Educational interventions for physical activity among Brazilian adults: systematic review
DOI:
https://doi.org/10.11606/s1518-8787.2021055003236Keywords:
Adult, Exercise, Health Education, Health Promotion, Systematic ReviewAbstract
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.
References
Programa das Nações Unidas para o Desenvolvimento. Movimento é Vida: Atividades Físicas e Esportivas para Todas as Pessoas: Relatório Nacional de Desenvolvimento Humano do Brasil 2017. Brasília, DF: PNUD; 2017 [citado 10 out 2020]. Disponível em: https://www.undp.org/content/dam/brazil/docs/publicacoes/relatorio-nacional-desenvolvimento-humano-2017.pdf
Warburton DER, Bredin SSD. Health benefits of physical activity: a systematic review of current systematic reviews. Curr Opin Cardiol. 2017;32(5):541-56. https://doi.org/10.1097/HCO.0000000000000437
World Health Organization. Global action plan on physical activity 2018–2030: more active people for a healthier world. Geneva (CH): WHO; 2018 [citado 10 out 2020]. Disponível em: https://apps.who.int/iris/bitstream/handle/10665/272722/9789241514187-eng.pdf?ua=1
Klepac Pogrmilovic B, Ramirez Varela A, Pratt M, Milton K, Bauman A, Biddle SJH, et al. National physical activity and sedentary behaviour policies in 76 countries: availability, comprehensiveness, implementation, and effectiveness. Int J Behav Nutr Phys Act. 2020;17:116. https://doi.org/10.1186/s12966-020-01022-6
Loch MR, Knuth AG, Silva ICM, Guerra PH. As práticas corporais/atividade física nos 30 anos do Sistema Único de Saúde. Cienc Saude Coletiva. 2018;23(10):3469. https://doi.org/10.1590/1413-812320182310.19102018
Silva ICM, Mielke GI, Bertoldi AD, Arrais PSD, Luiza VL, Mengue SS, et al. Overall and Leisure-Time Physical Activity Among Brazilian Adults: national survey based on the Global Physical Activity Questionnaire. J Phys Act Health. 2018;15(3):212-8. https://doi.org/10.1123/jpah.2017-0262
Lima MG, Malta DC, Monteiro CN, Silva Sousa NF, Stopa SR, Medina LPB, et al. Leisure-time physical activity and sports in the Brazilian population: a social disparity analysis. PLoS One. 2019;14(12):e0225940. https://doi.org/10.1371/journal.pone.0225940
Florindo AA, Barrozo LV, Cabral-Miranda W, Rodrigues EQ, Turrell G, Goldbaum M, et al. Public open spaces and leisure-time walking in Brazilian adults. Int J Environ Res Public Health. 2017;14(6):553. https://doi.org/10.3390/ijerph14060553
Sanchez A, Bully P, Martinez C, Grandes G. Effectiveness of physical activity promotion interventions in primary care: a review of reviews. Prev Med. 2015;76 Suppl:S56-67. https://doi.org/10.1016/j.ypmed.2014.09.012
Garrett S, Elley CR, Rose SB, O'Dea D, Lawton BA, Dowell AC. Are physical activity interventions in primary care and the community cost-effective? A systematic review of the evidence. Br J Gen Pract. 2011;61(584):e125-33. https://doi.org/10.3399/bjgp11X561249
Guerra PH, Ribeiro EHC, Rodrigues TL, Andrade DR, Loch MR. Effects of community-based interventions on physical activity levels: systematic review. Rev Bras Ativ Fis Saude. 2020;25:e0130. https://doi.org/10.12820/rbafs.25e0130
Costa EF, Guerra PH, Santos TI, Florindo AA. Systematic review of physical activity promotion by community health workers. Prev Med. 2015;81:114-21. https://doi.org/10.1016/j.ypmed.2015.08.007
Heath GW, Parra DC, Sarmiento OL, Andersen LB, Owen N, Goenka S, et al. Evidence-based intervention in physical activity: lessons from around the world. Lancet. 2012;380(9838):272-81. https://doi.org/10.1016/S0140-6736(12)60816-2
Hoehner CM, Ribeiro IC, Parra DC, Reis RS, Azevedo MR, Hino AA, et al. Physical activity interventions in Latin America: expanding and classifying the evidence. Am J Prev Med. 2013;44(3):e31-40. https://doi.org/10.1016/j.amepre.2012.10.026
Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al., editors. Cochrane handbook for systematic reviews of interventions. 2. ed. Chichester (UK): John Wiley & Sons; 2019.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6(7):e1000100. https://doi.org/10.1371/journal.pmed.1000100
Thomas BH, Ciliska D, Dobbins M, Micucci S. A process for systematically reviewing the literature: providing the research evidence for public health nursing interventions. Worldviews Evid Based Nurs. 2004;1(3):176-84. https://doi.org/10.1111/j.1524-475X.2004.04006.x
Assunção MCF, Gigante DP, Cardoso MA, Sartorelli DS, Santos IS. Randomized, controlled trial promotes physical activity and reduces consumption of sweets and sodium among overweight and obese adults. Nutr Res. 2010;30(8):541-9. https://doi.org/10.1016/j.nutres.2010.07.006
Baba CT, Oliveira IM, Silva AEF, Vieira LM, Cerri NC, Florindo AA, et al. Evaluating the impact of a walking program in a disadvantaged area: using the RE-AIM framework by mixed methods. BMC Public Health. 2017;17:709. https://doi.org/10.1186/s12889-017-4698-5
Chaves EC, Oyama SM. Abordagem telefônica como estratégia para promoção da saúde. Rev Gaucha Enferm. 2007;28(2):171-9.
Costa PRF, Assis AMO, Silva MCM, Santana MLP, Dias JC, Pinheiro SMC, et al. Mudança nos parâmetros antropométricos: a influência de um programa de intervenção nutricional e exercício físico em mulheres adultas. Cad Saude Publica. 2009;25(8):1763-73. https://doi.org/10.1590/S0102-311X2009000800012
Costa EF, Andrade DR, Garcia LM, Ribeiro EH, Santos TI, Florindo AA. Avaliação da efetividade da promoção da atividade física por agentes comunitários de saúde em visitas domiciliares. Cad Saude Publica. 2015;31(10):2185-98. https://doi.org/10.1590/0102-311X00106014
Ferreira M, Matsudo S, Matsudo V, Braggion G. Effects of an intervention program of physical activity and nutrition orientation on the physical activity level of physically active women aged 50 to 72 years old. Rev Bras Med Esporte. 2005;11(3):172-6. https://doi.org/10.1590/S1517-86922005000300004
Gomes MA, Duarte MFS. Efetividade de uma intervenção de atividade física em adultos atendidos pela Estratégia Saúde da Família: Programa Ação e Saúde Floripa – Brasil. Rev Bras Ativ Fis Saude. 2008;13(1):44-56. https://doi.org/10.12820/rbafs.v.13n1p44-56
Meurer ST, Lopes ACS, Almeida FA, Mendonça RD, Benedetti TRB. Effectiveness of the VAMOS strategy for increasing physical activity and healthy dietary habits: a randomized controlled community trial. Health Educ Behav. 2019;46(3):406-16. https://doi.org/10.1177/1090198118820095
Ribeiro EHC, Garcia LMT, Salvador EP, Costa EF, Andrade DR, Latorre MDRDO, et al. Assessment of the effectiveness of physical activity interventions in the Brazilian Unified Health System. Rev Saude Publica. 2017;51:56. https://doi.org/10.1590/s1518-8787.2017051006654
Ramires VV, Becker LA, Sadovsky ADI, Zago AM, Bielemann RM, Guerra PH. Evolução da pesquisa epidemiológica em atividade física e comportamento sedentário no Brasil: atualização de uma revisão sistemática. Rev Bras Ativ Fis Saude. 2014;19(5):529-30. https://doi.org/10.12820/rbafs.v.19n5p529
Jucá B. Cortes de verbas desmontam ciência brasileira e restringem pesquisa a mais ricos. El País (Brasil). 9 set 2020 [citado 10 out 2020]. Disponível em: https://brasil.elpais.com/brasil/2019/09/03/politica/1567542296_718545.htm
Norte DB. Cortes e mais cortes: o que será da ciência e da pesquisa no Brasil? VocêS/A. 9 mar 2020 [citado 10 out 2020]. Disponível em: https://vocesa.abril.com.br/carreira/cortes-bolsas-pesquisa-ciencia/
Orrow G, Kinmonth AL, Sanderson S, Sutton S. Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials. BMJ. 2012;344:e1389. https://doi.org/10.1136/bmj.e1389
Loch MR, Dias DF, Castro ASR, Guerra PH. Controle remoto ou remoto controle? A economia comportamental e a promoção de comportamentos saudáveis. Rev Panam Salud Publica. 2019;43:e18. https://doi.org/10.26633/RPSP.2019.18
Marteau TM. Changing minds about changing behaviour. Lancet. 2018;391(10116):116-7. https://doi.org/10.1016/S0140-6736(17)33324-X
Martins L, Dionor GA, El-Hani CN, Carvalho GS. Construtos teóricos e práticos da saúde: as abordagens biomédica e socioecológica. In: Anais do 10. Encontro Nacional de Pesquisa em Educação em Ciências –ENPEC; 24 - 27 nov 2015; Águas de Lindóia, SP. São Paulo: ABRAPEC; 2015. p.1-8.
Häfele V; Siqueira FV. Aconselhamento para atividade física e mudança de comportamento em Unidades Básicas de Saúde. Rev Bras Ativ Fis Saude. 2017;21(6):581-92. https://doi.org/10.12820/rbafs.v.21n6p581-592
Lin JS, O'Connor E, Whitlock EP, Beil TL. Behavioral counseling to promote physical activity and a healthful diet to prevent cardiovascular disease in adults: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2010;153(11):736-50. https://doi.org/10.7326/0003-4819-153-11-201012070-00007
Florindo AA, Mielke GI, Gomes GAO, Ramos LR, Bracco MM, Parra DC, et al. Physical activity counseling in primary health care in Brazil: a national study on prevalence and associated factors. BMC Public Health. 2013;13:794. https://doi.org/10.1186/1471-2458-13-794
Gagliardi AR, Faulkner G, Ciliska D, Hicks A. Factors contributing to the effectiveness of physical activity counselling in primary care: a realist systematic review. Patient Educ Couns. 2015;98(4):412-9. https://doi.org/10.1016/j.pec.2014.11.020
Florindo AA, Andrade DR, Guerra PH, Mota J, Crone D, Mafra ACCN, et al. Physical activity promotion by health practitioners: a distance-learning training component to improve knowledge and counseling. Prim Health Care Res Dev. 2018;19(2):140-50. https://doi.org/10.1017/S1463423617000676
Siqueira FV, Nahas MV, Facchini LA, Silveira DS, Piccini RX, Tomasi E, et al. Aconselhamento para a prática de atividade física como estratégia de educação à saúde. Cad Saude Publica. 2009;25(1):203-13. https://doi.org/10.1590/S0102-311X2009000100022
Lee M, Lee H, Kim Y, Kim J, Cho M, Jang J, et al. Mobile app-based health promotion programs: a systematic review of the literature. Int J Environ Res Public Health. 2018;15(12):2838. https://doi.org/10.3390/ijerph15122838
Stogios N, Kaur B, Huszti E, Vasanthan J, Nolan RP. Advancing digital health interventions as a clinically applied science for blood pressure reduction: a systematic review and meta-analysis. Can J Cardiol. 2020;36(5):764-74. https://doi.org/10.1016/j.cjca.2019.11.010
Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999;89(9):1322-7. https://doi.org/10.2105/AJPH.89.9.1322
Silva JA, Gonçalves ECA, Silva DAS, Silva KS. Programas de intervenção para atividade física nas escolas brasileiras: revisão com base no modelo RE-AIM. Cienc Saude Coletiva. 2019;24(9):3443-56. https://doi.org/10.1590/1413-81232018249.23502017
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Copyright (c) 2021 Paulo Henrique Guerra, Hugo Falqueto Soares, Ana Beatriz Mafra, Izadora Czarnobai, Guilherme Airon Cruz, William Vinícius Weber, Juliano Cesar Huf Farias, Mathias Roberto Loch, Evelyn Helena Corgosinho Ribeiro
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Conselho Nacional de Desenvolvimento Científico e Tecnológico
Grant numbers 449975/2014-2
