WHAT ARE THE STUDY GOALS?
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Build cross-national relationships - Establish and build cross-national, collaborative relationships with researchers, practitioners, and institutions in Brazil and Latin America to enhance capacity and determine evidence-based interventions that promote physical activity. To accomplish this aim we will continue to: establish an advisory board team to provide ongoing guidance on the project; identify new partners for the project including other prevention research centers and universities from Brazil and Latin America; develop formal relationships with scientists and practitioners in Latin America; conduct faculty and student exchanges between PRC-StL and partner institutions in Latin America; develop and submit grant applications that involve researchers from PRC-StL and partners in Latin America.
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Assess current evidence - Update the systematic review of the peer-reviewed and fugitive literature on community-based strategies, conducted in the first funding period of Project GUIA, with a significant focus on external validity. To accomplish this aim we will: refine the systematic review methods from the prior review; update the earlier review based on new literature; expand the scope of the review by conducting an assessment of external validity; and summarize information from the review process.
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Understand gaps and areas of priority - Gather additional practice-based evidence to understand gaps and areas of priority in evidence-based physical activity interventions in Brazil. To accomplish this aim we will: conduct a concept mapping with public health practitioners, including those funded by the Ministry of Health; carry out a survey of primary care practitioners in Brazil to understand knowledge and skills as well as the importance they place on counseling of physical activity; and synthesize the data from concept mapping and the primary care survey in order to refine intervention and interaction approaches with public health practitioners and primary care personnel.
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Evaluate projects - Evaluate two community-based demonstration projects based on the information gathered from the systematic review, primary care survey and concept mapping. To accomplish this aim we have evaluated two physical activity interventions programs from Brazil, the Academia da Cidade and CuritibAtiva programs. In addition we will develop criteria for comprehensive evaluations of two additional interventions to fill the gaps in the literature. We will include a strong focus on environmental and policy approaches;
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Disseminate the information - Disseminate the products from Project GUIA to communities, institutions, and public health professionals in Brazil and globally. To accomplish this aim we will develop policy/issue briefs for effective interventions; develop a training manual for early-career investigators based on GUIA methods; evaluate the cross-national collaborative process through the use of methods like Social Network Analysis; develop an e learning platform to disseminate GUIA methods and jointly publish and present results of our collaborations.
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WHAT ARE THE MAIN FINDINGS?
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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. This systematic review highlights the need for rigorous evaluation and documentation of existing and promising interventions to increase physical activity in Latin America.
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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 populations. 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.
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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.
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Strong correlations between awareness and 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.
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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. In the graph each node represents one organization. Blue nodes represent nominations of leadership. The white had no or very few leadership nominations, the light blue had a moderate number of leadership nominations, and the dark blue had a high number of leadership nominations. 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.
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OUR PARTNERS
LINKS OF INTEREST
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