Programa Atitude, Movimento e Escolhas para uma vida saudável em adolescentes: relação entre comportamento sedentário e desempenho cognitivo / Attitude, Movement and Choices Program for a healthy life in adolescents: relationship between sedentary behavior and cognitive performance

A adolescência é um período marcado por alterações neuroendócrinas que influenciam o desenvolvimento do cérebro e o comportamento. Adolescentes apresentam chances aumentadas de adotar comportamentos de risco em seu estilo de vida, dentre eles o comportamento sedentário. Nesse sentido, estudos de intervenção têm buscado desenvolver estratégias eficientes para estimular adolescentes a adotarem um estilo de vida saudável. No entanto, embora ações promissoras possam ser identificadas na literatura, o real mecanismo que atua na regulação do comportamento em adolescentes parece estar associado a uma neurotrofina chamada de Fator Neurotrófico Derivado do Cérebro (BDNF), e estudar como os comportamentos de risco influenciam na sua secreção são de grande relevância para desenvolver intervenções mais efetivas. Sendo assim, o objetivo da presente tese é descrever a fundamentação teórica para o planejamento de uma intervenção multicomponente baseada na escola com ações combinadas para a promoção da atividade física, redução do comportamento sedentário e educação alimentar e nutricional, e as possíveis consequências para o desempenho cognitivo e saúde de adolescentes. A metodologia está descrita em formato de coletânea de artigos e foi dividida em quatro etapas. A primeira etapa descreve uma revisão sistemática que foi desenvolvida durante os estudos de fundamentação teórica para o planejamento da intervenção do Programa Atitude, Movimento e Escolhas para uma vida saudável (Programa AME), em que foi possível identificar a necessidade de implementar uma etapa específica de formação dos professores de educação física. Na segunda etapa foi detalhada a metodologia de uma revisão sistemática que tem como objetivo de investigar a associação entre comportamento sedentário e BDNF em adolescentes. O protocolo metodológico da revisão foi registrado no Registro Internacional Prospectivo de Revisões Sistemáticas (PROSPERO) sob o identificador CRD42023392246 e segue as diretrizes dos Principais Itens para relatar Revisões Sistemáticas e Meta-análises (PRISMA). A etapa três apresenta essa revisão sistemática concluída, com todos os resultados das buscas e análise das informações extraídas dos artigos incluídos. A quarta etapa trata-se de um estudo de justificativa e fundamentação teórica para os métodos abordados no eixo de comportamento sedentário da intervenção do Programa AME, a qual foi registrada na plataforma do Registro Brasileiro de Ensaios Clínicos sob o número RBR-86xv46. Pode-se dizer que o Programa AME é uma proposta integrada, sustentável e de baixo custo, com grande potencial para produzir benefícios no estilo de vida, desempenho cognitivo e saúde de adolescentes. Por fim, os resultados desses estudos fortalecerão a prática baseada em evidências no âmbito de pesquisas voltadas para a promoção da saúde no contexto escolar (AU).

Adolescence is a period marked by several neuroendocrine changes that influence brain development and behavior. Adolescents are more likely to adopt risky behaviors in their lifestyle, including sedentary behavior. In this sense, intervention studies have sought to develop efficient strategies to encourage adolescents to adopt a healthy lifestyle. However, although promising actions can be identified in the literature, the real mechanism that acts in the regulation of behavior in adolescents seems to be associated with the neurotrophin Brain-Derived Neurotrophic Factor (BDNF), and studying how risk behaviors influence its secretion are of great relevance to develop more effective interventions. Therefore, the objective of this thesis is to describe the theoretical foundation to the planning of a school-based multicomponent intervention with combined actions to promote physical activity, reduction of sedentary behavior and food and nutrition education, and the possible consequences for cognitive performance and adolescent health. The methodology of this thesis is described in the format of a collection of articles and was divided into four stages. The first stage describes a systematic review that was developed during the theoretical foundation studies for planning the intervention of the Attitude, Movement and Choices for a Healthy Life Program (AME Program), and it was possible to identify the need to implement a specific training stage for physical education teachers. In the second stage, was detailed the methodology of a systematic review that will be developed with the objective of investigating the association between sedentary behavior and BDNF in adolescents. The methodological protocol for the review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the identifier CRD42023392246 and follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The third stage presents this completed systematic review, with all search results and analysis of information extracted from the included articles. The fourth step is a study of rationale and theoretical foundation for the methods addressed in the sedentary behavior axis of the AME Program intervention, which was registered on the Brazilian Registry of Clinical Trials platform under the number RBR-86xv46. It can be said that the AME Program is an integrated, sustainable and low-cost proposal, with great potential to produce benefits in lifestyle, cognitive performance and health of adolescents. Finally, the results of these studies will strengthen evidence-based practice in research aimed at promoting health in the school context (AU).

Training programs in communication skills to improve self-efficacy for health personnel: Protocol for a systematic review and meta-analysis.

BACKGROUND: Patient-centered care should be the focus of health services, where improvements in the communication skills of health professionals promote excellent health and quality care. Thus, this study is a protocol for a systematic review and meta-analysis to evaluate the effectiveness of training programs in communication skills to promote self-efficacy in the communication of health personnel. METHODS: This systematic review protocol is conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) statement guidelines and the Cochrane Handbook of Systematic Reviews of Interventions. The review should include studies carried out with health professionals who have undergone training in communication skills aimed at promoting their self-efficacy. Clinical trials (randomized, non-randomized), community trials, and quasi-experimental studies should be included. Therefore, the comprehensive search strategy will be conducted in the following databases: PubMed/Medline, Scopus, Web of Science, EMBASE, Science Direct, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials (CENTRAL). Two independent reviewers will conduct all study selection procedures, data extraction, and methodological evaluation, and disagreements will be referred to a third reviewer. RevMan 5.3 software will be used to gather data and perform the meta-analysis if possible. RESULTS: This systematic review will provide evidence on more effective programs for communication skills training and will consider information such as duration, educational strategies, assessment measures, and outcomes that promote health worker self-efficacy. DISCUSSION: This systematic review should provide evidence for effective communication skills training for health professionals in order to guide new strategies for quality care. DISSEMINATION AND ETHICS: The findings of this scoping review will be disseminated in print, at conferences, or via peer-reviewed journals. Ethical approval is not necessary as this paper does not involve patient data. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019129384.