Popular education, health promotion and active aging: an integrative literature review

Souza, Elza Maria de; Silva, Daiane Pereira Pires; Barros, Alexandre Soares de

doi:10.1590/1413-81232021264.09642019

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REVIEW • Ciênc. saúde coletiva 26 (4) • Apr 2021 • https://doi.org/10.1590/1413-81232021264.09642019 copy

Popular education, health promotion and active aging: an integrative literature review

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Abstract

Population ageing is a global phenomenon and requires actions to promote well-being and prevent illnesses and unnecessary hospital admissions. The objective of this study was to identify education and health promotion actions aimed at promoting active aging. An integrative literature review was conducted of relevant articles written in Portuguese, English and Spanish published between 2005 and August 2018 using the following electronic databases and virtual libraries: Lilacs, MEDLINE, SciELO, and BVS. The initial search resulted in 2,069 articles, of which 33 met the inclusion criteria. The analysis showed that the actions identified by the review promoted the adoption of healthy habits and participation of older people, characterizing them as actions that promote active aging. However, the actions were limited almost exclusively to this age group, which may lead to age segregation, and focused on old age rather than adopting a life course perspective of active aging. Despite the importance of these actions, only 11 were evaluated, suggesting that the evaluation of education and health promotion actions to demonstrate effectiveness and promote replication in other locations or services is not very common practice.

Key words
Popular health education; Health promotion; Active aging; Public health

Authors	Year of publication, place of study and action setting	Title	Objective	Action
Assis²²22 Assis M. Envelhecimento ativo e promoção da saúde: reflexão para as ações educativas com idosos. Revista APS. 2005; 8(1):15-24.	2005, Rio de Janeiro, Brazil, older adult outpatient clinic at a university hospital.	Active aging and health promotion: reflecting on education actions for older people.	To make a contribution to the discussion of the ethical and political aspects of education actions with older people.	Application of an individual assessment instrument and education action with a group of older people: Multidimensional Health and Quality of Life Assessment.
Sancho Castiello et al.²³23 Sancho Castiello MT, Yanguas Lezaun JJ, Díaz Veiga P, Rodríguez Rodríguez P, Pérez Salanova M, Serrano Garijo P, Bermejo García L, Mesa Lampre P, Gómez Pavón J, Ruipérez Canterai I, Gutiérrez B. "Saber envejecer. Prevenir la dependencia." Un modelo para el diseño de materiales didácticos. Revista Española de Geriatría y Gerontología 2006; 41(Supl. 2):2-16.	2006, Spain, Spanish Society of Geriatrics and Gerontology.	Knowing how to age. Preventing dependence. A model for designing teaching materials.	To describe an action research project using qualitative research methods aimed at promoting active aging and avoiding dependence.	Development of audiovisual teaching materials based on research with 13 focus groups consisting of people aged between 55 and 80 in 6 cities in Spain.
Assis et al.²⁴24 Assis M, Pacheco LC, Menezes MFG, Bernardo MHJ, Steenhagen CHVA, Tavares EL, Santos DM. Ações educativas em promoção da saúde no envelhecimento: a experiência do núcleo de atenção ao idoso da UNATI. Rev APS 2007; 31(3):438-347.	2007, Rio de Janeiro, Brazil, older adult care center at a university of the third age.	Education actions for health promotion during old age: the experience of an older adult care center at UNATI/UERJ	To present an extension project and demonstrate its contribution to a care model and professional training based on comprehensive care and health promotion.	Range of group activities: health meetings, health circles, and production of educational materials (pamphlets and murals).
Martins et al.²⁵25 Martins JJ, Barra DCC, Santos TM, Hinkel V, Nascimento ERP, Albuquerque GL, Erdmann AL. Educação em saúde como suporte para a qualidade de vida de grupos da terceira idade. Rev eletrônica enferm 2007; 9(2):443-456.	2007, Florianópolis, Brazil, reference outpatient clinic.	Health education as quality of life support for older people	To understand the health education needs of older people attending older adult groups.	Group techniques and activities, questionnaires, and participant observation related to diabetes, high blood pressure, osteoporosis, arthritis and arthrosis, and a balanced diet
Alencar et al.²⁶26 Alencar MDSS, Barros FDO, Carvalho CMRG. Os aportes sócio-políticos da educação nutricional na perspectiva de um envelhecimento saudável. Rev Nutr 2008; 21(4):369-381.	2008, Piauí, Brazil, university of the third age.	Social and political inputs of nutrition education from a healthy aging perspective	To reflect on classroom experiences from game-based learning workshops with older people from a university of the third age.	Weekly game-based learning workshops dealing with nutrition, health and aging with older persons attending a program at a university of the third age.
Bernardo et al.²⁷27 Bernardo MHJ, Menezes MFG, Assis M, Pacheco LC, Mecenas AS. A saúde no diálogo com a vida cotidiana: a experiência do trabalho educativo com idosos no grupo roda da saúde. Rev APS 2009; 12(4):504-509.	2009, Rio de Janeiro, Brazil, older adult care center at the Open University of the Third Age/UERJ.	Health in dialogue with everyday life: the experiences of education work with older people in the health circle group.	To present the methodology of the "Health Circle" and highlight some assessment data from the activities records.	Educational "afternoon tea" groups aimed at encouraging reflection and collective production regarding topics related to health and quality of life.
Mazo et al.²⁸28 Mazo GZ, Cardoso AS, Dias RG, Balbé GP, Virtuoso JF. Do Diagnóstico À Ação: Grupo De Estudos Da Terceira Idade : Alternativa Para a Promoção Do Envelhecimento Ativo. Rev Bras Atividade Física Saúde 2009; 14(1):65-70.	2009, Florianópolis, Brazil, third age study groups at the University of the State of Santa Catarina.	From appraisal to action: third age study groups: an alternative for the promotion of active aging	To describe the functioning of actions to promote physical exercise as part of an extension program to provide inputs to support future programs.	Physical activity actions of the third age study group.
Kuczmarksi, Cotugna.²⁹29 Kuczmarksi MF, Cotugna N. Outcome evaluation of a 3-year senior health and wellness initiative. J Community Health 2009; 34(1):33-39.	2009, Delaware, United States, Wilmington Senior Center.	Outcome evaluation of a 3-year senior health and wellness initiative.	To describe the development and implementation of the assessment methodology and results of a multidisciplinary senior health and wellness initiative.	11 multidisciplinary programs addressing senior health and well-being over a 3-year period.
Combinato DS et al.³⁰30 Combinato DS, Vecchia MD, Lopes EG, Manoel RA, Marino HD, Oliveira ACS, Silva KF. Grupos de Conversa: saúde da pessoa idosa na estratégia saúde da família. Psicologia & Sociedade 2010; 22(3):558-568.	2010, Paranaíba, Brazil, Mato Grosso do Sul, primary healthcare.	Chat groups: older people's health in the family health strategy.	To develop a group process for health promotion with older people geared towards active aging and quality of life.	Closed weekly, predominantly female, chat groups.
Firmino et al.³¹31 Firmino R, Patrício J, Rodrigues L, Cruz P, Vasconcelos AC. Educação popular e promoção da saúde do idoso: reflexões a partir de uma experiência de extensão universitária com grupos de idosos em João Pessoa - PB. Rev APS 2010; 13(4):523-530.	2010, João Pessoa, Brazil, primary healthcare.	Popular education and health promotion directed at older people: reflections based on the experiences of university extension with groups of older adults in João Pessoa.	To document experiences and outline lessons learnt and the difficulties and concerns of participants in a university extension project.	Health education activities with older people focused on nutrition.
Paiva et al.³²32 Paiva ACS, Hernandez SS, Sebastião E, Quadros Junior AC, Cury M, Costa JLR, Gobbi LTB, Gobbi S. Dança e envelhecimento: uma parceria em movimento!. Rev Bras Atividade Física e Saúde. 2010; 15(1):70-72.	2010, São Paulo, Brazil, São Paulo State University (UNESP).	Dance and aging: a partnership in motion	To present a program that develops a range of activities with people aged over 60.	Dance lessons as part of the Third Age Physical Activity Program (PROFIT) at UNESP.
Tahan, Carvalho³³33 Tahan J, Carvalho ACD. Reflexões de Idosos Participantes de Grupos de Promoção de Saúde Acerca do Envelhecimento e da Qualidade de Vida. Saúde Soc 2010; 19(4):878-888.	2010, Ribeirão Preto-São Paulo, Brazil, primary healthcare.	Reflections of older people participating in health promotion groups geared towards aging and quality of life.	To analyze and reflect on older people's perceptions of quality of life, aimed at promoting comprehensive care after adhesion to the health promotion groups.	Open handicraft, dance, relaxation and health groups using game-based learning and leisure activities.
Souza, Grundi³⁴34 Souza EM, Grundy E. Intergenerational interaction, social capital and health: Results from a randomized controlled trial in Brazil. Soc Sci Med 2007; 65(7):1397-1409.	2011, Ceilândia- Distrito Federal Brazil, primary school.	Intergenerational integration, social capital and health:a theoretical framework and results from a qualitative study	To evaluate intergenerational activities developed in a school and develop a theoretical framework to explain observed changes.	Intergenerational intervention where older people shared their life stories with teenage primary school students, evaluated using focus groups made up of individuals from both age groups.
Wichmann et al.³⁵35 Wichmann FMA, Areosa SVC, Roos NP. Promoção do envelhecimento saudável: adoção de uma prática multidisciplinar na atenção à saúde do idoso (UNISC). Estud interdiscip Envelhec 2011; 16(2):307-318	2011, Santa Cruz do Sul - Rio Grande do Sul, Brazil, teaching clinic at Santa Cruz do Sul University (UNISC).	Promotion of healthy aging: the adoption of a multidisciplinary approach to the provision of care for older people (UNISC)	To document the experiences of a university extension project and socialize multiprofessional and interdisciplinary practices adopted in the project.	Older adult groups for the discussion of topics related to health in old age with various activities.
Andrade PT et al.³⁶36 Andrade TP, Mendonça BPCK, Lima DC, Alfenas IC, Bonolo PF. Projeto conviver: estímulo à convivência entre idosos do Catete, Ouro Preto, MG. Rev bras educ méd. 2012; 36(Supl. 1):81-85.	2012, Ouro Preto-Minas Gerais, Brazil, community interaction center.	Projeto conviver: encouraging social interaction between older people from Catete, Ouro Preto, Minas Gerais.	To describe the experiences of a project to promote social interaction between groups of older people.	Workshops and encounters dealing with health-related topics.
Costa et al.³⁷37 Costa M, Rocha L, Oliveira S. Educação em saúde: estratégia de promoção da qualidade de vida na terceira idade. Rev. Lusófona de Educação 2012; 22:123-140.	2012, Patos-Paraíba, Brazil, teaching clinic at a higher education institution.	Health education: a strategy for the promotion of quality of life in the third age	To investigate whether level of quality of life in the third age is influenced by the teaching of psychomotor exercises as a health education strategy.	Older people practiced kinetic and functional exercises twice a week; the study used a pretest posttest design.
Patrocínio, Todaro³⁸38 Patrocínio WP, Todaro MA. Programa de educação para um envelhecimento saudável. Rev Kairós 2009; 15(2):5-27	2012, Campinas - São Paulo, Brazil, primary healthcare.	The healthy aging education program.	To implement and evaluate a healthy aging education program.	Weekly 150-minute meetings with 16 older people during a 4-month period developed from a Freirean perspective.
Silveira et al.³⁹39 Silveira MM, Pasqualotti A, Colussi EL. Educação gerontológica, envelhecimento humano e tecnologias educacionais: reflexões sobre velhice ativa. Estudos Interdisciplinares sobre o Envelhecimento 2012; 17(2):387-398.	2012, Rio Grande do Sul, Brazil, state universities.	Gerontological education, human aging, and educational technologies: reflections on active aging.	To reflect on aging and the possibility of participating in gerontological education, enhancing quality of life.	Actions developed by universities offering programs to older people.
Cyarto et al.⁴⁰40 Cyarto EV, Dow B, Vrantsidis F, Meyer C. Promoting healthy ageing: Development of the healthy ageing quiz. Australas J Ageing 2013; 32(1):15-20.	2013, Melbourne, Victoria, Australia.	Promoting healthy ageing: development of the Healthy Ageing Quiz	To design an easy-to-use instrument that allows older adults and people approaching old age to evaluate their lifestyle.	Development and application of the Healthy Ageing Quiz to increase awareness and knowledge of how to age well.
Patrocínio, Pereira⁴¹41 Patrocinio WP, Pereira BPC. Efeitos da educação em saúde sobre atitudes de idosos e sua contribuição para a educação gerontológica. Rev Trabalho, Educação e Saúde 2013; 11(2):375-394.	2013, Campinas-São Paulo, Brazil, primary healthcare.	Effects of health education on the attitudes of older people and its contribution to gerontological education.	To evaluate the effects of a community-based popular health education program for older persons dealing with attitudes towards old age.	16 weekly 150-minute meetings with groups of older people to discuss positive and negative images of old age.
Mendonça et al.⁴²42 Mendonça ET, Fernandes L, Aires A, Amaro MO, Moreira TR, Henriques BD, Castro JA, Fernandes VC, Brinati LM. A experiência de oficinas educativas com idosos:( Re) pensando práticas à luz do pensamento Freireano. Rev APS 2013; 16(4):479-484.	2013, Viçosa-Minas Gerais, Brazil, multiprofessional senior care reference center.	Experiences from educational workshops with older people: (Re)thinking practice in the light of Freirean thinking.	To document experiences to promote reflection on the use of workshops as a health education strategy from a Freirean perspective.	Workshops with older people on medication use.
Morrow-Howell et al.⁴³43 Morrow-Howell N, Lee YS, McCrary S, McBride A. Volunteering as a pathway to productive and social engagement among older adults. Health Educ Behav 2014; 41(Supl. 1):84S-90S.	2014, United States, schools.	Volunteering as a pathway to productive and social engagement among older adults.	To examine the effects of volunteering on subsequent social and civic activity of older adults.	Volunteering among older adults.
Sato et al.⁴⁴44 Sato AT, Batista MPP, Almeida MHM. Programas de estimulação da memória e funções cognitivas relacionadas: opiniões e comportamentos dos idosos participantes. Rev ter ocup. 2014; 25(151-159):130-138.	2014, São Paulo, Brazil, a university gerontology laboratory.	Memory stimulation and related cognitive function programs: opinions and behaviors of participating older persons.	To show the influence of a memory program on the performance of activities of daily living and incorporation of habits into everyday life.	Group activities with older people consisting of lectures and discussion classes, experiential activities, including memory strategies and reflection on active and healthy living behaviors.
Almeida et al.⁴⁵45 Almeida LFF, Freitas EL, Salgado SML, Gomes IS, Franceschini SCC, Ribeiro AQ. Projeto de intervenção comunitária "Em Comum-Idade": contribuições para a promoção da saúde entre idosos de Viçosa, MG, Brasil. Cien Saude Colet 2015; 20(12):3763-374.	2015, Viçosa - Minas Gerais, Brazil, primary healthcare.	Community intervention project "In Common-Age": contributions to health promotion among older people in Viçosa, Minas Gerais.	To analyze possible changes in anthropometric measurements and functional physical fitness levels among project participants.	Food and nutrition education and physical exercise and leisure workshops and conversation circles on topics related to healthy aging; intervention evaluation.
Massi et al.⁴⁶46 Massi G, Berberian AP, Guarinello AC, Lourenço RC, Tonocchi R, Stechman Neto J. Linguagem e envelhecimento: práticas de escrita autobiográfica junto a idosos. Rev CEFAC 2015; 17(6):2065-2071.	2015, Curitiba, Brazil, primary healthcare.	Language and aging: autobiographical writing practices with older persons.	To analyze, from a literacy perspective, the effects of autobiographical writing practices on autonomy and well-being among older people.	Weekly literacy workshops to promote literacy and the discussion of various topics, such as old age, family, the labor market, and spirituality.
Patrocínio⁴⁷47 Patrocinio W. Atividades práticas para o Envelhecimento Ativo. Kairós 2014; 18(19):167-187.	2014, São Paulo, Brazil, primary healthcare.	Practical activities for active aging.	To present a set of practical activities for promoting healthy aging developed from a Freirean and active aging perspective.	Meetings with older people involving various activities and discussion of various topics.
Valer et al.⁴⁸48 Valer DB, Bierhals CCBK, Aires M, Paskulin LMG. O significado de envelhecimento saudável para pessoas idosas vinculadas a grupos educativos. Rev Bras. Geriatr. Gerontol. 2015; 18(4):809-819.	2015, Porto Alegre - Rio Grande do Sul, Brazil, primary healthcare.	The meaning of healthy aging from the perspective of older people participating in education groups.	To describe the meaning of healthy aging from the perspective of older people participating in health education groups in a local health center.	Application of an instrument with older people participating in health education groups.
Zanjani et al.⁴⁹49 Zanjani F, Downer BG, Hosier AF, Watkins JD. Memory banking: a life story intervention for aging preparation and mental health promotion. J Aging Health 2015; 27(2):355-376.	2015, Kentucky, United States, various public places.	Memory Banking: a life story intervention for aging preparation and mental health promotion.	To examine the feasibility of Memory Banking as a tool for aging preparation.	Activity where older people document and share their life story, including mapping out future dreams, aspirations, plans, and decisions.
Costa NP et al.⁵⁰50 Costa NP, Polaro SHI, Vahl EAC, Gonçalves LHT. Contação de história: tecnologia cuidativa na educação permanente para o envelhecimento ativo. Rev. Bras. Enferm. 2016; 69(6):1132-1139.	2016, Belém - Pará, Brazil, primary healthcare	Story telling: a care technology in permanent education for active aging.	To evaluate the relevance and effectiveness of the "story telling" method as an active aging strategy.	Story telling activities aimed at older people.
Inouye et al.⁵¹51 Inouye K, Orlandi FS, Pavarini SCL, Pedrazzani ES. Efeito da Universidade Aberta à Terceira Idade sobre a qualidade de vida do idoso. Educ. Pesqui. 2018; 44:e142931.	2018, São Paulo, Brazil, the Open University of the Third Age.	The effect of the Open University of the Third Age on the quality of life of older people.	To determine the effect of the Open University of the Third Age program on the quality of life of older students.	Interviews with older students at the beginning and end of the academic year to measure the effects of education on quality of life.
Massi et al.⁵²52 Massi G, Wosiacki FT, Guarinello AC, Lacerda ABM, Carvalho TP, Wanderbrooke AC, Cairo NC, Lima RR. Active aging: an intervention-research report. Rev. CEFAC 2018; 20(1):5-12.	2018, Curitiba-Paraná, Brazil, university.	Active aging: an intervention-research report.	To examine the effects of activities such as language activities on autonomy and public participation among older people.	Evaluation of the effects of life story language activities on autonomy and public participation.
Mendes et al.⁵³53 Mendes NP, Costa NP, Campos ACV, Polaro SHI, Gonçalves LHT. Tecnologia socioeducacional de videodebate para o cultivo do envelhecimento ativo. Esc. Anna Nery 2018; 22(3):e20170427.	2018, Belém-Pará, Brazil, primary healthcare.	Socio-educational video debate technology for active aging promotion.	To evaluate the effectiveness of socio-educational video debate technology as a strategy for active aging.	8 video debate workshops with the association of videos with the participants' life stories and habits.
Olympio, Alvim⁵⁴54 Olympio PCAP, Alvim NAT. Board games: gerotechnology in nursing care practice. Rev. Bras. Enferm. 2018; 71(Suppl 2):818-826.	2018, Vitória-Espírito Santo, Brazil, the Open University of the Third Age.	Board games: gerotechnology in nursing care practice.	To develop a board game to be used as a gerotechnology for the promotion of active aging.	Interviews, participant observation, and group discussions, resulting in the development of a board game for older persons.

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[1] Collaborations

EM Souza, DPP Silva and AS Barros participated in all stages of this study. AS Barros also elaborated the flow diagram of the article search and selection process. All the collaborators read and approved the content of the manuscript.