health Units in Rio Claro City (São Paulo) were selected and 2 exercise inter-ventions were implemented with different volumes (3 weekly sessions, 90 minutes each; 2 weekly sessions, 60 minutes each). In total, 53 participants remained until the end of the interventions. Regardless of their number of absences, they were divided into 4 groups, according to the volume of participation (calculated individually according to the duration of sessions and the number of classes held), forming groups according to quartiles: Low Volume Group (LVG; 57.62 ± 9.97 years-old), Low Medium Volume Group (LMVG; 56.31 ± 12.18 years-old), High Medium Volume Group (HMVG; 53.00 ± 10.25 years-old), and High-Volume Group (HVG; 59.69 ± 7.66 years-old). Blood biochemical parameters were dosed using the ELISA method. The Generalized Estimation Equa-tion Model was used to compare the biochemical parameters (time, group, and interaction; p ≤ 0.05). The analysis showed significant and positive time effect for low-density lipoproteins (LDL) and glycemia in all groups and for total cholesterol (TC) in LVG, LMVG and HMVG; a significant group effect for HVG on TC (higher levels compared to all other groups) and LDL (higher levels compared to LVG and LMVG). It is concluded that the physical exercise programs offered in the PHC contributed to a significant reduction in LDL and blood glucose levels, regardless of the vol-ume of participation of individuals in the programs

O objetivo do presente estudo foi avaliar o efeito do volume de participação em programas de exercícios, ofer-tados na Atenção Primária à Saúde (APS), durante 24 semanas, nos parâmetros bioquímicos sanguíneos de mulheres adultas. Foram selecionadas 03 Unidades Básicas de Saúde de Rio Claro-São Paulo e implementa-das 2 intervenções de exercícios com diferentes volumes (3 sessões/semana, 90 minutos cada; 2 sessões/semana, 60 minutos cada). No total, 53 participantes se mantiveram até o final das intervenções, independentemente do número de faltas foram divididos em 4 grupos, de acordo com o volume de participação (calculado con-forme a duração das sessões e a quantidade de aulas realizadas de forma individual), formando os grupos segundo os quartis: Grupo Baixo Volume (GBV; 57,62 ± 9,97 anos), Grupo Baixo Médio Volume (GBMV; 56,31 ± 12,18 anos), Grupo Médio Alto Volume (GMAV; 53,00 ± 10,25 anos) e Grupo Alto Volume (GAV; 59,69 ± 7,66 anos). Os parâmetros bioquímicos sanguíneos foram dosados pelo método ELISA. Foi utilizado o Modelo de Equações de Estimações Generalizadas para a comparação dos parâmetros bioquímicos (tempo, grupo e interação; p ≤ 0,05). A análise evidenciou efeito significativo favorável do tempo para lipoproteínas de baixa densidade (LDL) e glicemia em todos os grupos e para colesterol total (CT) no GVB, GBMV e GMAV; e efeito significativo do grupo para GAV no CT (maiores níveis comparado a todos os grupos) e LDL (maiores níveis comparados ao GBV e GBMV ). Conclui-se que o programa de exercício físico ofertado na APS contribuiu para a redução significativa dos níveis de LDL e glicemia, independentemente do volume de participação dos indivíduos nos programas

Mudanças de hábitos e manifestações psicológicas durante os três primeiros meses de isolamento social / Changes in habits and psychological manifestations during the first three months of social isolation / Cambios de costumbres y manifestaciones psicológicas durante los tres primeros meses de aislamiento social

Objetivo: Verificar as mudanças de hábitos e manifestações psicológicas durante os três primeiros meses de isolamento social da pandemia de COVID-19. Métodos: Estudo transversal realizado entre 01 de novembro e 20 de dezembro de 2020 por meio da aplicação de questionário on-line do tipo recordatório e amostragem do método "bola de neve" no qual participaram 219 pessoas entre 18 e 65 anos, residentes do município de Uberaba, Minas Gerais, Brasil. Realizou-se análise descritiva (frequência absoluta e porcentagem) das variáveis sociodemográficas, das mudanças de hábitos e das manifestações psicológicas. A análise inferencial realizou-se pela comparação do intervalo de confiança de 95% (IC95%). Resultados: Houve diferença significativa na proporção da amostra que considerou diminuição da atividade física (64,8%; IC95%: 58,0-71,2) e aumento do tempo de tela (73,1%; IC95%: 67,1-79,5), dos comportamentos ansiosos (71,2%; IC95%: 66,2-78,1), do estresse (69,4%; IC95%:63,0-75,3), do medo (58,9%; IC95%: 52,1-65,3), da tensão (57,5%; IC95%: 50,7-64,4), da insegurança (60,3%; IC95%: 53,9-66,7) e do nervosismo (57,1%; IC95%: 50,2-63,9). Em relação ao consumo de bebidas alcoólicas e dos hábitos alimentares não houve diferenças significativas entre as proporções. Conclusão: Os três primeiros meses de isolamento social impostos pela pandemia da COVID-19 influenciaram a população investigada na redução da prática de atividade física, no aumento do tempo de tela e no aumento da frequência de manifestações psicológicas.

Objective: To check changes in habits and psychological manifestations during the first three months of social isolation during the COVID-19 pandemic. Methods: A cross-sectional study was carried out between November 1 and December 20, 2020 using an online recall questionnaire and "snowball" sampling with 219 people aged between 18 and 65 years who lived in the municipality of Uberaba, Minas Gerais, Brazil. Descriptive analysis (absolute frequency and percentage) of sociodemographic variables, changes in habits and psychological manifestations was performed. The inferential analysis was performed by comparing the 95% confidence intervals (95%CI). Results: There was a significant difference in the proportion of the sample that reported decreased physical activity (64.8%; 95%CI: 58.0-71.2) and increased screen time (73.1%; 95%CI: 67.1 -79.5), anxious behaviors (71.2%; 95%CI: 66.2-78.1), stress (69.4%; 95%CI: 63.0-75.3), fear ( 58.9%; 95%CI: 52.1-65.3), tension (57.5%; 95%CI: 50.7- 64.4),insecurity (60.3%; 95%CI: 53, 9-66.7) and nervousness (57.1%; 95%CI: 50.2-63.9). As for the consumption of alcoholic beverages and eating habits, there were no significant differences between the proportions. Conclusion: The first three months of social isolation imposed by the COVID-19 pandemic influenced the investigated population to reduce the practice of physical activity, increase screen time and increase the frequency of psychological manifestations.

Objetivo: Verificar los cambios de costumbres y manifestaciones psicológicas durante los tres primeros meses de aislamiento social de la pandemia de la COVID-19. Métodos: Estudio transversal realizado entre 01 de noviembre y 20 de diciembre de 2020 a través de la aplicación de un cuestionario on-line del tipo recordatorio y muestreo del método "pelota de nieve" en el cual participaron 219 personas entre los 18 y 65 años, residentes del municipio de Uberaba, Minas Gerais, Brasil. Se realizó el análisis descriptivo (frecuencia absoluta y porcentaje) de las variables sociodemográficas, de los cambios de costumbres y de las manifestaciones psicológicas. El análisis inferencial se dio por la comparación del intervalo de confianza del 95% (IC95%). Resultados: Hubo diferencia significativa en la proporción de la muestra que consideró disminución de la actividad física (64,8%; IC95%: 58,0-71,2) y el aumento del tiempo de pantalla (73,1%; IC95%: 67,1-79,5), de las conductas ansiosas (71,2%; IC95%: 66,2-78,1), del estrés (69,4%; IC95%:63,0-75,3), del miedo (58,9%; IC95%: 52,1-65,3), de la tensión (57,5%; IC95%: 50,7-64,4), de la inseguridad (60,3%; IC95%: 53,9-66,7) y del nerviosismo (57,1%; IC95%: 50,2-63,9). Respecto el consumo de bebidas alcohólicas y de las costumbres alimentarias, no hubo diferencias significativas entre las proporciones. Conclusión: Los tres primeros meses de aislamiento social de la pandemia de la COVID-19 han influenciado la población investigada para la reducción de la práctica de actividad física, el aumento del tiempo de pantalla y el aumento de la frecuencia de manifestaciones psicológicas.

Perceptions on activity behavior during the COVID-19 pandemic "second wave" among US adults: results of a short online survey.

Purpose: COVID-19 pandemic has disrupted the lives of people of all nations. This study examined physical activity (PA) behavior, barriers and facilitators to PA during the COVID-19 pandemic. Methods: This cross-sectional study assessed adults using a survey comprised of two parts: (a) demographics and general health and; (b) PA-related questions. The survey link was disseminated via email and various social media, and was active from September to October 2020. Results: A total of 277 adults (Mean ± SD; age = 32.6 ± 13.6 years, BMI = 27.1 ± 16.5 kg/m2) were evaluated. A majority of the sample was female (67%), single (53%) and White (70%). About a third of the participants reported good mental and physical health, with a similar amount reporting weight gain during the pandemic. Participants further reported on average 271 min of PA/week, and 5.7 h/day of sitting time. Overall, 41.5% of the participants reported a decrease in PA during the COVID-19 pandemic, but those not meeting PA recommendations reported higher rates (67.9%) of decrease in levels of PA than their active counterparts (23.6%); x 2 (2, N = 277) = 55.757, p < 0.01. Over 50% of the participants reported engaging in PA at home, with significantly more females (43.5%) than males (17.6%) making use of live stream PA/exercise session opportunities; x 2 (2, N = 277) = 18.896, p < 0.001. "Closed gyms" and "more time" were reported as the main negative and positive factors, respectively, affecting PA during the pandemic. Conclusions: Our findings suggest that PA behavior was negatively affected in US adults during the COVID-19 pandemic, and that "closed gym" (i.e., barrier), and "more time" (i.e., facilitator), were the main factors reported affecting PA participation. Given the well-known public health importance of PA, it is paramount that public health initiatives focus on providing not only educational but also environmental opportunities and support for PA during this period.

Análise da realocação do tempo sentado, sono e em atividades físicas sob a autoavaliação de saúde negativa de universitários / Analysis of the reallocation of time spent sitting, sleeping, and performing physical activities under negative self-rated heath of university students

O objetivo deste estudo foi examinar o efeito da substituição isotemporal da atividade física, do tempo sedentário e horas de sono em relação à autoavaliação de saúde (AAS) negativa em universitários de uma universidade pública do ensino superior do estado de Minas Gerais, MG, Brasil. Foi realizado um estudo de delineamento transversal, no qual os dados foram obtidos via questionário e a AAS negativa foi o desfecho deste estudo. O tempo por dia despendido em atividade física, tempo sentado e sono foram padronizados por constantes de 10, 30 e 60 minutos. O modelo de substituição isotemporal foi empregado por meio da estimativa do Odds Ratio, via regressão logística binária. O nível de significância foi de 5%. Participaram deste estudo 1.110 estudantes. Observou-se que a substituição de 10, 30 ou 60 minutos por dia de tempo sentado pela mesma quantidade de tempo em atividade física reduz as chances de AAS negativa entre os universitários. De modo geral, maiores chances de AAS negativa foram observadas ao substituir os mesmos tempos de atividade física por tempo sentado. Nenhuma associação foi observada com a realocação do tempo de sono. Conclui-se que a substituição de pelo menos 10 minutos de tempo sentado por atividade física pode reduzir progressivamente as chances de AAS negativa entre os universitários.

The aim of this study was to examine the effect of isotemporal substitution of physical activity, sedentary, and sleep time in relation to negative self-rated health (SRH) in university students from a public university in the state of Minas Gerais, Brazil. A cross-sectional study was carried out, in which data were obtained via a questionnaire and the study's outcome was the negative SRH. The time per day spent on physical activity, sitting, and sleeping were standardized by constants of 10, 30, and 60 minutes. The isotemporal substitution model was used through the estimation of the Odds Ratio via binary logistic regression. The significance level was 5%. A total of 1,110 students participated in this study. It was observed that replacing 10, 30, or 60 minutes per day of sitting time for the same amount of time in physical activity reduces the probability of negative SRH among university students. In general, greater probability of negative SRH were observed when replacing the same times of physical activity with sitting time. No association was observed with sleep time reallocation. It is concluded that replacing at least 10 minutes of sitting time with physical activity can progressively reduce chances of negative SRH among university students.

Prevalence of negative self-rated health in university students and its relationship with the co-occurrence of risk behaviors / Prevalência da autoavaliação de saúde negativa em universitários e sua relação com a concorrência de comportamentos de risco

ABSTRACT The present study estimate the prevalence of negative self-rated health and to analyze its association with simultaneous risk behaviors (insufficient levels of physical activity, greater exposure to sedentary time and inappropriate sleep time) in students at a public university in the state from Minas Gerais, Brazil. It consists of cross-sectional study, with data collected through a questionnaire. The outcome variable was negative self-rated health. The independent variables were estimated by the questions related to the time spent on physical activity, sitting and sleep time, and these three behaviors were considered according to the risk criteria (none, one, two and three risk behaviors). The association was estimated by the Prevalence Ratios (PR), via Poisson regression. 1,110 students participated in the study. The prevalence of negative self-rated health among university students was 47.3%, and the prevalence of two risk behaviors and three risk behaviors were 41.3% and 11.3%, respectively. The simultaneous occurrence of three risk behaviors was associated with negative self-rated health in university students. The information in this study makes it possible to characterize the need for actions to promote health in the university environment.

RESUMO O presente estudo estimou a prevalência da autoavaliação de saúde negativa e analisou a sua associação com comportamentos de risco simultâneos (níveis insuficientes de atividade física, maior exposição ao tempo sedentário e tempo de sono não apropriado) em estudantes de uma universidade pública do ensino superior do estado de Minas Gerais, Brasil. Consiste de um estudo transversal, com informações mensuradas via questionário e a variável desfecho foi a autoavaliação de saúde negativa. As variáveis independentes foram estimadas pelas perguntas referentes ao tempo despendido em: atividade física, tempo sentado e tempo de sono, e esses três comportamentos foram somados conforme os critérios de risco (nenhum, um, dois e três fatores de risco). A associação foi estimada pelas Razões de Prevalências (RP), via regressão de Poisson. Participaram do estudo 1.110 estudantes. A prevalência da autoavaliação de saúde negativa entre os universitários foi de 47,3%, e as prevalências de dois fatores de risco e de três fatores de risco foram de 41,3% e 11,3%, respectivamente. A ocorrência de forma simultânea de três fatores de risco mostrou-se associada com a autoavaliação de saúde negativa em universitários. As informações deste estudo possibilitam caracterizar a necessidade de ações na promoção de saúde no ambiente universitário.

Cost-analysis and cost-effectiveness of physical activity interventions in Brazilian primary health care: a randomised feasibility study.

Physical exercise programs have been carried out in primary health care in Brazil and have provided good results in terms of effectiveness, their economic contribution has not been investigated yet. The aim of the study is to verify the feasibility of brief counseling physical activity intervention and to compare its economic cost and cost-effectiveness with supervised physical exercise intervention in primary care. A multi-arm parallel feasibility trial, with equal randomization [1:1:1] was conducted in Basic Health Units in Brazil. 61 participants were randomized in Brief Counseling Intervention (BCI), Supervised Physical Exercise Intervention (SPEI) and Control Group (CG). Interventions lasted one year. The BCI is more economical than the SPEI, costing around 50% less in the economic comparisons (session cost, annual cost and cost per participant annually). At leisure time, the cost to move one person to the physically active category at 12 months is estimated in R$369.00 for BCI and R$426.21 for the SPEI. The Incremental Cost-effectiveness Ratio (ICER) is R$310.32. The BCI is feasible and more economic, however, the cost effective is not that different. Thus, it is strongly recommended that the two interventions be offered at primary care in Brazil.

Cost-analysis and cost-effectiveness of physical activity interventions in Brazilian primary health care: a randomised feasibility study / Análise de custo e custo-efetividade de intervenções de atividade física na atenção primária à saúde no Brasil: um estudo de viabilidade randomizado

Abstract Physical exercise programs have been carried out in primary health care in Brazil and have provided good results in terms of effectiveness, their economic contribution has not been investigated yet. The aim of the study is to verify the feasibility of brief counseling physical activity intervention and to compare its economic cost and cost-effectiveness with supervised physical exercise intervention in primary care. A multi-arm parallel feasibility trial, with equal randomization [1:1:1] was conducted in Basic Health Units in Brazil. 61 participants were randomized in Brief Counseling Intervention (BCI), Supervised Physical Exercise Intervention (SPEI) and Control Group (CG). Interventions lasted one year. The BCI is more economical than the SPEI, costing around 50% less in the economic comparisons (session cost, annual cost and cost per participant annually). At leisure time, the cost to move one person to the physically active category at 12 months is estimated in R$369.00 for BCI and R$426.21 for the SPEI. The Incremental Cost-effectiveness Ratio (ICER) is R$310.32. The BCI is feasible and more economic, however, the cost effective is not that different. Thus, it is strongly recommended that the two interventions be offered at primary care in Brazil.

Resumo Programas de exercício físico são ofertados na atenção primária à saúde no Brasil, apresentando bons resultados na eficácia, sua contribuição econômica ainda não foi investigada. O objetivo do estudo é verificar a viabilidade de uma intervenção breve de aconselhamento para atividade física, e comparar seu custo econômico e custo-efetividade com a intervenção supervisionada de exercício físico na atenção primária. Um estudo de viabilidade de múltiplos braços paralelos, com igual randomização [1:1:1] foi realizado em Unidades Básicas de Saúde no Brasil. 61 participantes foram randomizados em Intervenção Breve de Aconselhamento (BCI), Intervenção Supervisionada de Exercício Físico (SPEI) e Grupo Controle (CG). As intervenções tiveram duração de 1 ano. BCI é mais econômica que SPEI, custando cerca de 50% menos nas comparações econômicas (custo da sessão, custo anual e custo por participante anualmente). No lazer, o custo de mudança de uma pessoa para a categoria fisicamente ativa aos 12 meses é estimado em R$ 369,00 na BCI e R$ 426,21 na SPEI. O Índice de Custo-Efetividade Incremental (ICER) é de R$ 310,32. BCI é viável e mais econômica; no entanto, o custo-benefício não é tão diferente. Assim, é altamente recomendável que as duas intervenções sejam oferecidas.

Sedentary Behavior Is Associated With Low Leisure-Time Physical Activity and High Body Fatness in Older Brazilian Adults.

Sedentary behavior (SB) has emerged as a new health risk factor, including risk of premature death. This study examined the association between SB and measures of physical activity and body fatness in older Brazilian adults. Self-report measures of SB (ie, sitting time [ST]), leisure-time physical activity (LTPA), and body fatness (body mass index [BMI]) were collected from 355 older adults aged 60 years and older by trained interviewers. Statistical procedures were conducted using SPSS software with significance set at P < .05. Overall, the median ST was 3 hours per day. Mean values of LTPA and BMI for the entire sample were 90.0 (197.4) min/week and 26.5 (4.9) kg/m2, respectively. Partial correlations controlling for age revealed that ST was negatively associated with LTPA (pr = -.15 [-.25; -.04]; P = .006) and positively associated with BMI (pr = .25 [.14; .35]; P < .001). Age, BMI, and LTPA emerged as independent predictors of ST, explaining a small but significant variance in ST (R 2 = .12; P = .02). Furthermore, t test revealed a significant difference in LTPA and BMI between groups of different amounts of sitting. The findings suggest that prolonged ST may have a negative impact on LTPA and BMI in older Brazilian adults.

Validade e clareza dos conceitos e terminologias do Guia de Atividade Física para a População Brasileira / Validity and Clarity of the Concepts and Terminologies of the Physical Activity Guidelines for the Brazilian Population

Nosso objetivo foi avaliar a validade e a clareza dos conceitos e terminologias adotados na elaboração do Guia de Atividade Física para a População Brasileira (Guia). O Grupo de Trabalho Domínios da Atividade Física (GT Domínios) conduziu a avaliação da validade e da clareza dos conceitos e terminologias relacionados a atividade física (AF), comportamento sedentário, domínios (tempo livre, deslocamento, trabalho ou estudo e tarefas domésticas) e intensidades da AF (leve, moderada e vigorosa), em três etapas: 1- Proposição dos conceitos; 2- Escuta com pesquisadores (dois momen-tos); 3- Consulta pública. Os conceitos propostos pelo GT Domínios foram baseados em guias in-ternacionais, artigos científicos, relatórios nacionais e conhecimentos técnico-científicos-acadêmicos dos integrantes do GT Domínios, discutidos em reuniões (etapa 1). Na escuta com pesquisadores (etapa 2) foram testadas a validade e a clareza dos conceitos em dois momentos. Participaram 70 e 40 pesquisadores vinculados aos outros GT do Guia no primeiro e segundo momentos, respectiva-mente. Em ambas as escutas, todos os conceitos apresentaram índice de concordância para validade e clareza igual ou superior a 80%. As sugestões convergentes indicadas na etapa 2 foram incluídas e novas versões dos conceitos foram disponibilizadas para a terceira etapa (consulta pública) realizada pelo Ministério da Saúde. Foram realizadas 14 sugestões relacionadas aos conceitos que foram aceitas e incorporadas ao texto do Guia, quando pertinentes. Conclui-se que os conceitos e terminologias relacionados a AF propostos pelo GT Domínios para compor o Guia, após a avaliação de pesquisa-dores especialistas e da população consultada, são válidos e claros

We evaluated the validity and clarity of the concepts and terminologies adopted to develop the Physical Activity Guidelines for the Brazilian Population (Guidelines). The Physical Activity Domains Working Group (Domains WG) assessed the validity and clarity of the following concepts: physical activity, seden-tary behavior, PA domains (free time, commuting, work or study, and domestic tasks) and intensities (light, moderate and vigorous). The concepts were evaluated in three stages: 1- Concept proposition; 2- Expert consultation (two steps); 3- Public consultation. The concepts proposed by the Domains WG were based on international guidelines, scientific articles, official documents from the Ministry of Health, and techni-cal-scientific-academic knowledge of the Domains WG members, discussed in a series of meetings (stage 1). In the second stage (expert consultation), validity and clarity of the concepts were tested on two occasions. Seventy and forty researchers working in the other Guidelines WGs contributed to first and second steps, respectively. In both occasions, validity and clarity agreement were equal to or greater than 80% for all concepts. Suggestions provided in step 2 were adopted, and new versions of the concepts were made available for the third step, a public consultation carried out by the Ministry of Health. Fourteen suggestions related to the concepts were made and, when relevant, included in the Guidelines. According to the assessment and suggestions by experts and members of the public, the concepts and terminologies proposed by the Domains WG for the Guidelines are valid and clear

Outdoor Fitness Zone: utilization pattern, and environmental and individual characteristics associated with the volume of utilization

Abstract Aim: To examine the association between environmental and individual characteristics and utilization pattern of Outdoor Fitness Zones (OFZ) with the volume of utilization of these public spaces in Uberaba, Brazil. Methods: Cross-sectional descriptive study. Data collection was conducted using "in loco" interviews (three different days and times) and direct observation of nine OFZ. Poisson regression analysis was used to estimate prevalence ratios using the volume of utilization higher than 90 min per week as the dependent variable and a collection of socio-demographic, environmental, utilization pattern, and OFZ characteristics as independent variables. Results: Adjusted analysis revealed that volume of utilization higher than 90 min per week of OFZ was associated with a higher prevalence ratio among users utilizing such spaces to meet friends sometimes (PR = 2.43; 1.21-4.90) and always (PR = 3.43; 1.61-7.34) compared to not meeting friends. A lower prevalence ratio was found in users who attend the OFZ only during the week or only weekend days (PR = 0.52; 0.37-0.73) compared to a user who attends both (week and weekends days). OFZ not providing a space for walking or jogging (PR = 0.48; 0.23-0.99) were also associated with a lower prevalence ratio of utilization higher than 90 min per week. Conclusions: The findings demonstrated that most individual and environmental characteristics and utilization patterns of the OFZ in the city of Uberaba, MG, Brazil, were not associated with the volume of utilization. Users who meet friends and attend both week and weekend days OFZ that features walking or running trails were associated with a higher volume of utilization.

Efeito de duas intervenções com diferentes volumes de exercícios físicos na aptidão física de mulheres usuárias da atenção primária de saúde / Effect of two interventions with different volumes of physical exercises on the women´s physcal fitness carried out in primary health care

Considerando o impacto negativo que a inatividade física pode trazer para a população, o Sistema Único de Saúde torna-se responsável por melhorar os determinantes da saúde da população. O objetivo do estudo foi comparar o efeito de duas intervenções com diferentes volumes de exercícios físicos na aptidão física de mulheres usuárias da Atenção Primária de Saúde, no período de 12 meses. O estudo apresenta delineamento quase-experimental e longitudinal. Participaram do estudo 50 mulheres (G1= 25 e G2= 25). A intervenção 1 (G1) foi realizada 2x por semana com duração de 60 minutos por sessão e a intervenção 2 (G2) foi realizada 3x por semana com duração de 90 minutos por sessão, ambas com exercícios físicos combinados. Para avaliação da aptidão física foi utilizada a bateria de testes da AHHPERD. As variáveis de aptidão física foram analisadas pelo teste Anova de Variância Mista, sendo realizado as comparações post-hoc pelo teste de Bonferroni. A análise estatística não evidenciou interação (tempo x grupo) e diferença significativa entre grupo. A análise apontou diferenças significativas para o efeito do tempo no G1 em todas as variáveis de aptidão física nas comparações pré e 12 meses, e nas comparações pré e 6 meses, exceto para força. Para o G2, os principais resultados foram nas comparações pré e 12 meses, para todas as variáveis, exceto flexibilidade. Os ganhos mais evidenciados foram nas variáveis flexibilidade e resistência aeróbia para o G1 e na força para o G2. Conclui-se que ambas as intervenções apresentaram resultados positivos no efeito tempo, principalmente nas comparações pré e 12 meses. Não houve efeito de intervenção, evidenciando que independente do volume de exercício físico, para esse tipo de intervenção aplicado no contexto da Atenção Primária à Saúde, ambas intervenções promovem ganhos na aptidão física dos participantes.(AU)

The negative impact that physical inactivity can bring to the population makes the Unified Health System responsible to improve determinants of health in the population. The aim of study was to compare the effect of two interventions with different volumes of physical exercises on the physical fitness of women using Primary Health Care, in the period of 12 months. The study has quasiexperimental and longitudinal design. Fifty women (G1 = 25 women and G2 = 25 women) participated in the study. Intervention 1 (G1) was performed twice a week with a duration of 60 minutes per session and intervention 2 (G2) was performed 3x a week with a duration of 90 minutes per session, both with combined physical exercises. The physical fitness was accessed by AHHPERD's battery of tests. The physical fitness variables were analyzed by the ANOVA Mixed Variance test, and post-hoc comparisons were performed using the Bonferroni test. The statistical analysis didn't show interaction (time x group) and significant difference between group. The analysis showed significant differences for time effect in all variables of physical fitness for G1 (pre vs 12 months; and pre vs 6 months, except strength in this last comparison). Significant differences for time effect in all variables of physical fitness (pre vs 12 months), except flexibility, were verified for G2. The gain was more evident in the flexibility and aerobic resistance for G1 and strength for G2. It is concluded that both interventions showed a positive result in the time effect, mainly in the comparisons pre and 12 months. There was no intervention effect, showing that regardless of the volume of physical exercise, for this type of intervention applied in the context of Primary Health Care, both interventions promote gains in the physical fitness of the participants.(AU)

Antecedentes motivacionais para a prática de atividade física na atenção primária à saúde / Motivational background for physical activity in primary health care / Antecedentes motivacionales para la práctica de actividad física en la atención primaria de salud

Este estudo objetivou analisar a percepção sobre os antecedentes afetivos para a prática de atividade física (AF) relacionados às necessidades psicológicas básicas (NPB) e investigar as regulações motivacionais para prática de AF no discurso dos participantes iniciantes de um programa de exercício físico na Atenção Primária à Saúde. Trata-se de um estudo transversal de natureza qualitativa com a utilização de Grupo Focal. Participaram da pesquisa 41 adultos. Os resultados demonstram que as percepções dos participantes sugerem frustração para as NPB de autonomia e competência. O comportamento dos participantes para a iniciação ao programa é regulado por contingentes externos, caracterizados por punições e medos na adesão ao programa. Não foram observadas regulações motivacionais intrínsecas, e a autodeterminação para a participação no programa é baixa. Conclui-se que essa população não percebe sentimentos ligados ao prazer pela prática de AF per se, diminuindo as chances de manutenção do comportamento para realizar AF.

This study analyzed the perception about affective background for physical activity (PA) related to basic psychological needs (BPN) and investigated motivational regulations for PA in the discourse of beginners at an exercise program in primary health care. A cross-sectional study was carried out using the Focus Group technique to reach the study's goals. Participants were 41 adult users of Brazil's Unified Health System. Results show that their perceptions suggest frustration regarding basic needs for autonomy and competence. Beginners' behavior is primarily regulated by external circumstances characterized by punishment and fear when joining the program. Intrinsic motivational regulations and low self-determination to participate in the program were not observed. It can be argued that this population does not feel satisfaction and pleasure when doing PA per se, therefore decreasing their chances of maintaining the PA behavior.

Este estudio objetivó analizar la percepción sobre los antecedentes afectivos para la práctica de actividad física (AF) relacionados con las necesidades psicológicas básicas (NPB) e investigar las regulaciones motivacionales para la práctica de AF en el discurso de los participantes que empiezan un programa de ejercicio en la Atención Primaria de Salud. Es un estudio transversal, de naturaleza cualitativa, que utiliza Grupo Focal. Participaron 41 adultos en la investigación. Los resultados demuestran que las percepciones de los participantes sugieren frustración en las NPB de autonomía y competencia. El comportamiento de los participantes al iniciar el programa está reglamentado por contingentes externos, y se caracteriza por castigos y miedos al adherir al programa. No se han observado regulaciones motivacionales intrínsecas y la autodeterminación en la participación en el programa es baja. Se concluye que esta población no percibe sentimientos relacionados con el placer en la práctica de AF en sí, lo que reduce las posibilidades de mantener el comportamiento para realizar AF.

Effectiveness of exercise and health education interventions in Brazilian primary health care

Abstract AIM This study examined the effectiveness of two different behavioral change interventions to improve Physical Activity (PA) and to reduce Sedentary Behavior (SB) in a primary health care setting. METHODS This quasi-experimental study recruited and enrolled 31 users of a primary health care unit of the Brazilian Unified Health System aged 18 or more. Participants were allocated into two groups: Physical Exercise Group combined with Health Education (EHE) and Health Education Group (HE). The EHE group participated in 60 minutes of exercise, twice a week, and 20 minutes of counseling. The HE group participated in 40 minutes of counseling, once a week. Both programs were conducted for over 18 weeks. PA levels were self-reported (IPAQ) and PA and SB were objectively (accelerometer) assessed before and after the intervention period. Data were analyzed using intention-to-treat analysis with generalized estimating equations adopting p<0.05 for significance. Also, the individual PA and SB deltas were computed. Improvements in PA and SB were observed for both interventions (p<0.05). RESULTS Both groups increased the minutes of weekly leisure PA (p=0.006), time spent in light (p=0.003), and moderated-to-vigorous (p=0.042) PA and decreased the amount of SB, with a significant decrease in the HE group (p=0.010). Delta analyses further demonstrated the effectiveness of the interventions to increase PA in other domains (i.e., transportation, household) and maintenance of occupational PA. CONCLUSION Behavioral change interventions in the primary health care context involving exercise and counseling seem to be effective in improving PA and SB in adults.

Perfil dos usuários e padrão de utilização das Academias ao Ar Livre de Uberaba, Minas Gerais / Profile of the users and usage pattern of Outdoor Fitness Equipment in Uberaba, Minas Gerais

O objetivo foi analisar o perfil, nível de atividade física dos usuários e o padrão de uso das Academias ao Ar Livre (AAL) de Uberaba, Minas Gerais, Brasil. A coleta de dados foi realizada por meio de entrevista "in loco" com usuários de nove AAL. Foram entrevistados 148 usuários. Os usuários das AAL de Uberaba, Minas Gerais são na maioria mulher, adulto, casado, com ensino médio completo, percebem a saúde como boa e são ativos fisicamente. A proporção de usuários com renda até 2 salários mínimos foi de 53,4%. A maioria frequenta o espaço há mais de 1 mês, utiliza a AAL durante os dias de semana, mais de 3 vezes na semana com duração superior a 30 minutos. Os usuários consideram o local acessível, próximo à sua residência, e realizam deslocamento até o local caminhando. A grande maioria percebe a AAL como local seguro (93,9%), embora em três AAL não foram observados usuários nos dias da coleta. A maioria dos usuários não vai acompanhado, mas às vezes encontra pessoas que conhece e não possui acompanhamento de um profissional de educação física. Esses resultados devem ser considerados pelos gestores do município com a finalidade de promover maior utilização das AAL nos finais de semana e maior utilização de homens, jovens adultos e idosos e indivíduos de menor escolaridade

The objective was to analyze the profile, level of physical activity of users, and the usage pattern of Outdoor Fitness Equipment (OFE) of Uberaba, Minas Gerais, Brazil. Data were collected in loco in nine OFE. The OFE users were interviewed. A total of 148 users were interviewed. Most users are women, adult, married, with complete high school, perceive health as good are physically active. The proportion of low-income users was 53.4%. As for the pattern of use, most users attend the OFE for more than 1 month, on weekdays, more than 3 times a week lasting more than 30 minutes. The OFE users consider the location accessible, near the residence, and go on foot to the place. The majority perceive the OFE as a safe place (93.9%), however, any users were observed in three OFE. Most users are not accompanied but met new people on the spot and sometimes find people they know. Most users are not accompanied by a physical education professional. These results must be considered by the city managers in order to promote greater use of OFE on weekends and greater use of men, young adults, and the elderly and less educated people