ObjectiveThe aim of this study was to verify the efficacy of using theory-based strategies on implementation intentions in promoting physical activity (PA) among adults.MethodsThis review was conducted in accordance with the PRISMA recommendations. The search was carried out in seven electronic databases (LILACS, PubMed, SciELO, Cochrane, Web of Science) and two searches of the “grey literature” were performed (Openthesis and OpenGrey). Randomized clinical trials (RCT), published up to September 2016, were considered eligible for this study. Two reviewers independently and systematically evaluated the eligibility criteria, and performed data extraction. A meta-analysis was performed for the purpose of comparing the effect between the intervention and control groups. The effect sizes were grouped in two subgroups with the purpose of more accurately verifying the effect caused by reinforcing the implementation intentions strategy, and using the inverse variance statistical method with random effects models to estimate the main effect of the implementation intention strategy on the PA behavior. Heterogeneity among the studies was evaluated by using I-square statistics, and the Jadad scale to evaluate the quality of included papers.ResultsThe search resulted in 12,147 records, of which 13 RCTs were considered eligible for this review. Sample age ranged from 18 to 76 years, and participants had conditions such as medullary lesion, coronary disease, obesity, diabetes mellitus, sedentarism or occupational stress. When the summary of the effect was analyzed in the meta-analysis, the result found in the subgroup with reinforcement of the implementation intentions strategy was 0.25 (IC 95% = 0.05–0.45) in favor of the intervention group. This demonstrated that application of the implementation intentions strategy was capable of increasing PA practice in the participants of these studies, in comparison with others that did not use this reinforcement.ConclusionThe findings of this review indicated that application of the theory of implementation intentions promoted PA behavior among the adults who received reinforcement of this strategy. The systematic review protocol was registered in the PROSPERO database under the number CRD42018090482.

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OBJECTIVE: To evaluate the effect of implementation intentions as an intervention strategy to promote walking in adults with type 2 diabetes mellitus (T2DM). METHODS: We conducted a controlled and randomized trial, with 12 months of follow-up, involving 65 people with T2DM recruited from primary health care units and allocated them in the control group (CG, n = 32) and intervention group (IG, n = 33). The IG received the implementation intention strategy to promote walking and the CG remained in follow-up for conventional treatment in primary health care. The researchers were blinded by anthropometric measurements and the filling of the instruments. RESULTS: After twelve months of follow up, the IG presented a statistically significant increase in the leisure time physical activity when compared with the CG (p = 0.0413) and showed a significant decrease in waist circumference (p = 0.0061). No significant difference was observed regarding body mass index and glycated hemoglobin among groups. CONCLUSIONS: Implementation intention was effective in promoting walking and improving clinical indicators in adults with T2DM.

Objective: To evaluate the association between arterial stiffness and short term blood pressure variability (BPV). Design and method: Four hundred fifty-five suspected hypertensive patients were referred to record a 24-hours ambulatory blood pressure monitoring (ABPM), and also were randomly enrolled from a population. They performed an oscillometric pulse wave analysis, using Mobil-O-Graph (I.E.M., Stolberg, Germany), following recommendations of Expert Consensus Document on the Measurement of Aortic Stiffness-2012. They also had a 24- hour of ABPM recorded. ABPM was made following protocols of European Guidelines. Short term BPV was evaluated by systolic or diastolic BP with: the standard deviation (SD) of 24 hs BP (24hBP-SD), Daytime BP-SD, Nighttime BP-SD, the 24 hs BP coefficient of variation (24hs CV), the weighted 24-h BP-SD and average real variability of 24-hour BP (ARV 24-h BP). Statistical Analysis: the Pearson correlation coefficient (r) was calculated by an univariate way comparing all systolic and diastolic BPV measures with brachial pulse wave analysis (bPWV). Partial correlation was adjusted to age and gender, and then for age, gender, 24 hs BP, and office BP do to avoid statistic influence of such confounders. Results: Data from 455 patients were analyzed. Clinical characteristics of the sample: age 48.8 ± 13.93 – women (41.9%), white people (69.5%), treated hypertensives (36%), diabetes (12.7%), statin use 22%, body mass index 28. 6 ± 5.8, smokers (8.6%), obese (36.3%). The findings are showed in table 1. All BPV variables had a significant correlation with bPWV. Daytime BP-SD and weighted 24-h BP-SD showed the best association. The worst results of the correlation were found, in systolic, in nighttime BP-SD, and in diastolic, in 24 hs CV. However, the comparison of diastolic 24hBP-SD and bPWV showed a negative correlation. Conclusions: Our data indicated an association between short blood pressure variability and oscillometric pulse wave velocity. A moderate correlation was demonstrated by systolic BPV and weak by diastolic. The best results of the association between the studied variables were shown in Daytime BP-SD and in weighted 24-h BP-SD.

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Objetivo Investigar as barreiras percebidas e as estratégias de enfrentamento para a efetivação da prática de caminhada identificadas entre portadores do diabetes mellitus (DM) no âmbito do Sistema Único de Saúde (SUS).Metodologia Uma amostra de 83 portadores do DM, usuários do SUS, foi inquirida a refletir sobre os obstáculos que os impediam de praticar a caminhada, e formular planos de enfretamento para superar tais obstáculos. Foram categorizados os obstáculos levantados e os planos desenvolvidos quanto à similaridade e submetidos à análise de frequência.Resultados O principal obstáculo relatado foi o sentimento de “desânimo” (36,1%). O plano de enfrentamento mais frequente para superar as barreiras encontradas foi o ‘apoio social de familiares’, ‘vizinhos’ e ‘amigos’.Conclusão Os resultados possibilitaram conhecer as dificuldades e as potencialidades dos sujeitos relativas ao autocuidado para o DM no que se refere à prática da caminhada, conhecimento que pode auxiliar as equipes multidisciplinares do SUS.

Objective: Compare the performance of 3 or 6 sequential blood pressure (BP) measurements to predict awake BP (ABP) values by Predicting Out of Office Blood Pressure in the clinic (PROOF BP). Design and method: This study is a secondary analysis of published research. A nursey collected clinical characteristics, in all participants, taking six sequential observed BP measurements, with a 1-minute interval (Microlife-BP3BTOA). Also, it was recorded ABPM (DynaMAPA). We selected 426 suspected people having hypertension. We estimated out-of-office BP on an algorithm from first to third BP (PROOF BP 1–3) and fourth to sixth (PROOF BP 4–6). We classified the patients in four BP categories, such as true hypertension (HT), true normotension (NT), masked hypertension (MH), and white coat hypertension (WCT). The office standard average considered the first three measurements as office BP (cut off – 140/90) and ABP as a reference standard, and for ABP and tested BP, the cut off was 135/85. We correctly compared the proportion of classified patients, coefficient of correlation (r), receiver operating characteristic curve (AUC), and Bland–Altman plot. The differences of proportions were evaluated using the chi-square test for media analysis of covariance. Results: Among 446 patients, 40.1% were classified as HT, 17.4% (MH), 11.7% (WCH) and 30.8% (NT), age 43.3 ± 13.3, women (44.6%), white people (67.8%), diabetes (2.6%), dyslipidemia (19.2%), obese (39.9%), body mass index 28. 9 ± 5.3, smokers (8.6%). The algorithm recommended AMBP in 41.07%. The proportion of HT was 40.1% MH 17.4%, WCH 11.7%, and NT 30.8%. The main clinical characteristics were age 43.3 ± 13.3, women (44.6%), white people (67.8%), diabetic (2.6%), dyslipidemia (19.2%), obese (39.9%), body mass index 28. 9 ± 5.3, smokers (8.6%). The mains results are in Table 1. Figure 1 shows a Bland and Altman plot of PROOF BP 1–3 and 4–6 against ABP. Conclusions: In conclusion, this secondary analysis data reinforce that the algorithm correctly classifies the vast majority of hypertensive patients and recommends ABPM in less than half of patients. It also adds that six sequential measurements no longer add accuracy to the ambulatory BP prediction tool.