Public Open Spaces and Leisure-Time Walking: A Longitudinal Study With Brazilian People in the COVID-19 Pandemic.

AIM: To examine whether changes in public open spaces (POS) were associated with leisure-time walking (LTW) between 2014 and 2021. METHODS: The sample comprised a prospective cohort of individuals living in São Paulo City, Brazil. The baseline sample was collected in 2014/2015 (4042 people aged 12 y or older) and the second wave in 2020/2021 (1431 people aged 18 y or older, 35.4% of total). Changes in POS scores in 500-m network buffers were based on household address, including positive or negative maintenance and increases or decreases in parks, public squares, and bike paths between 2015 and 2020. The International Physical Activity Questionnaire was used to evaluate LTW in the baseline and second wave. To examine the association of LTW with changes in POS, we used multilevel models in 4 levels: health administration areas, census tracts, individuals, and observations of individuals. The exposure was the POS tertiles, and the outcome was LTW. RESULTS: Changes in LTW prevalence were observed in both periods and according to POS tertiles distributions. When adjusted for time (baseline/second wave), gender, education, and age, the highest POS tertile was significantly associated with a high likelihood for LTW (odds ratio = 1.44; 95% confidence interval, 1.03-2.02). CONCLUSION: The results showed that people in São Paulo who lived within 500-m buffers with the highest access to POS were more likely to practice LTW between 2014/2015 and 2020/2021. These results have important implications for policies that were implemented in 2014, including the New Master Plan to contribute to São Paulo's good ranking among healthy cities.

How can public open spaces contribute to physical activity promotion? / Como os espaços públicos abertos podem contribuir para a promoção da atividade física?

Public open spaces (POSs) are means to ensure one's right to recreation and health. The objective of this essay is to present reflections and evidence on how these spaces contribute to promoting physi-cal activity (PA). Understanding how to access (proximity/distance), quantity and diversity, and the surrounding and internal conditions of places (quality, structure, aesthetics, safety) can affect the use of POSs is imperative for public management actions. Thinking of POS use beyond PA by recog-nizing its social, economic, and cultural benefits can be fundamental to reduce inequalities regarding access to these places. POS-related actions and demands are intersectoral, multiprofessional, and interdisciplinary, thus requiring political, academic, and community involvement and commitment for PA promotion

Espaços públicos abertos (EPA) são equipamentos que promovem o direito à recreação e à saúde. O objetivo deste ensaio é apresentar reflexões e evidências sobre como esses espaços contribuem para a promoção da atividade física (AF). Compreender como o acesso (proximidade/distância), a quantidade e diversidade, as condições do entorno e internas dos locais (qualidade, estrutura, estética, segurança), podem afetar o uso dos EPA é fundamental para ações da gestão pública. Pensar o uso do EPA para além da prática de AF, reconhecendo seus benefícios sociais, econômicos e culturais pode ser fundamental para diminuir as iniquidades de acesso a esses locais. Ações e demandas relacionadas aos EPA são intersetoriais, multiprofissionais e interdisciplinares, necessitando com isso envolvimento e comprometimento político, acadêmico e comunitário, a fim de promover AF

The conception, content validation, and test-retest reliability of the Questionnaire for Screen Time of Adolescents (QueST)

Abstract Objective: To analyze the content validity and the test-retest reliability of the Questionnaire for Screen Time of Adolescents (QueST). Methods: A study was conducted with high school adolescents from Southern Brazil enrolled in public education (2019). The QueST measures screen time across five constructs: studying, working/internship-related activities, watching videos, playing games, using social media/chat applications. Content validation involved consulting with experts and adolescents to evaluate whether the five constructs were clear and representing screen time behaviors, all ratings were quantified. The experts' evaluation provided Content Validity Indexes (CVI) for clarity and representativeness of the questionnaire. Students answered the QueST twice (1-week apart), and differences between applications were verified. Test-retest reliability was assessed using Intraclass Correlation Coefficients (ICC) and Bland-Altman analyses. Results: Among the experts, the CVI indicated 94% and 98% of clarity and representativeness, respectively. All items were highly clear for at least 70% of the students. Test-retest reliability was assessed with 104 students (16.3 ± 1.02 years; 66.3% girls). The ICC ranged from 0.41 (95%CI 0.24-0.56) for videos to 0.76 (95%CI 0.66-0.83) for social media/chat applications on weekdays; and from 0.24 (95%CI 0.04-0.41) for videos to 0.67 (95%CI 0.54-0.77) for social media/chat applications on weekends. The lowest mean difference was -4.6 min for working on weekdays, while the highest was 40.6 min for videos on weekends. Conclusions: The QueST proved to be fair to excellent for measuring different screen time constructs. However, the item of videos (weekends) showed poor stability. The QueST demonstrates satisfactory content validity attested by the experts and adolescents.

Smartphone apps for tracking physical activity and sedentary behavior: A criterion validity review / Aplicativos de smartphone para monitorar a atividade física e o comportamento sedentário: uma revisão sistemática de estudos de validação

Smartphone apps have been developed and investigated in validation studies for tracking human be-havior such as physical activity (PA) and sedentary behavior (SB). However, as it is unclear whether these apps are valid for tracking PA and SB when compared to research-grade accelerometers, thus, this systematic review aimed to investigate the validity of smartphone apps for tracking PA and SB using the accelerometer as a criterion measure. A systematic search was conducted in PubMed, Web of Science, SportDiscus, and Scopus databases. The mean percentage difference (MPD) was used to evaluate criterion validity. Ten studies (n = 662) validating different apps using ActiGraph accelerometers as criteria measure (six were conducted in free-living conditions, two in laboratory conditions, and two in both conditions) were included for analyses. While four apps were considered valid for tracking PA, six were not valid or fully valid. The MPD analysis revealed that apps provide no valid scores for tracking PA measures (MPD = -12.6 ­ 37.7). The scarcity of studies investigat-ing SB limits the tracking of the results on this behavior. Study designs, smartphone location, and exercise intensity tend to affect the accuracy of apps tracking PA; thus, the current review showed conflicting results among studies. This review shows that it is not possible to generalize the valid scores for all apps

Aplicativos para smartphones têm sido desenvolvidos e investigados em estudos de validação para rastrea-mento de comportamento humano, como atividade física (AF) e comportamento sedentário (CS). No entan-to, como não está claro se esses aplicativos são válidos para rastrear AF e CS quando comparados a acelerôme-tros de grau de pesquisa, portanto, essa revisão sistemática teve o objetivo investigar a validade de aplicativos de smartphone para rastreamento de AF e CS usando o acelerômetro como medida de critério. Uma busca sistemática foi realizada em quatro bases de dados. A diferença percentual média (MPD) foi utilizada para avaliar a validade de critério. Dez estudos (n = 662) validando diferentes aplicativos usando acelerômetros ActiGraph como medida de critério (seis foram realizados em condições de vida diária, dois em condições de laboratório e dois em ambas as condições) foram incluídos para análise. Enquanto quatro aplicativos foram considerados válidos para rastreamento de AF, seis não eram válidos ou totalmente válidos. A análise do MPD revelou que os aplicativos não fornecem pontuações válidas para rastrear medidas de AF (MPD = -12,6 ­ 37,7). A escassez de estudos investigando o CS limita o rastreamento dos resultados sobre esse comportamento. Desenhos de estudo, localização do smartphone e intensidade do exercício tendem a afetar a precisão dos aplicativos que rastreiam AF; assim, a presente revisão mostrou resultados conflitantes entre os estudos. Esta revisão mostra que não é possível generalizar as pontuações válidas para todos os aplicativos.

Clustering of Physical Activity, Sleep, Diet, and Screen-Based Device Use Associated with Self-Rated Health in Adolescents.

BACKGROUND: Little is known about how the interplay among health-related behaviors impacts self-rated health (SRH). We examined the clustering of physical activity (PA), sleep, diet, and specific screen-based device use, and the associations between the emergent clusters and SRH among Brazilian adolescents. METHOD: The data used in this cross-sectional study were from the baseline of the Movimente Program. Self-reported data were analyzed. SRH was recorded as a 5-point scale (from poor to excellent). Daily duration of exposure to the computer, the television, the cell phone, and games; PA; sleep; and weekly consumption of fruits and vegetables and ultra-processed foods were included in a Two-Step cluster analysis. Multilevel ordered logistic regressions assessed the associations between the clusters and SRH. RESULTS: The data of 750 students (girls: 52.8%, 13.1 ± 1.0 years) were analyzed. Good SRH was more prevalent (52.8%). Three clusters were identified: the Phubbers (50.53%; characterized by the longest cell phone use duration, shortest gaming and computer use, lowest PA levels, and low consumption of fruits and vegetables), the Gamers (22.80%; longest gaming and computer use duration, PA < sample average, highest intake of ultra-processed foods), and a Healthier cluster (26.67%; physically active, use of all screen-based devices < sample average, and healthier dietary patterns). For both Gamers (-0.85; 95% CI -1.24, -0.46) and Phubbers (-0.71; 95% CI -1.04, -0.38), it was found a decrease in the log-odds of being in a higher SRH category compared with the Healthier cluster. CONCLUSION: Specific clusters represent increased health-related risk. Assuming the interdependence of health-related behaviors is indispensable for accurately managing health promotion actions for distinguishable groups.

The conception, content validation, and test-retest reliability of the Questionnaire for Screen Time of Adolescents (QueST).

OBJECTIVE: To analyze the content validity and the test-retest reliability of the Questionnaire for Screen Time of Adolescents (QueST). METHODS: A study was conducted with high school adolescents from Southern Brazil enrolled in public education (2019). The QueST measures screen time across five constructs: studying, working/internship-related activities, watching videos, playing games, using social media/chat applications. Content validation involved consulting with experts and adolescents to evaluate whether the five constructs were clear and representing screen time behaviors, all ratings were quantified. The experts' evaluation provided Content Validity Indexes (CVI) for clarity and representativeness of the questionnaire. Students answered the QueST twice (1-week apart), and differences between applications were verified. Test-retest reliability was assessed using Intraclass Correlation Coefficients (ICC) and Bland-Altman analyses. RESULTS: Among the experts, the CVI indicated 94% and 98% of clarity and representativeness, respectively. All items were highly clear for at least 70% of the students. Test-retest reliability was assessed with 104 students (16.3 ±â€¯1.02 years; 66.3% girls). The ICC ranged from 0.41 (95%CI 0.24-0.56) for videos to 0.76 (95%CI 0.66-0.83) for social media/chat applications on weekdays; and from 0.24 (95%CI 0.04-0.41) for videos to 0.67 (95%CI 0.54-0.77) for social media/chat applications on weekends. The lowest mean difference was -4.6 min for working on weekdays, while the highest was 40.6 min for videos on weekends. CONCLUSIONS: The QueST proved to be fair to excellent for measuring different screen time constructs. However, the item of videos (weekends) showed poor stability. The QueST demonstrates satisfactory content validity attested by the experts and adolescents.

Adequate sleep duration among children and adolescents: a review of the Brazil's Report Card / Duração do sono adequada entre crianças e adolescentes: revisão para o Report Card Brazil

abstract - This study aimed to summarize existing research examining the prevalence of adequate sleep duration or meeting sleep recommendations among Brazilian children and adolescents. A systematic review was conducted on eight databases. The criteria for inclusion were original research, samples including Brazilian children and adolescents (age 0-18), studies that reported variables regarding sleep duration using both objective or subjective measures, school- or population-based surveys with random sampling, and cross-sectional or cohort studies. Of the 54 articles included, only 27 used data from different studies. Most of the studies were conducted in the southern region (n = 17) with only two studies having a nationally representative sample. Two studies included children below age five, and the age group most investigated was adolescents (>10 years old). A majority of the studies used a self-reported questionnaire and showed variability in the cutoff point applied for adequate sleep duration with the most reported being ≥8 hours. The proportion of adolescents who met recommendations or had adequate sleep duration ranged from 15% to 89%. Among children, the prevalence ranged from 17% to 95%. The least variability was observed among toddlers, ranging from 93% to 95%. No consistent gender differences were observed among the gender-stratified groups of children and adolescents across the studies. It can be observed that, because of the wide range of results and the lack of data with national representativeness, the prevalence of sufficient sleep among young people aged below 18 remains undefined in Brazil.

resumo - Objetivou-se resumir os estudos existentes que examinaram a prevalência de duração adequada do sono ou atendimento às recomendações de sono entre crianças e adolescentes brasileiros. Uma revisão sistemática foi realizada em oito bases de dados. Os critérios de inclusão foram pesquisas originais, amostras incluindo crianças e adolescentes brasileiros (de 0 a 18 anos), estudos que relataram variáveis ​​relacionadas à duração do sono usando medidas objetivas ou subjetivas, pesquisas baseadas na escola ou na população com amostragem aleatória e transversal ou estudos de coorte. Dos 54 artigos incluídos, apenas 27 utilizaram dados de estudos diferentes. A maioria dos estudos foi realizada na região sul (n = 17), com apenas dois estudos tendo uma amostra representativa nacionalmente. Dois estudos incluíram crianças menores de cinco anos, e a faixa etária mais investigada foi de adolescentes (> 10 anos). A maioria dos estudos utilizou um questionário autorreferido e mostrou variabilidade no ponto de corte aplicado para a duração adequada do sono com a maioria relatada sendo ≥8 horas. A proporção de adolescentes que cumpriram as recomendações ou tiveram uma duração de sono adequada variou de 15% a 89%. Entre as crianças, a prevalência variou de 17% a 95%. A menor variabilidade foi observada entre as crianças, variando de 93% a 95%. Nenhuma diferença de gênero consistente foi observada entre os grupos. Observa-se que, pela ampla variabilidade de resultados e pela carência de dados com representatividade nacional, a prevalência de sono suficiente em jovens com menos de 18 anos permanece indefinida no Brasil.

Mediating role of screen media use on adolescents' total sleep time: A cluster-randomized controlled trial for physical activity and sedentary behaviour.

BACKGROUND: The present study aimed to analyse the effect of an intervention for increasing physical activity (PA) and reducing sedentary time on adolescents' total sleep time (TST) and to examine whether the effect on adolescents' TST was mediated by the intervention changes on screen-based sedentary time. METHODS: This study was a school-based cluster-randomized controlled trial conducted with Brazilian adolescents in Grades 7 to 9 (in 2017). Three schools participated in each of the intervention group (IG) and control group (CG). The intervention involved the following three strategies designed to increase PA and reduce sedentary time: (a) teacher training, (b) environmental improvements, and (c) health educational component. TST and screen-based sedentary time (television use, cell phone use, playing on computer/video game, and computer use that is not for gaming purposes) on weekdays and weekends were assessed using a standardized questionnaire. Generalized linear mixed models were conducted to verify the effect of the intervention on TST. Mediation analyses were used to examine the mediator role of changes in screen-based sedentary time in the relationship between the intervention and TST. RESULTS: Overall, 597 students participated in this study (mean age: 13.0 ± 1.0 years; IG: n = 351; CG: n = 246). The intervention had no effect on TST on weekdays and weekends. Adolescents in the IG were more likely to report ≤2 hr of television viewing per day on weekdays at follow-up. Mediated effects by screen media use were not significant. CONCLUSIONS: The school-based intervention for increasing PA and reducing sedentary time had no effect on adolescents' TST.

Smoking among industrial workers in Brazil: association with sociodemographic factors, alcohol consumption, and stress levels.

OBJECTIVE: To determine the prevalence of smoking, as well as its association with sociodemographic factors, alcohol consumption, and stress levels, among industrial workers in Brazil. METHODS: This was a nationwide survey, conducted in 24 capitals in Brazil through the application of a pre-tested questionnaire. The response to the question "What is your smoking status?" was the outcome variable. To determine the associations, we performed Poisson regression analyses in which the inputs were blocks of variables: block 1 (age and marital status); block 2 (level of education and gross family income); block 3 (geographic region); and block 4 (alcohol consumption and stress level). All analyses were stratified by gender. RESULTS: The sample consisted of 47,328 workers ≥ 18 years of age, of whom 14,577 (30.8%) were women. The prevalence of smoking was 13.0% (15.2% in men and 7.9% in women). Advancing age, alcohol consumption, and a high stress level were positively associated with smoking. A lower risk of smoking was associated with being married, having a higher level of education, and living in the northeastern region of the country (versus the southern region). CONCLUSIONS: The prevalence of smoking was greater in men than in women. Alcohol consumption and high stress levels appear to promote smoking.

The prevalence of global physical activity among young people: a systematic review for the Report Card Brazil 2018 / A prevalência de atividade física global entre jovens: uma revisão sistemática para o Report Card Brazil 2018

Abstract The aim of this study was to summarize data on the prevalence of global physical activity (PA) among children and adolescents in Brazil. This systematic review included an electronic search in 8 databases (PubMed, Scopus,Web of Science, LILACS, SPORTDiscus,BIREME,Scielo, and Google Scholar) and a manual search in the references of retrieved studies.Observational studies that assessed global PA among Brazilian children and adolescents were included. A narrative approach toward results was adopted. An initial database search reached 3276 potentially relevant titles (2534 titles after duplicate analysis); 92 (62 different studies) met all inclusion criteria. Studies were carried out between 2001 and 2015; most studies were conducted in Southern and Northeastern Brazil.Three were nationwide surveys (4.8%), but no studies included children aged 0-5 years. Eighteen different instruments for PA measurement were used; only two studies used objectively-measured PA. The most used definition was ≥ 300 minutes/week of moderate-to-vigorous PA. The overall proportion of young people who were physically active ranged from 6.5% to 92.3%.Fourteen studies (22.6%) found a prevalence of ≥ 50%. Three nationwide surveys reported the prevalence of physically active students ranging from 29.0% to 66.0%. A wide variability of PA estimates were found. Important research gaps (e.g., studies with objectively-measured PA, children aged up to 6 years-old and in Northern Brazil) should be considered to develop new research studies in Brazil.

Resumo Objetivou-se sumarizar dados sobre a prevalência de atividade física global (AF) entre crianças e adolescentes no Brasil. Esta revisão sistemática incluiu uma busca eletrônica em 8 bases de dados (PubMed, Scopus, Web of Science, LILACS, SPORTDiscus, BIREME, Scielo e Google Scholar) e uma busca manual nas referências de estudos recuperados. Estudos observacionais que avaliaram a AF global entre crianças e adolescentes brasileiros foram incluídos. Uma abordagem narrativa em relação aos resultados foi adotada. Uma pesquisa de banco de dados inicial atingiu 3276 títulos potencialmente relevantes (2534 títulos após análise duplicada); 92 (62 estudos diferentes) preencheram todos os critérios de inclusão. Os estudos foram realizados entre 2001 e 2015; a maioria dos estudos foi realizada no sul e nordeste do Brasil. Três foram pesquisas nacionais (4,8%), mas nenhum estudo incluiu crianças de 0 a 5 anos. Dezoito instrumentos diferentes para medida de PA foram utilizados; apenas dois estudos usaram PA medida objetivamente. A definição mais utilizada foi ? 300 minutos / semana de AF moderada a vigorosa. A proporção geral de jovens que eram fisicamente ativos variou de 6,5% a 92,3%. Quatorze estudos (22,6%) encontraram uma prevalência de ? 50%. Três pesquisas nacionais relataram a prevalência de estudantes fisicamente ativos variando de 29,0% a 66,0%. Uma ampla variabilidade de estimativas de PA foi encontrada. Lacunas importantes de pesquisa (por exemplo, estudos com PA medida objetivamente, crianças de até 6 anos de idade e no norte do Brasil) devem ser consideradas para o desenvolvimento de novas pesquisas no Brasil.

Physical aggression among adolescents from Santa Catarina: association with sociodemographic factors and physical activity / Envolvimento em brigas entre adolescentes de Santa Catarina: associação com fatores sociodemográficos e atividade física

Abstract The aims of the present study were to evaluate possible gender differences in the prevalence of physical aggression among adolescents, and to examine the association between sociodemographic factors and physical activity participation with physical aggression in boys and girls. The sample was composed of 6,529 high school students (aged 15-19 years) from public schools of the state of Santa Catarina. A questionnaire was applied to collect data regarding sociodemographic factors, involvement in physical aggressions and types of physical activity. Crude and adjusted binary logistic regression models were performed. Boys reported more involvement in physical aggression episodes (36.9%) compared to girls (26.0%, p<0.05). Boys who lived in urban areas (OR: 1.45) and did not live with the family (OR: 2.22), as well as girls enrolled in the night shift were more likely to engage in fights (OR: 1.26). Adolescents aged 17-19 years had reduced chances of getting involved in fights (ORBoys: 0.66; ORGirls: 0.80) compared to younger ones. The practice of team sports among boys (OR: 1.56) and the combined practice of team sports and individual physical activities among boys (OR: 1.91) and girls (OR: 1.36) were associated with physical aggressions. It was concluded that boys were more likely to engage in fights, mainly younger boys, who did not live with family and lived in urban areas. In boys and girls, the involvement in physical aggression was greater among those who are engaged in team sports.

Resumo Os objetivos do presente estudo foram testar possíveis diferenças entre os sexos quanto ao envolvimento em brigas nos últimos 12 meses e analisar a associação desse comportamento com fatores sociodemográficos e a participação em atividade física em rapazes e moças. Foram avaliados 6529 estudantes (15 a 19 anos) do ensino médio da rede pública estadual do estado de Santa Catarina. Dados sociodemográficos, o envolvimento em brigas e os tipos de atividades físicas foram investigados por meio de questionário previamente testado. Utilizou-se de análises de regressão logística binária bruta e ajustada. Os rapazes (36,9%) relataram maior envolvimento em brigas em relação às moças (26,0%, p<0,05). Rapazes que residiam em área urbana (OR:1,45) e não moravam com a família (OR: 2,22), assim como moças que estudavam no período noturno (OR: 1,26) apresentaram maiores chances de envolverem-se em brigas. Adolescentes de 17 a 19 anos possuíam chances reduzidas de envolverem-se em brigas (ORRapazes:0,66; ORMoças:0,80) comparados aos de 15 e 16 anos. A prática de atividades coletivas nos rapazes (OR: 1,56) e a prática combinada de atividades coletivas e individuais em rapazes (OR: 1,91) e moças (OR: 1,36) foram associadas ao envolvimento em brigas. Conclui-se que rapazes foram mais propensos a se envolverem em brigas, principalmente os mais novos, aqueles que não moravam com a família e que residiam em área urbana. Em ambos os sexos, o envolvimento em brigas foi maior entre os praticantes de atividades físicas coletivas.