Re-thinking Physical Activity Programs for Older Brazilians and the Role of Public Health Centers: A Randomized Controlled Trial Using the RE-AIM Model

Abstract

Background: Explored the role of public health centers in the delivery of physical activity programs to older Brazilians. Methods: Total of 114 older adults (81% women) from public health centers across the city of Florianopolis, Brazil, were randomized into three groups: behavior change group (n = 36), traditional exercise group (n = 52), and control group (n = 26). The behavioral change group included 12 weekly meetings (2 h each). The traditional exercise group offered a 12-week exercise class. Individuals in the control group participated only in measurements. Program evaluation included a mixed-methods approach following the RE-AIM framework (reach, effectiveness, adoption, implementation, and maintenance). Trained interviewers conducted 12 focus groups and 32 interviews with participants in the program, professionals delivering the programs, community health workers, and local and city administrators overseeing public health centers. Participants completed health, quality of life, and fitness assessments at four time points.

Vamos Program-Technological Innovation for Behavior Change for Older Adults in the Brazilian Unified Health System

“…To evaluate the effectiveness of the program, the level of physical activity, food consumption, weight loss and perception of quality of life are used as markers. Results showed a reduction in sedentary behavior, an increase in light physical activity, a 10% increase in the time spent on physical activity with moderate/vigorous intensities, lower consumption of industrialized foods, increased consumption of raw vegetables and reduction of 0.5kg of average body mass, besides the increase in the perception of quality of life [11,15,16]. a) This program has been advancing in the Brazilian health care system.…”

“…Public health centers are an example of community health strategy sponsored by the government. Most of health services provided by the public health centers focuses on primary health care and prevention programs focusing on healthy lifestyles are increasingly being offered to communities [11].…”

Active and healthy lifestyle in Brazilian Primary Health Care user’s: A pragmatic clinical trial about "VAMOS" behavior change program

“…However, the magnitude of non-communicable chronic diseases, associated with low adherence to physical activity and healthy eating by the population, calls on managers and health professionals to reflect on their practices, directing them towards an approach aimed at improving health conditions (Benedetti et al, 2012;Marques et al, 2020). Faced with this scenario and to promote health sustainably, the PHC intervention proposals started to adopt health education to guide people to adopt and maintain an active and healthy lifestyle (Benedetti et al, 2019;Benedetti et al, 2020).…”

“…Behavioral interventions developed in public health contribute of physical activity and healthy eating (Benedetti et al, 2012;Benedetti et al, 2020;Carvalho et al, 2020;Carvalho et al, 2021;Tomicki et al, 2021). Systematic reviews evidence the effectiveness of behavioral interventions developed in public health aimed at specific health outcomes, including obesity control (Menezes et al, 2020), promotion of healthy eating, and physical activity (Menezes et al, 2016).…”

Balance, physical conditioning, and health perception in elderly women submitted to a 32-week physical exercise program

“…Most of the physical activity programs implemented so far for people 60+ in Brazil include aerobics classes, aqua aerobics, team and individual sports, dance, and musclestrengthening exercise and the investigation period usually lasts around 12 weeks [1]. Therefore, a long-term exercise program with distinct implements (e.g., elastic bands, unstable surfaces, interactive games) and an electronic device (e.g., accelerometer) may increase balance, physical conditioning, and health perception of elderly women.…”