Physical Activity Interventions in Latin America. A Systematic Review

Prevention Research Center, Saint Louis University School of Public Health, St. Louis, Missouri 63104, USA.
American Journal of Preventive Medicine (Impact Factor: 4.53). 04/2008; 34(3):224-233. DOI: 10.1016/j.amepre.2007.11.016
Source: PubMed


Recommendations for physical activity in the Guide to Community Preventive Services (the Community Guide) have not been systematically examined or applied in developing countries such as those in Latin America. The aim of this systematic review was to assess the current evidence base concerning interventions to increase physical activity in Latin America using a modified Community Guide process and to develop evidence-based recommendations for physical activity interventions.
In 2006, a literature review of both peer-reviewed and non-peer-reviewed literature in Portuguese, Spanish, and English was carried out to identify physical activity interventions conducted in community settings in Latin America. Intervention studies were identified by searching ten databases using 16 search terms related to physical activity, fitness, health promotion, and community interventions. All intervention studies related to physical activity were summarized into tables. Six reviewers independently classified the intervention studies by the categories used in the Community Guide and screened the studies for inclusion in a systematic abstraction process to assess the strength of the evidence. Five trained researchers conducted the abstractions.
The literature search identified 903 peer-reviewed articles and 142 Brazilian theses related to physical activity, of which 19 were selected for full abstraction. Only for school-based physical education classes was the strength of the evidence from Latin America sufficient to support a practice recommendation.
This systematic review highlights the need for rigorous evaluation of promising interventions to increase physical activity in Latin America. Implementation and maintenance of school physical education programs and policies should be strongly encouraged to promote the health of Latin American children.

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    • "They found that there was insufficient evidence to make a recommendation for any intervention that focused on improving physical activity in adults. Poor methodological rigor resulting in low internal validity was noted as the primary limitation of the studies included in the review [6]. To improve the likelihood of having a public health impact it is necessary to also understand external validity and the influence that context may have on knowledge translation and engagement of participants who are representative of the population of interest [12-14]. "
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    ABSTRACT: The purpose of this review was to determine the degree to which physical activity interventions for Latin American populations reported on internal and external validity factors using the RE-AIM framework (reach & representativeness, effectiveness, adoption, implementation, maintenance). We systematically identified English (PubMed; EbscoHost) and Spanish (SCIELO; Biblioteca Virtual en Salud) language studies published between 2001 and 2012 that tested physical activity, exercise, or fitness promotion interventions in Latin American populations. Cross-sectional/descriptive studies, conducted in Brazil or Spain, published in Portuguese, not including a physical activity/fitness/exercise outcome, and with one time point assessment were excluded. We reviewed 192 abstracts and identified 46 studies that met the eligibility criteria (34 in English, 12 in Spanish). A validated 21-item RE-AIM abstraction tool was used to determine the quality of reporting across studies (0-7 = low, 8-14 = moderate, and 15-21 = high). The number of indicators reported ranged from 3-14 (mean = 8.1 +/- 2.6), with the majority of studies falling in the moderate quality reporting category. English and Spanish language articles did not differ on the number of indicators reported (8.1 vs. 8.3, respectively). However, Spanish articles reported more across reach indicators (62% vs. 43% of indicators), while English articles reported more across effectiveness indicators (69% vs 62%). Across RE-AIM dimensions, indicators for reach (48%), efficacy/effectiveness (67%), and implementation (41%) were reported more often than indicators of adoption (25%) and maintenance (10%). Few studies reported on the representativeness of participants, staff that delivered interventions, or the settings where interventions were adopted. Only 13% of the studies reported on quality of life and/or potential negative outcomes, 20% reported on intervention fidelity, and 11% on cost of implementation. Outcomes measured after six months of intervention, information on continued delivery and institutionalization of interventions, were also seldom reported. Regardless of language of publication, physical activity intervention research for Latin Americans should increase attention to and measurement of external validity and cost factors that are critical in the decision making process in practice settings and can increase the likelihood of translation into community or clinical practice.
    International Journal of Behavioral Nutrition and Physical Activity 06/2014; 11(1):77. DOI:10.1186/1479-5868-11-77 · 4.11 Impact Factor
    • "On the other hand, the local evidence in PA interventions was not enough and has some shortcomings.[15–17] At the level of global evidence, the findings show that some interventions have been effective and others have been ineffective.[18–23] The “Healthy people 2020” program also reflects a multiple approach to promote physical activity in children and adolescents.[24] "
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    ABSTRACT: Regular physical activity (PA) is an underlying factor since childhood and adolescence for having a healthy and active future for life. The aim of this stud y was to review the evidence on increasing the youth PA to develop the national program at country level. At first, the databases were searched using the sensitive keywords, and systematic reviews of the relevant databases were extracted. The studies were evaluated in terms of relevance and methodological quality for effective interventions that were detected. These cases were also identified in the effective interventions: disadvantages, benefits, costs, methods, and limitations of early studies, which were based on systematic review of the studies. Three interventions were identified as physical education curriculum reform, the creation of extra-curricular activities, as well as approaches to environmental and social support. Evidences showed that the relative impact of these interventions were not high. Thus, a combination of all three options of integrated approach is recommended for reducing the sedentary lifestyle of youths.
    International journal of preventive medicine 09/2012; 3(9):599-606.
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    • "The state capitals of Recife, Curitiba and Vitória have different social and environmental characteristics; however, they have in common the fact that they provide public PA programs free of cost to their population, Academia da Cidade in Recife, CuritibAtiva in Curitiba and Serviço de Orientação ao Exercício (Exercise Orientation Service) in Vitoria [19-21]. The surveys from Recife and Curitiba were part of a larger effort implemented by Project GUIA (Guide for Useful Interventions for Physical Activity in Brazil and Latin America)[22,23] to better understand physical activity promotion in cities from Brazil. Table 1 shows some characteristics and indicators of the three cities related to population, traffic conditions and safety. "
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    ABSTRACT: Walking is a popular form of physical activity and a convenient option to prevent chronic diseases. However, most of the evidence on this topic derives from high-income countries and little is known about walking patterns and its association with environmental features in low and middle income countries. To describe walking for leisure and to identify its association with perceived environment and personal factors among residents of three state capitals from different regions of Brazil Cross sectional phone surveys were conducted in Recife, Curitiba and Vitória (n = 6,166) in 2007, 2008 and 2009 respectively. Physical activity was measured using the leisure-time sections of the long version of the International Physical Activity Questionnaire (IPAQ). Perceived environment characteristics were assessed using a modified version of the Neighborhood Environment Walkability Scale (NEWS). Multivariable analysis tested the associations between walking for leisure and perceived environment characteristics across the cities using logistic regression. The proportions of respondents meeting physical activity recommendations through walking for leisure were 9.6%, 16.0% and 8.8% in Curitiba, Recife and Vitoria, respectively. Engaging in 150 min/wk or more of walking for leisure was significantly associated with younger age, higher education, better self-rated health and with lack of sidewalks on nearby streets. We did not find positive associations between walking for leisure and traffic conditions and safety related to cycling/walking during the day or night. Most environmental features were not associated with walking for leisure. Personal factors were stronger predictors of walking for leisure as compared with perceived environment factors.
    International Journal of Behavioral Nutrition and Physical Activity 10/2011; 8(1):111. DOI:10.1186/1479-5868-8-111 · 4.11 Impact Factor
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