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Pereira FHF, Santos-de-Araújo AD, Pontes-Silva A, Marinho RS, Garcia-Araújo AS, Borghi-Silva A, Gonçalves MC, de Cássia Mendonça de Miranda R, Protazio JB, Pinheiro CAB, Dibai-Filho AV, Bassi-Dibai D. Regular Physical Exercise Adherence Scale (REPEAS): a new instrument to measure environmental and personal barriers to adherence to regular physical exercise. BMC Public Health 2023; 23:2491. [PMID: 38093228 PMCID: PMC10717144 DOI: 10.1186/s12889-023-17438-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVE To create, develop, and validate a scale that identifies the environmental and personal barriers that make it difficult to adhere to the practice of physical exercise on a regular basis in a population of Brazilian adults. METHODS We include adult individuals, aged 18-59 years, practitioners or former practitioners of physical exercise, with Brazilian Portuguese as their mother tongue. In the development and validation phases of the process, 6 specialists in the field of the health assessed the content validity: firstly, the specialists were asked to freely list the questions they would ask to investigate the barriers to adherence to regulating physical activity. Secondly, after compiling all the suggestions listed and eliminating suggestions with similar content, the items suggested in the first round were sent to the specialists so that an evaluation of all questions using a 5-point Likert scale and the content validity coefficient was calculated. We then evaluated the structural validity, construct validity, reliability, internal consistency, and ceiling and floor effects of the Regular Physical Exercise Adherence Scale (REPEAS). RESULTS Sixteen items were proposed to measure the factors that make it difficult to adhere to the regular practice of physical exercise. The internal structure of the REPEAS initially tested was based on the theoretical proposal of creating the instrument with two domains. After the structural analysis, we used the modification indices to identify the redundant items of the instrument. Consequently, the final version of the REPEAS after factor analysis had 12 items. Thus, the structure with 2 domains and 12 items presented adequate fit indices. With regard to construct validity, the REPEAS scores were compared in two distinct groups: irregular practitioners/ex-practitioners versus regular practitioners of physical exercise, in which a significant difference could be observed between groups (p < 0.001) for both the domains. Acceptable reliability was observed for the environment and personal domains, with ICC values of 0.86 and 0.94, in the same order. For internal consistency, Cronbach's alpha value was 0.908 (environmental domain) and 0.915 (personal domain), these values being adequate for the REPEAS. CONCLUSION The REPEAS is a scale with a valid two-dimensional internal structure, consisting of 12 items, reliable and with a valid construct, which supports its use in the clinical, epidemiological, and research contexts in Brazil.
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Affiliation(s)
| | - Aldair Darlan Santos-de-Araújo
- Department of Physical Therapy, Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - André Pontes-Silva
- Department of Physical Therapy, Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Renan Shida Marinho
- Department of Physical Therapy, Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Adriana Sanches Garcia-Araújo
- Department of Physical Therapy, Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Audrey Borghi-Silva
- Department of Physical Therapy, Postgraduate Program in Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | | | | | - Jhonata Botelho Protazio
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, Maranhão, Brazil
| | | | - Almir Vieira Dibai-Filho
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, Maranhão, Brazil
- Postgraduate Program in Adult Health, Universidade Federal do Maranhão, São Luís, Maranhão, Brazil
| | - Daniela Bassi-Dibai
- Postgraduate Program in Environment, Universidade Ceuma, São Luís, Maranhão, Brazil.
- Postgraduate Program in Management of Health Services and Programs, Universidade Ceuma, São Luís, Maranhão, Brazil.
- Departament of Physical Therapy, Universidade Ceuma, São Luís, Maranhão, Brazil.
- Postgraduate Program in Dentistry, Universidade Ceuma, São Luís, Maranhão, Brazil.
- Programa de Pós-Graduação em Meio Ambiente, Universidade Ceuma, Rua Josué Montello, 1, Jardim Renascença. CEP 65075-120, São Luís, Maranhão, Brazil.
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Florindo AA, Onita BM, Knebel MTG, Wanderley Júnior RDS, Teixeira IP, Turrell G. Public Open Spaces and Leisure-Time Walking: A Longitudinal Study With Brazilian People in the COVID-19 Pandemic. J Phys Act Health 2023; 20:1027-1033. [PMID: 37591501 DOI: 10.1123/jpah.2023-0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/01/2023] [Accepted: 06/13/2023] [Indexed: 08/19/2023]
Abstract
AIM To examine whether changes in public open spaces (POS) were associated with leisure-time walking (LTW) between 2014 and 2021. METHODS The sample comprised a prospective cohort of individuals living in São Paulo City, Brazil. The baseline sample was collected in 2014/2015 (4042 people aged 12 y or older) and the second wave in 2020/2021 (1431 people aged 18 y or older, 35.4% of total). Changes in POS scores in 500-m network buffers were based on household address, including positive or negative maintenance and increases or decreases in parks, public squares, and bike paths between 2015 and 2020. The International Physical Activity Questionnaire was used to evaluate LTW in the baseline and second wave. To examine the association of LTW with changes in POS, we used multilevel models in 4 levels: health administration areas, census tracts, individuals, and observations of individuals. The exposure was the POS tertiles, and the outcome was LTW. RESULTS Changes in LTW prevalence were observed in both periods and according to POS tertiles distributions. When adjusted for time (baseline/second wave), gender, education, and age, the highest POS tertile was significantly associated with a high likelihood for LTW (odds ratio = 1.44; 95% confidence interval, 1.03-2.02). CONCLUSION The results showed that people in São Paulo who lived within 500-m buffers with the highest access to POS were more likely to practice LTW between 2014/2015 and 2020/2021. These results have important implications for policies that were implemented in 2014, including the New Master Plan to contribute to São Paulo's good ranking among healthy cities.
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Affiliation(s)
- Alex Antonio Florindo
- School of Arts, Sciences and Humanities, University of Sao Paulo, Sao Paulo,Brazil
- School of Public Health, University of Sao Paulo, Sao Paulo,Brazil
- Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo,Brazil
| | - Bianca Mitie Onita
- School of Public Health, University of Sao Paulo, Sao Paulo,Brazil
- Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo,Brazil
| | - Margarethe Thaisi Garro Knebel
- School of Public Health, University of Sao Paulo, Sao Paulo,Brazil
- Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo,Brazil
| | - Rildo de Souza Wanderley Júnior
- School of Arts, Sciences and Humanities, University of Sao Paulo, Sao Paulo,Brazil
- Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo,Brazil
| | - Inaian Pignatti Teixeira
- Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo,Brazil
- Minas Gerais State University, Passos,Brazil
| | - Gavin Turrell
- Centre for Urban Research, RMIT University, Melbourne, VIC,Australia
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Zhang J, Zheng Y, Wen T, Yang M, Feng QM. The impact of built environment on physical activity and subjective well-being of urban residents: A study of core cities in the Yangtze River Delta survey. Front Psychol 2022; 13:1050486. [PMID: 36570995 PMCID: PMC9773078 DOI: 10.3389/fpsyg.2022.1050486] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/18/2022] [Indexed: 12/14/2022] Open
Abstract
Objective In cities with high population density in China, the impact of built environment on human health is rather complicated. Physical activities are an important factor in promoting people's health. This study is aimed to explore ways of enhancing the residents' intensity of physical activities and psychological health in a limited built environment. For this purpose, this study conducted research on 1875 residents from cities in the Yangtze River Delta in China to clarify the complicated correlations among the residents' physical activities, the multi-dimensional geographic environment characteristics, and subjective well-being. Methods First, Neighborhood Environment Walkability Scale (NEWS-A), International Physical Activity Questionnaire Short Form (IPAQ-SF), and Subjective Well-being Scale for Chinese Citizens (SWBS-CC) were used to measure built environment characteristics, intensity of physical activities, and subjective well-being. Second, the correlations among built environment, physical activities, and subjective well-being were analyzed, which reflected different effects of built environment characteristics on physical activities and subjective well-being. Third, physical activities were viewed as a mediating variable in SEM to analyze the influence mechanism of each built environment characteristic on the subjective well-being of residents. Result Residents with different individual characteristics may have different levels of perception and usage of built environment. The intensity of physical activities has significant positive correlations with proximity to supporting facilities, accessibility of destinations, and public security, while no significant correlation with overall environmental aesthetics and street connectivity. The residents' subjective well-being has significant positive correlations with accessibility of destinations, overall environmental aesthetics, and public security, while no significant correlation with proximity to supporting facilities and street connectivity. Physical activities not only have a direct effect on subjective well-being, but also a mediating effect on the correlations between subjective well-being and built environment characteristics. Conclusion In the future, more research could be conducted on the optimization of correlations between residential built environment characteristics and physical activities as well as subjective well-being, so as to gain a deeper understanding about the impact of residential built environment on people's physical and mental health.
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Affiliation(s)
- Jing Zhang
- Faculty of Physical Education, Shanghai International Studies University, Shanghai, China
| | - Yan Zheng
- Faculty of Physical Education, Shanghai International Studies University, Shanghai, China
| | - Tao Wen
- Faculty of Physical Education, Shanghai International Studies University, Shanghai, China
| | - Min Yang
- Office of Campus Security, Shanghai International Studies University, Shanghai, China
| | - Qiang ming Feng
- Faculty of Physical Education, Shanghai International Studies University, Shanghai, China,*Correspondence: Qiang ming Feng,
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Exposure to Public Open Spaces and Leisure-Time Physical Activity: An Analysis of Adults in Primary Health Care in Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148355. [PMID: 35886212 PMCID: PMC9322836 DOI: 10.3390/ijerph19148355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/25/2022] [Accepted: 07/01/2022] [Indexed: 02/01/2023]
Abstract
Public open spaces (POS) enable many leisure activities. However, few studies have evaluated how different exposures to POS with structured physical activities (PA) could affect the leisure-time PA (LTPA) of adults with chronic diseases. This study aimed to analyze the associations between different exposures to POS and LTPA in adults in primary health care in Brazil. In 2019, a cross-sectional study was conducted with a representative sample of 615 users of 15 Basic Health Units in São José dos Pinhais. The POS exposure was measured by the presence and distance (GIS), and the usage and frequency of usage were self-reported. The IPAQ identified walking and moderate-to-vigorous PA (MVPA). Data were analyzed with multilevel Poisson regression adjusted for the possible confounders (sex, age, economic level, chronic diseases). The prevalence of walking and MVPA ≥150 min/week was 12% and 14%, respectively. The usage of POS increased by 52% the likelihood of walking ≥10 min/week (PR: 1.52; 95%CI: 1.02–2.21), while usage ≥2 times/week increased by 2 times the likelihood of this outcome (PR: 2.01; 95%CI: 1.28–3.05). The usage of POS increased by 2.7 times the likelihood of MVPA ≥10 min/week (PR: 2.73; 95%CI: 1.86–3.97), and usage ≥2 times/week increased by 3.5 times the likelihood of this outcome (PR: 3.45; 95%CI: 2.14–5.42). Finally, the usage of POS increased by 3 times the likelihood of MVPA ≥150 min/week (PR: 3.03; 95%CI: 1.92–4.74), while usage ≥2 times/week increased by 3.8 times the likelihood of this outcome (PR: 3.81; 95%CI: 2.19–6.38). In conclusion, only the usage of POS is positively associated with walking and MVPA in the leisure time of adult primary health care users.
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Rodrigues EQ, Garcia LMT, Ribeiro EHC, Barrozo LV, Bernal RTI, Andrade DR, Barbosa JPDAS, Nunes APDOB, Fermino RC, Florindo AA. Use of an Elevated Avenue for Leisure-Time Physical Activity by Adults from Downtown São Paulo, Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095581. [PMID: 35564976 PMCID: PMC9106045 DOI: 10.3390/ijerph19095581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/24/2022] [Accepted: 04/26/2022] [Indexed: 12/10/2022]
Abstract
Leisure-time physical activity (LTPA) is associated with access and use of public open spaces. The President João Goulart Elevated Avenue, currently denominated Minhocão, is a facility for leisure activities that is open for people during the night and weekends. The aim of this study was to examine if the prevalence of LTPA among individuals living in the surroundings of Minhocão is different according to proximity to, and use of, the facility. We conducted a cross-sectional study with cluster sampling with people aged ≥18 years who lived in households up to 500 m, and between 501 m and 1500 m of Minhocão. The survey was conducted between December 2017 and March 2019 using an electronic questionnaire. We conducted a bivariate analysis and Poisson regression to examine possible differences in LTPA according to the proximity of residences and use of Minhocão. The analysis used post-stratification weights. A total of 12,030 telephone numbers of people were drawn (≤500 m = 6942; and >500 m to ≤1500 m = 5088). The final sample included 235 residents who returned the questionnaires. There was a higher prevalence of individuals engaging in at least 150 min per week of LTPA among users than non-users (Prevalence Ratio = 2.19, IC95% 1.66 to 2.90), independently of sex, age, education, the distance of houses to nearest accesses and number of barriers. The main five barriers related to the usage of the Minhocão were safety issues in and around the Minhocão, rainy weather, lack of vegetation, and lack of facilities. People who used the park had higher prevalence of all types of LTPA than non-users. The results can serve to inform government decision-making on the future of Minhocão.
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Affiliation(s)
- Eduardo Quieroti Rodrigues
- Postgraduate Program in Nutrition in Public Health, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (J.P.d.A.S.B.); (A.A.F.)
- School of Arts, Sciences and Humanities, Research Group on Physical Activity Epidemiology, University of São Paulo, São Paulo 03828-000, Brazil; (L.M.T.G.); (E.H.C.R.); (D.R.A.); (A.P.d.O.B.N.)
- Correspondence: ; Tel.: +55-11-3091-8157
| | - Leandro Martin Totaro Garcia
- School of Arts, Sciences and Humanities, Research Group on Physical Activity Epidemiology, University of São Paulo, São Paulo 03828-000, Brazil; (L.M.T.G.); (E.H.C.R.); (D.R.A.); (A.P.d.O.B.N.)
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
| | - Evelyn Helena Corgosinho Ribeiro
- School of Arts, Sciences and Humanities, Research Group on Physical Activity Epidemiology, University of São Paulo, São Paulo 03828-000, Brazil; (L.M.T.G.); (E.H.C.R.); (D.R.A.); (A.P.d.O.B.N.)
| | - Ligia Vizeu Barrozo
- Department of Geography, School of Philosophy, Literature and Human Sciences, University of São Paulo, São Paulo 05508-080, Brazil;
| | | | - Douglas Roque Andrade
- School of Arts, Sciences and Humanities, Research Group on Physical Activity Epidemiology, University of São Paulo, São Paulo 03828-000, Brazil; (L.M.T.G.); (E.H.C.R.); (D.R.A.); (A.P.d.O.B.N.)
| | - João Paulo dos Anjos Souza Barbosa
- Postgraduate Program in Nutrition in Public Health, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (J.P.d.A.S.B.); (A.A.F.)
- School of Arts, Sciences and Humanities, Research Group on Physical Activity Epidemiology, University of São Paulo, São Paulo 03828-000, Brazil; (L.M.T.G.); (E.H.C.R.); (D.R.A.); (A.P.d.O.B.N.)
| | - Ana Paula de Oliveira Barbosa Nunes
- School of Arts, Sciences and Humanities, Research Group on Physical Activity Epidemiology, University of São Paulo, São Paulo 03828-000, Brazil; (L.M.T.G.); (E.H.C.R.); (D.R.A.); (A.P.d.O.B.N.)
| | - Rogério César Fermino
- Research Group on Environment, Physical Activity, and Health, Postgraduate Program in Physical Education, Federal University of Technology—Paraná, Curitiba 80230-901, Brazil;
- Postgraduate Program in Physical Education, Federal University of Paraná, Curitiba 80060-000, Brazil
| | - Alex Antonio Florindo
- Postgraduate Program in Nutrition in Public Health, Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil; (J.P.d.A.S.B.); (A.A.F.)
- School of Arts, Sciences and Humanities, Research Group on Physical Activity Epidemiology, University of São Paulo, São Paulo 03828-000, Brazil; (L.M.T.G.); (E.H.C.R.); (D.R.A.); (A.P.d.O.B.N.)
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de Moura Carlos F, Alves de Sousa PH, Gonçalves Campos C, Alves Lamounier J, Costa Bila W, Caetano Romano MC. Associação entre sedentarismo e nível socioeconômico em adolescentes. REVISTA CUIDARTE 2022. [DOI: 10.15649/cuidarte.2082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introdução: O sedentarismo em adolescentes contribui para a ocorrência de diferentes doenças, sendo relevante investigar sobre fatores associados. Objetivo: Analisar a associação entre sedentarismo e nível socioeconômico em adolescentes de escolas públicas. Materiais e métodos: Estudo transversal, realizado com 347 adolescentes matriculados em escolas públicas do ensino médio do município de Divinópolis, Minas Gerais. A coleta de dados ocorreu no ano de 2017. O sedentarismo foi avaliado utilizando-se o International Physical Activity Questionnaire e o nível socioeconômico pelo critério da Associação Brasileira de Empresas de Pesquisa. Foi realizada estatística descritiva e analítica através de modelo de regressão logística multivariada. Resultados: Participaram da investigação 347 adolescentes. A média de idade do grupo foi de 16,4 ± 1,0 anos. Os indivíduos caracterizados como sedentários constituíram 38,9% da amostra, sendo que, destes, 66,7% eram do sexo feminino. Possuir maior nível socioeconômico diminui a probabilidade de ser sedentário (OR=0,235; p=0,021), assim como ser estudante das escolas públicas da região sudoeste aumenta essa chance (OR=2,680; p=0,04). Discussão: Os motivos pelos quais as condições socioeconômicas podem influenciar o sedentarismo são variados. A ausência de espaços públicos pode contribuir para a elevação do sedentarismo em adolescentes com menor nível socioeconômico. Conclusão: Esta investigação sinaliza a importância de investimentos públicos em políticas de estímulo à prática de atividade física para os adolescentes, em especial para os do sexo feminino e de menor nível socioeconômico.
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Guerra PH, Soares HF, Mafra AB, Czarnobai I, Cruz GA, Weber WV, Farias JCH, Loch MR, Ribeiro EHC. Educational interventions for physical activity among Brazilian adults: systematic review. Rev Saude Publica 2021; 55:110. [PMID: 34932699 PMCID: PMC8664058 DOI: 10.11606/s1518-8787.2021055003236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 03/17/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To summarize the main evidence from educational interventions designed to increase levels of physical activity (PA) among Brazilian adults. METHODS Systematic review of intervention studies carried out in Brazil that implemented educational components aimed at promoting increased levels of PA among adult populations (18 to 65 years old). In October 2020, systematic searches were conducted in six databases, and in the reference lists of the assessed studies. RESULTS Of the initial 2,511 studies, nine were included in the synthesis. Samples with specific characteristics (such as social vulnerability, physical inactivity, and overweight or obesity) were observed, with a greater number of women. Five interventions (55.6%) occurred in primary healthcare settings (PHC) of the Brazilian Unified Health System (SUS). Only four studies (44.4%) described the pedagogical frameworks structuring the educational approaches, among which counseling was the most used strategy, such as those carried out through face-to-face meetings, home visits, lectures, and phone calls (n = 8; 88.9%). Positive results were observed in three different indicators: increase in weekly PA volume (n = 4); increase in leisure-time PA rate (n = 1); and increase in the proportion of women classified as “very active/active” (n = 1). Given the sampling specificities, the domain “participant selection” showed a high number of interventions with high risk of bias. CONCLUSIONS Educational approaches engendered some positive effects on different PA indicators, notably counseling as the main strategy used and approaches involving other health themes, such as nutrition and stress. However, considering the several determinants of PA in Brazil, future interventions should be conducted in different locations of Brazil in order to evaluate, in a broader way, their implementation processes and articulation with the many professionals working in PHC.
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Affiliation(s)
- Paulo Henrique Guerra
- Universidade Federal da Fronteira Sul. Curso de Medicina. Chapecó, SC, Brasil.,Universidade de São Paulo. Grupo de Estudos e Pesquisas Epidemiológicas em Atividade Física e Saúde da São Paulo, SP, Brasil
| | - Hugo Falqueto Soares
- Universidade Federal da Fronteira Sul. Curso de Medicina. Chapecó, SC, Brasil.,Universidade Federal da Fronteira Sul. Programa de Pós-Graduação em Ciências Biomédicas. Chapecó, SC, Brasil
| | - Ana Beatriz Mafra
- Universidade Federal da Fronteira Sul. Curso de Medicina. Chapecó, SC, Brasil
| | - Izadora Czarnobai
- Universidade Federal da Fronteira Sul. Curso de Medicina. Chapecó, SC, Brasil
| | | | | | | | - Mathias Roberto Loch
- Universidade Estadual de Londrina. Programa de Pós-Graduação em Saúde Coletiva. Londrina, PR, Brasil
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Silva PSCD, Boing AF. [Factors associated with leisure-time physical activity: analysis of Brazilians with chronic diseases]. CIENCIA & SAUDE COLETIVA 2021; 26:5727-5738. [PMID: 34852104 DOI: 10.1590/1413-812320212611.32432020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 09/08/2020] [Indexed: 11/21/2022] Open
Abstract
The scope of this study was to analyze the prevalence and the factors associated with sufficient leisure-time physical activity (LTPA) among Brazilians diagnosed with hypertension, diabetes and/or hypercholesterolemia. It involved a representative, cross-sectional population-based study for the entire Brazilian territory. Adults aged 20 years and over were interviewed. Prevalences were estimated and, by means of logistic regression, the crude and adjusted odds ratios (OR) of the outcome were calculated in accordance with each of the exploratory variables. The prevalence of sufficient LTPA was 15.9%, 15.3% and 21.4% among people with hypertension (n=12,228), diabetes (n=3,577) and hypercholesterolemia (n=7,124), respectively. These values were lower than those observed among adults who did not report one of the three diseases. Adjusted analysis showed that individuals with positive self-perception of health and with more schooling, who reported a public space near their homes for physical activity, the existence in the city of public programs that encourage physical activity and the recommendation of health professionals to practice LTPA, were associated with a greater chance of being sufficiently active.
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Affiliation(s)
- Paulo Sergio Cardoso da Silva
- Programa de Pós-Graduação em Saúde Coletiva, Departamento de Saúde Pública, Universidade Federal de Santa Catarina. R. Eng. Agronômico Andrei Cristian Ferreira s/n, Trindade. 88040-900 Florianópolis SC Brasil.
| | - Antonio Fernando Boing
- Programa de Pós-Graduação em Saúde Coletiva, Departamento de Saúde Pública, Universidade Federal de Santa Catarina. R. Eng. Agronômico Andrei Cristian Ferreira s/n, Trindade. 88040-900 Florianópolis SC Brasil.
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Time Trends and Sociodemographic Inequalities in Physical Activity and Sedentary Behaviors Among Brazilian Adults: National Surveys from 2003 to 2019. J Phys Act Health 2021; 18:1332-1341. [PMID: 34548416 DOI: 10.1123/jpah.2021-0156] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/31/2021] [Accepted: 06/28/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The authors analyzed time trends and sociodemographic inequalities in different physical activity and sedentary behavior domains between 2003 and 2019. METHODS A secondary analysis of data from 5 cross-sectional Brazilian epidemiological surveys (World Health Survey-2003, National Household Sample Survey-2008/2015, and Brazilian Health Survey-2013/2019) conducted among a nationally representative sample of Brazilian adults. The authors used data on different domains of physical activity (leisure, commute, total transport, and total physical activity) and sedentary behavior (TV viewing and other types of screens) that were available in the different surveys. Gender, age group, country region, ethnicity, type of area and city, and quintiles of income and educational achievement were used as sociodemographic correlates. RESULTS The prevalence of leisure-time physical activity increased over time (2008: 7.0% vs 2019: 26.5%). There was also an increased trend of social inequality in leisure-time physical activity. A trend of reduction was observed for active commuting (2008: 35.0% vs 2019: 21.8%), while total transport physical activity was stable (2013: 49.5% vs 2019: 49.6%). Directions of findings were opposite for sedentary behavior, with reduced trend for >3 hours per day of TV viewing (2008: 34.8% vs 2019: 21.8%) and increased trend for >3 hours per day of other types of screen time (2008: 6.4% vs 2019: 22.2%). CONCLUSION A positive trend exists in leisure-time physical activity, but there was also an increase in social inequalities for physical activity in Brazil.
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Silva PSCD, Lima TRD, Botelho LJ, Boing AF. Recommendation and physical activity practice in Brazilians with chronic diseases. ACTA ACUST UNITED AC 2021; 67:366-372. [PMID: 34468599 DOI: 10.1590/1806-9282.20200753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 09/29/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To analyze the prevalence and factors associated with professional recommendation and leisure-time physical activity (LTPA) in Brazilian individuals diagnosed with hypertension (HBP), diabetes, and/or hypercholesterolemia. METHODS This is a cross-sectional population-based study with a representative sample of the Brazilian population (aged ≥20 years) in 2013, with self-reported HBP (n=11.098), diabetes (n=3.176), and/or hypercholesterolemia (n=7.252). Prevalence and gross odds ratios were estimated and adjusted for both outcomes. RESULTS Professional recommendation and LTPA were more prevalent in individuals who received recommendation and presented with hypercholesterolemia (85.9 and 23.4%, respectively). Adjusted analysis showed an association in people 40 to 59 years of age and public programs in most diseases. Higher educational level was associated with receiving recommendations in all non-communicable diseases (NCDs). LTPA was associated in people 40 to 59 years of age for HBP and diabetes and in all investigated NCDs, higher educational level, positive perception of health, and a favorable environment in those who received recommendation. CONCLUSIONS Education presented the greatest magnitude in the associations, clearly showing the need for equitable methods to increase recommendation and LTPA levels for the most vulnerable population. Further studies analyzing other variables and NCD are needed, corroborating the Ministry of Health.
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Affiliation(s)
- Paulo Sergio Cardoso da Silva
- Universidade Federal de Santa Catarina, Departamento de Saúde Pública, Programa de Pós-Graduação em Saúde Coletiva - Florianópolis (SC), Brazil
| | - Tiago Rodrigues de Lima
- Universidade Federal de Santa Catarina, Departamento de Educação Física, Programa de Pós-Graduação em Educação Física - Florianópolis (SC), Brazil
| | - Lúcio José Botelho
- Universidade Federal de Santa Catarina, Departamento de Saúde Pública, Programa de Pós-Graduação em Saúde Coletiva - Florianópolis (SC), Brazil
| | - Antonio Fernando Boing
- Universidade Federal de Santa Catarina, Departamento de Saúde Pública, Programa de Pós-Graduação em Saúde Coletiva - Florianópolis (SC), Brazil
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11
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Florindo AA, Turrell G, Garcia LMT, Dos Anjos Souza Barbosa JP, Cruz MS, Failla MA, de Aguiar BS, Barrozo LV, Goldbaum M. Mix of destinations and sedentary behavior among Brazilian adults: a cross-sectional study. BMC Public Health 2021; 21:347. [PMID: 33579233 PMCID: PMC7881484 DOI: 10.1186/s12889-020-10123-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 12/23/2020] [Indexed: 11/10/2022] Open
Abstract
Background Sedentary behavior is influenced by contextual, social, and individual factors, including the built environment. However, associations between the built environment and sitting time have not been extensively investigated in countries with economies in transition such as Brazil. The objective of this study is to examine the relationship between sitting-time and access to a mix of destinations for adults from Sao Paulo city, Brazil. Methods This study uses data from the Health Survey of Sao Paulo. Sedentary behavior was assessed by a questionnaire using two questions: total sitting time in minutes on a usual weekday; and on a usual weekend day. The mix of destinations was measured by summing the number of facilities (comprising bus stops, train/subway stations, parks, squares, public recreation centres, bike paths, primary health care units, supermarkets, food stores, bakeries, and coffee-shops) within 500 m of each participant’s residence. Minutes of sitting time in a typical weekday and weekend day were the outcomes and the mix of destinations score in 500 m buffers was the exposure variable. Associations between the mix of destinations and sitting time were examined using multilevel linear regression: these models accounted for clustering within census tracts and households and adjusted for environmental, sociodemographic, and health-related factors. Results After adjustment for covariates, the mix of destinations was inversely associated with minutes of sitting time on a weekday (β=− 8.8, p=0.001) and weekend day (β=− 6.1, p=0.022). People who lived in areas with a greater mix of destinations had shorter average sitting times. Conclusion Greater mix of destinations within 500 m of peoples’ residences was inversely associated with sitting time on a typical weekday and weekend day. In Latin American cities like Sao Paulo built environments more favorable for walking may contribute to reducing sedentary behavior and prevent associated chronic disease.
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Affiliation(s)
- Alex Antonio Florindo
- School of Arts, Sciences and Humanities, University of Sao Paulo, Rua Arlindo Bettio, Sao Paulo, SP, 1000, Brazil. .,Graduate Program in Nutrition in Public Health, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil. .,Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo, Brazil.
| | - Gavin Turrell
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Canberra, Australia
| | - Leandro Martin Totaro Garcia
- Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo, Brazil.,Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | | - Michele Santos Cruz
- Graduate Program in Nutrition in Public Health, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil.,Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo, Brazil
| | - Marcelo Antunes Failla
- Department of Epidemiology and Information, Municipal Government of Sao Paulo, Sao Paulo, Brazil
| | - Breno Souza de Aguiar
- Department of Epidemiology and Information, Municipal Government of Sao Paulo, Sao Paulo, Brazil
| | - Ligia Vizeu Barrozo
- Department of Geography, School of Philosophy, Literature and Human Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Moises Goldbaum
- Department of Preventive Medicine, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
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12
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Florindo AA, Teixeira IP, Barrozo LV, Sarti FM, Fisberg RM, Andrade DR, Garcia LMT. Study protocol: health survey of Sao Paulo: ISA-Physical Activity and Environment. BMC Public Health 2021; 21:283. [PMID: 33541300 PMCID: PMC7859902 DOI: 10.1186/s12889-021-10262-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 01/18/2021] [Indexed: 11/18/2022] Open
Abstract
Background Many studies have investigated the association between the built environment and physical activity behavior in urban settings. However, most of the studies conducted in low- and middle-income countries were cross-sectional, which are limited to identify behavioral determinants. We propose a prospective cohort study to verify the relationship between built environment features and leisure-time and transport-related physical activity in adults from Sao Paulo city, Brazil. Methods Prospective multilevel cohort, denominated “ISA-Physical Activity and Environment”. It will build on the Health Survey of Sao Paulo in 2015 (“Inquérito de Saúde de São Paulo (ISA)” in Portuguese). The Health Survey of Sao Paulo, originally designed as a cross-sectional survey, had a multi-stage sample, covering 150 census tracts distributed in five health administrative areas. Data collection was performed by face-to-face interviews until December 2015 and the sample comprised 4043 individuals aged 12 years or more. The ISA-Physical Activity and Environment study will reassess people who are aged 18 years or more in 2020, including telephone and household interviews. The primary outcome will be leisure-time and transport-related physical activity, assessed through the International Physical Activity Questionnaire long version. Exposure variables will be built environment features in the areas participants live and work in the follow-up. Data analysis will include multivariate multilevel linear and logistic models. We will also conduct cost-effectiveness analysis and develop agent-based models to help inform decision-makers. The study will be conducted by an interdisciplinary research team specialized in physical activity epidemiology, nutritional epidemiology, georeferencing applied to health, statistics, agent-based modeling, public health policy, and health economics. Discussion There are few longitudinal studies on the relationship between the built environment and physical activity behavior in low- and middle-income countries. We believe that the ISA-Physical Activity and Environment study will contribute with important results for the progress of the knowledge in this field and for the implementation of policies that promote leisure-time physical activity and active travel in Sao Paulo and similar cities across the world.
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Affiliation(s)
- Alex Antonio Florindo
- School of Arts, Sciences and Humanities, University of Sao Paulo, Rua Arlindo Bettio, 1000, Sao Paulo, SP, 03828-000, Brazil. .,Graduate Program in Nutrition in Public Health, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil. .,Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo, Brazil.
| | - Inaian Pignatti Teixeira
- School of Arts, Sciences and Humanities, University of Sao Paulo, Rua Arlindo Bettio, 1000, Sao Paulo, SP, 03828-000, Brazil.,Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo, Brazil
| | - Ligia Vizeu Barrozo
- Department of Geography, School of Philosophy, Literature and Human Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Flávia Mori Sarti
- School of Arts, Sciences and Humanities, University of Sao Paulo, Rua Arlindo Bettio, 1000, Sao Paulo, SP, 03828-000, Brazil.,Graduate Program in Nutrition in Public Health, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Regina Mara Fisberg
- Graduate Program in Nutrition in Public Health, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil.,Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Douglas Roque Andrade
- School of Arts, Sciences and Humanities, University of Sao Paulo, Rua Arlindo Bettio, 1000, Sao Paulo, SP, 03828-000, Brazil.,Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo, Brazil
| | - Leandro Martin Totaro Garcia
- Physical Activity Epidemiology Group, University of Sao Paulo, Sao Paulo, Brazil.,Centre for Public Health, Queen's University Belfast, Belfast, UK
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13
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Dias TG, Nunes APBDO, Santos CDO, Cruz MDSD, Guerra PH, Bernal RTI, Uvinha RR, Florindo AA. Leisure-time physical activity in São Paulo adults: a trend analysis from 2006 to 2016. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200099. [PMID: 33053092 DOI: 10.1590/1980-549720200099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 06/10/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate the temporal trend of practicing physical exercise and sports during leisure time in adults in São Paulo between 2006 to 2016. METHODS Time series analysis study using the VIGITEL System. Adding up the number of people who participated each year, a total 21,357 people were studied. Analyzes of the physical exercises and sports practiced during leisure time (yes or no) stratified by sex, age and education were performed. The prevalences and the differences for all of the years were calculated using the Prains-Winster regression. RESULTS Practice of physical exercises or sports increased by 7.9 percentage points in the period (p = 0.003) (from 39.9% 95%CI 37.4 - 42.4 to 47.8% 95%CI 45.2 - 50.4). There was a significant increase for women (p = 0.011), for people between 18-24 years old (p = 0.001), 25-34 years old (p = 0.003), 45-54 years old (p = 0.003), and for people with up to eight years of schooling (p = 0.010). There was a decrease in walking and playing soccer and there was an increase in doing gymnastics. CONCLUSION There was an increase in the practice of physical exercise and sports during leisure time in adults from São Paulo. These increases were observed mainly in women, in people between 18 and 34 years old, between 45 and 54 years old, and in people with up to eight years of schooling. These results are important, as they have shown an increase in general and in more vulnerable groups, and may be related to environmental changes and interventions that have occurred in the city in the last 15 years.
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Affiliation(s)
- Tulio Gamio Dias
- Escola de Artes, Ciências e Humanidades, Universidade de São Paulo - São Paulo (SP), Brasil.,Grupo de Estudos e Pesquisas Epidemiológicas em Atividade Física e Saúde, Universidade de São Paulo - São Paulo (SP), Brasil
| | | | - Crislaine de Oliveira Santos
- Grupo de Estudos e Pesquisas Epidemiológicas em Atividade Física e Saúde, Universidade de São Paulo - São Paulo (SP), Brasil.,Programa de Pós-Graduação em Ciências da Atividade Física, Escola de Artes, Ciências e Humanidades, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Michele Dos Santos da Cruz
- Grupo de Estudos e Pesquisas Epidemiológicas em Atividade Física e Saúde, Universidade de São Paulo - São Paulo (SP), Brasil
| | | | - Regina Tomie Ivata Bernal
- Programa de Pós-Graduação da Escola de Enfermagem, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
| | - Ricardo Ricci Uvinha
- Escola de Artes, Ciências e Humanidades, Universidade de São Paulo - São Paulo (SP), Brasil
| | - Alex Antonio Florindo
- Escola de Artes, Ciências e Humanidades, Universidade de São Paulo - São Paulo (SP), Brasil.,Grupo de Estudos e Pesquisas Epidemiológicas em Atividade Física e Saúde, Universidade de São Paulo - São Paulo (SP), Brasil
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Quantitative Evaluation of Spatial Differentiation for Public Open Spaces in Urban Built-Up Areas by Assessing SDG 11.7: A Case of Deqing County. ISPRS INTERNATIONAL JOURNAL OF GEO-INFORMATION 2020. [DOI: 10.3390/ijgi9100575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Urban public open spaces refer to open space between architectural structures in a city or urban agglomeration that is open for urban residents to conduct public exchanges and hold various activities. Sustainable Development Goal (SDG) 11.7 in the 2030 UN Agenda for Sustainable Development clearly states that the distribution characteristics of public open spaces are important indicators to measure the sustainable development of urban ecological society. In 2018, in order to implement the sustainable development agenda, China offered the example of Deqing to the world. Therefore, taking Deqing as an example, this paper uses geographic statistics and spatial analysis methods to quantitatively evaluate and visualize public open spaces in the built area in 2016 and analyzes the spatial pattern and relationship of the population. The results show that the public open spaces in the built-up area of Deqing have typical global and local spatial autocorrelation. The spatial pattern shows obvious differences in different parts of the built area and attributes of public open spaces. According to the results of correlation analysis, it can be seen that the decentralized characteristics of public open spaces have a significant relationship with the population agglomeration, and this correlation is also related to the types of public open spaces. The assessment results by SDG 11.7.1 indicate that the public open spaces in the built-up area of Deqing conform to the living needs of residents on the whole and have a humanized space design and good accessibility. However, the per capita public open spaces of towns and villages outside the built area are relatively low, and there is an imbalance in public open spaces. Therefore, more attention should be paid to constructing urban public open spaces fairly.
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15
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da Cunha Leme DE. The use of Bayesian network models to identify factors related to frailty phenotype and health outcomes in middle-aged and older persons. Arch Gerontol Geriatr 2020; 92:104212. [PMID: 33007708 DOI: 10.1016/j.archger.2020.104212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/22/2020] [Accepted: 07/26/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Studies on frailty frequently only include older persons. The mapping of factors related to this syndrome and negative outcomes associated with it, also in middle age, may assist in health strategies to each age group. OBJECTIVES To investigate social and health factors related to the frailty phenotype and to analyze the probabilistic relationships between frailty, falls and hospitalization in middle-aged and older persons. METHODS This is a cross-sectional study using data for 4442 middle-aged (50-59 years) and older participants (60 years or older) from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) 2015 and 2016. Bayesian network models were estimated with the score-based hill-climbing algorithm to identify factors associated with frailty, falls and hospitalization. RESULTS Mean age was 63.7 years, and prevalence of frailty was 8.5 % and 11.9 % among middle-aged and older participants, respectively. In the former, the probability of frailty increased when "poor" self-rated memory was considered in the model; and in the latter, the probability of frailty was greatest among individuals who did not participate socially and had the lowest level of education. In both age groups, frailty was an important factor that influenced the probability of negative health outcomes such as falls and hospitalization. However, this result depended on combinations of health factors in each sample. CONCLUSIONS This study has identified potential vulnerabilities that should be considered when undertaking a comprehensive assessment of middle-aged and older persons and developing suitable health strategies for each of these phases of life.
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16
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Guerra PH, Garcia LMT, Ribeiro EHC, Maretti ALR, Andrade DR, Florindo AA. [Identification and analysis of national physical activity guidelines in the Americas]. CIENCIA & SAUDE COLETIVA 2020; 26:2961-2968. [PMID: 34378689 DOI: 10.1590/1413-81232021268.15922020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/09/2020] [Indexed: 11/21/2022] Open
Abstract
Given the potential of institutional approaches to health promotion, this study sought to identify the countries on the American continent which have national physical activity (PA) guidelines approved by their national health agencies. A scoping review was conducted in May 2019, with a search conducted in five electronic databases, national health agency websites and contacts with members of the Physical Activity Network of the Americas. In all, national PA guidelines were found in ten of the 36 countries surveyed (27.8%), published between 2011 and 2018, the majority being in South American countries (n = 6). All guidelines presented "approaches and strategies for primary health care," "PA recommendations for health," and the "involvement of different PA domains," however, few guidelines addressed "constructed environment and infrastructure" (n = 3), as well as "monitoring and surveillance actions" (n = 5). The conclusion can be drawn that, although few countries on the American continent have guidelines for PA and that the majority of those available address PA in a limited way, new national guidelines, based on the complexity of the determinants, monitoring and consequences of PA are needed to guide and foster policies to promote PA within the population.
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Affiliation(s)
- Paulo Henrique Guerra
- Universidade Federal da Fronteira Sul. Bairro Fronteira Sul s/n Km 02 Bloco dos professores sala 110, Fronteira Sul. 89802-112 Chapecó SC Brasil. .,Grupo de Estudos e Pesquisas Epidemiológicas em Atividade Física e Saúde, Universidade de São Paulo. São Paulo SP Brasil
| | - Leandro Martin Totaro Garcia
- Grupo de Estudos e Pesquisas Epidemiológicas em Atividade Física e Saúde, Universidade de São Paulo. São Paulo SP Brasil
| | | | - Ana Lúcia Rodrigues Maretti
- Grupo de Estudos e Pesquisas Epidemiológicas em Atividade Física e Saúde, Universidade de São Paulo. São Paulo SP Brasil
| | - Douglas Roque Andrade
- Grupo de Estudos e Pesquisas Epidemiológicas em Atividade Física e Saúde, Universidade de São Paulo. São Paulo SP Brasil
| | - Alex Antonio Florindo
- Grupo de Estudos e Pesquisas Epidemiológicas em Atividade Física e Saúde, Universidade de São Paulo. São Paulo SP Brasil
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Dias AF, Gaya AR, Santos MP, Brand C, Pizarro AN, Fochesatto CF, Mendes TM, Mota J, Gaya ACA. Neighborhood environmental factors associated with leisure walking in adolescents. Rev Saude Publica 2020; 54:61. [PMID: 32491115 PMCID: PMC7263801 DOI: 10.11606/s1518-8787.2020054002222] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 01/30/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To verify the associations of leisure walking with perceived and objective measures of neighborhood environmental factors stratified by gender and socioeconomic status (SES) in Brazilian adolescents. METHODS Cross-sectional study with a random sample of 1,130 high school students (47.3% girls; aged 14 to 20 years old) from Porto Alegre, Brazil. Leisure walking and SES were self-reported by the adolescents. Perceived environmental factors were assessed through Neighborhood Environment Walkability Scale for Youth (NEWS-Y). Objective measures were evaluated using Geographic Information Systems, with road network calculated around the adolescent’s residential address, using 0.5km and 1.0km buffers. Data collection was carried out in 2017 and generalized linear regression models were used. RESULTS Leisure walking was positively associated with access to services (0.5 km buffers [Odds ratio (OR) = 2.22] 1.0 km buffers [OR = 2.17]) and lower distance to parks and squares (0.5 km [OR=2.80] 1.0 km [OR = 2.73]) in girls from low SES. Residential density (0.5 km [OR = 1.57] 1.0 km [OR = 1.54]) and walkability index (0.5 km [OR = 1.17] 1.0 km [OR = 1.20]) were associated with leisure walking in girls from middle SES. Boys from low SES showed an inverse association between crime safety and leisure walking (0.5 km [OR = 0.59] 1.0 km [OR = 0.63]). Neighborhood recreation facilities was positively associated with leisure walking in middle SES (0.5 km [OR = 1.55] 1.0 km [OR = 1.60]). Land use mix (0.5 km [OR = 1.81] 1.0 km [OR = 1.81]), neighborhood recreation facilities (0.5 km [OR = 2.32] 1.0 km [OR = 2.28]) and places for walking (0.5 km [OR=2.07] 1.0 km [OR=2.22]) were positively associated with leisure walking in high SES. CONCLUSION Environmental factors (objectively and subjectively measured) and leisure walking show association in boys and girls of different SES.
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Affiliation(s)
- Arieli Fernandes Dias
- Programa de Pós-Graduação em Ciências do Movimento Humano, Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Anelise Reis Gaya
- Programa de Pós-Graduação em Ciências do Movimento Humano, Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Maria Paula Santos
- Centro de Investigação em Atividade Física, Saúde e Lazer, Faculdade de Desporto, Universidade do Porto, Porto, Portugal
| | - Caroline Brand
- Programa de Pós-Graduação em Ciências do Movimento Humano, Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Andreia Nogueira Pizarro
- Centro de Investigação em Atividade Física, Saúde e Lazer, Faculdade de Desporto, Universidade do Porto, Porto, Portugal
| | - Camila Felin Fochesatto
- Programa de Pós-Graduação em Ciências do Movimento Humano, Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Thiago Monteiro Mendes
- Centro de Estudos em Geografia e Ordenamento do Território, Universidade do Porto, Porto, Portugal
| | - Jorge Mota
- Centro de Investigação em Atividade Física, Saúde e Lazer, Faculdade de Desporto, Universidade do Porto, Porto, Portugal
| | - Adroaldo Cezar Araujo Gaya
- Programa de Pós-Graduação em Ciências do Movimento Humano, Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
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Elshahat S, O’Rorke M, Adlakha D. Built environment correlates of physical activity in low- and middle-income countries: A systematic review. PLoS One 2020; 15:e0230454. [PMID: 32182278 PMCID: PMC7077823 DOI: 10.1371/journal.pone.0230454] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/01/2020] [Indexed: 01/07/2023] Open
Abstract
Insufficient physical activity (PA) is the fourth major risk factor for many non-communicable diseases and premature mortality worldwide. Features of the built environment (BE) play a considerable role in determining population PA behaviors. The majority of evidence for PA-BE relationships comes from high-income countries and may not be generalizable to low- and middle-income countries (LMICs). We aim to systematically review the literature and assess the associations between perceived and/or objective BE characteristics and PA domains in LMICs. This review adopted a systematic search strategy for English language articles published between January 2000 and June 2019 from four electronic databases-Medline, Embase, Web of Science and PubMed-adhering to the PRISMA guidelines. Studies addressing the associations between self-reported and/or objective BE and PA were only included if they were conducted in LMICs, according to the World Bank classification list. Articles investigating PA-BE relationships across any age groups were included, and all study designs were eligible, except for qualitative studies and reviews. Thirty-three studies were included for evidence synthesis. Cross-sectional studies were the most prevailing study design (97%), revealing a notable gap in longitudinal PA-BE research in LMICs. A majority of the BE factors were not associated with different PA domains while others (e.g., density, proximity to services, aesthetics) exhibited an inconsistent association. Land-use mix diversity was positively associated with transport PA and the presence of recreation facilities resulted in an increase in PA during leisure-time. Increased safety from crime at night consistently increased total PA and walking levels. Research exploring the associations between BE attributes and PA behaviors in LMICs appears to be limited and is primarily cross-sectional. Longitudinal research studies with objective measures are needed for inferring well-grounded PA-BE causal relationships and informing the design of evidence-based environmental interventions for increasing PA levels in LMICs.
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Affiliation(s)
- Sarah Elshahat
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Michael O’Rorke
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, United States of America
| | - Deepti Adlakha
- School of Natural and Built Environment, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
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Manta SW, Del Duca GF, da Silva KS, Rech CR, Gomes RDS, Maximiano GP, Malta DC. Is the availability of open public spaces associated with leisure-time physical activity in Brazilian adults? Health Promot Int 2020; 35:e51-e58. [PMID: 30689849 DOI: 10.1093/heapro/day120] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study aims to analyse the association between perceived presence of public spaces near residences and practice of physical activity during leisure time by adults in the state capitals of Brazil, based on sociodemographic characteristics. Participants were individuals aged ≥18 years living in the 27 state capitals of Brazil (n = 52 929, 53.9% female) who responded to a national survey called VIGITEL in 2013. Physical activity during leisure time (≥1 time/week), perception of space, population and sociodemographic variables (sex, age, years of study and geographic region) were self-reported. The adjusted binary logistic regression analysis was used. Among adults, the prevalence of physical activity during leisure was 45.1% (95% CI [44.2; 46.0]), and 71.1% (95% CI [70.2, 71.8]) perceived public space near their residence. A direct association between perceiving public space and physical activity ([OR] = 1.43; 95% CI [1.32; 1.55]) was observed. No significant difference was observed in the population groups (men and women, younger and older adults, and those with more and fewer years of study). Thus, even with the possible regional differences in Brazilian state capitals, the presence of public spaces increases the practice of physical activity during leisure time, independent of sociodemographic variables.
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Affiliation(s)
| | | | | | | | | | | | - Débora Carvalho Malta
- Department of Surveillance of Diseases and Noncommunicable Diseases and Health Promotion, Secretariat of Health Surveillance, Ministry of Health, Brasilia-DF, Brazil
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20
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Pitilin EDB, Massaroli A, Luzardo AR, Lentsck MH, Baratieri T, Gasparin VA. Factors associated with leisure activities of elderly residents in rural areas. Rev Bras Enferm 2020; 73 Suppl 3:e20190600. [DOI: 10.1590/0034-7167-2019-0600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 03/13/2020] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To identify factors associated with leisure activities of elderly residents in rural areas. Method: Quantitative cross-sectional study carried out with 258 elderly living in the rural area of Paraná. The collection instrument addressed sociodemographic, economic, and self-reported leisure activities. The association between variables and leisure activities was verified by means of bivariate and multivariate analysis. Results: Among the elderly interviewed, 63.9% were female, and 36.1% were male, with an average of 68.3 years old (± 5.8 years). Participation in leisure activities was high (79.8%), and the factors associated with their practice were: marital status, gender, and education. Conclusion: Considering that the practice of leisure activities promotes better living and health conditions, we reinforce the need to implement actions and instruments that provide individual and collective leisure in rural areas.
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Nogueira LR, Fontanelli MDM, Aguiar BSD, Failla MA, Florindo AA, Leme AC, Barbosa JPDAS, Fisberg RM. Is the local food environment associated with excess body weight in adolescents in São Paulo, Brazil? CAD SAUDE PUBLICA 2020; 36:e00048619. [DOI: 10.1590/0102-311x00048619] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 08/02/2019] [Indexed: 11/21/2022] Open
Abstract
The obesogenic environment stimulates an inadequate diet by hampering healthy choices. This cross-sectional study evaluated the association between the local food environment and the prevalence of overweight and obesity in a representative sample population of adolescents living in the city of São Paulo, Brazil, using multilevel logistic regression models. Among the adolescents, 29.6% were overweight/obese. There were no significant differences between food environment and adolescents’ weight status. However, the presence of fast food restaurants near their home increased the chances of being overweight or obese (OR = 2.53; 95%CI: 1.02-6.27). Results suggest the need to intensify food and nutrition policies, development of culinary skills, and the reduction in prices of healthy foods to facilitate access to these foods, so that adolescents have options in locations to socialize with friends and family.
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Luis de Moraes Ferrari G, Kovalskys I, Fisberg M, Gómez G, Rigotti A, Sanabria LYC, García MCY, Torres RGP, Herrera-Cuenca M, Zimberg IZ, Guajardo V, Pratt M, King AC, Solé D. Original research Socio-demographic patterning of self-reported physical activity and sitting time in Latin American countries: findings from ELANS. BMC Public Health 2019; 19:1723. [PMID: 31870408 PMCID: PMC6929436 DOI: 10.1186/s12889-019-8048-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 12/08/2019] [Indexed: 11/13/2022] Open
Abstract
Background Low levels of physical activity (PA) and prolonged sitting time (ST) increase the risk of non-communicable diseases and mortality, and can be influenced by socio-demographic characteristics. The aim of this study was to use self-report data to characterise socio-demographic patterns of PA and ST in eight Latin American countries. Methods Data were obtained from the Latin American Study of Nutrition and Health (ELANS), a household population-based, multi-national, cross-sectional survey (n = 9218, aged 15–65 years), collected from September 2014 to February 2015. Transport and leisure PA and ST were assessed using the International Physical Activity Questionnaire–long version. Overall and country-specific mean and median levels of time spent in transport and leisure PA and ST were compared by sex, age, socioeconomic and education level. Results Mean levels of transport and leisure PA were 220.3 min/week (ranging from 177.6 min/week in Venezuela to 275.3 min/week in Costa Rica) and 316.4 min/week (ranging from 272.1 min/week in Peru to 401.4 min/week in Ecuador). Transport and leisure PA were higher (p < 0.005) in men than women with mean differences of 58.0 and 34.0 min/week. The mean and median for transport PA were similar across age groups (15–29 years: mean 215.5 and median 120 min/week; 30–59 years: mean 225.0 and median 120 min/week; ≥60 years: mean 212.0 and median 120 min/week). The median time spent in transport and leisure PA between three strata of socioeconomic and education levels were similar. The prevalence of not meeting PA recommendations were 69.9% (95% CI: 68.9–70.8) for transport and 72.8% (95% CI: 72.0–73.7) for leisure. Men, younger people (15–29 years), individuals with higher socioeconomic and education levels spent significantly (p < 0.001) more time sitting than women, older people (30–59 years and ≥ 60 years) and those in the middle and low socioeconomic and education groups, respectively. Conclusions Transport and leisure PA and ST range widely by country, sex, and age group in Latin America. Programs for promoting leisure and transport PA and reducing ST in Latin America should consider these differences by age and gender and between countries. Trial registration ClinicalTrials.Gov NCT02226627. Retrospectively registered on August 27, 2014.
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Affiliation(s)
- Gerson Luis de Moraes Ferrari
- Centro de Investigación en Fisiologia del Ejercicio - CIFE, Universidad Mayor, José Toribio Medina, 29. Estacion Central, Santiago, Chile. .,Departamento de Pediatria da Universidade Federal de São Paulo, São Paulo, Brazil.
| | - Irina Kovalskys
- Commitee of Nutrition and Wellbeing, International Life Science Institute (ILSI-Argentina), Buenos Aires, Argentina
| | - Mauro Fisberg
- Departamento de Pediatria da Universidade Federal de São Paulo, São Paulo, Brazil.,Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo, Brazil
| | - Georgina Gómez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | | | | | | | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas, Venezuela
| | - Ioná Zalcman Zimberg
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Viviana Guajardo
- Commitee of Nutrition and Wellbeing, International Life Science Institute (ILSI-Argentina), Buenos Aires, Argentina
| | - Michael Pratt
- Institute for Public Health, University of California San Diego, La Jolla, CA, USA
| | - Abby C King
- Health Research & Policy Department and the Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Dirceu Solé
- Departamento de Pediatria da Universidade Federal de São Paulo, São Paulo, Brazil
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de Souza Andrade AC, Mingoti SA, da Silva Costa DA, Xavier CC, Proietti FA, Caiaffa WT. Built and Social Environment by Systematic Social Observation and Leisure-Time Physical Activity Report among Brazilian Adults: a Population-Based Study. J Urban Health 2019; 96:682-691. [PMID: 31399814 PMCID: PMC6814682 DOI: 10.1007/s11524-019-00381-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this study was to investigate the relationship between built and social environment and leisure-time physical activity (LTPA) among adults living in an urban center. The individual data was from the household survey and the environmental data was assessed through systematic social observation by trained observers on street segments of respondents' residences. The relationship between environmental factors and LTPA was examined using multilevel logistic regression. The prevalence of LTPA was 30.2% (95% CI 27.4-32.9%). Individuals living in census tracts with higher walking environment indicators (OR = 1.20; 95% CI 1.02 to 1.40) and safety (OR = 1.18; 95% CI 1.01 to 1.38) were more likely to be active during leisure time, even after adjusting for individual variables. Improving the built and social environment is an important step for achieving higher levels of LTPA in the population in a middle-income country.
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Affiliation(s)
- Amanda Cristina de Souza Andrade
- Observatory for Urban Health in Belo Horizonte (OSUBH), School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil. .,Department of Public Health, Federal University of Mato Grosso, Avenida Fernando Corrêa, 2367, Cuiabá, Mato Grosso, 78060-900, Brazil.
| | - Sueli Aparecida Mingoti
- Department of Statistics, Institute of Exact Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Dário Alves da Silva Costa
- Observatory for Urban Health in Belo Horizonte (OSUBH), School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - César Coelho Xavier
- Faculty of Health and Human Ecology, Federal University of Minas Gerais, Minas Gerais, Brazil
| | | | - Waleska Teixeira Caiaffa
- Observatory for Urban Health in Belo Horizonte (OSUBH), School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Pereira JL, Vieira DADS, Alves MCGP, César CLG, Goldbaum M, Fisberg RM. Excess body weight in the city of São Paulo: panorama from 2003 to 2015, associated factors and projection for the next years. BMC Public Health 2018; 18:1332. [PMID: 30509223 PMCID: PMC6276135 DOI: 10.1186/s12889-018-6225-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 11/16/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Excess body weight (EBW: overweight and obesity) has high and rising prevalence in Brazil. Up-to-date information about the distribution and changes in the prevalence of EBW and their associated factors are essential to determine target groups and to identify priority actions. The aim of this study was to investigate the associated factors and to determine the prevalence of overweight and obesity in the adolescent and adult population of the city of São Paulo in the years of 2003, 2008, and 2015, as well as to estimate the prediction for the next years. METHODS Individuals aged 12 years and older from three editions of the Health Survey of São Paulo (ISA-Capital), a cross-sectional population-based survey, carried out in 2003 (n = 2144), 2008 (n = 2599), and 2015 (n = 3939), had their socioeconomic, anthropometric, and lifestyle data collected at households. Individuals were classified according to their age and BMI as: without excess body weight, overweight, or obese. Differences were evaluated through Pearson's Chi-square test and comparison of 95% CI. Generalized ordered logit models were used to evaluate factors associated to overweight/obesity and logistic regression models were used to predict their prevalence for the next years. RESULTS The prevalence (95% CI) of obesity in total population doubled: from 10% (8.0, 12.5) in 2003 to 19.2% (17.8, 20.6) in 2015. The main increase occurred in female adolescents from 2.5% (1.2, 5.3) to 11.2% (8.4, 14.7) and adults, from 9.2% (6.4, 13.1) to 22.3% (20.0, 24.8). Those with higher chance of having EBW were adults, those with higher income, and former smokers. The prevalence of EBW increased 31% from 2003 to 2008, and 126% from 2003 to 2015, when half of the population had EBW. If this pattern does not change, 77% of the population is expected to have EBW by 2030. CONCLUSIONS Our findings present up-to-date information about the distribution of EBW, which increased substantially over a short time and more prominently in specific groups. The factors associated with EBW may provide important information for decision makers and researchers to create or review the existing programs and interventions in order to decrease the trend for the next years.
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Affiliation(s)
- Jaqueline Lopes Pereira
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Moisés Goldbaum
- Department of Preventive Medicine, Medical School, University of São Paulo, São Paulo, Brazil
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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25
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Loch MR, Guerra PH. [Laziness as the single explanation for physical inactivity: commentary and reflections on discrepancies between scientific evidence and media discourse]. CAD SAUDE PUBLICA 2018; 34:e00223017. [PMID: 30517320 DOI: 10.1590/0102-311x00223017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 08/17/2018] [Indexed: 11/21/2022] Open
Abstract
This essay aims to suggest food for thought on discrepancies between scientific evidence on physical inactivity and the associated factors and determinants and information communicated by the media on this topic. We specifically examine a case in which "laziness" was used as the "explanatory" factor for the high levels of physical inactivity in the Brazilian population. We use as examples a scientific article published in Nature and two news stories published in mainstream Brazilian media channels (Veja magazine and O Globo newspaper) that commented on the former. There were important inconsistencies between the scientific content in the Nature article and the news stories, which took a simplistic approach to a real and complex problem (high levels of physical inactivity in Brazil), suggesting that "laziness" explains why Brazil ranks so poorly in the world in terms of physical activity. We highlight the need for mass communications media to better contextualize the information they republish, because otherwise the impact can be more negative than positive, especially when they build or reinforce misconceptions. This is particularly serious in the case of physical inactivity, since such news coverage can lend legitimacy to the lack of investments in measures to deal adequately with the problem. If physical inactivity is interpreted merely as a matter of "laziness", it makes much less sense to invest in modifying various determinants of this serious public health problem.
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Affiliation(s)
- Mathias Roberto Loch
- Programa de Pós-graduação em Saúde Coletiva, Universidade Estadual de Londrina, Londrina, Brasil
| | - Paulo Henrique Guerra
- Universidade Federal da Fronteira Sul, Chapecó, Brasil.,Grupo de Estudos e Pesquisas Epidemiológicas em Atividade Física e Saúde, Universidade de São Paulo, São Paulo, Brasil
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Pandian JD, Gall SL, Kate MP, Silva GS, Akinyemi RO, Ovbiagele BI, Lavados PM, Gandhi DBC, Thrift AG. Prevention of stroke: a global perspective. Lancet 2018; 392:1269-1278. [PMID: 30319114 DOI: 10.1016/s0140-6736(18)31269-8] [Citation(s) in RCA: 203] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 05/04/2018] [Accepted: 05/29/2018] [Indexed: 12/16/2022]
Abstract
Along with the rising global burden of disability attributed to stroke, costs of stroke care are rising, providing the impetus to direct our research focus towards effective measures of stroke prevention. In this Series paper, we discuss strategies for reducing the risk of the emergence of disease (primordial prevention), preventing the onset of disease (primary prevention), and preventing the recurrence of disease (secondary prevention). Our focus includes global strategies and campaigns, and measurements of the effectiveness of worldwide preventive interventions, with an emphasis on low-income and middle-income countries. Our findings reveal that effective tobacco control, adequate nutrition, and development of healthy cities are important strategies for primordial prevention, whereas polypill strategies, use of mobile technology (mHealth), along with salt reduction and other dietary interventions, are effective in the primary prevention of stroke. An effective collaboration between various health-care sectors, government policies, and campaigns can successfully implement secondary prevention strategies, through surveillance and registries, such as the WHO's non-communicable diseases programmes, across high-income and low-income countries.
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Affiliation(s)
- Jeyaraj D Pandian
- Department of Neurology, Christian Medical College and Hospital, Ludhiana, India.
| | - Seana L Gall
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Mahesh P Kate
- Department of Neurology, Christian Medical College and Hospital, Ludhiana, India
| | - Gisele S Silva
- Programa Integrado de Neurologia, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Rufus O Akinyemi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Bruce I Ovbiagele
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Pablo M Lavados
- Vascular Neurology Unit, Neurology Service, Department of Neurology and Psychiatry, Clínica Alemana de Santiago, Santiago, Chile; Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile; Department of Neurological Sciences, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Dorcas B C Gandhi
- College of Physiotherapy, Christian Medical College and Hospital Ludhiana, Ludhiana, India
| | - Amanda G Thrift
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
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27
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Cominato L, Di Biagio GF, Lellis D, Franco RR, Mancini MC, de Melo ME. Obesity Prevention: Strategies and Challenges in Latin America. Curr Obes Rep 2018; 7:97-104. [PMID: 29737493 DOI: 10.1007/s13679-018-0311-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW The purpose of this study is to present changes of policies and norms aimed to reduce obesity levels that have been adopted in some Latin American countries. RECENT FINDINGS The global increase of the excess weight within the population has been demanding governmental actions aimed at preventing health impacts generated by obesity. Over recent years, many Latin American countries have established a number of regulations aimed at reducing weight in the population using interventions that could effectively prevent childhood obesity, including the taxation of sugar-sweetened beverages (SSBs), increasing physical activity in open spaces, and, especially, front-of-package labeling. Some strategies are part of the Action Plan for Prevention of Child and Adolescence Obesity signed by all countries in Latin America, which currently have among the highest prevalence of childhood obesity in the world. Among them are the implementation of fiscal policies on energy-dense and nutrient-poor foods and taxes on SSBs; improvements in nutrition labeling, highlighting the front-of-package (FOP) labeling to promote the choice of healthier products at the time of purchase; and promotion of an active lifestyle, such as encouraging the use of bicycle paths or physical activity programs at school. The real impact of these prevention strategies implemented in Latin America on the prevalence of obesity is still unknown.
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Affiliation(s)
- Louise Cominato
- Pediatric Endocrinology Unit of the Children's Institute of the Medicine Faculty, University of São Paulo, São Paulo, Brazil.
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, Brazil.
- , São Paulo, Brazil.
| | - Georgia Finardi Di Biagio
- , São Paulo, Brazil
- League of Childhood Obesity of the Hospital das Clínicas of the Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Denise Lellis
- , São Paulo, Brazil
- Obesity and Metabolic Syndrome Group of the Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Ruth Rocha Franco
- Pediatric Endocrinology Unit of the Children's Institute of the Medicine Faculty, University of São Paulo, São Paulo, Brazil
- , São Paulo, Brazil
| | - Marcio Correa Mancini
- , São Paulo, Brazil
- League of Childhood Obesity of the Hospital das Clínicas of the Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- Obesity and Metabolic Syndrome Group of the Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Maria Edna de Melo
- Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), São Paulo, Brazil
- , São Paulo, Brazil
- League of Childhood Obesity of the Hospital das Clínicas of the Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- Obesity and Metabolic Syndrome Group of the Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
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Cycling for Transportation in Sao Paulo City: Associations with Bike Paths, Train and Subway Stations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040562. [PMID: 29561755 PMCID: PMC5923604 DOI: 10.3390/ijerph15040562] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 02/28/2018] [Accepted: 03/02/2018] [Indexed: 11/17/2022]
Abstract
Cities that support cycling for transportation reap many public health benefits. However, the prevalence of this mode of transportation is low in Latin American countries and the association with facilities such as bike paths and train/subway stations have not been clarified. We conducted a cross-sectional analysis of the relationship between bike paths, train/subway stations and cycling for transportation in adults from the city of Sao Paulo. We used data from the Sao Paulo Health Survey (n = 3145). Cycling for transportation was evaluated by a questionnaire and bike paths and train/subway stations were geocoded using the geographic coordinates of the adults' residential addresses in 1500-m buffers. We used multilevel logistic regression, taking account of clustering by census tract and households. The prevalence of cycling for transportation was low (5.1%), and was more prevalent in males, singles, those active in leisure time, and in people with bicycle ownership in their family. Cycling for transportation was associated with bike paths up to a distance of 500 m from residences (OR (Odds Ratio) = 2.54, 95% CI (Confidence interval) 1.16-5.54) and with the presence of train/subway stations for distances >500 m from residences (OR = 2.07, 95% CI 1.10-3.86). These results are important to support policies to improve cycling for transportation in megacities such as Sao Paulo.
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Access to Street Markets and Consumption of Fruits and Vegetables by Adolescents Living in São Paulo, Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018. [PMID: 29538324 PMCID: PMC5877062 DOI: 10.3390/ijerph15030517] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Food environment and income act as determinants of diet, and consequently, of the consumption of fruits and vegetables. The objective of this study is to investigate the association between fruit and vegetable consumption, income, and street market density in adolescents living in São Paulo, Brazil. Data from 521 adolescents (12 to 19 years) participating in the 2015 Health Survey of São Paulo were used. Buffers (500, 1000, and 1500 m) were drawn around the households and the street markets were counted in each zone. Multilevel logistic regression models were used to evaluate the association between fruit and vegetable consumption, income, and street market density. The main results showed that the presence of a street market in the zone closest to the households (500 m) was associated with higher consumption of fruits and vegetables (OR: 1.73; CI 95% 1.01-3.00). Higher family income was associated with a higher consumption of fruits and vegetables for models of 500 m buffer (OR: 2.56; CI 95% 1.47-4.45), 1000 m (OR: 2.30; CI 95% 1.33-3.96), and 1500 m (OR: 2.32; CI 95% 1.35-4.00). These results support the implementation of public policies that jointly consider income and the availability of street markets or healthy food environments.
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