Characteristics of physical activity programs in the
					Brazilian primary health care system

Gomes, Grace Angélica de Oliveira; Kokubun, Eduardo; Mieke, Grégore Iven; Ramos, Luiz Roberto; Pratt, Michael; Parra, Diana C.; Simões, Eduardo; Florindo, Alex A.; Bracco, Mario; Cruz, Danielle; Malta, Deborah; Lobelo, Felipe; Hallal, Pedro C.

doi:10.1590/0102-311X00085713

person Grace Angélica de Oliveira Gomes

schoolDepartamento de Gerontologia, Universidade Federal de São Carlos, São Carlos, Brasil.schoolNúcleo de Atividade Física, Esporte e Saúde, Universidade Estadual Paulista, Rio Claro, Brasil.

person Eduardo Kokubun

schoolNúcleo de Atividade Física, Esporte e Saúde, Universidade Estadual Paulista, Rio Claro, Brasil.

person Grégore Iven Mieke

schoolGrupo de Estudos em Epidemiologia da Atividade Física, Universidade Federal de Pelotas, Pelotas, Brasil.

person Luiz Roberto Ramos

schoolUniversidade Federal de São Paulo, São Paulo, Brasil.

person Michael Pratt

schoolNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, U.S.A.

person Diana C. Parra

schoolGeorge Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, U.S.A.

person Eduardo Simões

schoolGeorge Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, U.S.A.

person Alex A. Florindo

schoolEscola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, Brasil.

person Mario Bracco

schoolHospital Israelita Albert Einstein, São Paulo, Brasil.

person Danielle Cruz

schoolMinistério da Saúde, Brasília, Brasil.

person Deborah Malta

schoolMinistério da Saúde, Brasília, Brasil.

person Felipe Lobelo

schoolNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, U.S.A.schoolRollins School of Public Health, Emory University, Atlanta, U.S.A.

person Pedro C. Hallal

schoolGrupo de Estudos em Epidemiologia da Atividade Física, Universidade Federal de Pelotas, Pelotas, Brasil.

Correspondence: G. A. O. Gomes; Departamento de Gerontologia, Universidade Federal de São Carlos. Rod. Washington Luis Km 235, São Carlos, SP; 13565-905, Brasil.
emailgraceaogomes@yahoo.com.br

Colaboradores

G. A. O. Gomes contributed to the analysis and interpretation of the data, writing of the paper, critical revision of the intellectual content, and final approval of the manuscript to be submitted. E. Kokubun, E. Simões, M. Bracco and D. Cruz contributed to the critical revision of the intellectual content and final approval of the manuscript to be submitted. G. I. Mieke and A. A. Florindo contributed to the analysis and interpretation of the data, critical revision of the intellectual content, and final approval of the manuscript to be submitted. L. R. Ramos conceived the project and contributed to the analysis and interpretation of the data. M. Pratt, D. C. Parra, D. Malta, F. Lobelo and P. C. Hallal conceived the project and contributed to the interpretation of the data, critical revision of the intellectual content, and final approval of the manuscript to be submitted.

Regions	Cities	Cities/ Region (%)	UBS/Region	UBS/ Region (%)	Units interviewed	Response rate (%)
South	229	16.2	250	15.6	227	90.8
Southeast	400	28.2	473	29.6	452	95.5
Central West	113	7.3	110	6.8	81	73.6
Northeast	567	40.0	629	39.3	395	62.7
North	118	8.3	138	8.6	96	69.5
Total	1,417	100.0	1,600	100.0	1,251	78.1

	Physical activity intervention		p-value *
	n	%	p-value *
NASF in the city			< 0.001
No	201	32.8
Yes	212	50.0
Region			< 0.001
Southeast	200	50.6
Northeast	155	34.3
North	17	21.0
South	79	34.8
Central West	44	45.8

Variables	Total		Presence of NASF * in the city *		Absence of NASF in the city *
Variables	n	%	n	%	n	%
Types of physical activity (n = 495/1,762) **
Physical assessment	323	67.1	122	61.9	149	72.3
Walking group	397	81.1	162	80.6	171	81.8
External physical activity (Lia-Gong, Tai chi chuan)	26	13.6	9	11.6	13	15.6
Stretching and relaxation exercises	379	77.3	142	71.0	171	81.4
Gym classes ***	202	41.6	78	39.0	93	44.7
Weight lifting	35	7.2	19	9.5	13	6.2
Touring activities ^#	200	41.3	83	41.5	88	42.5
Communication	117	24.2	42	21.1	50	24.0
Capoeira ^##	18	3.7	6	2.9	6	2.8
Team sports (soccer, volleyball, handball, futsal)	65	13.4	30	14.9	25	12.0
Popular games	90	18.7	37	18.7	39	19.0
Dance	132	27.3	58	29.0	47	23.0
Treadmill cycling	28	5.7	10	5.0	15	7.1
Weekly frequency of physical activity (n = 449) ^###
1/week	149	33.1	63	33.5	64	33.5
2/week	132	29.4	62	32.9	49	25.6
3/week	102	22.7	38	20.2	48	25.1
4/week or more	66	14.7	25	13.2	30	15.7
Average duration of activities (n = 448) ^###
Less than 30 minutes	5	1.1	2	1.0	3	1.4
30 minutes to 1 hour	251	51.4	114	57.5	103	49.2
More than 1 hour	232	48.5	82	41.4	103	49.2
Time of day activities are offered (n = 488) ^###
Morning	429	87.9	176	88.0	183	87.6
Afternoon	251	51.5	107	53.8	106	50.7
Night	24	4.9	11	5.5	11	5.3
Professional who guides physical activity (n = 491) ^###
Physical education professional	240	48.8	88	44.0	115	54.5
Doctor	35	7.1	13	6.5	14	6.6
Nutritionist	17	3.4	8	4.0	5	2.3
Social worker	11	2.2	4	2.0	3	1.4
Physical therapist	87	17.6	35	17.5	39	18.4
Other	75	50.2	104	52.0	96	45.2
Additional activities (n = 490)
No	196	40.0	84	42.0	80	38.1
Yes	294	60.0	116	58.0	130	61.9
Types of additional activities (n = 201)
Lectures/Courses	163	45.5	59	41.2	72	47.6
Play/Games	13	6.2	3	3.4	10	11.2
Walking groups campaigns	18	8.4	10	10.6	6	7.0
Big classes ^§	7	3.4	5	5.6	1	1.2
Activities developed for schools (n = 489)
None	400	81.8	168	85.0	169	80.5
Playground	2	0.5	0	0.0	1	0.5
Classroom	26	5.3	9	4.5	14	6.6
Lectures	31	6.3	9	4.5	14	6.6
Others	30	6.1	12	6.0	12	5.8
Period when activity occurs in school (n = 91)
Weekend	2	2.2	0	0.0	1	2.3
Outside of school hours	45	49.4	11	35.4	26	61.9
Other	12	13.1	20	64.8	15	35.7

Variables	Total *		Presence of NASF in the city *		Absence of NASF in the city
Variables	n	%	n	%	n	%
Area where physical activities are performed
(n = 495/1,291) **
Health unit	272	55.5	106	53.2	121	57.3
Churches, community centers and associations	260	53.1	102	51.2	112	53.3
Plaza/Park	223	45.6	102	38.7	84	37.6
Streets/Sidewalks	214	43.7	93	46.7	95	45.2
Gymnasium	115	23.2	57	28.6	45	21.4
Jogging track	83	16.9	35	17.5	32	15.2
Gym	69	14.1	26	13.1	33	15.7
Pool	36	7.3	17	8.5	15	7.1
Bike paths	19	3.9	11	5.5	5	2.3
Quality of structures (n = 486) *
Majority are good/adequate	249	51.2	106	53.5	102	49.5
Some are adequate, some are not	156	32.1	59	29.8	71	34.4
The majority are bad/inadequate	81	16.7	33	16.6	33	15.7

Variables	Southeast *		Northeast *		North *		South *		Central West *
Variables	n	%	n	%	n	%	n	%	n	%
Types of physical activity and actions offered (n = 495/1,762) **
Walking group	158	80.2	121	79.1	15	88.2	63	79.7	40	93.0
Stretching and relaxation exercises	150	76.1	123	79.9	14	82.4	59	74.7	33	76.7
Physical assessment	135	70.7	106	69.7	11	64.7	49	62.0	22	52.4
Gym classes ***	97	49.7	51	33.8	6	35.3	38	48.1	10	23.3
Touring activities ^#	82	42.1	62	41.1	7	41.2	33	42.3	16	37.2
Dance	44	22.6	47	31.1	8	47.7	23	29.9	10	23.8
Communication	41	21.1	42	27.6	4	23.5	21	27.3	9	20.9
Popular games	34	17.9	36	23.7	4	23.5	11	14.3	5	11.6
Team sports (soccer, volleyball, handball, futsal)	23	11.9	26	17.1	3	17.6	9	11.4	4	9.3
Weight lifting	15	7.8	8	5.3	3	18.8	7	8.9	2	4,7
Alternative physical activity practices	11	17.5	11	16.4	0	0.0	1	2.9	2	10.0
Treadmill cycling	9	4.6	8	5.2	1	5.9	6	7.6	4	9.3
Capoeira ^##	5	2.6	11	7.2	0	0.0	1	1.3	1	2.3
Weekly frequency of physical activity (n = 449) ^###
1/week	47	24.5	54	42.5	4	30.8	29	37.2	15	38.5
2/week	64	33.3	29	22.8	6	46.2	21	26.9	12	30.8
3/week	45	23.4	26	20.5	2	15.4	19	24.4	10	25.6
4/week or more	36	18.8	18	14.2	1	7.7	9	11.5	2	5.1
Average duration of activities (n = 448) ^###
Less than 30 minutes	1	0.5	3	2.0	0	0.0	1	1.3	0	0.0
30 minutes to 1 hour	110	56.4	62	40.5	8	47.1	4	54.4	28	63.6
More than 1 hour	84	43.1	88	57.5	9	52.9	35	44.3	16	36.4
Time of day (n = 488) ^###
Morning	186	93.5	125	85.4	16	94.1	58	74.4	40	93.0
Afternoon	88	44.2	88	58.7	6	35.3	52	66.7	17	39.5
Night	13	6.5	3	2.0	0	0.0	7	9	1	2.3
Profession guiding physical activity (n = 491) ^###
Other	97	48.5	73	47.7	12	70.6	41	51.9	24	55.8
Physical education professional	95	47.5	83	54.2	3	17.6	45	57.7	14	32.6
Physical therapist	44	22.0	11	7.1	5	29.4	15	19.0	12	27.9
Doctor	12	6.0	6	3.9	1	5.9	9	11.5	7	16.3
Nutritionist	8	4.0	4	2.6	0	0.0	4	5.1	1	2.3
Social worker	3	1.5	4	2.6	0	0.0	3	3.8	1	2.3
Additional activities (n = 490)
No	78	39.4	57	37.3	7	41.2	30	38.0	24	55.8
Yes	120	60.6	96	62.7	10	58.8	49	62.0	19,0	44.2
Types of additional activities (n = 201)
Lectures/Courses	59	43.1	60	51.7	7	50.0	28	48.3	9	27.3
Walking groups	6	7.1	6	9.7	0	0.0	0	0.0	0	0.0
Play and games	4	4.9	7	11.7	0	0.0	2	6.3	0	0.0
Large classes ^§	3	3.7	3	5.1	0	0.0	0	0.0	1	4.0
Activities developed for schools (n = 489)
None	70	85.4	51	83.6	4	80.0	12	75.0	15	71.4
Classroom	5	6.1	4	6.6	0	0.0	1	6.3	2	9.5
Lectures	4	4.9	3	4.5	0	0.0	1	6.3	2	9.5
Others	3	3.7	3	4.5	1	20.0	2	12.5	2	9.5
Playground	0	0.0	0	0.0	0	0.0	0	0.0	0	0.0
Period when activity occurs in school (n = 91)
Outside of school hours	6	50.0	6	54.5	1	100	3	75.0	3	50.0
Other	5	41.7	5	45.5	0	0.0	1	25.0	3	50.0
Weekend	1	8.3	0	0.0	0	0.0	0	0.0	0	0.0

Variables	Southeast		Northeast		North		South		Central West
Variables	n	%	n	%	n	%	n	%	n	%
Area where physical activities are performed (n = 495/474) *
Health unit	41	50.0	28	45.2	2	40.0	7	41.2	8	40.0
Plaza/Park	39	47.6	28	38.7	1	20.0	7	41.2	13	65.0
Churches, community centers and associations	40	48.8	27	43.5	2	40.0	11	64.7	12	60.0
Streets/Sidewalks	27	32.9	27	43.5	4	80.0	5	29.4	13	65.0
Pool	7	8.5	7	11.3	1	20.0	0	0.0	1	5.0
Bike paths	5	6.1	5	8.1	0	0.0	0	0.0	1	5.0
Gym	10	12.2	9	14.5	1	20.0	2	11.8	2	10.0
Walking track	10	12.2	14	22.6	3	60.0	3	17.6	5	25.0
Gymnasium	23	28.0	13	21.0	1	20.0	3	17.6	6	30.0
Quality of structures (n = 483) **
Majority are good/adequate	94	47.7	76	51.3	9	52.9	47	59.4	21	50
Some are adequate, some are not	67	34.1	47	31.7	5	29.4	20	25.3	16	38.1
The majority are bad/inadequate	36	18.2	25	16.8	3	17.6	12	15.1	5	11.9

[TFN01] ^*
Chi-square test.

Characteristics of physical activity programs in the Brazilian primary health care system

Características de programas de atividade física na atenção básica de saúde do Brasil

Características de los programas de actividad física en la atención primaria de salud en Brasil

Abstracts