Active and healthy lifestyle in Brazilian Primary Health Care user’s: A pragmatic clinical trial about "VAMOS" behavior change program
DOI:
https://doi.org/10.33448/rsd-v10i13.20382Keywords:
Public health; Health promotion; Lifestyle; Motor activity; Diet healthy.Abstract
This study aimed to investigate the effectiveness and maintenance of the behavior change program "VAMOS", version 2.0, on behavioral and health outcomes in Brazilian users (≥ 18 years) of Primary Health Care (PHC) in Florianópolis, state of Santa Catarina, southern Brazil. A pragmatic clinical trial was carried out between 2016 and 2019 in Basic Health Units, with 265 users allocated in the intervention group (n = 125) and the control group (n = 140). The intervention group participated for three months in the VAMOS to promote physical activity (PA) and a healthy diet. The control group received in a single meeting counseling about the importance of an active and healthy lifestyle. Variables of PA (daily minutes in light PA, moderate-to-vigorous PA, total PA, and sedentary behavior), eating behavior (weekly consumption of fruits, vegetables, and soda drinks), anthropometry (body mass, waist circumference (WC), and body mass index), and quality of life (QOL) (positive or negative perception), were evaluated, through interviews and objective measures, in the pre-intervention, post-intervention, and 12 months after the end of the intervention. The intervention group increased moderate-to-vigorous PA bouts, consumed of vegetables and, QOL, and decreased the consumption of soda drinks and WC (p<0.05). The intervention was sufficient to maintain the achieved benefits of moderate-to-vigorous PA bouts, soda drink consumption, and WC. VAMOS effectively promote an active and healthy lifestyle in PHC users and, its strategies proved to be adequate to maintain the gains acquired. VAMOS is a pioneer and a health innovation.
References
Ajzen, I., & Madden, T. J. (1986). Prediction of goal-directed behavior: attitudes, intentions, and perceived behavioral control. Journal of Experimental Social Psychology, 22(5), 453-474. doi:10.1016/0022-1031(86)90045-4
Almeida, F. A., Brito, F. A., & Estabrooks, P. A. (2013). RE-AIM framework: translation and cultural adaptation to Brazil. Revista Família Ciclos de Vida e Saúde no Contexto Social, 1(1), 6-16. doi:10.18554/refacs.v1i1.602
Almeida, F. A., You, W., Harden, S. M., Blackman, K. C. A., Davy, B. M., Glasgow, R. E., Hill, J. L., Linnan, L. A., Wall, S. S., Yenerall, J., Zoellner, J. M., & Estabrooks, P. A. (2015). Effectiveness of a worksite-based weight loss randomized controlled trial: the worksite study. Obesity, 23(4), 737-745. doi:10.1002/oby.20899
Andrade, K. A., Toledo, M. T. T., Lopes, M. S., Carmo, G. E. S., & Lopes, A. C. S. (2012). Counseling regarding healthy lifestyles in Primary Healthcare and the dietary practices of clients. Revista da Escola de Enfermagem da USP, 46(5), 1117-1124. doi:10.1590/S0080-62342012000500012
Bandura, A. (2004). Health promotion by social cognitive means. Health Education & Behavior, 31(2), 143-164. doi:10.1177/1090198104263660
Becker, L. A., Gonçalves, P. B., & Reis, R. S. (2016). Primary health care programs for physical activity promotion in the Brazil: a systematic review. Revista Brasileira de Atividade Física & Saúde, 21(2), 110-122. doi:10.12820/rbafs.v.21n2p110-122
Benedetti, T. R. B., Manta, S. W., Gomez, L. S. R., & Rech, C. R. (2017). Logical model of a behavior change program for community intervention – Active Life Improving Health – VAMOS. Revista Brasileira de Atividade Física & Saúde, 22(3), 309-313. doi:10.12820/rbafs.v.22n3p309-313
Benedetti, T. R. B., Rech, C. R., Konrad, L. M., Almeida, F. A., Brito, F. A., Chodzko-Zajko, W., & Schwingel, A. (2020). Re-thinking physical activity programs for older Brazilians and the role of public health centers: a randomized controlled trial using the RE-AIM model. Frontiers in Public Health, 8(48), 1-11. doi:10.3389/fpubh.2020.00048
Benedetti, T. R. B., Schwingel, A., Gomez, L. S. R., & Chodzko-Zajko, W. (2012). Programa “VAMOS” (Vida Ativa Melhorando a Saúde): da concepção aos primeiros resultados. Revista Brasileira de Cineantropometria e Desempenho Humano, 14(6), 723-737. doi: 10.1590/1980-0037.2012v14n6p723
Benedetti, T. R. B., Tomicki, C., & Konrad, L. M. (2019). VAMOS program-technological innovation for behavior change for older adults in the Brazilian Unified Health System. Gerontology & Geriatrics Studies, 5(4), 527-528. doi:10.31031/GGS.2019.05.000616
Brazil. (2014). Food guide for the Brazilian population. Brasília, Brazil: Ministry of Health.
Brazil. (2021a). Physical activity guide for the Brazilian population. Brasília, Brazil: Ministry of Health.
Brazil. (2021b). Surveillance of risk factors for chronic non-communicable diseases. Ministry of Health. Retrieved Mar 24, 2021, from https://www.gov.br/saude/pt-br/assuntos/saude-de-a-a-z-1/v/vigitel, 2021
Brazil. (2020). Vigitel Brazil 2019: Surveillance of risk and protective factors for chronic diseases by telephone survey: Estimates on the frequency and sociodemographic distribution of risk and protective factors for chronic diseases in the capitals of the 26 Brazilian states and the Federal District in 2019. Brasília, Brazil: Ministry of Health.
Carlin, A., Perchoux, C., Puggina, A., Aleksovska, K., Buck, C., Burns, C., Cardon, G., Chantal. S., Ciarapica, D., Condello, G., Coppinger, T., Cortis, C., D'Haese, S., De Craemer, M., Di Blasio, A., Hansen, S., Iacoviello, L., Issartel, J., Izzicupo, P., … Boccia, S. (2017). A life course examination of the physical environmental determinants of physical activity behaviour: a “Determinants of Diet and Physical Activity” (DEDIPAC) umbrella systematic literature review. PLoS One, 12(8), e0182083. doi:10.1371/journal.pone.0182083
Carvalho, M. C. R., Menezes, M. C., Toral, N., & Lopes, A. C. S. (2021). Effect of a Transtheoretical Model-based intervention on fruit and vegetable intake according to perception of intake adequacy: a randomized controlled community trial. Appetite,161(105159). doi:10.1016/j.appet.2021.105159
Carvalho, M. C. R., Menezes, M. C., Toral, N., & Lopes, A. C. S. (2020). Does misperception of fruit and vegetable intake adequacy affect progression through the stages of behavior change after nutritional intervention? Appetite,151(104682). doi:10.1016/j.appet.2020.104682
Chastin, S. F. M., De Craemer, M., De Cocker, K., Powell, L., Cauwenberg J. V., Dall, P., Hamer, M., & Stamatakis, E. (2019). How does light-intensity physical activity associate with adult cardiometabolic health and mortality? systematic review with meta-analysis of experimental and observational studies. British Journal of Sports Medicine, 53(6), 370–376. doi:10.1136/bjsports-2017-097563
Chen, C., Jerome, G. J., LaFerriere, D., Young, D. R., & Vollmer, W. M. (2009). Procedures used to standardize data collected by RT3 triaxial accelerometers in a large-scale weight-loss. Journal of Physical Activity and Health, 6(3), 354-359. doi:10.1123/jpah.6.3.354
Choi, L., Liu, Z., Matthews, C. E., & Buchowski, M. S. (2011). Validation of accelerometer wear and nonwear time classification algorithm. Medicine & Science in Sports & Exercise, 43(2), 357-364. doi:10.1249/MSS.0b013e3181ed61a3
Claro, R. M., Maia, E. G., Costa, B. V. L., & Diniz, D. P. (2016). Food prices in Brazil: prefer cooking to ultra-processed foods. Cadernos de Saúde Pública, 32(8), 1-13. doi:10.1590/0102-311X00104715
Cohen, J. (1988). Statistical power analysis for behavioral sciences. Hillsdale, United States: Lawrence Erlbaum Associates.
Corrêa, E. N., Padez, C. M. P., Abreu, Â. H., & Vasconcelos, F. A. G. (2017). Geographic and socioeconomic distribution of food vendors: a case study of a municipality in the Southern Brazil. Cadernos de Saúde Pública, 33(2), 1-14. doi:10.1590/0102-311x00145015
Dumith, S. C., Domingues, M. R., & Gigante, D. P. (2009). Epidemiology of leisure-time physical activities among adults from Southern Brazil. Revista Brasileira de Epidemiologia, 12(4), 646-656. doi:10.1590/S1415-790X2009000400014
Ferreira, N. L., Mingoti, S. A., Jaime, P. C., & Lopes, A. C. S. (2014). Effectiveness of nutritional intervention in overweight women in Primary Health Care. Revista de Nutrição, 27(6), 677-687. doi:10.1590/1415-52732014000600003
Fjeldsoe, B., Neuhaus, M., Winkler, E., & Eakin, E. (2011). Systematic review of maintenance of behavior change following physical activity and dietary interventions. Health Psychology, 30(1), 99-109. doi:10.1037/a0021974
Fleck, M. P. A., Louzada, S., Xavier, M., Chachamovich, E., Vieira, G., Santos, L., & Pinzon, V. (2000). Application of the Portuguese version of the abbreviated instrument of quality life WHOQOL-bref. Revista de Saúde Pública, 34(2), 178-183. doi:10.1590/s0034-89102000000200012
Freedson, P. S., Melanson, E., & Sirard, J. (1998). Calibration of the computer science and applications, inc. accelerometer. Medicine & Science in Sports & Exercise, 30(5), 777-781. doi:10.1097/00005768-199805000-00021
Gerage, A. M., Benedetti, T. R. B., Cavalcante, B. R., Farah, B. Q., & Ritti-Dias, R. M. (2020). Efficacy of a behavior change program on cardiovascular parameters in patients with hypertension: a randomized controlled trial. Einstein (São Paulo), 18, 1-8. doi:10.31744/einstein_journal/2020ao5227
Gerage, A. M., Benedetti, T. R. B., Ritti-Dias, R. M., Santos, A. C. O., Souza, B. C. C., & Almeida, F. A. (2017). Effectiveness of a behavior change program on physical activity and eating habits in patients with hypertension: a randomized controlled trial. Journal of Physical Activity and Health, 14(12), 943-952. doi:10.1123/jpah.2016-0268
José, H. P. M., Konrad, L. M., Ribeiro, C. G., & Benedetti, T. R. B. (2019). Validation of e-learning training for multipliers of the Active Life Improving Health (VAMOS) Program. Journal of Physical Education, 30(1), 1-11. doi:10.4025/jphyseduc.v39i1.3040
Manta, S. W., Lopes, A. A. S., Hino, A. A. F., Benedetti, T. R. B., & Rech, C. R. (2018). Open public spaces and physical activity facilities: study of systematic observation of the environment. Revista Brasileira de Cineantropometria e Desempenho, 20(5), 445-455. doi:10.5007/1980-0037.2018v20n5p445
Marques, R. J. R., Rezende-Alves, K., Soares, C. S., Magalhães, K. A., Morelli, L. F., Lopes, A. C. S. (2020). Análise do trabalho em equipe multiprofissional para ações de alimentação e nutrição na atenção básica. Trabalho, Educação e Saúde, 18(1):e0024172, 1-17. doi:10.1590/1981-7746-sol00241
Mason-D’Croz, Bogard, J. R., Sulser, T. B., Cenacchi, N., Dunston, S., Herrero, M., & Wiebe, K. (2019). Gaps between fruit and vegetable production, demand, and recommended consumption at global and national levels: an integrated modelling study. Lancet Planet Health, 3(7), e318–e329. doi:10.1016/S2542-5196(19)30095-6
Matsudo, S., Araújo, T., Matsudo, V., Andrade, D., Andrade, E., Oliveira, L. C., & Braggion, G. (2001). International Physical Activity Questionnaire (lPAQ): study of validity and reliability in Brazil. Revista Brasileira de Atividade Física & Saúde, 6(2), 5-18. doi:10.12820/rbafs.v.6n2p5-18
Menezes, M. C., Bedeschi, L. B., Santos, L. C. D., & Lopes, A. C. S. (2016). Interventions directed at eating habits and physical activity using the Transtheoretical Model: a systematic review. Nutricion Hospitalaria, 33(5), 1194-1204. doi:10.20960/nh.586
Menezes, M. C., Duarte, C. K., Costa D. V. P., Lopes, M. S., Freitas, P. P., Campos, S. F., & Lopes, A. C. S. (2020). A systematic review of effects, potentialities, and limitations of nutritional interventions aimed at managing obesity in primary and secondary health care. Nutrition, 75-76(110784). doi:10.1016/j.nut.2020.110784
Mendonca, R. D., & Lopes, A. C. S. (2012). The effects of health interventions on dietary habits, and physical measurements. Revista da Escola de Enfermagem da USP, 46(3), 573–579. doi: 10.1590/S0080-62342012000300007
Meurer, S. T., Borges, L. J., Gerage, A. M., Lopes, A. C. S., & Benedetti, T.R.B. (2020). Promotion of physical activities and healthy eating habits in Primary Care: maintenance of benefits. Revista de Nutrição, 33, e190120. doi:10.1590/1678-9865202033e190120
Meurer, S. T., Lopes, A. C. S., Almeida, F. A., Mendonça, R. D., & Benedetti, T. R. B. (2019). Effectiveness of the VAMOS strategy for increasing physical activity and healthy dietary habits: a randomized controlled community trial. Health Education & Behavior, 46(3), 406-416. doi:10.1177/1090198118820095
Nahas, M. V. (2017). Physical activity, health and quality of life: Concepts and suggestions for an active lifestyle. Florianópolis, Brazil: Editora do Autor.
National Institutes of Health. (2013). Managing overweight and obesity in adults: Systematic evidence review from the obesity expert panel, 2013. Washington, United States: Department of Health and Human Services.
Passos, C. M., Maia, E. G., Levy, R. B., Martins, A. P. B., & Claro, R. M. (2020). Association between the price of ultra-processed foods and obesity in Brazil. Nutrition, Metabolism & Cardiovascular Diseases, 30(4), 589-598. doi:10.1016/j.numecd.2019.12.011
Quadros, E. N., Maciel, E. C., Konrad, L. M., Ribeiro, C. G., Lopes, A. C. S., Meurer, S. T., & Benedetti, T. R. B. (2020). Evaluating the effectiveness of Program VAMOS in the context of Program Academy of Health: a qualitative study. Movimento, 26(e26023), 1-15. doi:10.22456/1982-8918.94432
Ramos, L. R, Malta, D. C., Gomes, G. A. O., Bracco, M. M., Florindo, A. A., Mielke, G. I., Parra, D. C., Lobelo, F., Simoes, E. J., & Hallal, P. C. (2014). Prevalence of health promotion programs in primary health care units in Brazil. Revista de Saúde Pública, 48(5), 837-844. doi:10.1590/S0034-8910.2014048005249
Sá, G. B. A. R., Dornelles, G. C., Cruz, K. G., Amorim, R. C. A., Andrade, S. S. C. A., Oliveira, T. P., Silva, M. M. A., Malta, D. C., & Souza, M. F. M. (2016). The Health Academy Program as a strategy to promote health and healthy lifestyles: the national implementation scenario. Ciência & Saúde Coletiva, 21(6), 1849-1859. doi:10.1590/1413-81232015216.09562016
Saldiva, P. (2018). Vida urbana e saúde: os desafios dos habitantes das metrópoles. São Paulo, Brasil: Contexto.
Samdal, G. B., Eide, G. E., Barth, T., Williams, G., & Meland, E. (2017). Effective behaviour change techniques for physical activity and healthy eating in overweight and obese adults; systematic review and meta-regression analyses. International Journal of Behavioral Nutrition and Physical Activity, 14, 42. doi:10.1186/s12966-017-0494-y
Sasaki, J. E., John, D., & Freedson, P. S. (2011). Validation and comparison of ActiGraph activity monitors. Journal of Science and Medicine in Sport, 14(5), 411-416. doi:10.1016/j.jsams.2011.04.003
Sasaki, J. E., Silva, K. S., & Da Costa, B. G. G. (2018). Using an accelerometer to measure physical activity and sedentary behavior: What do we need to know? Londrina, Brazil: Midiograf.
Soeiro, R. L., Valente, G. S. C., Cortez, E. A., Mesquita, L. M., Xavier, S. C. M., & Lobo, B. M. I. S. (2019). Group health education in the treatment of obese class III: a challenge for health professionals. Revista Brasileira de Educação Médica, 43(1), 681-691. doi:10.1590/1981-5271v43suplemento1-20190005
Souza, P. V., Tomicki, C., Konrad, L. M., Sandreschi, P. F., Ribeiro, C. G., Maciel, E. C., Rech, C. R., & Benedetti, T. R. B. (2020). Effectiveness of an intervention in promoting the lifestyle of public servants. Revista Brasileira de Atividade Física & Saúde, 25(e0135), 1-9. doi:10.12820/rbafs.25e0135
Thompson, S. M., & Kent, J. L. (2017). Human health and a sustainable built environment. In: Abraham, M. Encyclopedia of sustainable technologies (pp. 71-80). Amsterdam, The Netherlands: Elsevier.
Tomicki, C., Rech, C. R., Konrad, L. M., Maciel, E. C., Almeida, F. A., & Benedetti, T. R. B. (2021). Promoting healthy lifestyles in Brazil: design and method of "VAMOS Program" in Public Health System. Revista Brasileira de Atividade Física & Saúde, 26(e0182), 1-5. doi:10.12820/rbafs.26e0182
Turner, C., Kalamatianou, S., Drewnowski, A., Kulkarni, B., Kinra, S., & Kadiyala, S. (2020). Food environment research in low- and middle-income countries: a systematic scoping review. Advances in Nutrition, 11(2), 387–397. doi:10.1093/advances/nmz031
World Health Organization. (2020). Guidelines on physical activity and sedentary behaviour. Geneva, Switzerland: World Health Organization.
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Copyright (c) 2021 Camila Tomicki; Cassiano Ricardo Rech; Aline Mendes Gerage; Elizabeth Nappi Corrêa; Lisandra Maria Konrad; Tânia Rosane Bertoldo Benedetti
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