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

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

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.

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.

Worse sleep quality predicts early drop out from physical exercise programs.

Introduction and Objective: Sleep quality (SQ) benefits from regular physical exercise (PE) practice, but the effect of SQ over behavioral aspects of PE is not well known. In this study, we tested whether sleep variables can predict the drop out risk for PE programs during a six-week critical period for habit formation at gyms. Material and Methods: We assessed 153 volunteers, freshly enrolled at three different gyms and from both sexes, with average age of 33.6 (±11.9) years. Questionnaires provided sociodemographic, health, sleep, physical activity and circadian rhythmicity information. Daily PE practice frequency was monitored using the gym's turnstiles electronic records. We created a multivariate model using Cox regression in order to test the risk of PE program drop out during the first six weeks. Results: Worse SQ predicted a higher drop out risk (HR=1.11; 95%CI = 1.02-1.21; p<0.05), even when adjusted for other potential confounding variables. Conclusion: We found that worse SQ predicted a higher early drop out from PE programs in the formal context of gyms during the first six weeks, along with other variables related to PE practice.

[Physical activity and mental health status among elderly people]. / Atividade física e estado de saúde mental de idosos.

OBJECTIVE: To evaluate the association between physical activity level and mental health status among elderly people. METHODS: This was a population-based survey with a probabilistic sample of 875 elderly people from a city of Southern Brazil, in 2002. The International Physical Activity Questionnaire and the Brazil Old Age Schedule questionnaire were applied. The mental health problems evaluated were depressions and dementia. Total physical activity (leisure-time, occupation, transportation and housework). After descriptive and bivariate analyses, adjusted analyses were performed by means of logistic regression, with adjustment for the factors of total physical activity, leisure-time activity and depression and dementia scores. RESULTS: There were statistically significant inverse associations between dementia and depression with total physical activity and leisure-time physical activity. The odds ratio for total physical activity adjusted for dementia among sedentary subjects in comparison with active subjects was 2.74 (95% CI: 1.85; 4.08), while the respective value adjusted for depression was 2.38 (95% CI: 1.70; 3.33). CONCLUSIONS: The results reinforce the importance of active lifestyles for preventing mental health problems among elderly people. It is inferred that the physical activity was able to reduce and/or delay the risks of dementia, although it cannot be stated that dementia is avoided through physical activity.

Ensino remoto emergencial em tempos de pandemia: Percepções de concluintes do curso de licenciatura em Educação Física da UFPR / Emergency remote education in times of pandemic: Perceptions of graduates of the Physical Education undergraduate course at UFPR / Educación remota de emergencia en tiempos de pandemia: Percepciones de los graduados del curso de licenciatura en Educación Física de la UFPR

O Ensino Remoto Emergencial (ERE) foi adotado por algumas instituições de ensino durante a pandemia da covid-19. Objetivou-se analisar a percepção de concluintes do curso de Licenciatura em Educação Física (EF) sobre o ERE. As participantes relataram ter bom ambiente para acompanhar as aulas remotas, não pensaram em trancar a matrícula/desistir do curso, mas se sentiram tristes por terem concluído pelo ERE. Foi detectada redução do interesse pelas aulas remotas e percepção que o ERE prejudicou a formação docente, além da falta de interação, distanciamento das aulas práticas e não poder estar presencialmente na escola nos estágios. A maior flexibilização de horário foi o aspecto positivo indicado.

Emergency Remote Learning (ERE) was adopted by some educational institutions during the pandemic of COVID-19. We aimed to analyze the perception of graduates of the Physical Education (PE) degree course about the ERE. The participants reported having a good environment to follow the remote classes, did not think about locking the enrollment/dropping out of the course, and felt sad to have concluded by the ERE. A reduction in interest in remote classes and the perception that the distance learning program had detrimental effects on teacher education were indicated, as well as a lack of interaction, distance from practical classes, and not being able to be present in the school during internships. The positive aspect indicated was a more flexible schedule.

El aprendizaje a distancia de emergencia (ERE) fue adoptado por algunas instituciones educativas durante la pandemia de COVID-19. El objetivo de este estudio fue analizar la percepción de los egresados de la carrera de Educación Física (EF) sobre el ERE. Los participantes manifestaron tener un buen ambiente para seguir las clases a distancia, no pensaron en cerrar la matrícula/abandonar el curso y se sintieron tristes por haber concluido por el ERE. Se indicó una reducción del interés por las clases a distancia y la percepción de que la ED había perjudicado su formación docente, así como la falta de interacción, el alejamiento de las clases prácticas y el no poder estar presente en la escuela durante las prácticas. La mayor flexibilidad de horarios fue el aspecto positivo indicado.

Ensino remoto emergencial em tempos de pandemia: Percepções de concluintes do curso de licenciatura em Educação Física da UFPR / Emergency remote education in times of pandemic: Perceptions of graduates of the Physical Education undergraduate course at UFPR / Educación remota de emergencia en tiempos de pandemia: Percepciones de los graduados del curso de licenciatura en Educación Física de la UFPR

O Ensino Remoto Emergencial (ERE) foi adotado por algumas instituições de ensino durante a pandemia da covid-19. Objetivou-se analisar a percepção de concluintes do curso de Licenciatura em Educação Física (EF) sobre o ERE. As participantes relataram ter bom ambiente para acompanhar as aulas remotas, não pensaram em trancar a matrícula/desistir do curso, mas se sentiram tristes por terem concluído pelo ERE. Foi detectada redução do interesse pelas aulas remotas e percepção que o ERE prejudicou a formação docente, além da falta de interação, distanciamento das aulas práticas e não poder estar presencialmente na escola nos estágios. A maior flexibilização de horário foi o aspecto positivo indicado (AU).

Emergency Remote Learning (ERE) was adopted by some educational institutions during the pandemic of COVID-19. We aimed to analyze the perception of graduates of the Physical Education (PE) degree course about the ERE. The participants reported having a good environment to follow the remote classes, did not think about locking the enrollment/dropping out of the course, and felt sad to have concluded by the ERE. A reduction in interest in remote classes and the perception that the distance learning program had detrimental effects on teacher education were indicated, as well as a lack of interaction, distance from practical classes, and not being able to be present in the school during internships. The positive aspect indicated was a more flexible schedule (AU).

El aprendizaje a distancia de emergencia (ERE) fue adoptado por algunas instituciones educativas durante la pandemia de COVID-19. El objetivo de este estudio fue analizar la percepción de los egresados de la carrera de Educación Física (EF) sobre el ERE. Los participantes manifestaron tener un buen ambiente para seguir las clases a distancia, no pensaron en cerrar la matrícula/abandonar el curso y se sintieron tristes por haber concluido por el ERE. Se indicó una reducción del interés por las clases a distancia y la percepción de que la ED había perjudicado su formación docente, así como la falta de interacción, el alejamiento de las clases prácticas y el no poder estar presente en la escuela durante las prácticas. La mayor flexibilidad de horarios fue el aspecto positivo indicado (AU).

Life and health conditions among elderly: results of the EpiFloripa Idoso cohort study. / Condições de vida e saúde de idosos: resultados do estudo de coorte EpiFloripa Idoso.

OBJECTIVE: to identify sociodemographic, behavioral and health changes in a follow-up of participants in the health survey EpiFloripa Idoso. METHODS: this is a population-based longitudinal study with elderly individuals in Florianópolis-SC, Brazil. RESULTS: 1,702 elderly individuals were interviewed in 2009-2010 and 1,197 in 2013-2014 (response rate: 89.1% and 70.2%, respectively); among followed-up individuals, most of them remained with a partner (53.4%), living with other people (76.0%), not working (78.0%), with positive health perception (44.0%), not using the Internet (67.5%), not smoking (57.5%), not consuming alcohol (53.3%), not physically active (56.3%), consuming <5 servings of fruits/vegetables (57.3%), independent (60.5%), overweight (47.0%), with negative screening for cognitive impairment (69.4%), with no depressive symptoms (72.0%) and not having suffered falls (60.6%). CONCLUSION: most elderly did not show significant changes in their sociodemographic, behavioral and health characteristics; the need to rethink more effective actions to improve the elderly health stands out.

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.

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.

EpiFloripa Aging cohort study: methods, operational aspects, and follow-up strategies.

OBJECTIVE: To describe the sample plan, operational aspects, and strategies used in the 2009/2010 and 2013/2014 EpiFloripa Aging Study. METHODS: The EpiFloripa Aging is a population-based longitudinal study with 1,705 older adults (60 years or more) living in the municipality of Florianópolis, State of Santa Catarina, Brazil, in 2009/2010 (baseline). The research was conducted with a face-to-face interviews, organized into blocks of identification, socioeconomic, mental health, health and life habits, global functionality, falls, physical activity, morbidities, use of health services, use of medications, food, oral health, and violence, evaluated in the first (2009/2010) and in the second wave (2013/2014). Additionally, in the second wave, we investigated the issue of discrimination and quality of life. RESULTS: The response rate of the first wave was 89.2% (n = 1,705). The baseline sample, with predominance of women (63.9%), was similar to the 2010 Census regarding age for women and slightly different for younger men. In the second wave, 1,197 participants were interviewed (response rate of 70.3%). Follow-up losses were only observed for the variable age group (p = 0.003), and predominantly for those aged 80 years or more. Mortality data linkage and active search for participants were used as a follow-up strategies. CONCLUSIONS: This study used strategies that were able to help locate the participants and maintain adherence, which ensured a good response rate during investigations.

Functional disability and factors of elderly people with regular physical activity: a cross-sectional study / Incapacidade funcional e fatores associados de idosas praticantes de atividade física regular: um estudo transversal

ABSTRACT Conducting studies in different regions of the country can help to understand which factors are associated with the functional disability of the elderly, considering that this is an important health indicator and may contribute to interventions in this population, aiming to reduce the risk of future dependence, complication or establishment of chronic diseases and morbidities. This study aimed to verify the factors associated with the functional disability of elderly women participating in a physical activity program in Manaus/AM. A cross-sectional study was conducted with 416 elderly women who answered a questionnaire with information on functional disability (dependent variable) and independent variables: age, marital status, monthly income, schooling, retirement, medication use, body mass index, depression symptoms, self-reported illness, and health perception. The overall prevalence of functional disability was 25.7%, which was associated with age ≥80 (OR=2.34, IC95%=1.11-4,94), incomplete primary school (OR=3.22, IC95%=1.24-8.35) and complete primary (OR=3.24, IC95%=1.40-7.50), overweight (OR=2.77, IC95%=1.69-4.54), presence of depression symptoms (OR=4.40, IC95%=1.48-13.07), arthrosis (OR=3.31, IC95%=1.80-5.73), rheumatoid arthritis (OR=2.84, IC95%=1.57-5.15) and negative health perception (OR=3.04, IC95%=1.19-7.78). It was concluded that functional disability was associated with modifiable health factors (scholling, overweight, depression syntoms) ans non modifiable (age, arthritis and arthrosis).

RESUMO A realização de estudos em diferentes regiões do país pode auxiliar no entendimento dos fatores associados à incapacidade funcional do idoso, considerando que este é um importante indicador de saúde e pode contribuir para intervenções nessa população, com o objetivo de reduzir o risco de dependência futura, complicação ou estabelecimento de doenças e morbidades crônicas. Esse estudo objetivou verificar os fatores associados à incapacidade funcional de idosas participantes de programa de atividade física de Manaus-AM. Estudo transversal foi conduzido em 416 mulheres idosas que responderam um questionário contendo informações sobre a incapacidade funcional (IF) (variável dependente) e variáveis independentes: idade, estado civil, renda mensal, escolaridade, aposentadoria, uso de medicação, índice de massa corporal, sintomas depressivos, doenças autorreferidas e percepção de saúde. A prevalência geral de IF foi de 25,7%, a qual esteve associada à idade ≥80 (OR=2.34, IC95%=1.11-4,94), ensino fundamental incompleto (OR=3,22, IC95%=1,24-8,35) e fundamental completo (OR=3,24, IC95%=1,40-7,50), sobrepeso (OR=2,77, IC95%=1,69-4,54), presença de sintomas depressivos (OR=4.40, IC95%=1.48-13.07), artrose (OR=3.31, IC95%=1.80-5.73), artrite reumatoide (OR=2.84, IC95%=1.57-5.15) e percepção de saúde negativa (OR=3.04, IC95%=1.19-7.78). Conclui-se que a IF esteve associada a fatores modificáveis de saúde (escolaridade, sobrepeso e sintomas depressivos) e não modificáveis (idade, artrite e artrose).

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

Promotion of physical activities and healthy eating habits in Primary Care: maintenance of benefits / Promoção da atividade física e hábitos alimentares saudáveis na Atenção Primária: manutenção dos benefícios

ABSTRACT Objective To evaluate the maintenance of the beneficial effects of the Vida Ativa Melhorando a Saúde Program, six months after its completion. Methods A randomized controlled community trial was conducted in two poles of the Academia da Saúde Program, randomly identified as control or intervention groups. The study involved 291 adults and elderly involved in the routine activities of the Academia da Saúde Program. Individuals in the intervention group also participated to the Vida Ativa Melhorando a Saúde Program for 12 weeks. Accelerometers were used to evaluate physical activities, questionnaires for the evaluation of eating habits and anthropometric measures for nutritional status. Results Six months after completion of the intervention, the beneficial results obtained for physical activities and nutritional status were not maintained. The benefits related to eating habits remained, but not exclusively due to the effect of the intervention. Conclusion The Vida Ativa Melhorando a Saúde Program, in the applied format, was not able to promote lasting beneficial effects on physical activities and nutritional status. The Program is being restructured regarding the extension of the intervention time and its didactic material.

RESUMO Objetivo Avaliar a manutenção dos efeitos benéficos do programa Vida Ativa Melhorando a Saúde seis meses após a sua finalização. Métodos Foi conduzido um ensaio comunitário controlado e randomizado em dois polos do programa Academia da Saúde, identificados aleatoriamente como grupo controle e grupo intervenção. Participaram do estudo 291 adultos e idosos envolvidos nas atividades rotineiras do programa Academia da Saúde. Indivíduos do grupo intervenção participaram, adicionalmente, do programa Vida Ativa Melhorando a Saúde durante 12 semanas. Foram utilizados acelerômetros para avaliação da atividade física, questionários para a avaliação dos hábitos alimentares e medidas antropométricas para mensuração do estado nutricional. Resultados Seis meses após a finalização da intervenção, os resultados benéficos obtidos com a prática de atividade física e o estado nutricional não se mantiveram. Quanto aos hábitos alimentares, os benefícios se mantiveram, mas não foram exclusivamente pelo efeito da intervenção. Conclusão O programa Vida Ativa Melhorando a Saúde, no formato aplicado, não foi capaz de promover efeitos benéficos duradouros sobre a prática de atividade física e o estado nutricional dos indivíduos. O programa está sendo reformulado com a ampliação do tempo de intervenção e reestruturação do material didático.

Estudo Longitudinal EpiFloripa Idoso - Rotinas de organização e protocolos referentes à coleta, análise e armazenamento de material biológico, exames de imagem e capacidade físico-funcional / EpiFloripa Ageing Longitudinal Study - Organizational routines and protocols related to the collection, analysis and storage of biological material, image exams and physical-functional capacity

Resumo Introdução Exames complementares podem contribuir para a compreensão da etiologia de agravos à saúde de idosos. Objetivo Descrever os aspectos operacionais e protocolos referentes à coleta, análise e armazenamento de material biológico, exames de imagem e capacidade físico-funcional. Método Estudo longitudinal, de base populacional, com 604 idosos (≥ 60 anos) do estudo EpiFloripa Idoso, em 2014. Foram coletados dados de material biológico, composição corporal, densitometria óssea, ultrassonografia da espessura íntima média das artérias carótidas, força de preensão manual e a atividade física. Resultados A taxa de resposta foi de 50,4%. Houve perda de seguimento em relação à faixa etária, estado cognitivo e atividades de vida diária. Os indivíduos que realizaram os exames eram mais novos, trabalhavam no momento da entrevista, ingeriam álcool, eram fisicamente ativos. Além de apresentarem menor grau de dependência, ausência de déficit cognitivo, ausência de sintomas depressivos e ausência de dificuldade na mobilidade. Conclusão Espera-se que a descrição das rotinas aplicadas possa auxiliar no desenvolvimento de novas pesquisas semelhantes em grupos de idosos. Assim, poderá ser acompanhado o processo de envelhecimento da população, seus fatores de risco e proteção.

Abstract Background Complementary exams may contribute to the understanding of the etiology of health problems in older adults. Objective To describe the operational aspects and protocols used to collect, analyze and storage biological materials, image exams and physical-functional capacity tests. Method This is a longitudinal and population-based study with 604 older adults (≥ 60 years) from EpiFloripa Ageing Study, in 2014. Data of biological material, body composition, bone densitometry, ultrasonography of the carotid artery intima average thickness, hand grip strength and physical activity were collected. Results The response rate was 50.4%. There was loss of follow-up in relation to age, cognitive status, and activities of daily living. The individuals who performed the tests were younger, worked by the time of the interview, ingested alcohol and were physically active. Also, they were less dependent, absence of cognitive impairment, absence of depressive symptoms and absence of difficulty in mobility. Conclusion It is expected that the description of the applied routines may help in the development of new similar research in the older adult population. Thus, the aging process of the population, its risk and protection factors can be followed.

Associated factors of depressive symptoms in the elderly: EpiFloripa study.

OBJECTIVE: To estimate the prevalence and associated factors of depressive symptoms in the elderly. METHODS: Cross-sectional population based epidemiological study (The EpiFloripa Elderly survey) was carried out in two stage clusters, census tracts and households, with 1.656 elderly individuals in Florianópolis, SC. The prevalence of depressive symptoms (outcome) was obtained using Geriatric Depression Scale (GDS-15) and its associations with socio-demographic, health, behavioral and social variables were assessed. Crude and adjusted prevalence ratios (PR) with 95% confidence intervals were calculated using Poisson regression. RESULTS: Depressive symptoms were observed in 23.9% of the elderly individuals (95%CI 21.84;26.01). In the fi nal model, depressive symptoms were associated with: 5 to 8 years of schooling (PR = 1.50, 95%CI 1.08;2.08); one to four years of schooling (PR = 1.62, 95%CI 1.18;2.23) and no schooling (PR = 2.11, 95%CI 1.46;3.05); being in a worse financial condition than at the age of 50 (PR = 1.33, 95%CI 1.02;1.74); cognitive impairment (PR = 1.45, 95%CI 1.21;1.75); perceiving their health to be regular (PR = 1.95, 95%CI 1.47;2.60) or poor (PR = 2.64, 95%CI 1.82;3.83); functional dependence (PR =1.83, 95%CI 1.43;2.33) and chronic pain (PR = 1.35, 95%CI 1.10;1.67). Factors with protective effects were: being in the 70 to 79 year old age group (PR = 0.77, 95%CI 0.64;0.93); physical activity in leisure time (PR = 0.75, 95%CI 0.59;0.94); participation in social or religious groups (PR = 0.80, 95%CI 0.64;0.99) and having sexual relations (PR = 0.70, 95%CI 0.53;0.94). CONCLUSIONS: Adverse clinical situations, being socioeconomically disadvantaged and low social and sexual activity were associated with depressive symptoms in the elderly.

Efeito de dois programas na promoção da atividade física em idosos / Effect of physical activity promotion programs in older adults

O objetivo deste estudo foi analisar o efeito de dois programas de promoção da atividade física (AF) nos níveis da AF de idosos usuários das Unidades Básicas de Saúde em Florianópolis, Santa Cata-rina, Brasil. Participaram do estudo 50 idosos (68,30 ± 7,01 anos), randomizados em três grupos: a) mudança de comportamento (programa Vida Ativa Melhorando a Saúde ­ VAMOS); b) exercício físico; c) controle. Para avaliar a AF utilizou-se o acelerômetro (GT3x, Actigraph) no baseline, três (término dos programas), seis e 12 meses (follow-up). Verificou-se efeito isolado do momento para a AF leve e AF moderada/vigorosa, aos seis e três meses, respectivamente, para cada nível da AF. Foram identificados aumentos significativos nos minutos/dia despendidos em AF em relação ao ba-seline (p < 0,050), independente do grupo. Não foi identificado efeito isolado do grupo ou interação grupo vs. momento, o que indica que os grupos submetidos aos programas de AF não se diferiram entre si e do grupo controle ao longo do tempo. Não houve influência significante da assiduidade nos programas de intervenção de prática da AF (min/dia). Assim, conclui-se que os programas de promoção da AF avaliados não foram capazes de aumentar o tempo diário despendido em AF, su-gerindo a necessidade de adaptações na forma de estruturação e implementação destes programas

The objective of this study was to analyze the effects of two physical activity promotion programs on levels of physical activity in older adults users of Health Care Units from Florianopolis, Santa Catarina, Brazil. Fifty older adults (68.30 ± 7.01 years old) participated in the study, randomized in three groups: a) Be-havior Change (Active Life Improving Health Program ­ VAMOS); b) Physical Exercise; c) Control. The accelerometer (GT3x, Actigraph) was used to evaluate the level of physical activity at the baseline, three (end of program), six, and 12 months (follow-up). Main effect of time was observed for light and moderate/vigorous physical activity, with increases after six and three months, respectively, compared with baseline (p < 0.050), independently of the group. There was no main effect of group or interaction (group vs. time), showing that the groups submitted to physical activity programs did not differed between them and from control group. There was no significant influence of the attendance on intervention programs on physical activity levels. Then, it was concluded that the physical activity promotion programs assessed were able to increase the daily time spent in physical activity, suggesting the need for adaptations in the structure and in the implementation form of these programs

[Health status and physical activity levels among the elderly who are participants and non-participants in social welfare groups in Florianópolis]. / Condições de saúde e nível de atividade física em idosos participantes e não participantes de grupos de convivência de Florianópolis.

This study sought to verify the association between health status and physical activity levels among the elderly who are participants and non-participants in social welfare groups in Florianópolis in the State of Santa Catarina, Brazil. The sample included 1,062 elderly people (625 women), mean age 71.9 (± 7.6). The variables analyzed were gender, age, schooling, marital status, physical activity levels (International Physical Activity Questionnaire) and physical health status information (Brazil Elderly Schedule Questionnaire). Data were analyzed by Chi-square test. The results revealed that 60.6% were classified as physically active (total physical activity level) and 74% of the elderly reported illness. Illness status was more prevalent among social welfare group participants than non-participants. However, a better positive perception of physical health status was observed among social groups participants. For women, participation in social welfare groups was associated with a positive perception of physical health status (p<0.001) and with illness (p=0.005). The conclusion was that participation in social welfare groups contributes to a better perception of physical health status, as well as for the maintenance of adequate physical activity levels.

Effectiveness and maintenance of behavior change and exercise programs on depressive symptoms in older adults / Efetividade e manutenção de programas de mudança de comportamento e de exercícios físicos sobre os sintomas depressivos de idosos

The aim of the study was to compare the effectiveness and maintenance of two health promotion programs on depressive symptoms (DS) of older adults. The research was conducted with the network of primary health care in a southern capital of Brazil. In total, 119 older adult participants were allocated into different groups: behavior change (BCG; n=40), exercise (EG; n=51) and control (CG; n=28), assessed at baseline (A1) and followed-up at three (A2), six (A3) and twelve months (A4). BCG attended "VAMOS Vida Ativa Melhorando a Saúde" (in English, Active Living Improving Health) program while EG attended aerobic gymnastic sessions. The DS were measured by the Geriatric Depression Scale (GDS-15) and level of physical activity (LPA) through accelerometers. Results show that only BCG reduced the number of older adults with high DS (A1=9; A2=4) and this reduction was maintained after six (A3=3) and twelve months (A4=4). Six older adults became physically active (BCG=3; EG=2; CG=1) after the intervention. However, there was no LPA maintenance after six and twelve months, once the frequency of insufficiently active older adults increased or was similar to baseline. When comparing DS, an interaction was found between group and assessment (F=2.94, p=0.01) for BCG, highlighting the reduction (A1=4.0; A2=2.5) and maintenance (A3=2.6; A4=2.8) of mean DS in this group. The results indicate that behavior change programs may bring benefits to the mental health of older adults and the VAMOS program seems to be a viable option for older adults in the community.

Objetivou-se comparar a efetividade e a manutenção de dois programas de promoção da saúde sobre os sintomas depressivos (SD) da população idosa. A pesquisa foi desenvolvida no âmbito da rede de atenção primária à saúde de uma capital do sul do Brasil. Participaram 119 idosos alocados nos grupos: mudança de comportamento - GMC (n=40), exercício físico - GEF (n=51) e controle - GC (n= 28), avaliados no baseline (A1), após três (A2), seis (A3) e 12 meses (A4). O GMC participou do "VAMOS ­ Vida Ativa Melhorando a Saúde" e o GEF de aulas de ginástica. Os SD foram avaliados pela Geriatric Depression Scale (GDS-15) e o nível de atividade física (NAF) por acelerômetro. Os resultados indicam que após a intervenção, somente no GMC houve redução do número de idosos com SD elevados (A1=9; A2=4) e essa redução se manteve após seis (A3=3) e doze meses (A4=4). Em relação ao NAF, após a intervenção, seis idosos tornaram-se fisicamente ativos (GMC=3; GEF=2 e GC=1). Todavia, não foi observada manutenção do NAF após seis e doze meses, uma vez que a frequência de idosos insuficientemente ativos aumentou ou foi semelhante ao baseline. Na comparação dos SD, identificou-se interação grupo versus avaliação (F=2,94, p=0,01) para o GMC, destacando redução (A1=4,0; A2=2,5) e manutenção (A3=2,6; A4=2,8) das médias dos SD nesse grupo. Os resultados sinalizam que programas de mudança de comportamento podem oportunizar benefícios à saúde mental dos idosos e que o programa VAMOS mostrou-se uma possibilidade viável de desenvolvimento no contexto comunitário para esta população.

Physical education Professionals and their role in Primary Care in Curitiba / O profissional de Educação Física e sua atuação na Atenção Primária à Saúde de Curitiba

The aim of this study was to describe the inclusion of the Physical Education professor, relating historical aspects and outlining the role of these professionals in Primary Care in Curitiba, Brazil. Inclusion occurred in 2009 with the hiring of 29 professionals, 26 of whom were still employed in early 2016. Activities performed include exercise groups; individual care; clinical support; continuing education; health education; as well as participation in social control, by representing the profession at the Municipal Health Council of Curitiba and Teaching-Service integration via a Multidisciplinary Residency preceptorship. The historical background reveals advances, achievements and much more to accomplish, in a permanent and ongoing process.

O objetivo desse texto foi descrever a inserção do profissional de Educação Física, resgatando aspectos históricos e descrevendo a atuação desses profissionais na Atenção Primária à Saúde de Curitiba-PR. A inserção aconteceu em 2009, com a contratação de 29 profissionais, dos quais 26 permanecem em atuação até início de 2016. As ações desenvolvidas pautam-se em grupos de exercício físico; atendimento individual; apoio matricial; educação permanente; educação em saúde; além da participação no Controle Social, por meio da representação da classe no Conselho Municipal de Saúde de Curitiba e da aproximação Ensino-Serviço, com a preceptoria da Residência Multiprofissional. O percurso histórico revela avanços, conquistas e um longo caminho a ser percorrido, que está em permanente construção.