Intervenção com aconselhamento à prática de atividade física para profissionais de saúde de unidades básicas de saúde

Abstract

In this thesis two articles are presented: 1. Interventions with health professionals of primary care about physical activity counseling: sistematic review; 2. Effectiveness of an intervention with health professionals about counseling to physical activity practice in health basic units. The first was a systematic review study that sought to describe the interventions performed with health professionals in primary care with a focus on increasing counseling for the practice of physical activity. Eight studies were included, which were carried out in three countries, with heterogeneous samples of health professionals and primary care users. As for the effect of the intervention on increasing counseling for physical activity, half of the studies showed to be positive, while the other half showed no difference. The second article aimed to describe the effectiveness of an intervention with health professionals from basic health units (BHU) with advice on the practice of physical activity. Intervention study, with a randomized community trial design. First, a baseline study was carried out with 525 users from 35 BHU in the city of Pelotas-RS. Subsequently, the UBS were randomized, according to the prevalence of counseling found at baseline, in intervention group (IG) and control group (CG). One BHU from the baseline study was excluded because it changed its format to a basic unit for immediate care. Thus, 17 UBS were part of the IG and 17 of the CG. The health professionals of the intervention BHU participated in two lectures of 50 minutes each and received a folder about counseling for the practice of physical activity. The health professionals of the control BHU did not receive any type of intervention. The intervention took place between April and July 2018. One year after the end of the intervention, postintervention data were collected. Only users, from GI and GC BHU, answered the questionnaire, and health professionals only participated in the intervention. Thirty users were interviewed in each UBS, totaling 510 interviews in the BHU of the IG and 510 of the CG. The prevalence of counseling for physical activity was assessed through interviews with BHU users, who were asked about receiving advice by health professionals at BHU and by community health agents in their homes. There were 259 health professionals in the IG, of which 218 participated in at least one meeting. There were no differences in the prevalence of counseling for the practice of physical activity, either performed by health professionals in the BHU (baseline: 35.8% CI95% 31.8 - 40.1; Post-intervention - IG: 39.4% CI95% 35.2 - 43.7; CG: 38.0% CI95% 33.9 - 42.3), as for the advice given by community health agents at home (Postintervention - IG: 29.1% CI95% 23.5 – 35.5; CG: 24.9% 95% CI 19.4 - 31.3). It is concluded that the intervention was not effective to modify the prevalence of counseling to physical activity in the UBS. New strategies are needed to assist health professionals at work with counseling for physical activity. New research with the objective of increasing counseling for the practice of physical activity may start from the intervention applied in the present study, increasing its development and followup period, with observations immediately after the intervention, at 4 months, 8 months and when completing 12 months after the intervention.