Exercício físico e educação em saúde: efetividade de diferentes intervenções a mudança de comportamento relacionada à atividade física de usuários da atenção básica de saúde.

Abstract

he purpose of this study was to analyze the effectiveness of two distinct physical exercise and health education interventions (Saúde Ativa Uberaba Program) in behavioral changes to practice physical activity of Primary Health Care users. Variables were measured by accelerometer, IPAQ questionnaire, anamnesis and Focus Group. The results of this dissertation were presented in two articles. In the article 1, the aim was to analyze the motivation to practice physical activity through the Self-Determination Theory in the discourse of beginners participants of the Program. A cross-sectional qualitative study using the Focus Group for data analysis was conducted. Forty-one adults, users of Unified Health System, participated in the study. The results suggest that all participants are extrinsically motivated and fit into the identified and integrated regulation, and almost half of them presented feelings demarked by external and introjected regulation. The psychological need most evident was “relatedness”. A small number of participants presents feelings of action autonomy and competence, key elements for the development of motivation. We concluded that, although beginners participants feel interested in a Program of Physical Activity and Health Education participation, they present feelings of inferiority and incapacity to performing physical activity per se. In article 2, the aim was to analyze the effectiveness of two different interventions in the behavioral change to practice physical activity and to decrease sedentary behavior of participants of Saúde Ativa Uberaba. A longitudinal, quasi-experimental study was conducted. The instruments used were accelerometers and the IPAQ questionnaire. For the analyses, the intention-to-treat principle, generalized estimating equations and the individually physical activity delta were used. The sample comprised 31 adults and users of the Brazilian Unified Health System. According to the analysis, the results were significant, regardless of the type of intervention. Both intervention groups (G1– Physical Exercise combined to Health Education; G2– Health Education) have increased the minutes of weekly leisure time physical activity (p=0,006), increased the time spent in light physical activities (p = 0.003), vigorous (p = 0.011) and decreased time in sedentary behavior, with a significant decrease in G2 (p = 0.010). Furthermore, for the other domains, delta analysis demonstrated effectiveness in increasing the time spent in moderate activities and in the transport, work and domestic-related physical activity domains. Although there are controversies in the literature regarding the effectiveness of health education programs, this study empirically demonstrated the importance of combined approaches of physical exercise combined to health education.