Background:To describe the lessons learned after 10 years of use of the International Physical Activity Questionnaire (IPAQ) in Brazil and Colombia, with special emphasis on recommendations for future research in Latin America using this instrument.Methods:We present an analytical commentary, based on data from a review of the Latin American literature, as well as expert consultation and the authors' experience in administering IPAQ to over 43,000 individuals in Brazil and Colombia between 1998 and 2008.Results:Validation studies in Latin America suggest that the IPAQ has high reliability and moderate criteria validity in comparison with accelerometers. Cognitive interviews suggested that the occupational and housework sections of the long IPAQ lead to confusion among respondents, and there is evidence that these sections generate overestimated scores of physical activity. Because the short IPAQ considers the 4 physical activity domains altogether, people tend to provide inaccurate answers to it as well.Conclusions:Use of the leisure-time and transport sections of the long IPAQ is recommended for surveillance and studies aimed at documenting physical activity levels in Latin America. Use of the short IPAQ should be avoided, except for maintaining consistency in surveillance when it has already been used at baseline.

This study summarizes the evidence from quantitative systematic reviews that assessed the association between urban environment attributes and physical activity. It also documents sociopolitical barriers and facilitators involved in urban interventions linked with active living in the ten most populated urban settings of Latin America. The synthesis of evidence indicates that several attributes of urban environments are associated with physical activity, including land-use mix and cycling infrastructure. The documentary analysis indicated that despite the benefits and opportunities provided by the programs and existing infrastructure in the examined cities, an overall concern is the rising inequality in the coverage and distribution of the initiatives in the region. If these programs and initiatives are to achieve a real population level effect that helps to reduce health disparities, they need to examine their social and spatial distribution within the cities so they can reach underserved populations and develop to their full potential.

Background:Even though there is increasing evidence that the built environment (BE) has an influence on leisure-time physical activity (LTPA), little is known about this relationship in developing countries. The objective of this study was to assess the associations between objective built environment characteristics and LTPA.Methods:A cross-sectional multilevel study was conducted in 27 neighborhoods in which 1315 adults aged 18−65 years were surveyed. An adapted version of the IPAQ (long version) was used to assess LTPA. Objective BE characteristics were obtained using Geographic Information Systems. Associations were assessed using multilevel polytomous logistic regression.Results:Compared with inactive people, those who resided in neighborhoods with the highest tertile dedicated to parks (7.4% to 25.2%) were more likely to be regularly active (POR = 2.05, 95% CI = 1.13−3.72; P = 0.021). Those who resided in neighborhoods with presence of TransMilenio stations (mass public transportation system) were more likely to be irregularly active (POR = 1.27, 95% CI = 1.07−1.50, P = 0.009) as compared with inactive people.Conclusions:These findings showed that park density and availability of TransMilenio stations at neighborhood level are positively associated with LTPA. Public health efforts to address physical inactivity should consider the potential influences of urban planning and mass public transportation systems on health.

There is an increasing interest in establishing the influence of urban environments on health. The importance of changes to environmental policy in order to promote physical activity has been emphasized during recent years. Bogotá, the capital of Columbia, is recognized as a Latin American leader in its creation of a more activity friendly environment. The city has undergone a number of urban and social changes which have resulted in a positive effect on the recovery of public spaces, access to recreational facilities, and promotion of non-motorized and public transportation options. These changes may have enhanced perceptions of quality of life and facilitated increased physical activity. The experience of Bogotá could be used as a potential example for leaders of other cities to encourage similar programs.

The Ciclovia program (CP) has emerged as an effective initiative to promote active living in urban spaces in Latin America. This study assessed the association between social conditions, the urban environment and participation in the CP among adults living in the city of Cali, Colombia. A cross-sectional study was conducted in 2011 and 2012 among 719 adults aged 18 to 44. Urban environment measures were obtained using Geographic Information Systems. A multilevel logistic regression was used for the analysis. Slightly more than 7% of participants had participated in the CP in the previous four weekends. Being male and having a high school degree were positively associated with participation in the CP. Participation in the CP was positively associated with living in neighborhoods with Ciclovia lanes. In contrast, a negative association was found among those living in neighborhoods with a presence of traffic fatalities. This study provides new insights about a recreational program that has potential health benefits in a region marked by urban inequalities in terms of opportunities for physical activity.

Background:The health benefits of physical activity are well documented in scientific literature. Bicycling for transportation is a modality of physical activity that people can incorporate easily into their daily lives.Methods:A qualitative study using 11 semi-structured individual interviews and 5 focus groups was conducted among 31 male and 13 female adult residents of Bogotá, Colombia in 2006, to explore barriers and facilitators of bicycle use for transportation purposes. People were selected based on socioeconomic status, age, and gender. Thematic analysis complemented with thematic network analysis was used to analyze the data.Results:Six main themes emerged from the study: 1) general acknowledgment of individual and collective benefits of bicycle use, 2) built environment conditions were linked with bicycle use, 3) some social factors affect bicycling negatively, 4) people perceived conflicts over public space related to the use of bike-paths, 5) general negative public perception of bicyclists, and 6) gender differences influence patterns of bicycle use.Conclusion:The findings from this qualitative study show that various social and physical barriers must be addressed to increase bicycle use as a means of transportation in Bogotá.

Objective: To describe the design, validation, and implementation of the education material The world of malaria: let´s learn to handle it in the community. Methods: The development of the educational material was carried out in the urban area of Buenaventura (main city in the Colombian Pacific coast) in 1995. The design was based on the results of a knowledge, beliefs, and practices study in the city. By using the PRECEDE- PROCEED MODEL strategy, community groups were brought together with the research team to design the materials. Results: The educational materials were designed according to cultural and ethnographic characteristics of the population studied. These materials are table games, comics, videotapes and cassettes, magazines, altogether in a black bag called «The world of malaria: let´s learn to handle it in the community». Conclusions: This innovative educational material shows that interventions in public health should be based on results from scientific projects, because control strategies are based on local realities.

Background: In Latin American for improving health sector performance and for decreasing corruption process, a social control initiatives like accountability process are been realized by social actors involved in health sector. Objectives: To describe and to analyze accountability to health management process with the involvement of health services consumers. Methodology: A pilot control social experience was developed in Cali with community participation in an accountability experience. Three public accountability experiences were developed. A methodology proposal was design to achieve community participation in accountability process. Results: 745 persons, indirectly, and 54 community leaders of Consumer Association of health local services of Cali, directly, were wrapped up. They had technical support in two out of the three accountability meetings carried out. In each stage was identified technical and methodological weakness in the accountability process. Conclusions: Despite of an understanding of the accountability process in health was improved, the experience showed some obstacles such as: difficulties in the access of information, low community leadership in social control issue and resistance of public health workforce to see their performance in health sector as a matter to be account.