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.

Characteristics and counseling strategies for physical activity used by primary health care professionals. / Características e estratégias de aconselhamento para atividade física utilizadas por profissionais da atenção primária à saúde.

This study aim to describe the characteristics and strategies of counseling for physical activity used by Primary Health Care (PHC) professionals. A survey was carried out with 587 (85.4% women) health professionals who work in PHC in Florianopolis, in the state of Santa Catarina, southern Brazil. Counseling carried out in the last 12 months was considered. Operational aspects related to counseling practices and strategies used for counseling were evaluated. The frequency of physical activity guidance was 86.2% (95%CI = 83.2-88.8%). Counseling was characterized as a brief practice, carried out in individual consultations, aimed at adults and the older adults and people with morbidities. The most used strategy was to guide users to participate in physical activity groups at the Health Center (89.5%) and in relation to the 5As method, giving some "advice" was the most used strategy (99.0%) and the least used. used was to follow strategies (22.6%). Counseling for physical activity has been based on a brief practice, carried out in individual consultations and focused on people with morbidities and on adults and the elderly. The strategies used do not seem to cover the full care of the advised users.

O estudo buscou descrever as características e estratégias de aconselhamento para atividade física utilizadas por profissionais da atenção primária à saúde (APS). Foi realizada uma pesquisa com 587 profissionais de saúde (85,4% mulheres) que atuam na APS de Florianópolis, no estado de Santa Catarina, Sul do Brasil. Foram considerados os aconselhamentos efetuados nos últimos 12 meses, avaliando-se aspectos operacionais relacionados às práticas e estratégias utilizadas. A frequência de orientação de atividade física foi de 86,2% (IC95% = 83,2-88,8%). O aconselhamento se caracterizou como uma prática breve, realizada em consultas individuais, voltadas para adultos e idosos e pessoas com morbidades. A estratégia mais utilizada foi orientar usuários a participarem de grupos de atividade física no Centro de Saúde (89,5%), e em relação ao método 5As, dar algum "conselho" foi a estratégia mais utilizada (99,0%), e a menos utilizada foi seguir estratégias (22,6%). Aconselhamento para atividade física tem sido baseado em uma prática breve, realizada em consultas individuais e focada em pessoas com morbidades e em adultos e idosos. As estratégias utilizadas parecem não abranger o cuidado integral dos usuários aconselhados.

Características e estratégias de aconselhamento para atividade física utilizadas por profissionais da atenção primária à saúde / Characteristics and counseling strategies for physical activity used by primary health care professionals

Resumo O estudo buscou descrever as características e estratégias de aconselhamento para atividade física utilizadas por profissionais da atenção primária à saúde (APS). Foi realizada uma pesquisa com 587 profissionais de saúde (85,4% mulheres) que atuam na APS de Florianópolis, no estado de Santa Catarina, Sul do Brasil. Foram considerados os aconselhamentos efetuados nos últimos 12 meses, avaliando-se aspectos operacionais relacionados às práticas e estratégias utilizadas. A frequência de orientação de atividade física foi de 86,2% (IC95% = 83,2-88,8%). O aconselhamento se caracterizou como uma prática breve, realizada em consultas individuais, voltadas para adultos e idosos e pessoas com morbidades. A estratégia mais utilizada foi orientar usuários a participarem de grupos de atividade física no Centro de Saúde (89,5%), e em relação ao método 5As, dar algum "conselho" foi a estratégia mais utilizada (99,0%), e a menos utilizada foi seguir estratégias (22,6%). Aconselhamento para atividade física tem sido baseado em uma prática breve, realizada em consultas individuais e focada em pessoas com morbidades e em adultos e idosos. As estratégias utilizadas parecem não abranger o cuidado integral dos usuários aconselhados.

Abstract This study aim to describe the characteristics and strategies of counseling for physical activity used by Primary Health Care (PHC) professionals. A survey was carried out with 587 (85.4% women) health professionals who work in PHC in Florianopolis, in the state of Santa Catarina, southern Brazil. Counseling carried out in the last 12 months was considered. Operational aspects related to counseling practices and strategies used for counseling were evaluated. The frequency of physical activity guidance was 86.2% (95%CI = 83.2-88.8%). Counseling was characterized as a brief practice, carried out in individual consultations, aimed at adults and the older adults and people with morbidities. The most used strategy was to guide users to participate in physical activity groups at the Health Center (89.5%) and in relation to the 5As method, giving some "advice" was the most used strategy (99.0%) and the least used. used was to follow strategies (22.6%). Counseling for physical activity has been based on a brief practice, carried out in individual consultations and focused on people with morbidities and on adults and the elderly. The strategies used do not seem to cover the full care of the advised users.

Geocoding processes in cohort studies: methods applied in the EpiFloripa Aging.

OBJECTIVE: To describe the process and epidemiological implications of georeferencing in EpiFloripa Aging samples (2009-2019). METHOD: The EpiFloripa Aging Cohort Study sought to investigate and monitor the living and health conditions of the older adult population (≥ 60) of Florianópolis in three study waves (2009/2010, 2013/2014, 2017/2019). With an automatic geocoding tool, the residential addresses were spatialized, allowing to investigate the effect of the georeferencing sample losses regarding 19 variables, evaluated in the three waves. The influence of different neighborhood definitions (census tracts, Euclidean buffers, and buffers across the street network) was examined in the results of seven variables: area, income, residential density, mixed land use, connectivity, health unit count, and public open space count. Pearson's correlation coefficients were calculated to evaluate the differences between neighborhood definitions according to three variables: contextual income, residential density, and land use diversity. RESULT: The losses imposed by geocoding (6%, n = 240) caused no statistically significant difference between the total sample and the geocoded sample. The analysis of the study variables suggests that the geocoding process may have included a higher proportion of participants with better income, education, and living conditions. The correlation coefficients showed little correspondence between measures calculated by the three neighborhood definitions (r = 0.37-0.54). The statistical difference between the variables calculated by buffers and census tracts highlights limitations in their use in the description of geospatial attributes. CONCLUSION: Despite the challenges related to geocoding, such as inconsistencies in addresses, adequate correction and verification mechanisms provided a high rate of assignment of geographic coordinates, the findings suggest that adopting buffers, favored by geocoding, represents a potential for spatial epidemiological analyses by improving the representation of environmental attributes and the understanding of health outcomes.

How do the year's seasons and specific weather indices affect physical activity and the patterns of use of public open spaces in the Brazilian context?

BACKGROUND: Public open spaces (POS) can offer various resources to promote visitation and engagement in moderate-to-vigorous physical activity (MVPA). However, the influence of seasonal variations and specific meteorological conditions on this relationship remains unclear. Thus, this study aims to investigate the effect of seasonal variations and specific meteorological elements on different days of the week and times of day on POS use and POS-based MVPA in the Brazilian context. METHODS: In 2018, repeated measurements carried out in Southern Brazil used a systematic observation to identify the presence of users in the POS and their engagement in MVPA. The meteorological elements (temperature, thermal sensation, and relative humidity), as well as seasonality (summer, autumn, winter, and spring), were aggregated into the observations. RESULTS: A total of 19,712 systematic observations were conducted across nine POS. During these observations, a total of 59,354 users were identified. Out of theses, 39,153 (66.0%) were engaged in POS-based MVPA. The presence of users was found to be more frequent during the spring season (38.7%) and on weekends (ranging from 37.6 to 50.1% across seasons). Additionally, user presence was higher in the late afternoon (ranging from 36.4 to 58.2% across seasons) and at higher temperatures with lower relative humidity (p-value < 0.001). Regarding POS-based MVPA, it was more frequent during the winter season (36.4%) and on weekdays (ranging from 73.2 to 79.9% across seasons). Similarly, MVPA was higher in the late afternoon (ranging from 58.3 to 67.5% across seasons) and at lower temperatures and thermal sensations (p-value < 0.005). CONCLUSIONS: Higher presence of users in POS, as well as their visiting, to practice POS-based MVPA, depending on the seasons and specific meteorological elements. By creating infrastructure and conducive conditions, cities can encourage individuals to adopt more active and healthy behaviors. These findings emphasize the importance of designing urban spaces that promote physical activity and contribute to overall well-being.

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.

Is Walk Score Associated With Physical Activity and Screen Time in Brazilian Older Adults?

This study aimed to examine the relationship between Walk Score index with walking to commuting, moderate-to-vigorous physical activity, and screen time in older adults. Georeferenced addresses were entered into the Walk Score platform. Walking to commute and moderate-to-vigorous physical activity were assessed using the International Physical Activity Questionnaire and categorized according to the World Health Organization recommendations. Screen time was analyzed through self-reported time watching television/being on the computer. We used binary logistic regression to estimate the association between variables. Older adults who lived in places with higher Walk Score had a higher prevalence of walking to commuting (odds ratio = 1.73; 95% confidence interval [1.18, 2.55]) and engaging in moderate-to-vigorous physical activity (odds ratio = 1.76; 95% confidence interval [1.05, 2.98]). A relationship also was observed between higher Walk Score and more time in screen time (odds ratio = 1.67; 95% confidence interval [1.19, 2.34]). The results showed that residing in a more walkable neighborhood increased the chances of the older adults spending 3 hr or more in front of a screen.

How can public open spaces contribute to physical activity promotion? / Como os espaços públicos abertos podem contribuir para a promoção da atividade física?

Public open spaces (POSs) are means to ensure one's right to recreation and health. The objective of this essay is to present reflections and evidence on how these spaces contribute to promoting physi-cal activity (PA). Understanding how to access (proximity/distance), quantity and diversity, and the surrounding and internal conditions of places (quality, structure, aesthetics, safety) can affect the use of POSs is imperative for public management actions. Thinking of POS use beyond PA by recog-nizing its social, economic, and cultural benefits can be fundamental to reduce inequalities regarding access to these places. POS-related actions and demands are intersectoral, multiprofessional, and interdisciplinary, thus requiring political, academic, and community involvement and commitment for PA promotion

Espaços públicos abertos (EPA) são equipamentos que promovem o direito à recreação e à saúde. O objetivo deste ensaio é apresentar reflexões e evidências sobre como esses espaços contribuem para a promoção da atividade física (AF). Compreender como o acesso (proximidade/distância), a quantidade e diversidade, as condições do entorno e internas dos locais (qualidade, estrutura, estética, segurança), podem afetar o uso dos EPA é fundamental para ações da gestão pública. Pensar o uso do EPA para além da prática de AF, reconhecendo seus benefícios sociais, econômicos e culturais pode ser fundamental para diminuir as iniquidades de acesso a esses locais. Ações e demandas relacionadas aos EPA são intersetoriais, multiprofissionais e interdisciplinares, necessitando com isso envolvimento e comprometimento político, acadêmico e comunitário, a fim de promover AF

Describing physical activity in public open spaces in Brazil: Active City, Healthy City Program / Descrevendo a atividade física em espaços públicos abertos no Brasil: Programa Cidade Ativa, Cidade Saudável

This study aimed to describe the physical activity (PA) in public open spaces (POS) in a medi-um-sized city in Brazil. The System for Observing Play and Recreation in Communities (SOPARC) was applied to evaluate a representative sample of users in 10 POS which received actions from the Active City, Healthy City Program. The places were evaluated four days a week (Tuesday, Wednes-day, Saturday, and Sunday) at four times (8 am, 10 am, 2 pm, and 4 pm). The proportion of users by gender, age group, skin color, and PA level was compared between the POS using the chi-square test for heterogeneity in the STATA software (p<0.05). As main results, 32,768 scans were performed in 64 target areas and identified 8,634 individuals. The highest proportion of people were males (58%), adults (38%), with white skin color (97%), and in light or moderate PA (76%). Except for skin color, there was a significant difference in the proportion of all other variables between the POS (p < 0.05). In conclusion, the POS was more commonly used by men, adults, and people of white skin color for light and moderate PA. Based on the results, program managers could reallocate resources to increase utilization and PA at each place

O objetivo deste estudo foi descrever a atividade física (AF) em espaços públicos abertos (EPA) em uma cidade de médio porte do Brasil. O System for Observing Play and Recreation in Communities (SOPARC) foi utilizado para avaliar uma amostra representativa de frequentadores de 10 EPA que receberam ações do programa Cidade Ativa, Cidade Saudável. Os locais foram avaliados quatro dias da semana (terça-feira, quarta-feira, sábado, domingo) em quatro horários (8h, 10h, 14h, 16h). A proporção de frequentadores por sexo, faixa etária, cor de pele e nível de AF foi comparada entre os EPA pelo teste do qui-quadrado para heterogeneidade no software STATA (p < 0,05). Como resultados principais, foram realizados 32.768 scans em 64 áreas-alvo e 8.634 frequentadores foram identificados. Foi observada maior proporção de pessoas do sexo masculino (58%), adultos (38%), de cor de pele branca (97%) e em AF de intensidade leve ou moderada (76%). Com exceção da cor da pele, houve diferença significante na proporção das demais variáveis entre os EPA (p < 0,05). Em conclusão, os EPA são mais comumente utilizados por homens, pessoas adultas, de cor de pele branca e para a prática de AF de intensidade leve e moderada. Com base nos resultados, os gestores do programa poderiam realocar recursos para aumentar a utilização e a AF em cada local

Reabilitação funcional e barreiras para atividade física na COVID-longa: um ensaio clínico randomizado / Functional rehabilitation and barriers to physical activity after COVID-19: a randomized clinical trial

O estudo teve como objetivo analisar as barreiras percebidas à prática de atividade física durante um programa de treinamento multicomponente em adultos e idosos pós infecção por COVID-19. Realizou-se um ensaio clínico randomizado com 40 participantes (19 grupo controle e 21 grupo intervenção). Foram coletadas informações sociodemográficas, de saúde e de barreiras para a prática de atividade física, antes, 12 e 24 semanas após o início da intervenção. A medida das barreiras para a prática de atividade física foi obtida por meio de uma escala válida composta por 16 itens. As diferen-ças de barreiras entre os grupos e ao longo de tempo foi analisada a partir das Equações de Estimativa Generalizada, α = 0,05. As barreiras mais citadas pelos dois grupos na linha de base foram "Preguiça, cansaço ou desânimo" (71%), "Dores, lesões ou incapacidade" (38%) e "Falta de motivação" (48%). As análises principais indicaram que ambos os grupos tiveram redução na frequência da barreira "Pre-guiça, cansaço ou desânimo" na 12ª semana (p = 0,003), porém voltando aos valores iniciais na 24ª semana (p = 0,441). Já a barreira "Por causa da epidemia de coronavírus" foi reduzida na 12ª semana (p = 0,704) e ainda mais reduzida na 24ª semana (p = 0,158), comportamento também similar entre os grupos. Como principal conclusão, barreiras para atividade física podem ser reduzidas pela parti-cipação em programas de exercício supervisionado e recomendação para a prática de atividade física

The study aimed to analyze perceived barriers to physical activity during a multicomponent training pro-gram in adults and seniors post-COVID-19 infection. A randomized clinical trial was conducted with 40 participants (19 control group and 21 intervention group). Sociodemographic, health, and barriers to physical activity information were collected before, 12 and 24 weeks after the start of the intervention. The measure of barriers to physical activity was obtained through a valid scale composed of 16 items. Differences in barriers between groups and over time were analyzed using Generalized Estimating Equations, α = 0.05. The most frequently mentioned barriers at baseline by both groups were "Laziness, fatigue, or lack of enthusiasm" (71%), "Pain, injuries, or disability" (38%), and "Lack of motivation" (48%). The main analyses indicated that both groups had a reduction in the frequency of the barrier "Laziness, fatigue, or lack of enthusiasm" at week 12 (p = 0.003), but returned to initial values at week 24 (p = 0.441). The barrier "Because of the coronavirus epidemic" was reduced in week 12 (p = 0.704) and further reduced in week 24 (p = 0.158), with a similar pattern between groups. The key conclusion is that barriers to physical activity can be reduced through participation in supervised exercise programs and recommendations for physical activity

Neighborhood Availability and Use of Food, Physical Activity, and Social Services Facilities in Relation to Overweight and Obesity in Children and Adolescents.

OBJECTIVE: To evaluate the association of a combined measure of availability and use of facilities from the food environment and overweight (including obesity) among schoolchildren, while taking into account the physical activity and social-assistance environments. METHODS: Cross-sectional study with a probabilistic sample of schoolchildren aged 7 to 14 years living in a southern Brazilian city (n = 2026). Multilevel analyses were performed with overweight as outcome and the food environment as main exposure. Models were adjusted for the physical activity and social-assistance environments, as well as individual and other residential neighborhood characteristics. RESULTS: Greater availability of restaurants around the home was associated with higher odds of overweight (odds ratio [OR] = 1.40; 95% CI = 1.06-1.85). Stronger associations were found for schoolchildren reporting to use restaurants (OR = 1.48; 95% CI = 1.15-1.90). This association remained significant after adjusting for the presence of other food retailers. Schoolchildren who had social-assistance facilities around their homes, but reported not to use them, showed consistently higher odds of being overweight (OR = 1.34; 95% CI = 1.01-1.78) as compared to schoolchildren who had these facilities near home and used them. The physical activity environment was not associated with the outcome. CONCLUSIONS: Availability and use of the food and social-assistance environments were significantly associated with overweight (including obesity) among the schoolchildren. Future research should consider the use of environmental facilities in combination to their geographical availability. Our results highlight the need for policies that limit the access to obesogenic food outlets by children and adolescents.

Effects of physical training on functional, clinical, morphological, behavioural and psychosocial outcomes in post-COVID-19 infection: COVID-19 and REhabilitation study (CORE-study)-a study protocol for a randomised controlled clinical trial.

BACKGROUND: The COVID-19 pandemic remains ongoing, with a significant number of survivors who have experienced moderate to severe clinical conditions and who have suffered losses of great magnitude, especially in functional capacity, triggering limitations to daily autonomy and quality of life. Among the possibilities of intervention for disease rehabilitation, physical exercise training stands out, which can benefit several health outcomes and favours the adoption of healthier behaviours. Therefore, the aim of the study will be to analyse the effects of physical training on the functional, clinical, morphological, behavioural and psychosocial status in adults and the elderly following COVID-19 infection. METHODS: A randomised controlled clinical trial is to be conducted in parallel, with the experimental group undergoing an intervention involving a multicomponent physical rehabilitation programme, carried out at the Sports Center in partnership with the Academic Hospital of the Federal University of Santa Catarina, in Florianópolis, Brazil. Participants will be adults and the elderly, of both sexes, in a post-COVID-19-infection state, who were hospitalised during the infection. The intervention will have a total duration of 24 weeks and will include a multicomponent physical training programme, which will have gradual progression in frequency, duration and intensity over time. Regarding the outcomes, before, at the 12th and after 24 weeks of intervention, functional (primary outcome = functional index of aerobic capacity), clinical, morphological, behavioural and psychosocial outcomes will be assessed. DISCUSSION: This study will contribute to a greater understanding of the safety, adherence and benefits of physical training in the rehabilitation of post-COVID-19 patients. The results of this study will be disseminated through presentations at congresses, workshops, peer-reviewed publications and local and international conferences, especially with a view to proposing a post-COVID-19 rehabilitation care protocol. TRIAL REGISTRATION: ReBEC, RBR-10y6jhrs . Registered on 22 February 2022. 2015.

Assessement of the quality of bicycle paths and its correlation with bicycle use in florianópolis / Análise da qualidade das ciclovias e sua relação com o uso de bicicleta em florianópolis

ABSTRACT Bicycle paths are important infrastructures in the cities to promote active commuting. Thus, understanding the information inherent to their quality might help to understand their effects on human behavior. This study aimed at assessing the quality of the bike paths in the city of Florianopolisl by using the QualiCicle instrument. SOPARC tool was used to verify the use profile. A total of 38 cycling axes with a length of 54 km were selected. The qualitative analysis was classified as sufficient, with an overall average of 1.61 points. A total of 6,113 cyclists were observed; the majority was adult men who used to cycle in moderate intensity. Better-quality bike paths had a greater number of cyclists (50.5%). The logistic regression analyzes showed that young people are less likely to use cycle paths classified as 'good' ones (OR: 0.40; 95% CI: 0.24-0.67). Considering per category, there is a greater chance of women to use bike paths with a 'good/excellent' infrastructure quality, and a 'sufficient' and 'good/excellent' signalization. It is concluded that Florianopolis has an adequate bikeway network; however, the infrastructure distribution and the cycle path connections are irregular along the city regions. A better quality of the cycling infrastructures can promote greater use by women and the elderly, groups that perform less physical activity.

RESUMO Ciclovias são estruturas importantes nas cidades para promover o deslocamento ativo. Assim, compreender as informações inerentes à sua qualidade pode auxiliar na compreensão de seus efeitos sobre o comportamento humano. O objetivo deste estudo foi avaliar a qualidade das ciclovias de Florianópolis por meio do instrumento QualiCiclo. O instrumento SOPARC foi utilizado para verificar o perfil de uso. Foram selecionados ao todo 38 eixos de ciclovias com 54 km de extensão, sendo a análise qualitativa classificada como suficiente, com média geral de 1,61 pontos. Foram observados 6.113 ciclistas dos quais a Mayria eram homens, adultos e em intensidade moderada. As ciclovias de melhor qualidade possuem Mayr número de ciclistas (50,5%). As análises de regressão logística mostraram que, usualmente, jovens possuem menos chance de utilizarem as ciclovias classificadas como "boa" (OR:0,40; IC95%: 0,24-0,67). Quando observado por categoria, há uma Mayr chance de mulheres utilizarem os eixos de ciclovia que possuem "boa/ótima" qualidade de infraestrutura e "suficiente" e "boa/ótima" qualidade de sinalização. Conclui-se que Florianópolis possui uma rede de ciclovias adequada, contudo, a distribuição das estruturas e conexão de ciclovia é irregular entre as regiões da cidade. Uma Mayr qualidade da infraestrutura cicloviária pode promover Mayr uso por mulheres e idosos, grupos que menos realizam atividade física.

Geocoding processes in cohort studies: methods applied in the EpiFloripa Aging / Processos de geocodificação em estudos de coorte: métodos aplicados no EpiFloripa Idoso

ABSTRACT OBJECTIVE To describe the process and epidemiological implications of georeferencing in EpiFloripa Aging samples (2009-2019). METHOD The EpiFloripa Aging Cohort Study sought to investigate and monitor the living and health conditions of the older adult population (≥ 60) of Florianópolis in three study waves (2009/2010, 2013/2014, 2017/2019). With an automatic geocoding tool, the residential addresses were spatialized, allowing to investigate the effect of the georeferencing sample losses regarding 19 variables, evaluated in the three waves. The influence of different neighborhood definitions (census tracts, Euclidean buffers, and buffers across the street network) was examined in the results of seven variables: area, income, residential density, mixed land use, connectivity, health unit count, and public open space count. Pearson's correlation coefficients were calculated to evaluate the differences between neighborhood definitions according to three variables: contextual income, residential density, and land use diversity. RESULT The losses imposed by geocoding (6%, n = 240) caused no statistically significant difference between the total sample and the geocoded sample. The analysis of the study variables suggests that the geocoding process may have included a higher proportion of participants with better income, education, and living conditions. The correlation coefficients showed little correspondence between measures calculated by the three neighborhood definitions (r = 0.37-0.54). The statistical difference between the variables calculated by buffers and census tracts highlights limitations in their use in the description of geospatial attributes. CONCLUSION Despite the challenges related to geocoding, such as inconsistencies in addresses, adequate correction and verification mechanisms provided a high rate of assignment of geographic coordinates, the findings suggest that adopting buffers, favored by geocoding, represents a potential for spatial epidemiological analyses by improving the representation of environmental attributes and the understanding of health outcomes.

RESUMO OBJETIVO Descrever o processo e as implicações epidemiológicas do georreferenciamento nas amostras do EpiFloripa Idoso (2009-2019). MÉTODO O estudo de coorte EpiFloripa Idoso buscou investigar e acompanhar as condições de vida e saúde da população idosa (≥ 60) de Florianópolis em três ondas de estudo (2009/2010, 2013/2014, 2017/2019). Com uma ferramenta de geocodificação automática, os endereços residenciais foram espacializados, permitindo a investigação do efeito das perdas amostrais do georreferenciamento em relação a 19 variáveis, avaliadas nas três ondas. A influência de diferentes definições de vizinhança (setores censitários, buffers euclidianos e buffers pela rede de ruas) foi examinada nos resultados de sete variáveis: área, renda, densidade residencial, uso misto do solo, conectividade, contagem de unidades de saúde, e contagem de espaços livres públicos. Coeficientes de correlação de Pearson foram calculados para avaliar as diferenças entre as definições de vizinhança de acordo com três variáveis: renda contextual, densidade residencial e diversidade de uso do solo. RESULTADO As perdas impostas pela geocodificação (6%, n = 240) não ocasionaram diferença estatística significativa entre a amostra total e a georreferenciada. A análise das variáveis do estudo sugere que o processo de geocodificação pode ter incluído uma maior proporção de participantes com melhor nível de renda, escolaridade e condições de vida. Os coeficientes de correlação evidenciaram pouca correspondência entre medidas calculadas pelas três definições de vizinhança (r = 0,37-0,54). A diferença estatística entre as variáveis calculadas por buffers e setores censitários ressalta limitações no uso destes na descrição dos atributos geoespaciais. CONCLUSÃO Apesar dos desafios relacionados à geocodificação, como inconsistências nos endereços, adequados mecanismos de correção e verificação propiciaram elevada taxa de atribuição de coordenadas geográficas. Os achados sugerem que a adoção de buffers, favorecida pela geocodificação, representa uma potencialidade para análises epidemiológicas espaciais ao aprimorar a representação dos atributos do ambiente e a compreensão dos desfechos de saúde.

Neighbourhood walkability and mental health in older adults: A cross-sectional analysis from EpiFloripa Aging Study.

This study aims to analyse the association between walkability index and depressive symptoms and cognitive impairment and test the mediating role of moderate-vigorous physical activity (MVPA) in this relationship among older adults from Florianópolis, Brazil. This is cross-sectional research with data from the third wave of the EpiFloripa Aging cohort study, conducted in 2017-2019. Depressive symptoms were assessed using the short version of the Geriatric Depression Scale (GDS), and cognitive impairment, using the Mini-Mental State Examination (MMSE) scales. The neighbourhood environment was assessed using a walkability index, which considered 500-m network buffers around the participants' homes. Binary logistic regression analysis the association between the walkability index (quartile) and mental health outcomes (yes vs. no). Structural equation modelling evaluated the mediation between the walkability index and cognitive impairment by MVPA with an estimator of dichotomous variables. 1,162 people participated in the study (61.5% women, average age = 73.1). Older adults residing in places with a high and highest walkability index were 38% and 44% less likely to have cognitive impairment, respective. There was no association between depressive symptoms and walkability index in crude nor adjusted analysis. Engaging in MVPA had a partial but not significant effect (14%; p = 0.087), showing a tendency for this relationship to be partially explained by the greater engagement in physical activities in places with greater walkability. Policy planning to prevent and reduce the risks of cognitive impairment should consider factors of the physical environment as determinants in older adults.

How much time in sedentary behavior is associated with probable sarcopenia in older adults?

Sedentary activities, such as watching television and using the computer, are frequent conditions in older adults and can be associated with sarcopenia. The objectives of this study were: (a) to establish sedentary behavior (SB) cutoff values for screening probable sarcopenia in community-dwelling older adults and (b) to verify the association between SB and probable sarcopenia according to the established cutoff point. This was a cross-sectional study including 1,165 community residents in Florianopolis/SC. SB was assessed using the International Physical Activity Questionnaire. The outcome was probable sarcopenia (assessed by time ≥ 15 s in the Five times sit-to-stand test). The cut-off points found for SB were time > 120 min/day [AUC: 0.54 (95%CI: 0.51; 0.57)] watching TV or video/DVD and ≤ 20 min/day [AUC: 0.59 (95%CI: 0.56;0.62)] using computer/internet. Older adults with SB had 1.30 (95% CI: 1.01; 1.66) and 1.46 (95% CI: 1.08; 1.96) greater chances of having sarcopenia, respectively.

Barriers to physical activity among adults in primary healthcare units in the National Health System: a cross-sectional study in Brazil

ABSTRACT BACKGROUND: Many factors may negatively impact physical activity (PA), but studies lack evidence of individual predictors of perceived barriers to PA among adults in primary healthcare units. OBJECTIVE: To analyze associations between sociodemographic characteristics, health conditions, leisure-time physical activity (LTPA), PA counseling and perceived barriers to LTPA among adult patients in primary healthcare units of the National Health System in Brazil. DESIGN AND SETTING: Cross-sectional study on a representative sample of adults in primary healthcare units in São José dos Pinhais, Paraná, Brazil. METHODS: This study was conducted in 2019, among 779 adults (70% women). Barriers to LTPA, sociodemographic characteristics (sex, age, marital status, skin color, education and income), health conditions (body mass index, hypertension, diabetes, dyslipidemia, coronary disease and medications), LTPA level and PA counseling received were measured using validated, standardized procedures. The data were analyzed using chi-square and Mann-Whitney U tests. RESULTS: The most prevalent barriers were "feeling too tired" (53%) and "lack of time" (52%). PA counseling was inversely associated with "lack of time" (45% versus 57%; P < 0.001) but positively associated with "injury or disease" (38% versus 29%; P = 0.008). There was an inverse linear trend between the number of barriers and LTPA (walking and total) (P < 0.001). Most barriers differed in comparisons of sociodemographic characteristics, health conditions, LTPA and counseling (P < 0.05). CONCLUSIONS: The barriers vary according to the individual predictors. Counseling strategies need to be specific for each barrier and may be promising for promoting LTPA within primary healthcare.

Aconselhamento para atividade física realizado por profissionais da Atenção Primária à Saúde / Physical activity counseling in Primary Health Care

Resumo O objetivo deste estudo foi descrever a prevalência e analisar os fatores associados ao aconselhamento para a atividade física realizado por profissionais da Atenção Primária à Saúde (APS) de Florianópolis, Santa Catarina. Foi realizado inquérito com 587 profissionais de 49 centros de saúde. A realização de aconselhamento nos últimos 12 meses foi avaliada. Os fatores explorados na associação foram os sociodemográficos, de formação e atuação profissional, do conhecimento das recomendações de atividade física e do nível de atividade física. A proporção de profissionais que relataram aconselhar para atividade física foi 86,2% (IC95%: 83,2-88,8%). Os profissionais com maiores chances de aconselhar foram os com pós-graduação em Saúde Pública (OR: 3,71; IC95%: 1,69-9,37), que tiveram experiências acadêmicas na APS (OR: 2,68; IC95%:1,32-5,92), que pertenciam ao Núcleo Ampliado de Saúde da Família (OR: 4,52; IC95%: 1,31-28,50), que participavam de reuniões de matriciamento sobre atividade física (OR: 1,91; IC95%: 1,08-3,44) e eram fisicamente ativos (OR: 1,80; IC95%: 1,01-3,27). Os resultados sugerem que aspectos da formação e atuação profissional e o nível de atividade física dos profissionais contribuem positivamente nas ações de aconselhamento para atividade física na APS.

Abstract The aim of this study was to determine the prevalence and examine the correlates of physical activity counseling by primary health care professionals in Florianopolis, state of Santa Catarina. A face-face survey was carried out with 587 professionals from 49 Health Centers. Physical activity counseling was evaluated in the last 12 months. The correlates explored in the association were sociodemographic, training and professional performance, knowledge of physical activity recommendations and physical activity level. The prevalence of physical activity counseling was 86.2% (95%CI=83.2-88.8%). The professionals most likely to provide counseling were those with graduate degrees in Public Health (OR=3.71; 95%CI: 1.69-9.37), who had academic experiences in primary health care (OR=2.68; 95%CI: 1.32-5.92), who belonged to the Family Health Support Center (OR=4.52; 95%CI: 1.31-28.50), who participated in meetings of physical activity (OR=1.91; 95%CI: 1.08-3.44) and were physically active (OR=1.80; 95%CI: 1.01-3.27). The results show that aspects of training and professional performance and the physical activity level of professionals contribute positively to counseling for physical activity in primary health care.

Physical activity counseling in Primary Health Care. / Aconselhamento para atividade física realizado por profissionais da Atenção Primária à Saúde.

The aim of this study was to determine the prevalence and examine the correlates of physical activity counseling by primary health care professionals in Florianopolis, state of Santa Catarina. A face-face survey was carried out with 587 professionals from 49 Health Centers. Physical activity counseling was evaluated in the last 12 months. The correlates explored in the association were sociodemographic, training and professional performance, knowledge of physical activity recommendations and physical activity level. The prevalence of physical activity counseling was 86.2% (95%CI=83.2-88.8%). The professionals most likely to provide counseling were those with graduate degrees in Public Health (OR=3.71; 95%CI: 1.69-9.37), who had academic experiences in primary health care (OR=2.68; 95%CI: 1.32-5.92), who belonged to the Family Health Support Center (OR=4.52; 95%CI: 1.31-28.50), who participated in meetings of physical activity (OR=1.91; 95%CI: 1.08-3.44) and were physically active (OR=1.80; 95%CI: 1.01-3.27). The results show that aspects of training and professional performance and the physical activity level of professionals contribute positively to counseling for physical activity in primary health care.

O objetivo deste estudo foi descrever a prevalência e analisar os fatores associados ao aconselhamento para a atividade física realizado por profissionais da Atenção Primária à Saúde (APS) de Florianópolis, Santa Catarina. Foi realizado inquérito com 587 profissionais de 49 centros de saúde. A realização de aconselhamento nos últimos 12 meses foi avaliada. Os fatores explorados na associação foram os sociodemográficos, de formação e atuação profissional, do conhecimento das recomendações de atividade física e do nível de atividade física. A proporção de profissionais que relataram aconselhar para atividade física foi 86,2% (IC95%: 83,2-88,8%). Os profissionais com maiores chances de aconselhar foram os com pós-graduação em Saúde Pública (OR: 3,71; IC95%: 1,69-9,37), que tiveram experiências acadêmicas na APS (OR: 2,68; IC95%:1,32-5,92), que pertenciam ao Núcleo Ampliado de Saúde da Família (OR: 4,52; IC95%: 1,31-28,50), que participavam de reuniões de matriciamento sobre atividade física (OR: 1,91; IC95%: 1,08-3,44) e eram fisicamente ativos (OR: 1,80; IC95%: 1,01-3,27). Os resultados sugerem que aspectos da formação e atuação profissional e o nível de atividade física dos profissionais contribuem positivamente nas ações de aconselhamento para atividade física na APS.

Barriers to physical activity among adults in primary healthcare units in the National Health System: a cross-sectional study in Brazil.

BACKGROUND: Many factors may negatively impact physical activity (PA), but studies lack evidence of individual predictors of perceived barriers to PA among adults in primary healthcare units. OBJECTIVE: To analyze associations between sociodemographic characteristics, health conditions, leisure-time physical activity (LTPA), PA counseling and perceived barriers to LTPA among adult patients in primary healthcare units of the National Health System in Brazil. DESIGN AND SETTING: Cross-sectional study on a representative sample of adults in primary healthcare units in São José dos Pinhais, Paraná, Brazil. METHODS: This study was conducted in 2019, among 779 adults (70% women). Barriers to LTPA, sociodemographic characteristics (sex, age, marital status, skin color, education and income), health conditions (body mass index, hypertension, diabetes, dyslipidemia, coronary disease and medications), LTPA level and PA counseling received were measured using validated, standardized procedures. The data were analyzed using chi-square and Mann-Whitney U tests. RESULTS: The most prevalent barriers were "feeling too tired" (53%) and "lack of time" (52%). PA counseling was inversely associated with "lack of time" (45% versus 57%; P < 0.001) but positively associated with "injury or disease" (38% versus 29%; P = 0.008). There was an inverse linear trend between the number of barriers and LTPA (walking and total) (P < 0.001). Most barriers differed in comparisons of sociodemographic characteristics, health conditions, LTPA and counseling (P < 0.05). CONCLUSIONS: The barriers vary according to the individual predictors. Counseling strategies need to be specific for each barrier and may be promising for promoting LTPA within primary healthcare.