PROMOTION OF PHYSICAL ACTIVITY AND HEALTHY EATING IN PUBLIC HEALTH: DEVELOPMENT OF VAMOS VERSION 3.0, PRINTED AND ONLINE / ALCANCE Y EFICACIA DEL PROGRAMA "VIDA ACTIVA MEJORANDO LA SALUD" (VAMOS 3.0), IMPLEMENTADO EN ATENCIÓN PRIMARIA DE SALUD EN SANTA CATARINA, BRASIL / ALCANCE E EFICÁCIA DO PROGRAMA "VIDA ATIVA MELHORANDO A SAÚDE" (VAMOS 3.0), IMPLEMENTADO NA ATENÇÃO PRIMÁRIA À SAÚDE EM SANTA CATARINA, BRASIL

Introduction: We developed the intervention Programa Vida Ativa Melhorando a Saúde (VAMOS 3.0). This behavior change program aims to motivate people towards an active and healthy lifestyle. Objective: describe the development process of VAMOS 3.0 in print and online formats. Methods: A methodological study of content analysis, structure, implementation, and evaluation were carried out to develop a new version of VAMOS 3.0. Results: The new version had changes in content (short, direct, and affirmative sentences, images, color palette), structure (increased number of sections, time of application), and implementation (duration, form of participation, monitoring). In addition to the printed format, an online program was created containing the same characteristics to expand the reach. Final considerations: VAMOS 3.0 is suitable for public health in Brazil and has promising strategies for application in basic health units, as well as in other types of institutions such as schools, government offices, gyms, public or private companies.

Introducción: Desarrollamos la intervención Programa Vida Ativa Melhorando a Saúde (VAMOS 3.0). Este programa de cambio de comportamiento tiene como objetivo motivar a las personas hacia un estilo de vida activo y saludable. Objetivo: describir el proceso de desarrollo de VAMOS 3.0 en formato impreso y en línea. Métodos: Se realizó un estudio metodológico de análisis de contenido, estructura, implementación y evaluación para desarrollar una nueva versión de VAMOS 3.0. Resultados: La nueva versión tuvo cambios en contenido (oraciones cortas, directas y afirmativas, imágenes, paleta de colores), estructura (mayor número de secciones, tiempo de aplicación) e implementación (duración, forma de participación, seguimiento). Además del formato impreso, se creó un programa online con las mismas características para ampliar el alcance. Consideraciones finales: VAMOS 3.0 es adecuado para la salud pública en Brasil y tiene estrategias prometedoras para su aplicación en unidades básicas de salud, así como en otro tipo de instituciones como escuelas, oficinas gubernamentales, gimnasios, empresaspúblicas o privadas.

Introdução: Desenvolvemos a intervenção Programa Vida Ativa Melhorando a Saúde (VAMOS 3.0). Este programa de mudança de comportamento visa motivar as pessoas para um estilo de vida ativo e saudável. Objetivo: Descrever o processo de desenvolvimento do VAMOS 3.0 nos formatos impresso e online. Métodos: Foi realizado um estudo metodológico de análise de conteúdo, estrutura, implementação e avaliação para desenvolver uma nova versão do VAMOS 3.0. Resultados: A nova alteração teve no conteúdo (frases curtas, diretas e afirmativas, imagens, paleta de cores), estrutura (aumento do número de versões, tempo de aplicação) e implementação (duração, forma de participação, acompanhamento). Além do formato impresso, foi criado um programa online contendo as mesmas características para ampliar o alcance. Considerações finais: O VAMOS 3.0 é adequado para a saúde pública no Brasil e possui estratégias promissoras para aplicação em unidades básicas de saúde, bem como em outros tipos de instituições como escolas, repartições públicas, academias, empresas públicas ou privadas.

Food consumption scale validation in VAMOS Program: a proposal to assess eating behavior changes in Brazil / Validação da escala de consumo alimentar no Programa VAMOS: uma proposta para avaliar as mudanças no comportamento alimentar no Brasil

Abstract This study aimed to validate the frequency consumption scale (FCS) and establish cut-off points to assess changes in the eating behavior of participants in the VAMOS Program. The study was based on a community intervention conducted in 2019 in 70 Brazilian cities, with 458 adults from Primary Care. The questionnaire consisted of 12 questions about food frequency consumption. The questions were inserted into the analytical workflow, divided into the descriptive analysis, exploratory and confirmatory factor analysis (EFA), item response theory (IRT) modeling, and construction and validity of an applied questionnaire score. EFA indicated a two-factor structure, with three "healthy" (raw vegetables, fruits, and cooked vegetables) and three "unhealthy" (sugary drinks, sweets, and the replacement of meals with snacks) eating items. Items responses' probabilities indicate a daily consumption of two healthy and once or nonweekly consumption of unhealthy items. Finally, the four categories proposed for FCS can respond over time. Therefore, the FCS proposal can be used effectively for program nutrition evaluation. Furthermore, it is possible to attribute behavior change in Brazilian primary care users with six items.

Resumo Este estudo teve como objetivo validar a escala de consumo de frequência (ECF) e estabelecer pontos de corte para avaliar mudanças no comportamento alimentar dos participantes do Programa VAMOS. O estudo baseou-se em uma intervenção comunitária realizada em 2019 em 70 cidades brasileiras, com 458 adultos da Atenção Básica. O questionário era composto por 12 questões sobre o consumo de frequência alimentar. As questões foram inseridas no fluxo de trabalho analítico, divididas em análise descritiva, análise fatorial exploratória e confirmatória (EFA), modelagem da teoria de resposta ao item (TRI) e construção e validade de um escore de questionário aplicado. EFA indicou uma estrutura de dois fatores, com três itens alimentares "saudáveis" (vegetais crus, frutas e vegetais cozidos) e três "não saudáveis" (bebidas açucaradas, doces e a substituição de refeições por lanches). As probabilidades das respostas dos itens indicam um consumo diário de dois itens saudáveis e um consumo único ou não semanal de itens não saudáveis. Por fim, as quatro categorias propostas para o ECF podem fornecer respostas ao longo do tempo. A proposta do ECF pode ser usada efetivamente para avaliação nutricional do programa. Além disso, é possível atribuir a mudança de comportamento em usuários da atenção básica brasileira com seis itens.

Food consumption scale validation in VAMOS Program: a proposal to assess eating behavior changes in Brazil.

This study aimed to validate the frequency consumption scale (FCS) and establish cut-off points to assess changes in the eating behavior of participants in the VAMOS Program. The study was based on a community intervention conducted in 2019 in 70 Brazilian cities, with 458 adults from Primary Care. The questionnaire consisted of 12 questions about food frequency consumption. The questions were inserted into the analytical workflow, divided into the descriptive analysis, exploratory and confirmatory factor analysis (EFA), item response theory (IRT) modeling, and construction and validity of an applied questionnaire score. EFA indicated a two-factor structure, with three "healthy" (raw vegetables, fruits, and cooked vegetables) and three "unhealthy" (sugary drinks, sweets, and the replacement of meals with snacks) eating items. Items responses' probabilities indicate a daily consumption of two healthy and once or nonweekly consumption of unhealthy items. Finally, the four categories proposed for FCS can respond over time. Therefore, the FCS proposal can be used effectively for program nutrition evaluation. Furthermore, it is possible to attribute behavior change in Brazilian primary care users with six items.

Evaluating the implementation of the active life improving health behavior change program "BCP-VAMOS" in primary health care: Protocol of a pragmatic randomized controlled trial using the RE-AIM and CFIR frameworks.

Introduction: The effective translation of evidence-based interventions has contributed to implementing actions that impact public policies and the population's health. However, there is a gap in the literature regarding the factors associated with the successful implementation of these interventions. The Active Life Improving Health Behavior Change Program (BCP-VAMOS) uses behavioral strategies to promote an active and healthy lifestyle in the community. Characterized as a health innovation, it also provides health professionals with online training to implement the program in Primary Health Care (PHC). Our study describes a pragmatic trial that aims to evaluate the implementation of BCP-VAMOS, version 3.0, in PHC in southern Brazil. Methods and analysis: A pragmatic randomized controlled trial (PRCT) of two arms comparing a group of PHC professionals who will participate in a traditional didactic approach (control group) vs. a group that will receive ongoing support (intervention group) for the implementation of BCP-VAMOS. The intervention will be available to adults (≥18 years old) registered at PHC. Program recipient's will be assessed at baseline and post-intervention (9 months after) to measure markers of physical activity and eating behavior (primary outcomes). Program's implementation process will be monitored for 12 months and will be evaluated using the RE-AIM and Consolidated Framework for Implementation Research (CFIR) frameworks. Discussions: The survey findings can be used widely throughout Brazil, guiding the work of health professionals, service planners and policy-makers. Also, the results may help to inform the national health promotion policy to plan interventions and improve the implementation of programs in PHC. This research results will provide practical guidance for researchers to develop similar protocols to implement and adapt public health interventions. Ethics and dissemination: Ethics approval has been granted by the Human Research Ethics Committee of the Federal University of Santa Catarina (UFSC), Brazil, under no. 1394492. Results will be published in full as open access in the UFSC library and main trial results and associated papers in high-impact peer-reviewed journals. Trial registration number: RBR-2vw77q-Brazilian Registry of Clinical Trials - ReBEC (http://www.ensaiosclinicos.gov.br).

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.

Sociodemographic determinants of multimorbidity in Brazilian adults and older adults: a cross-sectional study

ABSTRACT BACKGROUND: Multimorbidity due to non-communicable chronic diseases (NCDs) constitutes a significant challenge for healthcare systems. To attenuate its impacts, it is essential to identify the sociodemographic determinants of this condition, which can discriminate against population segments that are more exposed. OBJECTIVE: To identify associations between multimorbidity conditions and sociodemographic indicators among Brazilian adults and older adults. DESIGN AND SETTING: Cross-sectional telephone-based survey in 26 Brazilian state capitals and the federal district. METHODS: The Vigitel 2013 survey was used, with data collected via a questionnaire. The outcome was multimorbidity (2, 3 or 4 NCDs), and the exposures were sociodemographic indicators (age, sex, skin color, marital status and education). The analysis consisted of multinomial logistic regression (odds ratio), stratified by age. RESULTS: Among adults, multimorbidity comprising two, three or four diseases was associated with advancing age (P < 0.001); two and three diseases, with having a partner (P = 0.004 and P < 0.001, respectively); and two, three or four diseases, with lower education (P < 0.001). Among older adults, two, three or four diseases were associated with female sex (P < 0.001); three diseases, with living with a partner (P = 0.018); two diseases, with black skin color (P = 0.016); and two or three diseases, with lower education (P < 0.001). CONCLUSIONS: To control and prevent multimorbidity, strategies for individuals with existing chronic diseases, with partners and with lower education levels are needed. Particularly for adults, advancing age should be considered; and for older adults, being a woman and having black skin color.

Sociodemographic determinants of multimorbidity in Brazilian adults and older adults: a cross-sectional study.

BACKGROUND: Multimorbidity due to non-communicable chronic diseases (NCDs) constitutes a significant challenge for healthcare systems. To attenuate its impacts, it is essential to identify the sociodemographic determinants of this condition, which can discriminate against population segments that are more exposed. OBJECTIVE: To identify associations between multimorbidity conditions and sociodemographic indicators among Brazilian adults and older adults. DESIGN AND SETTING: Cross-sectional telephone-based survey in 26 Brazilian state capitals and the federal district. METHODS: The Vigitel 2013 survey was used, with data collected via a questionnaire. The outcome was multimorbidity (2, 3 or 4 NCDs), and the exposures were sociodemographic indicators (age, sex, skin color, marital status and education). The analysis consisted of multinomial logistic regression (odds ratio), stratified by age. RESULTS: Among adults, multimorbidity comprising two, three or four diseases was associated with advancing age (P < 0.001); two and three diseases, with having a partner (P = 0.004 and P < 0.001, respectively); and two, three or four diseases, with lower education (P < 0.001). Among older adults, two, three or four diseases were associated with female sex (P < 0.001); three diseases, with living with a partner (P = 0.018); two diseases, with black skin color (P = 0.016); and two or three diseases, with lower education (P < 0.001). CONCLUSIONS: To control and prevent multimorbidity, strategies for individuals with existing chronic diseases, with partners and with lower education levels are needed. Particularly for adults, advancing age should be considered; and for older adults, being a woman and having black skin color.

Programa vida ativa melhorando a saúde: alcance e efetividade em idosas com excesso de peso / Active life improving health program: reach and effectiveness in overweight elderly

O objetivo deste estudo foi verificar o alcance e a efetividade do Programa Vida Ativa Melhorando a Saúde (VAMOS) sobre o nível de atividade física, comportamento alimentar e em variáveis antropo-métricas em idosas com excesso de peso participantes do projeto de extensão "Atividade Física para a Terceira Idade". Participaram da pesquisa 34 idosas com excesso de peso divididas em dois grupos: Grupo Intervenção (GI; n=17) com média de idade de 69,2±5,8 anos e Grupo Controle (GC; n=17) com 69,9±6,0 anos. O GI participou de 12 encontros semanais, durante três meses, do VAMOS ­ programa de mudança de comportamento que objetiva motivar as pessoas a adotarem um estilo de vida ativo e saudável. Ambos os grupos praticaram ginástica duas vezes por semana e realizaram avaliações no início e ao final do Programa. Foram realizadas avaliações sociodemográficas, antropométricas, de nível de atividade física e do comportamento alimentar. Os resultados demonstraram que o programa VAMOS teve uma taxa de alcance de 27,5% e manteve a circunferência do quadril (CQ). Quanto à alimentação, foi identificado aumento no preparo de carnes na forma não fritura e diminuição no preparo de frituras em ambos os grupos (p=0,012). Conclui-se que o Programa VAMOS foi efetivo em não aumentar a CQ de idosas com excesso de peso.(AU)

This study has as aim to verify the reach and effectiveness of the Active Life Improving Health Program on the physical activity level, eating behavior and anthropometric variables in overweight elderly women participating in the extension project "Physical Activity for Third Age". Thirty-four overweight elderly women participated in the research, divided into two groups: Intervention Group (IG; n = 17), with a mean age of 69.2 ± 5.8 years; and Control Group (CG; n = 17), with 69.9 ± 6.0 years. IG participated in 12 weekly meetings, during three months of VAMOS, which is a behavior change program that aims to motivate people to adopt an active and healthy lifestyle. Both groups practiced gymnastics twice a week and performed evaluations at the beginning and the end of the program. Sociodemo- graphic, anthropometric, physical activity level and eating behavio assessments were collected. The results showed that the VAMOS program had a reach rate of 27.5% and maintained the hip circumference (HC). Regarding food, it was identified an increase in meat preparation in the non-fried form and a decrease in the preparation as fried in both groups (p = 0.012). It is concluded that the VAMOS Program was effective in not increasing the HC of elderly women with overweight.(AU)

Análise bibliométrica das produções científicas brasileiras na temática atividade física e envelhecimento / Bibliometric analysis of the Brazilian scientific productions about physical activity and aging

A análise de conteúdo e de redes de colaboração pode contribuir para as reflexões e estudos sobre o fluxo informacional. O objetivo do presente estudo é realizar uma análise bibliométrica das produções científicas brasileiras na temática atividade física e envelhecimento. O banco de dados foi construído utilizando-se a base de dados Web of Science (WoS), selecionando-se a Coleção SciELOBrazil. Os termos utilizados na busca foram relacionados com "atividade física" e "envelhecimento". Foram coletadas variáveis de autoria, número/ média de publicações, número/média de citações, quantidade de publicações realizadas por instituição e palavras-chave citadas nos estudos. Posteriormente, os dados foram analisados no software VOS viewer, onde mapas de rede foram criados. Foram encontrados 19 clusters de autores, sendo identificadosaqueles que mais publicam na área da atividade física e envelhecimento no Brasil. Com relação às instituições, verificou-se uma concentração de publicações em Universidades do Sul e Sudeste, com destaque para São Paulo. Com relação às palavras-chave, verificou-se que as mais utilizadas nos estudos foram: qualidade de vida, força muscular, fatores de risco, obesidade e hipertensão. Em conclusão, a temática apresentou expansão com o passar dos anos, identidade própria e consistência nas redes de produção e colaboração entre autores.(AU)

The analysis of content and collaboration networks can contribute to the reflections and studies on the information flow. The objective of the present study is to perform a bibliometric analysis of the Brazilian scientific productions about the physical activity and aging. The database was built using the Web of Science (WoS) database, selecting the SciELO Brazil Collection. The terms used in the search were related to "physical activity" and "aging". Authors' variables, number/average of publications, number/average of cita- tions, number of publications per institution and keywords cited in the studies were collected. Subsequently, the data were analyzed in the VOSviewer software where network maps were created. We found 19 clusters of authors, being identified the ones that publish the most in the area of physical activity and aging in Brazil. With regard to the institutions, there was a concentration of publications in Southern and Southeastern Universities, especially in São Paulo. Regarding the keywords, it was verified that the most used in the studies were: quality of life, muscular strength, risk factors, obesity, and hypertension. In conclusion, the theme presented expansion over the years, its own identity and consistency in the networks of production and collaboration between authors.(AU)

Physical activity and sedentary behavior as multimorbidity discriminators among elderly Brazilians: a cross-sectional study

ABSTRACT BACKGROUND: Associations between behaviors and individual chronic diseases have been demonstrated. However, the relationship between time spent on sedentary behavior and multimorbidity remains less clear. OBJECTIVE: To identify the predictive power of various intensities of physical activity versus sedentary behavior, as discriminatory factors for cardiometabolic multimorbidity (cardiovascular diseases and diabetes) in the elderly. DESIGN AND SETTING: Cross-sectional study in different residential census tracts and residential households in Florianópolis (SC). METHODS: The participants were 425 elderly people (65% women) from the EpiFloripa Aging study in 2014. Sociodemographic variables and self-reported incidence of cardiovascular diseases and diabetes were obtained via a questionnaire. Light physical activity (LPA), moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) were measured using accelerometers. The analyses were stratified according to sex and included a diagnosis for interpretation. Behaviors were taken into consideration if their predictive power in terms of area under the receiver operating characteristic (ROC) curve was greater than 0.50. The time cutoff point was defined from sensitivity and specificity. RESULTS: For older adult men with diabetes, the predictive value of MVPA for absence of multi-morbidity was an area of 0.75 (95% confidence interval, CI: 0.538-0.962), and a cutoff of 17 minutes per day. Older adult women with diabetes had an area of 0.71 (95% CI: 0.524-0.866) and a cutoff of 10 minutes per day. LPA and SB did not present predictive values. CONCLUSION: The time spent on MVPA is a predictor of absence of multimorbidity in elderly people with diabetes, for both sexes.

Physical activity and sedentary behavior as multimorbidity discriminators among elderly Brazilians: a cross-sectional study.

BACKGROUND: Associations between behaviors and individual chronic diseases have been demonstrated. However, the relationship between time spent on sedentary behavior and multimorbidity remains less clear. OBJECTIVE: To identify the predictive power of various intensities of physical activity versus sedentary behavior, as discriminatory factors for cardiometabolic multimorbidity (cardiovascular diseases and diabetes) in the elderly. DESIGN AND SETTING: Cross-sectional study in different residential census tracts and residential households in Florianópolis (SC). METHODS: The participants were 425 elderly people (65% women) from the EpiFloripa Aging study in 2014. Sociodemographic variables and self-reported incidence of cardiovascular diseases and diabetes were obtained via a questionnaire. Light physical activity (LPA), moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) were measured using accelerometers. The analyses were stratified according to sex and included a diagnosis for interpretation. Behaviors were taken into consideration if their predictive power in terms of area under the receiver operating characteristic (ROC) curve was greater than 0.50. The time cutoff point was defined from sensitivity and specificity. RESULTS: For older adult men with diabetes, the predictive value of MVPA for absence of multi-morbidity was an area of 0.75 (95% confidence interval, CI: 0.538-0.962), and a cutoff of 17 minutes per day. Older adult women with diabetes had an area of 0.71 (95% CI: 0.524-0.866) and a cutoff of 10 minutes per day. LPA and SB did not present predictive values. CONCLUSION: The time spent on MVPA is a predictor of absence of multimorbidity in elderly people with diabetes, for both sexes.

Promoting healthy lifestyles in Brazil: design and method of "VAMOS Program" in public health system / Promoção de estilos de vida saudáveis no Brasil: design e método do "Programa VAMOS" no sistema público de saúde

The "Programa Vida Ativa Melhorando a Saúde ­ VAMOS" (Active Life Improving Health) is a community intervention with a behavioral approach. It uses educational strategies to assist health professionals in support the population about the importance of adherence and maintenance of healthy lifestyles. This descriptive study shows the design and method of the VAMOS Program version 2.0. The intervention is for adults and older adults' users of Brazilian public health and aims to motivate them to adopt an active and healthy lifestyle regarding physical activity and eating. The program follows an intervention design that considers the dimensions of the RE-AIM framework. The VAMOS Program version 2.0 has the potential to be offered as a health promotion tool in the Brazilian public health system by using available resources and accessible and healthy behavioral strategies

O "Programa Vida Ativa Melhorando a Saúde ­ VAMOS" é uma intervenção comunitária com abordagem comportamental. Utiliza estratégias educativas para auxiliar os profissionais de saúde a orientar a população sobre a importância da adesão e manutenção de estilos de vida saudáveis. Este estudo descritivo apresenta o design e método do Programa VAMOS, versão 2.0. A intervenção é voltada para adultos e idosos usuários da saúde pública brasileira e visa motivá-los a adotarem um estilo de vida ativo e saudável no que diz respeito à atividade física e à alimentação. O programa segue um design de intervenção que considera as dimensões da ferramenta RE-AIM. O Programa VAMOS, versão 2.0, tem potencial para ser oferecido como ferramenta de promoção da saúde no sistema público de saúde brasileiro por meio da utilização de recursos disponíveis e acessíveis e estratégias comportamentais saudáveis

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

Atividade física para idosos: Guia de Atividade Física para a População Brasileira / Physical activity for older adults: Physical Activity Guidelines for the Brazilian Population

Por iniciativa do Ministério da Saúde, em colaboração com pesquisadores nacionais, elaborou-se o primeiro Guia de Atividade Física (AF) para a População Brasileira, incluindo recomendações para as várias fases da vida e populações especiais. O objetivo deste estudo é apresentar o processo me-todológico e os resultados do capítulo de recomendações de AF para idosos. O Grupo de Trabalho Idosos (GT Idosos) contou com a participação de 11 pesquisadores/profissionais que realizaram reuniões virtuais semanais, revisão sistemática de revisões, que incluiu 50 artigos ao final, e escutas com profissionais de Educação Física (n = 143), gestores (n = 17) e com idosos (n = 22), de todas as regiões do país, por meio de entrevistas telefônicas e formulários eletrônicos. Baseado nos resultados da revisão e das escutas, elaborou-se uma primeira versão das recomendações de AF para idosos, que foi submetida à consulta pública. No total foram recebidas 46 sugestões válidas, das quais 34 foram aceitas e incorporadas ao texto final por possuírem relevância técnica e/ou social. Como resultados, o Guia destaca os principais benefícios da AF para idosos, como melhora dos aspectos físicos, mentais e sociais, e recomenda um mínimo de 150 minutos por semana de AF de intensidade moderada, ou 75 minutos de intensidade vigorosa, considerando as AF no tempo livre, no deslocamento, no trabalho/estudo ou nas tarefas domésticas. Acredita-se que o Guia auxiliará os idosos e profissionais de saúde a conhecerem os benefícios da AF, a quantidade recomendada e as diversas possibilidades de prática, por meio de mensagens e exemplos culturalmente apropriados

At the Ministry of Health initiative, in collaboration with national researchers, the first Physical Activity (PA) Guidelines for the Brazilian Population was prepared, including recommendations for the various stages of life and special populations. This study aims to present the methodological process of the chapter on PA recommendations for the elderly. The Elderly Work Group had 11 researchers/professionals who held weekly virtual meetings, made a systematic review of reviews, which included 50 articles, and promoted a listening among elderly (n = 22), managers (n = 17) and professionals (n = 143) from all country regions, through telephone interviews and online forms. Based on the review and the listening results, a first version of the PA Guidelines for the elderly was elaborated, which was submitted to public consultation. Forty-six valid suggestions were received for the Guide's writing, of which 34 were accepted and incorporated into the final text since they had technical and/or social relevance. As results, the Guidelines highlight the major benefits of PA for the elderly, such as enhancement of the physical, mental and social aspects, and recommends a minimum of 150 minutes of moderate PA or 75 minutes of vigorous PA per week, considering PA in leisure time, commuting and domestic activities, as well as in work/study time. It is believed that these Guidelines will help the elderly and health professionals to get to know the benefits of PA, the recommended amount, and the different possibilities of practice through culturally appropriate messages and examples. Politically, it will reinforce the central role of PA in the prevention and control of chronic non-communicable diseases, boosting actions for its dissemination and implantation

Práticas exitosas em atividade física na Atenção Primária à Saúde: elaboração do conceito / Best practices for physical activity in Primary Health Care settings: a concept elaboration study

Elaborar o conceito de práticas exitosas em atividade física (AF) na atenção primária à saúde (APS). Para análise conceitual empregou-se as etapas: (1) seleção do conceito; (2) determinação dos objetivos; (3) identificação dos possíveis usos do conceito e (4) determinação dos atributos. Foram utilizados análise documental, questionário online, oficina e painel de especialistas. Os participantes foram gestores, coordenadores, profissionais de saúde, usuários e pesquisadores da APS das cinco regiões do Brasil. Para análise foi utilizada a análise de conteúdo, por meio do software NVivo. O conceito de prática exitosa em AF na APS foi definido como uma ação que promove aumento da AF dos participantes por meio de um processo planejado, replicável e sustentável que garante e promove a participação e autonomia. Os atributos foram: planejamento, sustentabilidade, replicação, participação e autonomia. O conceito com seus atributos é essencial para orientar o planejamento, implementação e avaliação de uma prática exitosa em AF na APS.

To develop a concept for best practices in physical activity (PA) in primary health care (PHC) settings. The following steps were taken as part of the conceptual development: (1) concept selection, (2) objective determination, (3) identification of possible uses of the concept, and (4) attribute determination. For data collection, we used document analysis, online questionnaires, a workshop, and an expert panel. Participants included administrators, coordinators, health professionals, community members, and PHC researchers of the five Brazilian regions. To evaluate the qualitative data gathered, content analysis using NVivo software was performed. The concept for best practices in PA in PHC settings was defined as an action that promotes an increase in PA among participants through a planned, replicable, and sustainable process that guarantees and promotes participation and autonomy. This concept includes the following attributes, planning, sustainability, replication, participation, and autonomy. The concept and its attributes are essential to guide the planning, implementation, and evaluation of best practices in PA in the Brazilian PHC.

Validação de tecnologia educacional para implementar um programa comunitário na saúde pública / Validation of educational technology to implement a community program in public health

O objetivo do estudo foi validar o treinamento on-line para implementar o Programa Vida Ativa Melhorando a Saúde "VAMOS", versão 3.0, na Atenção Primária à Saúde. Participaram 48 profissionais (especialistas = 22; profissionais da saúde = 26) que utilizaram o Suitability Assessment of Materials ­ SAM para avaliar a adequação do material e o System Usability Scale ­ SUS para a usabilidade do treinamento. As análises incluíram o Índice de Validade de Conteúdo (IVC ≥ 0,75) e Coeficiente Kappa (k = ≥ 0,61). A adequação do material (SAM = 92,92 ± 4,60; 95,59 ± 4,59) e a usabilidade (SUS = 96,14 ± 5,83; 97,40 ± 3,24) apresentaram escores gerais altos para os dois grupos de avaliadores. O IVC (> 0,80) e a consistência interna (k = 0,60 a 0,77) mostraram percentuais de concordância entre 70 e 84%. Assim, o treinamento on-line foi validado para capacitar profissionais da saúde para implementação do Programa VAMOS

The present study aims to validate online training to implement Active Life Improving Health Pro-gram "VAMOS" version 3.0, in Primary Health Care. A group of 48 professionals (experts = 22; health professionals = 26) used the Suitability Assessment of Materials (SAM) to evaluate the suit-ability of the material and the System Usability Scale (SUS) for online usability. The analyzes included the Content Validity Index (CVI ≥ 0.75) and Kappa Coefficient (k = ≥ 0.61). The suitability of the material (SAM = 92.92 ± 4.60; 95.59 ± 4.59) and the usability (SUS = 96.14 ± 5.83; 97.40 ± 3.24) presented high overall scores for the two groups of evaluators. The CVI (> 0.80) and internal consistency (k = 0.60 to 0.77) showed agreement percentages between 70 and 84%. Thus, the online training was validated to train health professionals to implement VAMOS Program

Planejamento em saúde sobre práticas corporais e atividade física no Programa Academia da Saúde / Health planning on body practices and physical activity in the health academy program

O objetivo foi analisar o planejamento das práticas corporais e atividades físicas (PC/AF) dos profissionais de educação física concluintes do Curso de Aperfeiçoamento em Implementação da Política Nacional de Promoção da Saúde: Programa Academia da Saúde (PAS). Das ações analisadas (n = 149), 60,5% (n = 286) eram de PC/AF. A ginástica foi mais frequente (20,1%; n = 95) e 21,4% (n = 101) das práticas tinham a alimentação associada. Mais de 60% das ações não informaram instrumentos (n = 330), cronograma (n = 345), recursos financeiros (n = 366) e alcance dos usuários (n = 394). A atuação multiprofissional foi prevista em 61,7% (n = 292) das ações. Sendo assim, o planejamento em saúde carece de informações metodológicas, avaliação e público-alvo para implementação de ações

The aim was to analyze the planning of body practices and physical activities (BP/PA) of physical education professionals concluding the Improvement Course in Implementation of the National Health Promotion Policy: Academia da Saúde Program (PAS). Of the analyzed actions (n = 149), 60.5% (n = 286) were of BP/PA. Gymnastics was more frequent (20.1%; n = 95) and 21.4% (n = 101) of the practices had associated food. More than 60% of the actions did not inform instruments (n = 330), schedule (n = 345), financial resources (n = 366) and reach of users (n = 394). Multiprofessional action was expected in 61.7% (n = 292) of the actions. Thus, health planning lacks methodological information, assessment, and target audience for implementing actions

Efetividade de uma intervenção na promoção de estilo de vida de servidores públicos / Effectiveness of an intervention in promoting the lifestyle of public servants

Este estudo teve por objetivo avaliar o alcance e a efetividade do programa de mudança de comportamento denominado "Vida Ativa Melhorando a Saúde" ­ VAMOS (versão 2.0) em servidores públicos técnico-administrativos da Universidade Federal de Santa Catarina (UFSC). Trata-se de um estudo de intervenção, do tipo quase experimental, realizado com 35 servidores divididos em grupo intervenção (GI = 22) e controle (GC = 13). O GI participou durante seis meses da intervenção VAMOS e o GC recebeu informações em um único momento sobre a importância de comportamentos saudáveis. O alcance e a efetividade da intervenção foram avaliados por meio da ferramenta RE-AIM. Foram realizadas medidas de pré e pós-intervenção para avaliar o nível de atividade física, o comportamento alimentar, a antropometria e a qualidade de vida. Para a análise dos dados foi utilizado o teste qui-quadrado, análise de variância two way para medidas repetidas e método de equações de estimações generalizadas (p < 0,05). As análises dos dados foram realizadas no programa IBM® versão 22.0. O alcance da intervenção foi de 14,5%. Em relação a efetividade, o GI diminuiu o tempo gasto em comportamento sedentário e aumentou a atividade física de intensidade moderada/vigorosa, elevou o consumo de alimentos saudáveis, reduziu as medidas antropométricas e melhorou a percepção da qualidade de vida positiva. Por meio de orientações educacionais sobre a importância da adesão de comportamentos saudáveis relacionados a atividade física e alimentação, o VAMOS promoveu mudanças de comportamentos que produziram impactos positivos na saúde dos servidores públicos técnico-administrativos

This study aimed to evaluate the reach and effectiveness of the behavior change program called "Active Life Improving Health" - VAMOS (version 2.0) in technical-administrative public servants at the Federal University of Santa Catarina (UFSC). It is an intervention study, of an almost experimental type, carried out with 35 servers divided into an intervention group (IG = 22) and a control group (CG = 13). The IG participated for six months in the intervention, and the CG received information in a single moment about the importance of healthy behaviors. The reach and effectiveness of the intervention were assessed using the RE-AIM tool. Pre- and post-intervention measures were taken to evaluate the level of physical activity, eating behavior, anthropometry and quality of life. For data analysis, the chi-square test, two-way analysis of variance for repeated measures and generalized estimation equation method were used (p < 0.05). The data was analyzed using the IBM® program version 22.0. The reach of the intervention was 14.5%. Regarding effectiveness, the IG decreased the time spent on sedentary behavior and increased the moderate/vigorous physical activity, increased consumption of healthy foods, reduced anthropometric measurements and improved the perception of a positive quality of life. Through educational guidelines on the importance of adhering to healthy behaviors related to physical activity and food, VAMOS promoted behavioral changes which produced positive impacts on the health of technical-administrative public servants