Effectiveness of exercise and health education interventions in Brazilian primary health care

Maria Clara Elias Polo,Emerson Sebastião,Ana Carolina Kanitz,Giselle Helena Tavares,Camila Bosquiero Papini,Danilo Rodrigues Pereira Da Silva

doi:10.1590/s1980-6574202000030004

Abstract

Abstract AIM This study examined the effectiveness of two different behavioral change interventions to improve Physical Activity (PA) and to reduce Sedentary Behavior (SB) in a primary health care setting. METHODS This quasi-experimental study recruited and enrolled 31 users of a primary health care unit of the Brazilian Unified Health System aged 18 or more. Participants were allocated into two groups: Physical Exercise Group combined with Health Education (EHE) and Health Education Group (HE). The EHE group participated in 60 minutes of exercise, twice a week, and 20 minutes of counseling. The HE group participated in 40 minutes of counseling, once a week. Both programs were conducted for over 18 weeks. PA levels were self-reported (IPAQ) and PA and SB were objectively (accelerometer) assessed before and after the intervention period. Data were analyzed using intention-to-treat analysis with generalized estimating equations adopting p<0.05 for significance. Also, the individual PA and SB deltas were computed. Improvements in PA and SB were observed for both interventions (p<0.05). RESULTS Both groups increased the minutes of weekly leisure PA (p=0.006), time spent in light (p=0.003), and moderated-to-vigorous (p=0.042) PA and decreased the amount of SB, with a significant decrease in the HE group (p=0.010). Delta analyses further demonstrated the effectiveness of the interventions to increase PA in other domains (i.e., transportation, household) and maintenance of occupational PA. CONCLUSION Behavioral change interventions in the primary health care context involving exercise and counseling seem to be effective in improving PA and SB in adults.

Highlights

Due to the high rates of non-communicable diseases (NCDs; e.g. cardiovascular diseases, diabetes, cancer) observed around the globe, NCDs lead to major discussions on health promotion and prevention in Public Health
The present study examined the effectiveness of two distinct interventions carried out at a Primary Health Care (PHC) Centers in Brazil on physical activity (PA) and sedentary behavior (SB) in adults
Significant differences were observed for leisure-time Physical Activity (PA) with both groups increasing leisure physical activity levels (PAL) in the post-intervention period, but no differences were observed between groups (p=0.31)

Summary

Introduction

Due to the high rates of non-communicable diseases (NCDs; e.g. cardiovascular diseases, diabetes, cancer) observed around the globe, NCDs lead to major discussions on health promotion and prevention in Public Health. There is compelling evidence of the detrimental health effects of a physically inactive lifestyle[3,4,5] and other harmful health behaviors, such as a sedentary lifestyle To this end, it is important to devise initiatives related to exercise and physical activity promotion as well as transdisciplinary health education strategies (e.g., counseling) for the adult population. It is important to devise initiatives related to exercise and physical activity promotion as well as transdisciplinary health education strategies (e.g., counseling) for the adult population This is important because, through these types of programs, the population will be able to have access to updated information on health issues, quality of life, and specifics of PA practice; which may help to increase long-term adherence

Methods

Results

Discussion

Conclusion