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We examined the association of physical activity (PA) facilities and access to school with total PA and domain-specific PA in adolescents. We enrolled 2610 adolescents (mean: 14.9 years) from Sao Paulo city. The number and presence of sports courts, swimming pools, locker rooms, running/athletics tracks, entrance accessible for student cyclists, bike racks, speed limit signal around the school, and pedestrian crossing were assessed in each school. All participants responded to a questionnaire about frequency and duration of physical education classes, leisure time, and active commuting. Total PA was obtained by adding up all PA domains. Presence of three or more (OR: 1.62; 95% CI: 1.15 to 2.30) sports courts, swimming pool available in usable conditions (OR: 1.45; 95% CI: 1.01 to 2.10), running/athletics tracks (OR: 2.35; 95% CI: 1.07 to 5.18), and bike racks (OR: 1.38; 95% CI: 1.07 to 1.78) were positively associated with total PA. Number of sports courts, swimming pool available in usable conditions, speed limit signals around the school, and pedestrian crossings were positively associated with physical education classes. The bike racks, speed limit signs around the school, and pedestrian crossings were positively associated with active commuting. School environment was associated with increased PA. Our findings should be considered in future epidemiologic studies and for educational and health policy makers. [ABSTRACT FROM AUTHOR]

Background: Managing HIV infection as a chronic condition includes encouraging adoption of healthy behaviors and promotion of physical activity (PA). However, people living with HIV (PLH) are often under social and programmatic vulnerability that may compromise behavior change. Understanding such barriers is crucial for successful incorporation of PA in their comprehensive care. Methods and findings: In this study, we describe PA, energy intake from diet, and anthropometry of a cohort of PLH starting antiretroviral therapy (ART) at a Brazilian reference clinic, report how PA was addressed in routine care and investigate association between PA, energy intake and psychosocial constructs that may facilitate PA (social support and self-efficacy for PA). Among 61 PLH (86.9% males, mean age = 32.5 years) anthropometry was normal, but 47.5% reported PA below recommendations. Despite presenting high social support scores, family encouragement for PA was low, and self-efficacy classified as medium. Chart reviews yielded infrequent reports concerning PA. After adjusting for gender and age, we found a negative association between energy intake from diet and self-efficacy, but none between PA and energy intake or between PA and psychosocial constructs. Conclusions: We conclude that patients in our cohort were insufficiently active when starting ART, and that PA was poorly addressed by caretakers in routine HIV care. Nevertheless, social support and self-efficacy scores suggest potential for behavioral change. Caregivers should therefore start considering patients' vulnerabilities and establishing strategies to help them overcome barriers to incorporate PA in their comprehensive care effectively. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to describe a methodology for training to provide counseling on physical activity among community health workers working within primary healthcare in Brazil. Methods: This was an intervention study conducted with 65 community health workers in the Ermelino Matarazzo district in the São Paulo, Brazil (30 in intervention group). The intervention group received a course of 12 hours (with 4 meetings of 3 hours each in 1 month) that aimed to improve their knowledge and be autonomous with regard to promoting physical activity. For data analysis, focus groups and questionnaires on knowledge and perceptions regarding physical activity were used. Results: The average attendance for the 4 meetings was 29 workers (93% of total). There was an improvement in knowledge on physical activity recommendations in comparison with the control (P = .03), and qualitative results revealed that the professionals appreciated the learned content, valued its application based on knowledge construction and felt secure about promoting physical activity. This was seen through high adherence levels and construction collective of proposal for home visits for physical activity promotion. Conclusion: The training was effective in improving knowledge and attitudes toward counseling on physical activity among community health workers. [ABSTRACT FROM AUTHOR]

Background: Many studies have investigated the association between the built environment and physical activity behavior in urban settings. However, most of the studies conducted in low- and middle-income countries were cross-sectional, which are limited to identify behavioral determinants. We propose a prospective cohort study to verify the relationship between built environment features and leisure-time and transport-related physical activity in adults from Sao Paulo city, Brazil.Methods: Prospective multilevel cohort, denominated "ISA-Physical Activity and Environment". It will build on the Health Survey of Sao Paulo in 2015 ("Inquérito de Saúde de São Paulo (ISA)" in Portuguese). The Health Survey of Sao Paulo, originally designed as a cross-sectional survey, had a multi-stage sample, covering 150 census tracts distributed in five health administrative areas. Data collection was performed by face-to-face interviews until December 2015 and the sample comprised 4043 individuals aged 12 years or more. The ISA-Physical Activity and Environment study will reassess people who are aged 18 years or more in 2020, including telephone and household interviews. The primary outcome will be leisure-time and transport-related physical activity, assessed through the International Physical Activity Questionnaire long version. Exposure variables will be built environment features in the areas participants live and work in the follow-up. Data analysis will include multivariate multilevel linear and logistic models. We will also conduct cost-effectiveness analysis and develop agent-based models to help inform decision-makers. The study will be conducted by an interdisciplinary research team specialized in physical activity epidemiology, nutritional epidemiology, georeferencing applied to health, statistics, agent-based modeling, public health policy, and health economics.Discussion: There are few longitudinal studies on the relationship between the built environment and physical activity behavior in low- and middle-income countries. We believe that the ISA-Physical Activity and Environment study will contribute with important results for the progress of the knowledge in this field and for the implementation of policies that promote leisure-time physical activity and active travel in Sao Paulo and similar cities across the world. [ABSTRACT FROM AUTHOR]

Background: To estimate the prevalence of and identify factors associated with physical activity in leisure, transportation, occupational, and household settings. Methods: This was a cross-sectional study aimed at investigating living and health conditions among the population of São Paulo, Brazil. Data on 1318 adults aged 18 to 65 years were used. To assess physical activity, the long version of the International Physical Activity Questionnaire was applied. Multivariate analysis was conducted using a hierarchical model. Results: The greatest prevalence of insufficient activity related to transportation (91.7%), followed by leisure (77.5%), occupational (68.9%), and household settings (56.7%). The variables associated with insufficient levels of physical activity in leisure were female sex, older age, low education level, nonwhite skin color, smoking, and self-reported poor health; in occupational settings were female sex, white skin color, high education level, self-reported poor health, nonsmoking, and obesity; in transportation settings were female sex; and in household settings, with male sex, separated, or widowed status and high education level. Conclusion: Physical activity in transportation and leisure settings should be encouraged. This study will serve as a reference point in monitoring different types of physical activities and implementing public physical activity policies in developing countries. [ABSTRACT FROM AUTHOR]