Characteristics of physical activity programs in the Brazilian primary health care system.

Grace Angélica De Oliveira Gomes,Deborah Malta,Danielle Cruz,Luiz Roberto Ramos,Mario Bracco,Felipe Lobelo,Eduardo Kokubun,Michael Pratt,Alex A Florindo,Diana C Parra,Grégore Iven Mieke,Eduardo Simões,Pedro C Hallal

doi:10.1590/0102-311x00085713

Abstract

The aim of this study was to describe the characteristics of programs that promote physical activity in the public primary care system by region of Brazil, subject to the presence or absence of multidisciplinary primary care teams (NASF). We conducted a cross sectional and population-based telephone survey of the health unit coordinators from 1,251 health care units. Coordinators were asked about the presence and characteristics of physical activity programs. Four out of ten health units reported having a physical activity intervention program, the most common involving walking groups. Most of the activities were performed in the morning, once or twice a week, and in sessions of 30 minutes or more. Physical education professionals were primarily responsible for directing the activities. Interventions occurred in the health unit itself or in adjacent community spaces. In general, these characteristics were similar between units with or without NASF, but varied substantially across regions. These findings will guide future physical activity policies and programs within primary care in Brazil.

Highlights

Physical inactivity is a global pandemic 1, responsible for 9% of premature mortality worldwide in 2008 2
In the cities with Núcleo de Apoio à Saúde da Família (NASF), the prevalence of health units with physical activity interventions distributed by region were 41.0% in the Northeast, 34% in the Southeast, 12.3% in the South, 9.4% in the Central West and 3.3% in the North
Data from this study showed that four out of ten primary care units offered physical activity promotion programs, while units with NASF in the city had a larger proportion of physical activity interventions

Summary

Introduction

Physical inactivity is a global pandemic 1, responsible for 9% of premature mortality worldwide in 2008 2. In order to reduce the high proportion of inactive individuals around the world 3, the implementation of incentive programs as well as mobilization and support for physical activity programs have been considered priority strategies to promote health in many countries [4,5,6]. In low and middle-income countries, the emphasis of public health policies has been on groups who have less access to physical activity opportunities [7,8]. There is still ample room for improvement regarding the central role that public policy can play in the promotion and facilitation of healthy lifestyles, in low and middle-income countries 9. Primary care clinics are one of the potential entry points to deliver physical activity counseling and referral to programs linked to the corresponding health care model in Brazil. The NASF is composed of different health professionals including nutritionists, physical educators, physiotherapists, psychologists, speech therapists, occupational therapists, psychiatrists, and social workers, among others, who work together with primary care teams to support and develop health practices in the population 11

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