Scaling up of physical activity interventions at the national level in Brazil: An effective solution to increase physical activity at the population level
Why this case study?
This illustrates the importance of engaging different sectors for the scale up of effective interventions.
It also highlights challenges to scale up – such as changes in policies and funding mechanisms.
Title
Scaling up of physical activity interventions at the national level in Brazil: An effective solution to increase physical activity at the population level
Source
Washington University in St. Louis, St Louis, Missouri, United States of America
Health issue
Inadequate levels of physical activity and the need to address health disparities in the population of Brazil
Setting
Community (Brazil)
Target population
Brazil (adults and older adults from the general community)
Background
In Brazil, guidelines on physical activity suggest a minimum of 150 minutes of moderate or vigorous physical activity per week. However, the most recent national survey showed that nearly half the adult population did not reach this level of activity, with approximately 15% being completely inactive. The most commonly cited barriers to engaging in physical activity include lack of time and work/family responsibilities.
Community-based interventions that make use of readily available resources (i.e. parks, trails, community centres), while providing professional guidance can be a promising strategy to increase physical activity at the population level.(103, 104)
Project GUIA (Guide for Useful Interventions for Physical Activity in Brazil and Latin America)(105) is a cross-national collaboration funded by the Prevention Research Centers programme (run by the Centers for Disease Control and Prevention (CDC)); it sets out to evaluate a programme taking place in Brazil for over a decade.(106)
Description of policy or intervention
The programme ‘Academia da Cidade’ or ‘City Gym’ started in Recife, Pernambuco in the north-east of Brazil, and was institutionalized in 2002. It is carried out at a number of points of intervention or so called polos – new spaces or re-engineered and beautified public spaces.
Physical and cultural activities are provided by professional instructors and include: dancing, aerobics, strength training, flexibility and other health enhancing activities.
What took place?
In 2008, Project GUIA evaluated the Academia da Cidade programme using a combination of qualitative and quantitative methods including a phone survey, systematic direct observation, historical evaluation, logic models and qualitative interviews of coordinators, staff and users.(107-111)
Results from the evaluation showed that the programme was effective in increasing and maintaining physical activity levels of the population and helped meet the guide- lines for physical activity.
The evaluation also assessed reach, showing that women, older adults, and lower in- come people were the segments of the population that benefited the most from the programme.(112)
What have we learnt?
Two significant events took place after results from the evaluation were shared with Project GUIA stakeholders:
- In early 2011, the government of the state of Pernambuco created the Academias das Cidades de Pernambuco (ACP), a programme that aimed to expand the basic offering of Academia da Cidade.(113)
- Later in 2011, the ministry of health created the Academia da Saude (AS), a national programme with added nutritional and social development components.(113) Changes in the supportive policies and in the funding mechanisms have represented challenges for implementation at a large scale and for sustainability.
The experience and lessons learned in Brazil show the challenge of scaling up physical activity interventions and the need to consider long-term political and financial support.(113)