RESUMO
Background: Socioeconomic characteristics of locations where physical activity equipment is installed may affect the activity level of users. The purpose of this study was to verify patterns of use and physical activity levels in fitness zones installed in low- and high-income neighborhoods in the city of Curitiba, Brazil. Methods: Over 1200 observations were conducted in 20 fitness zones in the city of Curitiba, Brazil. Data were collected during the months of November and December 2012, in 4 periods of the day (8 AM, 11 AM, 2 PM, and 5 PM), on 2 weekdays and 2 weekend days. Results: A total of 2232 people were observed in the fitness zones. Age group, level of physical activity in the area, use of fitness zones during weekend days, and occupation of spaces were significantly associated with neighborhood income. Moreover, users of fitness zones located in high-income neighborhoods showed higher odds ratio (OR = 1.74; 95% confidence interval, 1.46-2.07) of moderate to vigorous physical activity than light or sedentary activities, regardless of gender or day of the week. Conclusions: The sole presence of equipment does not seem to favor the use of fitness zones in low-income neighborhoods. Future studies should investigate intrinsic factors for the use of fitness zones for physical activity.
Assuntos
Exercício Físico/fisiologia , Parques Recreativos/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Fatores Socioeconômicos , Adulto , Brasil , Feminino , Humanos , Renda/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Características de Residência/estatística & dados numéricosRESUMO
BACKGROUND: Little is known about the contextual factors affecting the uptake of evidence-based chronic disease interventions in the United States and in other countries. This study sought to better understand the contextual similarities and differences influencing the dissemination and implementation of evidence-based chronic disease prevention (EBCDP) in Australia, Brazil, China, and the United States. METHODS: Between February and July 2015, investigators in each country conducted qualitative, semi-structured interviews (total N = 50) with chronic disease prevention practitioners, using interview guides that covered multiple domains (e.g., use of and access to EBCDP interventions, barriers and facilitators to the implementation of EBCDP interventions). RESULTS: Practitioners across the four countries reported only a few programmatic areas in which repositories of EBCDP interventions were used within their workplace. Across countries, academic journals were the most frequently cited channels for accessing EBCDP interventions, though peers were commonly cited as the most useful. Lack of time and heavy workload were salient personal barriers among practitioners in Australia and the United States, while lack of expertise in developing and implementing EBCDP interventions was more pertinent among practitioners from Brazil and China. Practitioners in all four countries described an organizational culture that was unsupportive of EBCDP. Practitioners in Brazil, China and the United States cited an inadequate number of staff support to implement EBCDP interventions. A few practitioners in Australia and China cited lack of access to evidence. Partnerships were emphasized as key facilitators to implementing EBCDP interventions across all countries. CONCLUSIONS: This study is novel in its cross-country qualitative exploration of multilevel constructs of EBCDP dissemination and implementation. The interviews produced rich findings about many contextual similarities and differences with EBCDP that can inform both cross-country and country-specific research and practice to address barriers and improve EBCDP implementation among the four countries long-term.
Assuntos
Doença Crônica/prevenção & controle , Promoção da Saúde/métodos , Adulto , Austrália , Brasil , China , Barreiras de Comunicação , Medicina Baseada em Evidências , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Humanos , Relações Interprofissionais , Masculino , Pessoa de Meia-Idade , Prática Profissional/estatística & dados numéricos , Pesquisa Qualitativa , Estados Unidos , Adulto JovemRESUMO
Abstract The aim of this study was to analyze the validity and reliability of an instrument to assess bicycle use patterns in urban areas through systematic observation. The instrument items were selected from a literature review. Content validity was established by consensus opinion of experts of the physical activity area. The temporal stability (reliability) was verified by percentage of agreement and intraclass correlation coefficient (ICC). Observations were conducted using an adapted protocol based on the System for Observing Play and Recreation in Communities (SOPARC), consisting of systematic scans for counting cyclists in an urban area through video images provided by the public transport control system of Curitiba (URBS). Observers A and B recorded a total of 383 and 378 cyclists. Most of the observed subjects were men (87%), adults (84%), cycling on the BRT lane (54%), coming from downtown (54%), rode the bicycle on the wrong side of the street (58.2%), were not wearing a helmet (76.8) and bicycled alone (64%). Agreement percentiles ranged from 89.2 to 99.5% and ICC values from 0.922 to 0.999. According to criteria adopted, reliability was considered high in all categories included in the instrument. The instrument showed validity and reliability to be used in studies aiming to evaluate bicycle use patterns in Brazilian urban areas.
Resumo O objetivo deste estudo foi analisar a validade e fidedignidade de um instrumento para avaliar o padrão de uso de bicicleta em áreas urbanas de forma observacional. Os itens componentes do instrumento foram selecionados a partir da revisão da literatura sobre o tema. A validade de conteúdo foi estabelecida pelo parecer consensual de especialistas da área de atividade física e saúde. A estabilidade temporal (fidedignidade) foi verificada por meio do percentual de concordância e pelo coeficiente de correlação intraclasse (CCI). As observações foram realizadas com um protocolo adaptado e baseado no System for Observing Play and Recreation in Communities (SOPARC), consistindo de varreduras sistemáticas e periódicas para a contagem de ciclistas em uma via urbana, a partir de filmagens cedidas pelo controle do transporte público de Curitiba (URBS). Ao todos foram realizadas 383 e 378 observações de ciclistas, respectivamente pelos avaliadores A e B. A maior parte dos sujeitos observados eram homens (87%), adultos (84%), pedalaram no BRT (54%), na direção centro/bairro (54%), conduziram a bicicleta na contramão (58,2%), sem capacete (76,8) e sozinhos (64%). Os percentis de concordância variaram entre 89,2 e 99,5% e os valores de CCI entre 0,922 e 0,999. Segundo os critério empregados, a fidedignidade foi classificada como elevada em todas as categorias de observação contidas no instrumento. O instrumento apresenta validade e fidedignidade para o emprego em pesquisas para avaliação do padrão de uso de bicicleta em contextos urbanos brasileiros.
Assuntos
Humanos , Ciclismo , Inquéritos e Questionários/normas , Reprodutibilidade dos Testes , Área UrbanaRESUMO
Physical inactivity causes 5.3 million deaths annually worldwide. We evaluated the impact on population leisure-time physical activity (LTPA) of scaling up an intervention in Brazil, Academia das Cidades program (AC-P). AC-P is a health promotion program classified as physical activity classes in community settings which started in the state of Pernambuco state in 2008. We surveyed households from 80 cities of Pernambuco state in 2011, 2012 and 2013, using monitoring data to classify city-level exposure to AC-P. We targeted 2370 individuals in 2011; 3824 individuals in 2012; and 3835 individuals in 2013. We measured participation in AC-P and whether respondents had seen an AC-P activity or heard about AC-P. We measured LTPA using the International Physical Activity Questionnaire. We estimated the odds of reaching recommended LTPA by levels of exposure to the three AC-P measures. For women, the odds of reaching recommended LTPA were 1.10 for those living in cities with AC-P activity for less than three years, and 1.46 for those living in cities with AC-P activity for more than three years compared to those living in cities that had not adopted AC-P. The odds of reaching recommended LTPA increased with AC-P participation and knowledge about AC-P. AC-P exposure is associated with increased population LTPA. Extending AC-P to all cities could potentially impact non-communicable diseases in Brazil.
Assuntos
Participação da Comunidade , Exercício Físico/fisiologia , Promoção da Saúde/estatística & dados numéricos , Atividades de Lazer , Adolescente , Adulto , Brasil , Feminino , Promoção da Saúde/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , População Urbana/estatística & dados numéricos , Adulto JovemRESUMO
Latin America (LA) has a unique structural, political, cultural and social environment. This study aimed to identify the places where Latin American adults are physically active; and to determine the association of using public- and restricted-access places with physical activity (PA). We used data from the International PA Environment Network study in Bogota, Colombia (n=1000, accelerometry=249); Cuernavaca, Mexico (n=677, accelerometry=652); and Curitiba, Brazil (n=697, accelerometry=331) (2010-2011). Walking and moderate-to-vigorous PA for leisure were measured with the International Physical Activity Questionnaire. Overall PA and PA within 10-minute bouts were measured with accelerometers. Participants reported use of public- and restricted-access places for PA. Mixed-effects regression models were used to determine the association of using public- and restricted-access places with PA. The streets were the most frequently-reported place for PA, and walking was the most common PA in the studied places. 'Informal', non-exercise-or-sports places (e.g., shopping malls) ranked high for use for PA in Bogota and Cuernavaca. In Curitiba, use of 'formal' places for sports/exercise (e.g., gyms) was more prevalent. Using public-access places was directly related to walking for leisure in all cities, and to additional PA outcomes in Bogota and Cuernavaca. In Cuernavaca and Curitiba, using restricted-access places was also associated with PA. Our study highlights the importance of public-access places for PA in LA. In some contexts, places for social interaction may be as important for PA as places for exercise/sport. Strategies increasing the availability, accessibility and quality of these places may effectively promote PA in LA.
Assuntos
Planejamento Ambiental , Exercício Físico , Atividades de Lazer/psicologia , Caminhada/estatística & dados numéricos , Acelerometria/métodos , Adulto , Idoso , Brasil , Colômbia , Estudos Transversais , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Características de Residência/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
The built environment is an important factor associated with physical activity and sedentary behavior (SB) during adolescence. This study presents the methods for objective assessment of context-specific moderate to vigorous physical activity (MVPA) and SB, as well as describes results from the first project using such methodology in adolescents from a developing country. An initial sample of 381 adolescents was recruited from 32 census tracts in Curitiba, Brazil (2013); 80 had their homes geocoded and wore accelerometer and GPS devices for seven days. Four domains were defined as important contexts: home, school, transport and leisure. The majority of participants (n=80) were boys (46; 57.5%), with a normal BMI (52; 65.0%) and a mean age (SD) of 14.5 (5.5) years. Adolescents spent most of their time at home, engaging in SB. Overall, the largest proportion of MVPA was while in transport (17.1% of time spent in this context) and SB while in leisure (188.6min per day). Participants engaged in MVPA for a median of 28.7 (IQR 18.2-43.2) and 17.9 (IQR 9.2-32.1) minutes during week and weekend days, respectively. Participants spent most of their day in the leisure and home domains. The use of Geographic Information System (GIS), Global Positioning System (GPS) and accelerometer data allowed objective identification of the amount of time spent in MVPA and SB in four different domains. Though the combination of objective measures is still an emerging methodology, this is a promising and feasible approach to understanding interactions between people and their environments in developing countries.
Assuntos
Exercício Físico , Sistemas de Informação Geográfica/estatística & dados numéricos , Pesquisa , Acelerometria/métodos , Adolescente , Brasil , Feminino , Humanos , Atividades de Lazer , Masculino , Instituições Acadêmicas , Comportamento Sedentário , Autorrelato , Meios de TransporteRESUMO
BACKGROUND: The aim of this study was to review the evidence to date on the association between physical activity and safety from crime. METHODS: Articles with adult populations of 500+ participants investigating the association between physical activity and safety from crime were included. A methodological quality assessment was conducted using an adapted version of the Downs and Black checklist. RESULTS: The literature search identified 15,864 articles. After assessment of titles, abstracts and full-texts, 89 articles were included. Most articles (84.3%) were derived from high-income countries and only 3 prospective articles were identified. Articles presented high methodological quality. In 38 articles (42.7%), at least one statistically significant association in the expected direction was reported (ie, safety from crime was positively associated with physical activity). Nine articles (10.1%) found an association in the unexpected direction and 42 (47.2%) did not find statistically significant associations. The results did not change when we analyzed articles separately by sex, age, type of measurement, or domains of physical activity evaluated. CONCLUSION: The current evidence, mostly based on cross-sectional studies, suggests a lack of association between physical activity and safety from crime. Prospective studies and natural experiments are needed, particularly in areas with wide crime variability.
Assuntos
Crime/prevenção & controle , Exercício Físico/fisiologia , Segurança/normas , Adulto , HumanosRESUMO
OBJECTIVES: In public health and clinical settings insufficient dissemination of evidence-based practices limits the reach of new discoveries to broad populations. This study aimed to describe characteristics of the dissemination process by researchers across three countries (Brazil, United Kingdom, and United States), explore how designing for dissemination practices has been used, and analyze factors associated with dissemination. METHODS: A similar online survey was used to query researchers across the three countries; data were pooled to draw cross-country conclusions. FINDINGS: This study identified similarities and differences between countries. Importance of dissemination to nonresearcher audiences was widely recognized as important; however, traditional academic venues were the main dissemination method. Several factors were associated with self-rated dissemination effort in the pooled sample, but these predictive factors (e.g., support and resources for dissemination) had low prevalence. Less than one-third of researchers rated their level of effort for dissemination as excellent. Respondents reported limited support and resources to make it easier for researchers who might want to disseminate their findings. CONCLUSION: Though intentions show the importance of dissemination, researchers across countries lack supports to increase dissemination efforts. Additional resources and training in designing for dissemination along with improved partnerships could help bridge the research-practice gap.
Assuntos
Acesso à Informação , Pesquisa sobre Serviços de Saúde/estatística & dados numéricos , Disseminação de Informação/métodos , Internacionalidade , Alocação de Recursos/estatística & dados numéricos , Ciência/estatística & dados numéricos , Brasil , Saúde Pública/estatística & dados numéricos , Reino Unido , Estados UnidosRESUMO
BACKGROUND: The objectives of this study were to describe the accelerometer based total and bout-specific PA levels for a representative sample of adults from Cuernavaca, Mexico, and to examine the relationships with sociodemographic characteristics and BMI status. METHODS: Cross sectional study of adults from Cuernavaca, Mexico (2011, n = 677). Participants wore Actigraph GT3X accelerometers for seven days and sociodemographic data was collected through a survey. Weight and height were objectively measured. Total minutes/week of moderate-to-vigorous PA (MVPA) and of MVPA occurring within bouts of at least ten minutes were obtained. Intensity-specific (moderate and vigorous) total PA and bouted-PA was also obtained. The relation of each PA variable with sex, age, socioeconomic status, education, marital status and BMI status was assessed using unadjusted and adjusted linear models. RESULTS: The mean total MVPA among adults from Cuernavaca was 221.3 ± 10.0 (median = 178.3 min/week). Average MVPA within bouts was 65.8 ± 4.7 min/week (median = 30.0 min/week). 9.7 % of total MVPA occurred within bouts. Significant associations were found for total and bout-specific MVPA with being male (positive) and owning a motor vehicle (negative). Additional associations were found for intensity-specific PA outcomes. Mexican adults were more active during weekdays than weekends, suggesting that PA may be more strongly driven by necessity (transport) than by choice (leisure). CONCLUSIONS: This is the first study to objectively measure PA for a representative sample of Mexican adults in an urban setting. The sociodemographic correlates vary from those known from high income countries, stressing the need for more correlate studies from lower-to-middle income countries.
Assuntos
Índice de Massa Corporal , Países em Desenvolvimento , Exercício Físico , Veículos Automotores , Obesidade/etiologia , Meios de Transporte , População Urbana , Acelerometria , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Atividades de Lazer , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Atividade Motora , Obesidade/epidemiologia , Propriedade , Esforço Físico , Fatores Sexuais , Inquéritos e Questionários , Adulto JovemRESUMO
BACKGROUND: Ecological models of health behaviour are an important conceptual framework to address the multiple correlates of obesity. Several single-country studies previously examined the relationship between the built environment and obesity in adults, but results are very diverse. An important reason for these mixed results is the limited variability in built environments in these single-country studies. Therefore, the aim of this study was to examine associations between perceived neighbourhood built environmental attributes and BMI/weight status in a multi-country study including 12 environmentally and culturally diverse countries. METHODS: A multi-site cross-sectional study was conducted in 17 cities (study sites) across 12 countries (Australia, Belgium, Brazil, China, Colombia, Czech Republic, Denmark, Mexico, New Zealand, Spain, the UK and USA). Participants (n = 14222, 18-66 years) self-reported perceived neighbourhood environmental attributes. Height and weight were self-reported in eight countries, and measured in person in four countries. RESULTS: Three environmental attributes were associated with BMI or weight status in pooled data from 12 countries. Safety from traffic was the most robust correlate, suggesting that creating safe routes for walking/cycling by reducing the speed and volume of traffic might have a positive impact upon weight status/BMI across various geographical locations. Close proximity to several local destinations was associated with BMI across all countries, suggesting compact neighbourhoods with more places to walk related to lower BMI. Safety from crime showed a curvilinear relationship with BMI, with especially poor crime safety being related to higher BMI. CONCLUSIONS: Environmental interventions involving these three attributes appear to have international relevance and focusing on these might have implications for tackling overweight/obesity.