Systematic Review

We are documenting physical activity interventions that work and how can they be implemented in other settings. We developed a new framework for classifying interventions as effective, promising, or emerging. For more information click here. Below are our main findings related to our systematic reviews.

Need for Rigorous Evaluations of PA Interventions

More than 3,500 articles were reviewed in the first systematic review of project GUIA. The literature search identified 903 peer-reviewed articles and 142 Brazilian theses related to physical activity, of which only 19 studies meet the Community Guide standards to be selected for a full abstraction process. A recent systematic review of literature was conducted. The search yielded over 2,500 articles published between 2006 and 2010, of which 35 were physical activity interventions. 13 articles met inclusion criteria and were systematically abstracted for internal and external validity. A new intervention classification based on evidence about effectiveness was developed. Seven interventions were classified as effective, promising, or emerging. Similarly, interventions were rated based on reporting of external validity components and their effectiveness in other contexts regarding population reach, adoption and implementation characteristics, and institutionalization. These systematic reviews highlight the need for rigorous evaluation and documentation of existing and promising interventions to increase physical activity in Latin America, as well as increasing reporting of external validity elements.

Recommend School-Based Physical Education

School physical education (PE) was the only intervention that met criteria for strongly recommended based on five positive studies in Latin American population. The core elements of these five interventions included capacity building and staff training (PE specialists and/or classroom teachers); changes in the PE curricula; provision of equipment and materials; and adjustment of the interventions to specific target populations. Implementation and maintenance of school physical education programs and policies should be strongly encouraged to promote the health of Latin America children.According to the last systematic review of project GUIA no additional interventions could be recommended for practice by using U.S. Community Guide criteria.

New Categories of PA Interventions Identified

Three new intervention categories were identified during the systematic review of project GUIA:

  • Delivery of short physical activity-related messages: These interventions involve short physical activity-related educational and motivational messages (about 5 minutes) delivered to a specific population on a routine basis. Settings for this intervention included worksites, senior centers, or community centers.
  • Physical activity classes in community settings: Regular, structured exercise group classes that involve some educational component. They may be implemented in worksites and community centers.
  • Community-wide policy and planning: Involve community-wide efforts to promote physical activity (all forms) through policy agendas, guidelines, incentives, policies that reduce environmental or institutional barriers to physical activity, and media campaigns.

Concept Mapping & Physical Activity Policies

A brainstorming process was used to develop a research agenda and highlight the changes that are likely to promote and increase physical activity. “Effectiveness & Innovation in Physical Activity Interventions” and “Evaluation & impact of Physical Activity policies were rated the most important strategies among public health practitioners and researchers in Brazil. Furthermore, qualitative approaches, observation techniques and quasi-experimental or longitudinal designs were suggested as methods and tools for moving the agenda forward. The results may contribute to improving interventions to promote PA in Brazil and other countries in Latin America.

Strong Correlations Between Awareness & Participation

Based on the results from the systematic review, the project identified two community-based physical activity promotion strategies in Brazil to be evaluated. The first evaluation involved the Academia da Cidade program (ADC), an ongoing community-based program designed to promote leisure-time physical activity in the city of Recife, in northeastern Brazil. A second program (CuritibAtiva, which translates to “active Curitiba”) located in the city of Curitiba in southern Brazil was also evaluated. Results from the comprehensive evaluation of the programs indicate that exposure to the programs increases the likelihood to meet recommended levels of physical activity during leisure time.

Leadership of GUIA Organizations

GUIA organizations had twice as many connections on average and were eight times as likely to provide a connection between two organizations not otherwise connected. They also had three times as many leadership nominations. These findings show that the organizations involved with Project GUIA in Brazil are in a perfect position to disseminate information throughout the network. All of the GUIA organizations had at least a moderate number of leadership nominations and three GUIA organizations (i.e., CELAFISCS, the Brazil Ministry of Health, CDC) had the highest numbers of leadership nominations.

Primary Health Care & Physical Activity

We evaluated knowledge, behaviors and attitudes related to physical activity counseling among primary health care professionals in Brazil through a Nationwide survey. Our goal was to understand if physical activity is included within the health promotion agenda of primary health care settings and professionals in Brazil.

We are currently producing five different publications related to our results. One of the publications has already been published in the BMC Public Health Journal. The PDF can be downloaded here.

For more information read our papers on this topic: