Associated factors with physical activity counseling among Brazilian Family Health Strategy workers

Souza Neto, João Miguel de; Florindo, Alex Antônio; Costa, Filipe Ferreira da

doi:10.1590/1413-81232020261.10082019

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FREE THEMES • Ciênc. Saúde Colet. 26 (01) • Jan 2021 • https://doi.org/10.1590/1413-81232020261.10082019 copy

Associated factors with physical activity counseling among Brazilian Family Health Strategy workers

Fatores associados ao aconselhamento em atividade física entre trabalhadores da Estratégia Brasileira de Saúde da Família

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study aimed to determine the prevalence and associated factors with physical activity counseling among Brazilian Family Health Strategy workers. This is a cross-sectional study conducted with a random sample of 591 health workers who work in the Family Health Teams of João Pessoa-PB, Brazil. Counseling for physical activity was defined as any advising targeted for increasing patients’ physical activity levels conducted for at least six months. The following factors were considered: time working in health care units, amount of daily attendance, continuing education, perceived barriers, self-efficacy, attitude, self-rated health, physical activity level and nutritional status. Prevalence of counseling was 46.3%, being higher among physicians (74.5%; 95%CI: 59.6-85.2) and nurses (60.3%; 95%CI: 48.0-71.4) compared to community health workers (42.9%; 95%CI: 38.2-47.7) and nurses assistants (31.5%; 95%CI: 20.2-45.4). The results showed health professionals with positive self-rated health, without perception of barriers, having a positive attitude and high self-efficacy were more likely to perform physical activity counseling. Knowledge and actions on factors associated with physical activity counseling can help broaden the involvement of primary health care providers in health education.

Key words:
Health personnel; Preventive counseling; Primary Health Care; Motor Activity

Psychosocial factors and barriers	n° of items	Score	Kappa	Questions	Scale
Self-efficacy	8	8 - 16	0,45 (0,18 - 0,63)	I would be able to conduct physical activity counseling for users of the Basic Health Unit even if ... [had no one to teach how to do, I had lack of knowledge, I did not know places to practice physical activity, I had no instructional material...]	Dichotomous scale (yes/no)
Attitude	5	5 - 20	0,62 (0,53 - 0,76)	For you, conduct physical activity counseling for (children/adolescents, adults, elderly, people with noncommunicable diseases) is....	4-point Likert scale, ranging from unimportant = 1 to very important = 4
Perceived barriers	8	_	0,66 (0,62 - 0,83)	What are the difficulties for you to counsel users for physical activity? Response options: lack of time due to work demand; lack of knowledge about the subject; lack of professionals to guide how to do counseling; lack of instructional material; lack of financial resources of users; I do not perceive any difficulty; blank space for adding other barriers.	Dichotomous scale (yes/no)

Characteristic	General practitioner		Nurse		Nurse assistant		CHW*		All
Variables	n	%	n	%	n	%	n	%	n	%
Gender
Male	29	61.7	65	97.0	53	100.00	311	74.8	459	78.6
Female	18	38.3	2	3.0	-	-	105	25.2	125	21.4
Age (year)
20-29	17	37.8	3	4.5	1	1.9	10	2.4	31	5.3
30-39	9	20.0	21	31.8	18	33.3	174	42.0	222	38.2
40-49	2	4.4	17	25.8	20	37.0	140	33.7	179	30.8
≥50	17	37.8	25	37.9	15	27.8	91	21.9	149	25.7
Schooling
Middle school	-	-	-	-	-	-	216	51.5	216	36.6
Technician	-	-	-	-	44	80.0	76	18.1	121	20.5
Undergraduate	25	53.2	16	23.2	7	12.7	97	23.2	145	24.5
Graduate degree	22	46.8	53	76.8	4	7.3	30	7.2	109	18.4
Income (multiple of minimum wages ≈ 275 US dollars)
1 to 2	-	-	-	-	55	100	416	100	472	80.3
3 to 4	6	12.8	65	94.2	-	-	-	-	71	12.1
≥5	41	87.2	4	5.8	-	-	-	-	45	7.6
Time working at FHS** (years)
<5	31	65.9	13	18.8	12	21.8	31	7.5	87	14.9
≥5	16	34.4	56	81.2	43	78.2	381	92.5	496	85.1
Daily number of patients consultations
3rd tertile	14	29.8	20	29	18	32.7	82	19.6	135	22.8
1st/2nd tertile	33	70.2	49	71	37	67.3	337	80.4	456	77.2
Self-rated health
Negative	45	95.7	64	92.8	46	85.2	378	90.4	533	90.5
Positive	2	4.3	5	7.2	8	14.8	40	9.6	56	9.5
Nutritional status
Overweight	27	57.5	37	55.2	38	69.1	266	63.4	368	62.7
Normal	20	42.5	30	44.8	17	30.9	152	36.4	219	37.3
Physical activity level
Inactive	29	61.7	24	34.8	8	14.6	270	64.4	210	35.6
Active	18	38.3	45	65.2	47	85.4	149	35.6	380	64.4
Participation in physical activity courses
No	39	84.8	55	80.8	44	83.0	374	91.4	512	88.9
Yes	7	15.2	13	19.2	9	17.0	35	8.6	64	11,1
Support from multiprofessional teams
No	33	70.2	35	50.7	33	62.3	257	62.1	358	61.4
Yes	14	29.8	34	49.3	20	37.7	157	37.9	225	38.6
Perceived barriers for counseling
Yes	31	6.0	40	58.0	41	74.5	333	79.5	445	75.4
No	16	34.0	29	29.0	14	25.5	86	29.5	145	24.6
Self-efficacy for counseling
Lower	29	65.9	39	58.2	38	73.1	306	79.1	378	68.9
Higher	16	34.1	28	41.8	14	26.9	81	20.9	171	31.1
Attitude for counseling
Lower	31	66.0	38	56.7	38	74.5	327	79.2	322	57.4
Higher	16	34.0	29	43.3	13	24.5	86	20.2	246	42.6

Characteristic	Physical activity counseling
	%	Crude		Adjusted*
	%	OR	95%CI	OR	95%CI
Time working at FHS (years)
≥5	44.3	1		1
<5	58.6	1.78	(1.12-2.82)	1.21	(0.67-2.18)
Daily number of patients consultations
3rd tertile	38.0	1		1
1st/2nd tertile	48.8	1.55	(1.04-2.29)	1.44	(0.91-2.27)
Self-rated health
Negative	33.5	1		1
Positive	53.1	2.24	(1.57-3.20)	2.02	(1.33-3.08)
Nutritional status
Overweight	42.9	1		1
Normal	52.1	1.44	(1.03-2.02)	0.85	(0.57-1.27)
Physical activity level
Inactive	41.2	1		1
Active	55.5	1.77	(1.26-2.49)	0.72	(0.48-1.08)
Participation in physical activity courses
No	46.2	1		-
Yes	49.2	1.12	(0.65-1.27)	-	-
Support from multiprofessional teams
No	47.6	1		-
Yes	45.3	0.91	(0.65-1.27)	-	-
Perceived barriers for counseling
Yes	38.8	1
No	69.4	3.65	(2.42-5.51)	3.49	(2.17-5.62)
Self-efficacy for counseling
Lower	41.1	1		1
Higher	57.8	1.96	(1.36-2.84)	1.79	(1.18-2.68)
Attitude for counseling
Lower	38.7	1	1	1	1
Higher	58.3	2.21	(1.57-3.09)	1.69	(1.11-2.45)

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E-mail: cienciasaudecoletiva@fiocruz.br

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[1] Collaborations

JM Souza Neto worked on the design, development of the study and writing of the manuscript. AA Florindo participated in the conception and final revision of the manuscript. FF Costa worked on designing, developing the study and writing the manuscript.