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BACKGROUND: Many factors may negatively impact physical activity (PA), but studies lack evidence of individual predictors of perceived barriers to PA among adults in primary healthcare units. OBJECTIVE: To analyze associations between sociodemographic characteristics, health conditions, leisure-time physical activity (LTPA), PA counseling and perceived barriers to LTPA among adult patients in primary healthcare units of the National Health System in Brazil. DESIGN AND SETTING: Cross-sectional study on a representative sample of adults in primary healthcare units in São José dos Pinhais, Paraná, Brazil. METHODS: This study was conducted in 2019, among 779 adults (70% women). Barriers to LTPA, sociodemographic characteristics (sex, age, marital status, skin color, education and income), health conditions (body mass index, hypertension, diabetes, dyslipidemia, coronary disease and medications), LTPA level and PA counseling received were measured using validated, standardized procedures. The data were analyzed using chi-square and Mann-Whitney U tests. RESULTS: The most prevalent barriers were “feeling too tired” (53%) and “lack of time” (52%). PA counseling was inversely associated with “lack of time” (45% versus 57%; P < 0.001) but positively associated with “injury or disease” (38% versus 29%; P = 0.008). There was an inverse linear trend between the number of barriers and LTPA (walking and total) (P < 0.001). Most barriers differed in comparisons of sociodemographic characteristics, health conditions, LTPA and counseling (P < 0.05). CONCLUSIONS: The barriers vary according to the individual predictors. Counseling strategies need to be specific for each barrier and may be promising for promoting LTPA within primary healthcare.

Counseling by health professionals has promising results in behavior change and is recommended as part of integrated community interventions. However, the knowledge about sedentary behavior (SB) counseling is incipient. The study aimed to identify the prevalence and explore the associated factors with SB counseling received from healthcare professionals by adults in primary health care (PHC) in Brazil. A cross-sectional study was conducted in 2019 that included a representative sample of 779 users in all 15 basic health units (BHU) in São José dos Pinhais, Paraná. We identified those who reported having received SB counseling during a consultation. The association between the sociodemographic factors, chronic diseases, access to health services, physical activity, SB, and counseling were analyzed using Poisson regression in a hierarchical model. The prevalence of counseling was 12.2% (95% CI: 10.1–14.7%); it was higher in women (PR: 1.77; 95% CI: 1.10–2.83), those aged ≥60 yrs (PR: 1.84; 95% CI: 1.14–2.98), BMI ≥ 30 kg/m2 (PR: 2.60; 95% CI: 1.31–5.17), who consume ≥3 medications (PR: 2.21; 95% CI: 1.06–4.59), and those who spend a prolonged period of the day engaged in SB (4th quartile PR: 3.44; 95% CI: 1.88–6.31). The results highlight that SB counseling is underutilized and incipient in PHC. Understanding these results can help managers and healthcare professionals in BHU teams to implement and direct specific actions to reduce SB in adults through counseling.

Objective Summarize the effects of interventions designed to promote physical activity during elementary school recess in children between 5 and 10 years old. Effective school interventions for children can promote physical activity and healthy behaviors. Methods PubMed, Scopus, Bireme, SciELO, Web of Science, PsychINFO, Proquest, Physical Education Index, Sports Discus, and Eric databases were included in the data search. Original intervention articles on physical activity that used regression methods, published between 2000 and 2019 in English, Portuguese and Spanish were analyzed. Analyses were performed in 2019. Outcomes were organized according to the direction of the association by independent variables. Ten articles were considered eligible for data extraction and evaluation. Results Several strategies were used including playground markings, demarcation of physical activities zones, group activities, availability of sports equipment and facilities. Most of the studies were conducted in the United States. Recess periods ranged from 20–94 min per day and intervention time ranged from 6 weeks to 2 years. Recess duration and intervention effects were positively associated with physical activity. Gender (girls) and age (oldest) were negatively associated with physical activity during recess. Conclusions Interventions based on modifications of school environment such as playground markings demarcation of physical activities zones, group activities, availability of sports equipment and facilities are cheap and cost-effective for increasing physical activity in school recess.

Background The ability to ‘age in place’ is dependent on a range of inter-personal, social and built environment attributes, with the latter being a key area for potential intervention. There is an emerging body of evidence that indicates the type of built environment features that may best support age friendly communities, but there is a need to expand and consolidate this, while generating a better understanding of how on how research findings can be most effectively be translated in to policy and practice. Methods The study is based on two case study cities, Curtiba (Brazil) and Belfast (UK), which have highly contrasting physical, social and policy environments. The study deploys a mix methods approach, mirrored in each city. This includes the recruitment of 300 participants in each city to wear GPS and accelerometers, a survey capturing physical functioning and other personal attributes, as well as their perception of their local environment using NEWS-A. The study will also measure the built environments of the cities using GIS and develop a tool for auditing the routes used by participants around their neighbourhoods. The study seeks to comparatively map the policy actors and resources involved in healthy ageing in the two cities through interviews, focus groups and discourse analysis. Finally, the study has a significant knowledge exchange component, including the development of a tool to assess the capacities of both researchers and research users to maximise the impact of the research findings. Discussion The HULAP study has been designed and implemented by a multi-disciplinary team and integrates differing methodologies to purposefully impact on policy and practice on healthy ageing in high and low-middle income countries. It has particular strengths in its combination of objective and self-reported measures using validated tools and the integration of GPS, accelerometer and GIS data to provide a robust assessment of ‘spatial energetics’. The strong knowledge exchange strand means that the study is expected to also contribute to our understanding of how to maximise research impact in this field and create effective evidence for linking older adult’s physical activity with the social, built and policy environments.

OBJECTIVE: To analyze the moderator effect of socioeconomic status in the association between the perceived environment and active commuting to school. METHODS: A total of 495 adolescents and their parents were interviewed. Perceived environment was operationalized in traffic and crime safety and assessed with the Neighborhood Environment Walkability Scale. Active commuting was self-reported by the adolescents, categorized in walking, bicycling or skating at least one time/week. Socioeconomic status was used as moderator effect, reported from adolescents’ parents or guardians using Brazilian standardized socioeconomic status classification. Analyses were performed with Poisson regression on Stata 12.0. RESULTS: Prevalence of active commuting was 63%. Adolescents with low socioeconomic status who reported “it is easy to observe pedestrians and cyclists” were more likely to actively commute to school (PR = 1.18, 95%CI 1.03–1.13). Adolescents with low socioeconomic status whose parents or legal guardians reported positively to “being safe crossing the streets” had increased probability of active commuting to school (PR = 1.10, 95%CI 1.01–1.20), as well as those with high socioeconomic status with “perception of crime” were positively associated to the outcome (PR = 1.33, 95%CI 1.03–1.72). CONCLUSIONS: Socioeconomic status showed moderating effects in the association between the perceived environment and active commuting to school.

The perceived stress scale (PSS-10) reliability and validity were evaluated in Brazilian adults. A two-stage translation procedure was employed to achieve a Portuguese version. Participants were 793 Brazilian university teachers. The exploratory factor analysis showed two factors with eigenvalues greater than 1.0 (56.8% of variance). The Cronbach’s alpha coefficients were 0.83 (Factor 1), 0.77 (Factor 2) and 0.87 (Total Score). The test—retest reliability scores were 0.83 (Factor 1), 0.68 (Factor 2) and 0.86 (Total Score). PSS-10 and perceived health correlations ranged from —0.22 to —0.35. The PSS-10 showed an adequate reliability and validity supporting its use in this population.

The aim of this study was to verify the association between different types and sources of social support and physical activity among adolescents from Curitiba, Paraná State, Brazil. A school-based survey was conducted with a representative sample of adolescents from public schools (n = 1,469). Multiple regression models were used to test the association between weekly frequency and sources of social support from family and friends and weekly frequency of physical activity. Among boys, frequent company of family (PR: 2.88; 95%CI: 2.00-4.13) and friends (PR: 5.46; 95%CI: 2.33-12.78) and positive reinforcement from friends (PR: 1.81; 95%CI: 1.18-2.77) were positively associated with physical activity. Sporadic invitation by the family was negatively associated with physical activity (PR: 0.66; 95%CI: 0.46-1.14). For girls, frequent company of family (PR: 3.39; 95%CI: 1.49-7.69) and friends (PR: 4.06; 95%CI: 2.22-7.45) increased the likelihood of physical activity. Company of friends was the most important type of social support for physical activity among these adolescents.

The aim of this study was to verify the association between perceived distance to recreational facilities (parks, gyms, sports courts, and bike lanes) for physical activity and exercise among adolescents in Curitiba, Paraná State, Brazil. A cross-sectional study was conducted with a representative sample of 1,474 adolescents (14-18 years) enrolled in public schools. There was an inverse association between distance (31 minutes) to gyms and sports courts and physical activity among boys (PR = 0.78; 95%CI: 0.69-0.88 and PR = 0.79; 95%CI: 0.66-0.95, respectively). The number of facilities near home was positively associated with physical activity in boys (PR = 1.18; 95%CI: 1.04-1.34). Among girls, distance (31 minutes) to sports courts was inversely associated with strength training (PR = 0.93; 95%CI: 0.87-0.99). The findings suggest that distance from home and number of recreational facilities in the neighborhood may affect patterns of physical activity among adolescents and that the association differs between boys and girls.

This study aimed to examine the association between physical activity and self-efficacy in adolescents. A school-based survey was conducted with 1,698 adolescents from Curitiba, Paraná State, Brazil. Physical activity was evaluated as weekly frequency (days per week) of moderate or vigorous physical activity. Self-efficacy was analyzed as the sum of a 10-item scale. The association between self-efficacy and physical activity was tested by Poisson regression (p0.05), stratified by gender. Among boys, only high self-efficacy was associated with all categories of physical activity (p0.001), while for girls moderate and high levels of self-efficacy were associated with all categories of physical activity (p0.001). In conclusion, self-efficacy showed a positive association with physical activity in adolescents, although the relationship was more consistent in girls. The finding is important for designing interventions to promote physical activity in this age group.

To estimate the prevalence of physical activity in adolescents and to identify associated factors.A cross-sectional study was conducted with a representative sample (n=1,518, 59.2% females) of students aged between 14 and 18 years, enrolled in the public school network of the city of Curitiba, Southern Brazil, in 2006. Physical activity practice was self-reported, according to the number of days per week when they perform moderate to vigorous physical activity lasting60 minutes. This practice was analyzed in two distinct models. In the first model, the variable was dichotomized into "0 day" and "1 day"; in the second, into "4 days" and "5 days". Independent variables were as follows: biological-demographic (sex, age, body mass index); socioeconomic (parents' level of education, number of cars); behavioral (number of hours spent watching television, number of hours spent using a computer); and sociocultural (social support from family and friends and the perception of barriers to the practice of activities), tested with Poisson regression.In the first model of analysis, the prevalence of physical activity was 58.2% (75.1% in males; 46.5% in females; p0.001), while, in the second, it was 14.5% (22.3% and 9.1%, respectively; p0.001). In the first model, the variables associated with physical activity were: male sex (PR=1.63, 95% CI: 1.48;1.78), social support from family (PR=1.14, 95% CI: 1.05;1.23), social support from friends (PR=1.52, 95% CI: 1.31;1.78) and high perception of barriers (PR=0.54, 95% CI: 0.46;0.62). In the second model, only male sex (PR=2.45, 95% CI: 1.73;3.46) and high perception of barriers (PR=0.24, 95% CI: 0.15;0.38) were associated with physical activity.More than half of adolescents practice physical activity at least one day of the week, although 14.5% achieved the current recommendations. The recommended levels are associated with a lower number of factors. Gender and perception of barriers were consistently associated with physical activity levels.

Background:The purpose of this study was to analyze the relationship between adolescents’ physical activity practice and their perception about the environment of urban parks.Methods:A school-based representative sample (n = 1,718; boys = 40.4%) of teenagers of Curitiba, Southern region of Brazil. A questionnaire was employed to identify perceived parks environmental features as well as physical activity practice in the parks (PAP), habitual physical activity (HPA) and demographics. The relationship between PAP and parks environments was analyzed through multivariate logistic regression controlling for age and socioeconomic status, HPA and parks distance.Results:After controlling for confounders PAP was associated with lack of space to be physically active, activities to choose from and equipments for both boys and girls, (odds ratio (OR)—ranging from 1.5 to 1.8). Among boys, having people of same age (OR = 1.5) and accessibility (OR = 2.0) showed association with PAP only in crude analysis. However, among girls, to be bulled or teased (OR = 1.4) and accessibility (OR = 1.7) were associated with PAP after confounding control.Conclusions:The results showed that specific attributes in parks may be considered and offered to increase the likelihood of physical activity practice among adolescents in such locations.

The aim of this study was to analyze the prevalence and association of barriers to physical activity among adolescents. This cross-sectional study evaluated a representative sample of public high school students in Curitiba-PR, Brazil. A total of 1,609 school adolescents (59.7% male) between 14 and 18 years of age answered a questionnaire on physical activity status and barriers to physical activity. Logistic regressions were conducted for each barrier investigated to verify the association between the prevalence of barriers and physical activity, adjusting for confounding variables (age and socioeconomic status). Analyses were done separately for boys and girls. Only 22% of boys and 9% of girls achieved the current physical activity recommendation. Among the 12 barriers investigated, only "there is nobody to take" did not differ between boys and girls. The perception of barriers was higher for girls than boys (p0.05) for all other barriers. "Lack of friends company" and "feel lazy" were the barriers most often reported by boys (30.4%) and girls (51.8%) respectively; however, the barrier most strongly associated with prevalence of physical inactivity was "prefer to do other things" for both boys (OR = 5.02 (2.69 - 9.37); p0.05) and girls (OR = 7.10 (3.71 - 13.60); p0.05). Perceived barriers for the practice of physical activity were more prevalent in girls and differed as to the extent of importance between genders.

Inappropriate lifestyles have been responsible for the leading causes of mortality. The purpose of the Fantastic Lifestyle Questionnaire is to help physicians involved in health prevention to identify and assess their patients' lifestyles.To translate and validate the Fantastic Lifestyle Questionnaire for use with young adults.The process of translation into Portuguese and validation consisted of four steps: 1) translation; 2) correction and semantic adaptation by professional experts (judges); 3) content validation; and 4) a final evaluation by the target population. The statistical analyses used were Cronbach's alpha to measure internal consistency reliability, intra-class correlation coefficient (R) for external consistency, and the Kappa index to test construct validity.Cronbach's alpha coefficient measured the correlation between items and the total was 0.69, which is considered reasonable for an instrument designed to evaluate a latent variable that can only be estimated and not measured. When the items were grouped into domains, it was possible to verify that they all contributed equally to the stability of the questionnaire (alpha=0.60). The external consistency evaluated by intra-class correlation was R=0.92 (p=0.2), which demonstrates a high degree of reproducibility; the construct validity of 4 and 3 categories was 75 and 80.7% with Kappa indices of 0.58 and 0.7, respectively, which show an excellent discriminatory classificatory capacity.The Fantastic Lifestyle Questionnaire has an adequate internal and external consistency for evaluating young adult lifestyles, and it can be recommended for primary care and epidemiological studies.

Background Neighborhood safety is one of the environmental aspects that can influence physical activity. We analyzed the association between perceived neighborhood safety and physical inactivity (PI) in adults and examined effect modification according to sociodemographic variables. Methods A cross-sectional study was conducted with 1,261 adults (62% women), age 18–69 years from Curitiba, Brazil. Results The perception of unsafe neighborhood was higher among women, older participants, those classified in the high socioeconomic (SES) group, overweighed and also among those reporting to have PA equipments and children. The association between perception safety of walking during the day and walking for leisure (women PR = 1.12 CI95% = 1.02–1.22; men PR = 0.82 CI95% = 0.64–1.05; interaction term PR = 1.38 CI95% = 1.03–1.83) and safe perception was associated with PI, just in the highest SES group (PR = 1.09; CI95% = 1.00–1.19; p trend = 0.032) when compared with their counterparts (low SES PR = 0.99; CI95% = 0.90–1.04; p trend = 0.785; interaction term PR = 1.09; CI95% = 1.03–1.15; p trend = 0.007). Conclusion The perception of safety in the neighborhood was associated with PI in transport, but this association varies across of sociodemographic variables.