Estilo de vida activo y saludable en usuarios brasileños de Atención Primaria de Salud: Un ensayo clínico pragmático sobre el programa de cambio de comportamiento “VAMOS”

Autores/as

DOI:

https://doi.org/10.33448/rsd-v10i13.20382

Palabras clave:

Salud pública; Promoción de la salud; Estilo de vida; Actividad motora; Dieta saludable.

Resumen

Este estudio tuvo como objetivo investigar la efectividad y el mantenimiento del programa de cambio de comportamiento "VAMOS", versión 2.0, sobre los resultados conductuales y de salud en usuarios brasileños (≥ 18 años) de Atención Primaria de Salud (APS) en Florianópolis, estado de Santa Catarina, sur Brasil. Se realizó un ensayo clínico pragmático entre 2016 y 2019 en Unidades Básicas de Salud con 265 usuarios asignados en el grupo de intervención (n = 125) y en el grupo de control (n = 140). El grupo de intervención participó durante tres meses en VAMOS con el objetivo de promover la actividad física (AF) y la alimentación saludable. El grupo de control recibió, en un único encuentro, asesoramiento sobre la importancia de un estilo de vida activo y saludable. Se evaluaron las variables de AF (minutos diarios en AF leve, AF moderada y vigorosa, AF total y comportamiento sedentario), conducta alimentaria (consumo semanal de frutas, verduras y refrescos), antropometría (masa corporal, circunferencia de la cintura (CC) e índice de masa corporal) y calidad de vida (CV) (percepción positiva o negativa), a través de entrevistas y medidas objetivas, en el preintervención, posintervención y 12 meses después del final de la intervención. El grupo de intervención aumentó los episodios de AF moderada y vigorosa, el consumo de verduras y la CV, y disminuyó el consumo de refrescos y la CC. La intervención fue suficiente para mantener los beneficios logrados con relación a los episodios de AF moderada y vigorosa, consumo de refrescos y CC (p<0,05). VAMOS fue eficaz en la promoción de un estilo de vida activo y saludable en los usuarios de APS y sus estrategias demostraron ser adecuadas para mantener los beneficios adquiridos. VAMOS es pionero e innovador en salud.

Citas

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.

Descargas

Publicado

03/10/2021

Cómo citar

TOMICKI, C.; RECH, C. R.; GERAGE, A. M.; CORRÊA, E. N.; KONRAD, L. M.; BENEDETTI, T. R. B. Estilo de vida activo y saludable en usuarios brasileños de Atención Primaria de Salud: Un ensayo clínico pragmático sobre el programa de cambio de comportamiento “VAMOS”. Research, Society and Development, [S. l.], v. 10, n. 13, p. e21101320382, 2021. DOI: 10.33448/rsd-v10i13.20382. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/20382. Acesso em: 23 nov. 2024.

Número

Sección

Ciencias de la salud