Public Health Promotion Policies Research Articles

Instruments For Evaluating Promotion Policies to Improve Public Health : an Integrative Review

Introduction: Policy assessment has a very important role in efforts to improve public health to ensure effectiveness, fairness and sustainability. Efficient evaluation procedures enable policy makers and stakeholders to recognize advantages, address shortcomings, and adapt strategies to achieve desired health goals. This integrative review aims to compile a synthesis of the various approaches and tools available in evaluating public health policies, while highlighting their application and impact on health promotion practice. Objective : The objective of this study was to examine and evaluate a range of tools utilized for assessing public health promotion policies, emphasizing their strengths, weaknesses, and effectiveness in enhancing health outcomes. The research delves into the methodologies and metrics employed by these instruments, evaluating their role in shaping and improving policies targeting public health advancements. Through this analysis, the authors aim to offer recommendations for the selection and development of more efficient tools for evaluating health promotion strategies. Methods : This study is an integrative literature review that utilizes databases from the Online Scientific Electronic Library and the Virtual Health Library (Biblioteca Virtual em Saúde), as well as gray literature, with sources available in English, Portuguese, and Spanish, covering the period from 2010 to 2020, with descriptors consulted in MeSH and DeCS. Results : A total of 828 publications were identified, with 18 meeting the inclusion criteria. The evaluation processes revealed the use of diverse methodologies, including quantitative and multidimensional approaches. However, there remains a limited availability of tools for monitoring and evaluating health promotion initiatives. While significant advancements have been observed in assessing impacts and outcomes, particularly in primary health care, challenges and gaps persist. Thus, integrating structural and procedural elements into evaluation methodologies is essential.Conclusion : It is crucial to acknowledge the significance of cross-sectoral, participatory methodologies and the creation of evaluative models that integrate both quantitative and qualitative approaches, while also addressing the socio-political factors inherent in the diverse contexts where intra-sectoral and cross-sectoral health promotion policies are implemented. However, the complexity involved in evaluating health promotion policies prevents the establishment of standardized evaluation criteria, highlighting the need for further research to develop effective strategies for evaluating health promotion initiatives.

Variants of unknown significance (VUS) in DNA repair genes in Caucasian men with muscle invasive bladder cancer (MIBC): A case of “serendipity” pushing for a BC screening program.

683 Background: In 2021 we started an enhanced PCa screening in healthy Caucasian men with germline DNA repair pathogenic variants. Over 109 enrolled men, we found two naïve patients with bladder cancer (BC), but none with PCa. This observation prompted us to investigate the prevalence of germline pathogenic variants in patients with BC and suggest genetic counselling, testing and screening for healthy relatives of subject with BC. Methods: This is a prospective ongoing study aiming to detect, by exome analysis, the prevalence of germline pathogenic (PV), likely pathogenic (LPV) variants and variant of unknown significance (VUS) in patients with BC attending the urological department from January 2024. The following DNA repair genes were considered: ATM , ATR , MRE11A , BAP1 , BARD1 , BRCA1 , NBN , BRCA2 , PALB2 , BRIP1 , CHEK2 , RAD51C , FAM175A , RAD51D , GEN1 , and XRCC1 , plus mismatch repair genes MLH1 , PMS2 , MSH2 , and MSH6 . Healthy relatives (>35 years) of patients tested positive, are being offered genetic counselling, testing and finally screening for early detection of BC. Screening consists of urine analysis, urine cytology, ultrasound abdominal assessment and cystoscopy, when indicated, every year. The study is financed/supported by Associazione Italiana per la Ricerca sul Cancro (AIRC): Protocol ICH-2812, code IG 2020-ID-25027. Results: From January to March 2024, 41 patients with BC (25 non-muscle invasive, NMIBC and 16 muscle invasive, MIBC) were tested. Overall, we found 919 variants in the 20 DNA repair genes analysed, of which 385 rare (minor allele frequency <1%). No PV and LPV were identified, while 18 VUS were found in 12 patients (29.3%; mean age 66.75 SD 11.75 vs. 69.82 SD 13.71 in negative).The reported variants affected the following genes: ATM (4); ATR (3); BARD1 (3); PMS2 (2), and BRCA2 , CHEK2 , MSH6 , NBN , PALB2 , GEN1 (1 variant each). Interestingly, all variants were found in MIBC patients or HG-NMIBC, whereas no variant was observed in low-grade NMIBC (p< 0.00001, Fisher exact test). Patients with multiple variants had a significant lower age: mean age 58.16 SD 9.02 p<0.01. Conclusions: According to Merriam-Webster dictionary “serendipity” is the phenomenon of finding valuable or agreeable things not sought for. Starting from a PCa screening in healthy men, although no clearly pathogenic variants were identified in our BC cohort, we found the presence of about 30% of VUS linked to aggressive cancers and patient low age. Those findings challenge the current (no)recommendation on genetic counselling and testing in this setting and strongly support the urgent need to raise awareness of genetic risk for BC and to design effective public health promotion policies.

Factors that influence the increase of type 2 Diabetes Mellitus in children and adolescents: a systematic review

Type 2 diabetes mellitus (T2DM) has shown a significant increase among children and adolescents in recent decades, especially due to factors such as sedentary lifestyle and obesity. The Covid-19 pandemic has intensified these factors, resulting in an alarming scenario for global public health. This article carries out a systematic review of the literature, with the aim of identifying the main factors that influence the increase in T2DM cases in this age group. The analysis includes studies that address aspects related to lifestyle, dietary practices, and the direct and indirect impacts of the pandemic on the development of the disease. It is concluded that public health promotion policies, combined with preventive strategies, are essential to combat the advancement of T2DM in young people, in addition to highlighting the importance of future research that can deepen knowledge about the management and prevention of the disease in pediatric populations.

ENTORNOS ALIMENTARIOS: AVANCES Y DESAFÍOS EN INVESTIGACIÓN

Poor nutrition is currently the leading cause of death and disability in Chile and worldwide. Interventions based solely on behavioral changes have shown limited impact unless accom­panied by changes in individuals’ environments. Food environments are defined as the places and conditions where people access food and make decisions about their diet, including as­pects such as physical and economic availability, promotion, and nutritional content of food. Research on the role of food environments in population health is relatively recent and has primarily focused on developed countries. However, in Chile, relevant information has been generated in the last decade, enabling the formulation of public health promotion policies. In June 2019, the implementation of the Chilean Food Labeling Law was completed, inter­nationally recognized as an innovative policy that integrates improved information actions with restrictions on the promotion of unhealthy foods and measures favoring healthier school environments. Evaluations conducted so far show that the law was successfully implemented and has led to modifications in both consumer behaviors and the food industry, promoting healthier food environments, especially for children. Nevertheless, the mere implementation of this law is insufficient, and it is necessary to continue complementing these actions with others that promote healthier environments to advance in improving the nutrition and health of the entire population.

Overview of the ten global conferences on health promotion and implications for future work

Since 1986, the WHO has held ten global health promotion conferences covering various health promotion issues and sustainable development worldwide. These sessions have formed a series of consensus and actions that guide promoting health globally. This study analyzed the declarations, reports, and news materials from the ten conferences that studied health promotion action areas, focal topics, actor networks, partnership relationships, and other significant outcomes. It also explored how these conferences contributed to the construction and advancement of global health promotion consensus and actions. The first Global Conference on Health Promotion identified the concept of health promotion and five key action areas, laying the foundation for subsequent conferences and health promotion actions. Over the years, the ten conferences continuously expanded the essence of health promotion, developed partnership relationships, formulated public health promotion policies, and called for health promotion actions. This process culminated in the formation of global consensus and collective actions. The latter conferences have gained significant attention and influence. The conferences offer valuable insights for future global health promotion endeavors and provide global perspectives and pathways for the development of Healthy China.

Exploring the Viability and Acceptance of Nudge in Public Policies for Health Promotion.

Behaviorally informed interventions, such as nudging, encourage actions intended to promote longer and healthier lives. Holding significant potential for influencing health policies and healthcare practices, these interventions are partaking of a shift in governance and public health policymaking. However, a substantial knowledge gap remains regarding the feasibility and appropriateness of implementing policies that draw on nudge. Ae survey on nudge's acceptability) was adapted to the Portuguese context to access attitudes towards 16 nudge measures. The research focused on evaluating attitudes among political science and public administration BSc and MSc students from nine Portuguese universities, and analyzing the relationship between these attitudes, sociodemographic characteristics, and sociopolitical attitudes. The data analysis involved the application of descriptive and inferential statistics. The participants exhibited a moderate-to-high level of approval for various nudge measures, particularly those related to nutrition and public education/awareness raising. The study identified a nuanced relationship between the level of intrusiveness of nudges and their public approval, indicating that interventions preserving the architecture of choice gathered higher acceptance compared to more intrusive approaches. Notably, approval was associated with a high level of trust in social groups and a low propensity for risk-taking and alcohol consumption. This study not only sheds light on the types of nudge measures that are likely to be more acceptable for promoting healthy behaviors, but also establishes a crucial link between behavioral interventions and healthcare policies. Understanding the nuanced factors influencing the public acceptance of nudges contributes to the discourse on the implementation of behaviorally informed health policies and emphasizes the importance of tailoring interventions to align with public values and preferences.

Health conditions in land transport workers and climate change. Exploratory systematic review.

A systematic exploratory review was carried out to describe the influence of climate change on the health conditions of land transport drivers, both physical and mental. Additionally, actions for the prevention of these complications are described. For the review, several databases, such as Science Direct, MEDLINE, Springer, PubMed, Redalyc, EBSCO, SciELO, and Scopus, were examined. There was the need to extend the search timeframe from 5 years to 10 years. The studies found consisted mainly of review articles, showing an emphasis on public health and a high frequency of possible physical effects on the cardiovascular and respiratory systems. At the mental level, the presence of cases of anxiety, depression and stress were mentioned. As for alternatives for the prevention of these effects, the importance of creating public policies for health promotion and disease prevention was highlighted. It is important to increase scientific production in the field of occupational safety and health and applied studies.

Public Policies for Health Promotion in Brazil: A Look at Dengue Control

In 2024, Brazil recorded more than a thousand deaths from dengue in the first thirteen weeks of the year, the third highest number since the beginning of the historical series in 2000. On the same date, eleven Brazilian states declared an emergency because of dengue fever

Inequalities in the receipt of healthcare practitioner counseling for adults after COVID-19 in southern Brazil

Health counseling is a prevention and health promotion action, especially in the context of a pandemic, for both preventing disease and maintaining health. Inequalities may affect receipt of health counseling. The aim was to provide an overview of the prevalence of receiving counseling and to analyze income inequality in the receipt of health counseling. Methods: This was a cross-sectional telephone survey study with individuals aged 18 years or older with diagnosis of symptomatic COVID-19 using RT-PCR testing between December 2020 and March 2021. They were asked about receipt of health counseling. Inequalities were assessed using the Slope Index of Inequality (SII) and Concentration Index (CIX) measures. We used the Chi-square test to assess the distribution of outcomes according to income. Adjusted analyses were performed using Poisson regression with robust variance adjustment. Results: A total of 2919 individuals were interviewed. Low prevalence of health counseling by healthcare practitioner was found. Participants with higher incomes were 30% more likely to receive more counseling. Conclusions: These results serve as a basis for aggregating public health promotion policies, in addition to reinforcing health counseling as a multidisciplinary team mission to promote greater health equity.

Health policies for the LGBT population, cultural competence, and the organization for access to services:

This is a literature review that aimed to analyze the scope of public health policies for the LGBT population in different countries on the European continent, North America and Oceania in order to identify the differences and similarities in content and organization of services and programs. 24 articles were selected to compose the corpus of this review. The results demonstrated the existence of different scopes of health policies for LGBT in the USA, Canada, Australia and the United Kingdom and a heterogeneous result with regard to the objective of the implementation of actions, with emphasis on directions related to LGBT aging, smoking cessation, control of alcohol and other drugs use, as well as cancer and HIV care policies. There was a predominance of approaches limited to the diseases (or unsafe sexual practices, instead focus to comprehensive health care to the LGBT population at different levels of complexity in health care. Furthermore, cultural differences imply granting comprehensive or restrictive health rights. It's necessary to improve the design of public health promotion policies for gender and sexual diversity that are more inclusive and concatenated with other determinants that permeate comprehensive health care.

FATORES ASSOCIADOS À ADICÇÃO AO SMARTPHONE EM UNIVERSITÁRIOS DE ENFERMAGEM

ABSTRACT Objective to analyze the factors associated with smartphone addiction in nursing students. Method a descriptive, correlational and quantitative study, conducted in two public universities in the Northeast of Brazil, from April to June 2019. Four instruments were used for the purpose of data collection: sociodemographic characterization, Alcohol Use Disorder Identification Test (AUDIT), Pittsburgh Sleep Quality Index (PSQI) and the Smartphone Addiction Inventory (SPAI) scale. Results the majority of nursing students were female, 239 (80.2%), and had an average age of 22 years. One hundred and sixty-five (55.4%) declared themselves brown, 236 (79.2%) only studied and 11 (37.2%) had one to two minimum wages as family income. Regarding marital status, 277 (93.0%) were single and 168 (56.4%) lived with their parents. Two hundred and two (67.8%) did not practice physical activity and 269 (90.3%) had never smoked or smoked for less than one month. The overall prevalence of smartphone addiction in nursing students was 142 (47.7%). The factors associated with smartphone addiction in nursing students were: AUDIT (p=0.036), overall PSQI score (p <0.001), sleep quality (p=0.008), sleep latency (p=0.001), medication use (p=0.050) and daytime dysfunction (0.000). Conclusion there is a need to develop educational interventions for rational use of the smartphone inside and outside universities and to develop public policies for health promotion and prevention of related comorbidities.

Biopsychosocial inequality, active lifestyle and chronic health conditions: a cross-sectional National Health Survey 2013 in Brazil

This study estimated the biopsychosocial factors related to active physical behavior in the Brazilian population with and without chronic non-transmissible disease (NCD). Cross-sectional study of the National Health Survey (NHS) in Brazil, with 60,202 individuals in 2013. Participants were randomly selected by complex sampling. The outcome was physically active behavior measured by performing a minimum of 150 min of physical exercise per week. The independent variables were social and psychological characteristics, lifestyle and health. Cox regression was applied to estimate the prevalence ratio (PR). There are 29,666 (48.3%; 95% CI 47.0–50.0) participants reported having NCD. Not being a smoker or alcoholic, living in an urban area (PR = 1.44; CI95% 1.23–1.68/PR = 1.38; CI95% 1.08–1.75), having informal social support (PR = 1.26; CI95% 1.10–1.44/PR = 1.19; CI95% 1.05–1.34), A social class (PR = 0.43; CI95% 0.25–0.73/PR = 0.46; CI95% 0.26–0.80), high schooling (PR = 0.34; CI95% 0.23–0.51/PR = 0.33; CI95% 0.24–0.46) as well as paid work (PR = 0.87; CI95% 0.78–0.96/PR = 0.89; CI95% 0.79–0.99) are more associated with active lifestyle in both groups. However, only in the group without NCD, the male sex (PR = 1.42; CI95% 1.28–1.57), no having some disability (PR = 1.31; CI95% 1.03–1.66) and having private health insurance (PR = 1.26; CI95% 1.13–1.41) were more associated with active behavior, while in the group with NCD, being elderly (PR = 1.22; CI95% 1.05–1.42), not be white (PR = 0.85; CI95% 0.77–0.95) and not having restful sleep (PR = 1.23; CI95% 1.08–1.40) are associated with active lifestyle. People with and without NCD in Brazil have very close active behavior, however, some biopsychosocial factors such as: sex, age, lifestyle, socioeconomic level are unevenly associated with the active lifestyle in the groups. Thus, therapeutic or preventive proposals as well as public policies for health promotion must observe these distinctions when elaborating their actions.

Forecasting Dengue, Chikungunya and Zika cases in Recife, Brazil: a spatio-temporal approach based on climate conditions, health notifications and machine learning

Dengue has become a challenge for many countries. Arboviruses transmitted by Aedes aegypti spread rapidly over the last decades. The emergence chikungunya fever and zika in South America poses new challenges to vector monitoring and control. This situation got worse from 2015 and 2016, with the rapid spread of chikungunya, causing fever and muscle weakness, and Zika virus, related to cases of microcephaly in newborns and the occurrence of Guillain-Barret syndrome, an autoimmune disease that affects the nervous system. The objective of this work was to construct a tool to forecast the distribution of arboviruses transmitted by the mosquito Aedes aegypti by implementing dengue, zika and chikungunya transmission predictors based on machine learning, focused on multilayer perceptrons neural networks, support vector machines and linear regression models. As a case study, we investigated forecasting models to predict the spatio-temporal distribution of cases from primary health notification data and climate variables (wind velocity, temperature and pluviometry) from Recife, Brazil, from 2013 to 2016, including 2015’s outbreak. The use of spatio-temporal analysis over multilayer perceptrons and support vector machines results proved to be very effective in predicting the distribution of arbovirus cases. The models indicate that the southern and western regions of Recife were very susceptible to outbreaks in the period under investigation. The proposed approach could be useful to support health managers and epidemiologists to prevent outbreaks of arboviruses transmitted by Aedes aegypti and promote public policies for health promotion and sanitation.

Voice disorders in teachers and the International Classification of Functioning, Disability and Health (ICF)

Introduction. Contemporary occupational diseases are increasingly expressed by function disorders, which include voice disorders, forcing workers to request a leave of absence from work and leading to an incapacity to perform their work activities. Teachers have the higher prevalence of vocal disorders among the professionals who use their voices professionally, which is reported as the second cause of teaching work absences in Brazil.
 Objective. To analyze the environment and organization aspects of the teaching work associated with the development of voice disorder of teachers, according to the International Classification of Functioning, Disability and Health (ICF).
 Method. This study consisted of two steps. Initially, an integrative bibliographic review was performed to search for references related to the topic in the LILACS, MEDLINE and SCIELO databases, using the health descriptors "voice disorders" and "teachers". Then, the selected articles were read in full in order to identify the work factors associated with the voice disorder and compared with the theoretical framework of the ICF, in order to identify possible indicators of loss of functioning and capacity for teaching work resulting from voice disorders.
 Results. The presence of dust and noise were the most prevalent environment aspects. In turn, the high demand for work and the lack of autonomy to perform the work were identified as factors related to the organization of the work of the teaching work, as well as stress at work and the presence of situations of violence at school as the most reported work absences.
 Conclusion. As shown, the factors of teaching work described impact all components of functioning and lead to the incapacity of the teacher to work. The use of the ICF may contribute to systematize and quantify, in a standardized way, the loss of functioning and work capacity resulting from voice disorders, in addition to assisting in the development of public health promotion policies and in the prevention of vocal disorders in teachers.

Analysis of the health effects of the transition of traditional Chinese food on the emergence of nontraditional eating behaviors

BackgroundTraditional Chinese food has been believed to be closely associated with affecting salubrious health outcomes, enhancing longevity, and interoperating with traditional Chinese medicine. Over the past several decades, traditional Chinese food has been going through significant evolution and qualitative transition of nontraditional eating behaviors. This food transition and eating pattern transformation are propelled by China’s vast population size, rapid socioeconomic development, lifestyle changes, and global influence. Inevitably, these dietary shifts are having a considerable impact not only on public health in China but also globally.PurposeThe purpose of the present study is to examine the socioeconomic and health effects of the shift from consuming traditional Chinese food into increasingly consuming Western-style processed foods, fast foods, saturated fats, snacks, sugary beverages, and eating out more often than the traditional home cooking. This study also investigates the prevalence, health effects, and sociodemographic implications of food transition and adopting Western-style eating patterns.MethodsCross-sectional analysis of primary data collected from 1292 adult male and female participants was performed. Participants responded to a cross-sectional self-administered paper-and-pencil-based food history and beverage intake questionnaire. Chi-square analyses were employed to analyze data obtained from the nonparametric variables, whereas t tests were performed to analyze data obtained from the parametric variables.ResultsThere were significant differences in snack food shopping distributions between gender and marital status factors. Females were more likely to purchase more snacks than males, whereas singles were more likely to purchase more snacks than married. Pooled data suggest that 79.67% of the respondents consumed fast food with wide-ranging frequencies. There were significant differences between water and all other typical drinks, as water recorded the highest consumption rate by 65.31%. There were significant differences between the three meal-eating locations, as 48.45% of the respondents were more likely to consume most of their daily meals at home, whereas, combined, 51.55% were more likely to consume most of their daily meals out-of-home. Baking food scored 77.94% compared with all other food preparation methods. Overall healthy eating behaviors results indicated that 49.67% of the respondents consumed a healthy diet most of the time, whereas combined, 50.33% either consumed a healthy diet sometimes or not at all.ConclusionsTraditional Chinese eating practices have been transitioning into nontraditional eating behaviors that may be associated with a multitude of chronic non-communicable diseases and high mortality rates. As these rates have been projected to continue rising, there is a need to focus on introducing public health promotion policies, including health education and lifestyle-enhancing initiatives aimed at promoting nutritive balance and adopting healthier eating behaviors. These policies can be tailored to support the most affected groups among the lower- and middle-income Chinese, as well as similar populations in developing countries.

Looking Ahead: Health Impact Assessment of Front-Of-Pack Nutrition Labelling Schema as a Public Health Measure.

This study aimed to describe the underlying process, used methods and major recommendations emerging from a comprehensive and prospective health impact assessment of the endorsement of a front-of-pack nutrition labelling (FOP-NL) system by the Portuguese health authorities. A mixed-methods approach was used to gather information on the impact of four FOP-NL schemes on consumers’ selection of food products according to the perception of their nutritional quality, combining a systematic literature review, focus groups (FG), in-depth individual interviews, and an open-label crossover randomized controlled study. The relevance of FOP-NL as a public health promotion policy has emerged as a consensual idea among either FGs’ participants (i.e., consumers and experts), or interviewed stakeholders. Although all of the evaluated FOP-NLs result better than no system on promoting the choice of the healthiest product, the effectiveness of easy-to-interpret FOP-NL among vulnerable groups raised concerns related to the need of integrating specific nutritional information to promote a better self-management of chronic diseases, and related to the level of literacy of consumers, which could impair the usage of FOP-NL. Educational campaigns addressing skills to use FOP-NL is recommended. Furthermore, a monitoring strategy should be considered to evaluate the long-term effectiveness of this policy in promoting healthier food choices, and in reducing diet-related non-communicable diseases burden.

Risco cardiovascular e o papel da aptidão física para o bombeiro militar

In this study, we address the main cardiovascular risks associated with activities firefighters' work, with the presentation of ways of measuring the components health-related physical fitness, which can serve as a screening tool in the identification of professionals more prone to certain comorbidities. Initially, the activities of firefighters and their cardiovascular overload are briefly described related to fire fighting. Then, the factors of health risks that have been the target of research in this occupational group. Posteriorly, We emphasize the importance of good physical fitness to minimize the risk of cardiovascular events and, finally, we discussed the importance of the physical fitness test as a way assessment of physical fitness components. In addition, evidence is presented the effectiveness of the partnership established with the Public University, as well as the of public health promotion policies aimed at reducing harm caused in this working class that aims to save lives.

Spirituality and Health in Brazil: A Survey Snapshot of Research Groups

Articles on “Spirituality and Health” have multiplied considerably in Brazil in the last decade. More recently, however, research groups created specifically to investigate this topic have emerged. This study aims to provide an overview of the field by means of a survey in the Directory of Research Groups in Brazil. Thirty-three groups were initially identified, of which 16 were selected for analysis and placed into two categories: “established” groups and lines of research, and “in-process” groups and lines of research. The survey made it possible to identify postgraduate programs that develop studies on this theme, the main researchers, and the potentials and challenges of this research field in Brazil. The results also indicate that “Spirituality and Health” is a fundamentally interdisciplinary field of research that is expanding and has gained greater legitimacy in the scientific community in the last four years. The main challenges to and potentials for advancement of knowledge are the need for theoretical and methodological development to support research, educational improvement in spiritual care, development of a critical and conscious reflection on the political implications of the field (especially due to the religious diversity in the Brazilian cultural context), and the role of spirituality/religiosity in public health promotion policies.

Health Academy Program: importance for users and funding difficulties

The Health Academy Program (PAS) is a public health promotion policy in primary care (PC) that has physical activity (PA) as one of its main axes. The Previne Brasil Program (PPB) established a new funding program for PC in 2019. The aim of this study was to understand the meaning of PA and PAS according to its users and to discuss the consequences of PPB in the structuring and functioning of the program. This is a qualitative approach study, supported by the theory of social representations. 33 in-depth interviews were performed on users from the Belo Horizonte PAS, interpreted by the Structural Narration Analysis. It was revealed that there are profound representations on PA as remedy for physical and psychosocial diseases and others, such as a contribution for the improvement of quality of life. Users see PAS as a necessary and inclusive health promotion policy, as it offers free access to quality PA, defined as one of the main aspects for joining it. The funding provided from the PPB does not include specific funding for team maintenance for the Extended Nucleus of Family Health in Primary Care, removing responsibility from the municipal managers to gather multiprofessional teams. The absence of these teams, which include physical education professionals who are responsible for 90% of the actions of the PAS, can compromise the outcomes recognized by the users of the program, especially those related to the reduction of inequalities of access and also the various actions to promote health within the PC.

Evolução anual da prevalência de excesso de obesidade em adultos nas capitais dos 26 estados brasileiros e no Distrito Federal entre 2010 e 2019

Nas últimas duas décadas, a América Latina tem passado por uma acelerada transição epidemiológica e nutricional, caracterizando uma elevação do sobrepeso e obesidade, e a redução da desnutrição, devido a mudanças como industrialização, urbanização, e o sedentarismo. Objetivo: mostrar a evolução nutricional da população adulta brasileira através da investigação de inquéritos, caracterizando as mudanças que ocorreram na última década. Metodologia: Estudo transversal, com base de dados secundários. A busca dos dados foi proveniente do Sistema de vigilância de fatores de risco e proteção para doenças crônicas por inquérito (VIGITEL). Primeiramente foi efetuada a análise dos dados, que possibilitou a constituição do corpus; com a análise possibilitando chegar-se a uma conclusão. Conclusão: A predominância de obesidade mórbida vem aumentou em todas as capitais do Brasil, com um percentual maior no publico feminino, nas faixas de idade de 25 a 44 anos, em todos os níveis de educação e regiões do país, um alerta para a necessidade de elaboração políticas públicas de promoção da saúde que incentivem a construção e a manutenção de estilos de vida saudáveis ainda na infância e na adolescência. Pois a obesidade é uma condição que pode facilitar o surgimento de doenças crônicas não transmissíveis, como doenças cardiovasculares, câncer, diabetes mellitus e hipertensão arterial.