Physical activity counseling in primary health care in Brazil: a national study on prevalence and associated factors

Alex Antonio Florindo,Eduardo J Simoes,Diana C Parra,Luiz Roberto Ramos,Felipe Lobelo,Mário Maia Bracco,Gregore Iven Mielke,Pedro Curi Hallal,Grace Angélica De Oliveira Gomes

doi:10.1186/1471-2458-13-794

Abstract

BackgroundThe aim of this study was to determine the prevalence and correlates of physical activity counseling among physicians and nurses working in primary health care in Brazil.MethodsA phone survey was carried out in 2011 with professionals working in primary health care in Brazil. The target sample consisted of 1,600 randomly selected primary care units covering all regions of the country. We successfully interviewed 529 professionals within the sampled units; 182 physicians and 347 nurses. The overall response rate was 49.6%. Multivariable logistic regression was used to estimate correlates of counseling in the whole sample and separately for physicians and nurses.ResultsThe prevalence of regular physical activity counseling for at least six months was 68.9% (95% CI 64.9; 72.8) and was significantly higher among physicians compared to nurses (p < 0.05). Most professionals (93.2%) interviewed were unfamiliar with current physical activity recommendations for health. In the adjusted analysis, physical activity counseling was more frequent among those who report assessing patient’s physical activity (OR = 2.16; 95% CI 1.41; 3.29), those reporting that lack of time was not a barrier for counseling (OR = 0.62 95% CI 0.42-0.93), those who felt prepared to provide physical activity counseling (OR = 2.34; 95% CI 1.50-3.66), and those working at primary care units offering physical activity programs for patients (OR = 2.06; 95% CI 1.33-3.20). In the stratified analysis, only assessing patient’s physical activity was a significant correlate among physicians whereas assessing patient’s physical activity, feeling prepared to provide counseling and working in units with physical activity interventions were significant correlates among nurses.ConclusionsPhysicians and nurses deemed physical activity counseling of great importance in primary health care in Brazil. However, in order to increase the quality of counseling and the number of professionals engaging in this activity, these health teams require greater knowledge about physical activity (global recommendations for health) as well as training on the application of instruments for assessing physical activity. Moreover, sufficient time must be allowed during consultations for the counseling process, and physical activity promotion programs should be implemented within the primary health care units.

Highlights

The aim of this study was to determine the prevalence and correlates of physical activity counseling among physicians and nurses working in primary health care in Brazil
Health professionals who reported assessing patients’ physical activity levels, who did not feel that lack of time was a barrier for them to counsel, those who felt well prepared to advise patients about physical activity, and who worked in health units offering physical activity programs for patients, had a greater likelihood of providing physical activity counseling in primary health care settings in Brazil
Another survey among North-American nurses [25] found a prevalence of regular physical activity counseling of 57%

Summary

Introduction

Given the benefits of physical activity counseling for public health, an increasing number of surveys have been conducted, mostly in high-income countries, to evaluate its prevalence and correlates in primary health care settings [14,15,16,17,18,19]. These studies showed that the prevalence of counseling ranged from 19% to 76% [14,16,17,18]. A systematic review showed that the two main barriers to physical activity counseling perceived by primary care professionals were lack of time and limited knowledge [20]

Objectives

Methods

Results

Discussion

Conclusion