Consumer food environments change over a 5-year period.

OBJECTIVE: Evaluate the 5-year changes in the consumers' food environment in the area of a health promotion service in Brazilian primary health care. Our hypothesis is that the consumers' food environment in the areas with primary healthcare services has changes that may favour healthy eating habits over time. DESIGN: Longitudinal study. SETTING: The territory around the primary healthcare services in Belo Horizonte, Minas Gerais, Brazil. PARTICIPANTS: All food stores and open-air food markets that sell fruits and vegetables around the primary healthcare services in 2013 (n 272) and in 2018 (n 265). RESULTS: Fruit diversity increased by 13·4 % (P < 0·001) and vegetables variety and quality by 16·1 % (P = 0·003) and 12·5 % (P < 0·001), respectively. Corn snacks showed an increase in availability (13·5 %; P = 0·002). The increase in advertising was observed for fruits and vegetables (34·6 %; P < 0·001) and ultra-processed foods (47·6 %; P < 0·001). Supermarkets showed an increase in the Healthy Food Store Index (three points; P < 0·001), while fruits and vegetables stores showed a decrease of one point in the index (P < 0·001). CONCLUSIONS: The unequal changes in the consumers' food environment according to the food stores types demonstrate the importance of food supply policies that promote a healthy environment and favour the maintenance of traditional healthy food retailers.

Health promotion of long-haul truck drivers and their families.

OBJECTIVES: to describe the development of a Health Information and Communication Technology for the health care of long-haul truck drivers and their families. METHODS: this is a description of the development of an Information and Communication Technology, developed from March to September 2023, following the systematization of the experience in five steps: 1) starting point, 2) initial questions, 3) recovery of the lived process, 4) background reflection, and 5) arrival points. RESULTS: the technology called "Work-Family Balance," electronically available, presents resources for the health care of long-haul truck drivers. It is anchored in studies on the health of long-haul truck drivers, notes from the International Labor Organization, the Strategic Action Plan for Confronting Chronic Diseases and Non-Communicable Diseases in Brazil, 2021-2030, and the Declaration by the International Association of Family Nursing. FINAL CONSIDERATIONS: the theoretical improvement of nursing can potentially improve the health care of long-haul truck drivers, prevent Chronic Non-Communicable Diseases, and promote work-life balance to achieve the goals of Agenda 2030.

[A conceptual framework for good preventive practices (or for quaternary prevention)]. / Uma articulação conceitual para boas práticas preventivas (ou para a prevenção quaternária).

Prevention is universally advocated, especially in the case of noncommunicable diseases. However, given the proliferation of preventive technologies, it does not seem defensible to generically encourage preventive behaviors and tests for healthcare professionals and users. In this essay, we articulate concepts, ideas and criteria for considering preventive measures, providing a minimum guide to be used by professionals (especially in primary healthcare) and managers. The concepts of primary, secondary and quaternary prevention are explored, as well as those of reductive and additive prevention, high-risk and population-based preventive strategies; evidence-based medicine and its contemporary crisis; the precautionary principle; health promotion, an expanded, person-centered approach and shared decision-making. This discussion was designed to improve competence in the evaluation of preventive measures, making clinical and health decisions more judicious and less iatrogenic regarding primary and secondary prevention.

A prevenção é consensualmente defendida, especialmente para as doenças crônicas não transmissíveis. Porém, dada a proliferação de tecnologias preventivas, não parece defensável estimular genericamente condutas e exames preventivos em profissionais de saúde e usuários. Neste ensaio, apresentamos uma articulação de conceitos, ideias e critérios para a consideração de medidas preventivas, como um roteiro mínimo a ser manejado pelos profissionais (especialmente os da atenção primária à saúde) e gestores. São articulados os conceitos de: prevenção primária, secundária e quaternária; prevenção redutiva e aditiva, estratégias preventivas de alto risco e populacional; medicina baseada em evidências e sua crise contemporânea; princípio da precaução; promoção da saúde, abordagem ampliada e centrada na pessoa e decisão compartilhada. Tal articulação foi concebida visando melhorar a competência na avaliação de medidas preventivas, tornando as decisões clínicas e sanitárias mais criteriosas e menos iatrogênicas quanto à prevenção primária e secundária.

La prevención es defendida consensuadamente, especialmente en las enfermedades crónicas no transmisibles. Sin embargo, dada la proliferación de tecnologías preventivas, no parece sostenible fomentar genéricamente conductas y exámenes preventivos entre los profesionales de la salud y los usuarios. En este ensayo, presentamos una articulación de conceptos, ideas y criterios para considerar medidas preventivas, como una guía mínima que manejar por parte de los profesionales (especialmente en la atención primaria de salud) y gestores. Se articulan los conceptos de prevención primaria, secundaria y cuaternaria; prevención reductiva y aditiva, estrategias preventivas de alto riesgo y poblacional; medicina basada en evidencias y su crisis contemporánea; principio de precaución; promoción de la salud, abordaje ampliado y centrado en la persona y toma de decisiones compartida. Esta articulación fue diseñada para mejorar la competencia en la evaluación de medidas preventivas, haciendo que las decisiones clínicas y de salud sean más juiciosas y menos iatrogénicas con relación a la prevención primaria y secundaria.

How to Reduce Physical Inactivity in School Context? A Systematic Review of the Concept of Body Practices.

(1) Background: Physical inactivity is a recognized global problem, with schools identified by UNESCO and WHO as critical settings for intervention. Despite existing efforts, the prevalence of physical inactivity remains high. This study aims to explore the potential of the concept of body practices as a novel framework to address physical inactivity within school contexts, potentially offering an alternative to traditional intervention models. (2) Methods: This study carried out a systematic review of the concept of body practices to understand its use in the scientific literature. (3) Results: The results indicate that (a) the definition of the concept that the authors used is broad; (b) the problems they face are varied, such as the life cycle, negative emotions, gender, physical inactivity, well-being, and social problems; (c) the research methodologies are predominantly quantitative; (d) and the intervention in schools focuses on students, but not on the entire school community. (4) Conclusions: this concept has great potential for use in initiatives and/or policies that seek to address physical inactivity in the school context.

[Dictatorship, Health and Propaganda: The National Immunization Program (PNI) and the media campaign for compulsory vaccination]. / Ditadura, Saúde e Propaganda: O Programa Nacional de Imunização (PNI) e a campanha midiática de vacinação obrigatória.

This article analyzes the films produced and broadcast between 1976 and 1978 by the National Agency and the Public Relations Office (ARP) for the campaign to publicize the mandatory vaccination that was instituted by the National Immunization Plan (PNI), created in 1975 and regulated by Decree No. 78,231 of August 12, 1976. The objective is to understand the narrative constructed through images and speeches aimed at convincing the population to make vaccination a culturally accepted practice. To achieve this, we examine the legislation on the subject during the period under analysis, namely the civil-military dictatorship. The dictatorial regime is approached based on the conceptual aspects that guide the analysis of the appropriation of health campaigns as propaganda and investments in a private and curative health model. We can therefore conclude that the initiative to create the PNI is a hiatus in this process of privatizing health, since it is not an action guided by the dictatorship's responsibility for the health of the population, but an action that involved the management of multiple actors in the health field, and which was embraced by the regime because it was a process directly linked to interests connected to the country's conservative modernization project.

Este artigo analisa os filmes produzidos e veiculados, entre 1976 e 1978, pela Agência Nacional e pela Assessoria de Relações Públicas (ARP) para a campanha de divulgação da vacinação obrigatória que foi instituída pelo Plano Nacional de Imunizações (PNI), criado em 1975, e regulamentado pelo Decreto nº 78.231, de 12 de agosto de 1976. O objetivo é compreender a narrativa construída através de imagens e discursos visando tornar a vacina uma prática culturalmente aceita. Para isso, recorre-se à legislação que versa sobre o tema no período analisado, qual seja na ditadura civil-militar. O regime ditatorial é abordado a partir dos aspectos conceituais que orientam as análises sobre a apropriação das campanhas de saúde como propaganda e dos investimentos em um modelo de saúde privada e curativista. Conclui-se, assim, que a iniciativa de criação do PNI trata-se de um hiato nesse processo de privatização da saúde, já que não é uma ação orientada pela responsabilidade da ditadura para com a saúde da população, mas sim, uma ação que envolveu a gerência de múltiplos atores do campo da saúde, e que foi encampada pelo regime por se tratar de um processo diretamente atrelado a interesses ligados ao projeto de modernização conservadora do país.

Promoting mental health in the workplace: web software development and validation.

OBJECTIVE: to develop and validate the content and technical aspects of a web software program for promoting mental health in the workplace. METHOD: applied methodological study and technological development, carried out in three stages: 1) Umbrella review development; 2) Web software development; 3) Content and technical validation carried out by 14 judges. The data was submitted to descriptive statistical analysis and calculation of the content validity index. RESULTS: based on the guidelines' recommendations, information was defined and extracted in order to develop the web software consisting of the following dimensions: mental health education, support among coworkers, promotion strategies and mental health self-assessment. For the technical development, the objectives, general functions and technological infrastructure were defined. After development and functional testing, the version was made available for content and technical validation by judges. The overall content validity index was 0.98 and for the technical aspects it was 0.97. CONCLUSION: the agreement between the judges in relation to the content and technical aspects, as well as the suggestions incorporated, demonstrated the potential for using web software to promote mental health in the workplace.

Determining RE-AIM indicators for evaluating the Estratégia Amamenta e Alimenta Brasil (EAAB - Brazilian Breastfeeding and Complementary Feeding Strategy).

OBJECTIVE: To confirm the diagram of the program's impact pathways and Estratégia Amamenta e Alimenta Brasil (EAAB - Brazilian Breastfeeding and Complementary Feeding Strategy) core functions, and to determine indicators for evaluating EAAB. METHODS: This is a qualitative study within the field of implementation research. Data collection included two focus groups with EAAB implementers, document analysis, and literature review. The analysis included a review of the participants' suggestions and two stages of reviewing the diagram and the names of the impact pathways and core functions. Questions for evaluating the EAAB were then constructed based on the confirmed diagram. The indicators of the RE-AIM framework (reach, effectiveness, adoption, implementation, maintenance) were adapted to the EAAB context. The evaluation questions were revised according to the RE-AIM domains and, finally, indicators were determined for each evaluation question. RESULTS: This study advanced the analysis of EAAB implementation, defining 22 indicators for its monitoring and evaluation. Most of the indicators are already used in implementation, however, the analysis with the RE-AIM framework allowed the indicators to be updated to be more specific, measurable, and relevant to the desired objectives. CONCLUSION: The results of the study support the pragmatic application of RE-AIM evaluation in health programs and encourage the planning of evaluation indicators for other child health and development programs in primary care.

EHealth technologies in parental care for preterm infants: an integrative review. / Tecnologias eHealth nos cuidados parentais aos bebês nascidos prematuros: revisão integrativa.

The eHealth technologies promote parental care practices for preterm infants. Nonetheless, we should underscore the abundant information and available apps and disparities in these resources' quality, usability, and reliability. This article examines eHealth technologies directed at parents to care for preterm infants. An integrative review was conducted across the principal health databases (Capes, EBSCO, BVS, PubMed, Scholar, and SciELO), selecting works published from 2011 to 2022 in Portuguese and English, focusing on the use of eHealth technologies for the care of preterm infants. We identified 13 articles related to information and communication technologies in strategies for educating and promoting the health of preterm infants and their parents and the importance of evaluating and validating eHealth technologies in maternal and child health promotion. Properly validated eHealth technologies can be crucial in supporting parents in promoting health and providing care for preterm infants after hospital discharge, which, in turn, can drive the evolution of healthcare systems and improve clinical practices.

As tecnologias eHealth contribuem na promoção das práticas parentais de cuidado para bebês pré-termo. Não obstante, é notável a abundância de informações e aplicativos disponíveis, a disparidade na qualidade, facilidade de uso e confiabilidade desses recursos. Este artigo objetiva examinar as tecnologias eHealth direcionadas aos pais para o cuidado de bebês pré-termo. Realizou-se uma revisão integrativa nas principais bases de dados da área da saúde (Capes, EBSCO, BVS, PubMed, Scholar e SciELO), com a seleção de publicações de 2011 a 2022, em português e inglês, sobre a utilização de tecnologias eHealth voltadas aos cuidados de bebês pré-termo. Identificaram-se 13 artigos com temáticas sobre: as tecnologias da informação e comunicação nas estratégias de educação e a promoção da saúde de bebês pré-termo e seus pais; e importância da avaliação e validação das tecnologias eHealth na promoção da saúde materno-infantil. Tecnologias eHealth validadas adequadamente podem desempenhar um papel fundamental em apoiar os pais na promoção da saúde e na prestação de cuidados ao bebê pré-termo após a alta hospitalar. Isso, por sua vez, tem o potencial de impulsionar a evolução dos sistemas de saúde e a melhoria das práticas clínicas.

Where has the circle taken us? A conversation on sexual health promotion for sex-dissident populations. / Para onde a roda nos levou? Uma conversa sobre promoção da saúde sexual para populações sexo-dissidentes.

This work discusses the health promotion challenges of men who have sex with men (MSM) through the use of data from a conversation circle with people from institutions that provide services to MSM in the Metropolitan Region of Recife. The results allow for the identification of the following challenges for health promotion work, not only for MSM but also for sex dissidents: difficulties with the use of identity categories, stigmatization for providing them with sexual health care, structural racism, the deprivation of liberty, extreme poverty, and literacy.

O texto discute os desafios para promoção da saúde de homens que fazem sexo com homens (HSHs) por meio de dados oriundos de uma roda de conversa, com pessoas de instituições que prestam serviços para HSHs na Região Metropolitana do Recife. Os resultados permitiram identificar desafios para o trabalho de promoção à saude, não só para HSHs, mas para pessoas sexo-dissidentes: dificuldades com o uso das categorias de identidade; estigmatização por prestar-lhes cuidado em saúde sexual; racismo estrutural; contexto de privação de liberdade; extrema pobreza; letramento.

Culture circle in primary care: dialogues with managers on health promotion.

OBJECTIVE: To identify health promotion strategies used by managers in primary health care. METHOD: Qualitative research, of a participant action nature, which adopted the Culture Circle proposed by Paulo Freire as its methodological reference. Eleven primary health care managers from a medium-sized municipality in southern Brazil took part. RESULTS: Nine generative themes emerged, categorized into four themes that highlight the interconnection between health promotion, social determinants and primary health care. These themes highlight preventive approaches, healthy habits and underline the need for a multidisciplinary approach to health care, recognizing the complexity of the dimensions involved, the influence of social determinants, environmental and health issues. These aspects call for intersectoral policies and actions, demonstrating the viability of health promotion in line with the principles of the Unified Health System. FINAL CONSIDERATIONS: The autonomy of professionals working in primary health care services is highlighted, especially that of nurses, who play a central role in connecting and organizing health promotion actions.

Mobile Apps to Promote and Motivate Exercise in Adolescents in Mexico: A Systematic Review.

Worldwide, more than 5.4 billion people have a smartphone. Based on this, thousands of Apps are being developed, each one with different functions such as: education, communication, organization, home automatization and exercising. The aim of this study was to analyze the scientific evidence available worldwide on mobile applications to promote and motivate exercise in adolescents. It was carried out following the PRISMA. A total of 483 articles were identified, of which 300 were eliminated. For title 247, for abstract 33 and 20 for other reasons, giving a total of 183 articles to assess their eligibility, 158 were eliminated. Remaining 25 articles, 12 for abstract and 26 for other reasons, giving a total of 6 articles included for the study. The use of Apps aimed at adolescents are tools that can help with personal care and health issues in this group.

Determinants of health-promoting behaviors in pregnant women.

OBJECTIVE: The aim of the study was to examine the relationship between social support, marital dissatisfaction, psychological factors, and health-promoting behaviors in pregnant women. METHODS: This cross-sectional study was conducted on 1,265 pregnant women who visited the outpatient clinic of a maternity hospital between May and August 2023. The Health Promotion Lifestyle-II Questionnaire was used to measure the healthy lifestyle behaviors of pregnant women. The mental health status of pregnant women was measured using the Depression Anxiety and Stress Scale-21. The Marital Disaffection Scale was used to assess the level of disaffection toward a spouse. Perceived social support was measured by the Multidimensional Perceived Social Support Scale. RESULTS: Pregnant women had a mean age of 26.46±5.09 years. Multivariate linear regression analysis revealed that there was a positive association between perceived social support and health-promoting behaviors. It was also found that marital disaffection was negatively associated with health-promoting behaviors (p<0.001). CONCLUSION: The present study suggests that stress, anxiety, depression, and marital disaffection are negatively associated with health-promoting lifestyle behaviors, while social support is positively associated with the adoption of health practices in pregnant women. Understanding the complex interplay between psychosocial factors and healthy behaviors is crucial to improving healthy behaviors in pregnant women.

Educational intervention on perceived stress among adults with type 2 diabetes and metabolic syndrome: a non-randomized clinical trial.

Objective: To assess the effectiveness of an educational intervention on perceived stress and metabolic syndrome parameters among adults with type 2 diabetes mellitus. Method: Fifty-one adults (aged 48.73±7.84; 86.3% of women) were included in a non-randomized clinical trial performed in a healthcare unit for six months (Brazilian Clinical Trial Registry: RBR-43K52N). All participants were diagnosed with type 2 diabetes mellitus and metabolic syndrome (intervention group, n=26; control group, n=25). The intervention consisted of a nurse-led educational health-promoting program with a multidisciplinary approach organized in seven workshops. The primary outcome was decreased perceived stress, and the secondary outcome was improvement in metabolic syndrome parameters according to perceived stress levels. These outcomes were assessed at two points in time, at the baseline and follow-up. Results: Participation in the intervention program resulted in a significant decrease in perceived stress (p=0.028). The stressed participants in the intervention group experienced a significant decrease in blood glucose levels (p=0.001) and a significant increase in high-density lipoprotein-cholesterol (p=0.003) concentrations after the six-month intervention. Conclusion: The nurse-led educational health-promoting program decreased perceived stress among adults with type 2 diabetes mellitus and metabolic syndrome, improving fasting blood glucose and high-density lipoprotein cholesterol among the stressed participants in the intervention group.

Impact of the ActTeens Program on physical activity and fitness in adolescents: a cluster randomized controlled trial.

BACKGROUND: The aim of our study was to evaluate the impact of the ActTeens Program on physical activity and health-related physical fitness among adolescents in Brazil. METHODS: The "ActTeens Program" was conducted using a cluster-randomized controlled trial during 24-week school term. The sample consisted of 317 adolescents (52.7% girls; 13.61 ± 0.70 years) from four secondary schools that were randomly assigned to intervention group (N = 169) or control group (N = 148). This school-based physical activity (PA) intervention involved two components: (i) structured physical activity sessions delivered within physical education (PE) and (ii) healthy lifestyle guidance (mHealth). The primary outcome was PA assessed using Physical Activity Questionnaire for Adolescents (PAQ-A); secondary outcomes included muscular (MF) and cardiorespiratory fitness (CRF) assessed using 90-push-up, handgrip dynamometer, standing long jump, and 20 m PACER shuttle run test. Assessments were conducted at baseline, 12- and 24-week. Intervention effects were assessed using linear mixed models (LMM). RESULTS: For the primary outcome (PA), no significant group-by-time effects were observed for physical education based-PA (0.3 score; 95%CI: -0.1; 0.6; and - 0.01 score; 95%CI: -0.03; 0.03, at 12-wk and 24-wk respectively) and total PA (-0.02 score; 95%CI: -0.2; 0.2; and - 0.01score; 95%CI: -0.2; 0.2, at 12 and 24 weeks respectively). After 24 weeks, we observed a significant group by time effects for lower body muscular fitness (12.9 cm; 95%CI, 3.2 to 22.2). CONCLUSION: The implementation of aerobic and muscle-strengthening exercises used in the ActTeens intervention did not lead to improvements in physical activity. The intervention resulted in improved lower body muscular fitness, however, we found no significant differences for upper body muscular and cardiorespiratory fitness.

Mexican-origin women's individual and collective strategies to access and share health-promoting resources in the context of exclusionary immigration and immigrant policies.

BACKGROUND: A growing literature has documented the social, economic, and health impacts of exclusionary immigration and immigrant policies in the early 21st century for Latiné communities in the US, pointing to immigration and immigrant policies as forms of structural racism that affect individual, family, and community health and well-being. Furthermore, the past decade has seen an increase in bi-partisan exclusionary immigration and immigrant policies. Immigration enforcement has been a major topic during the 2024 Presidential election cycle, portending an augmentation of exclusionary policies towards immigrants. Within this context, scholars have called for research that highlights the ways in which Latiné communities navigate exclusionary immigration and immigrant policies, and implications for health. This study examines ways in which Mexican-origin women in a midwestern northern border community navigate restrictive immigration and immigrant policies to access health-promoting resources and care for their well-being. METHODS: We conducted a grounded theory analysis drawing on interviews with 48 Mexican-origin women in Detroit, Michigan, who identified as being in the first, 1.5, or second immigrant generation. Interviews were conducted in English or Spanish, depending on participants' preferences, and were conducted at community-based organizations or other locations convenient to participants in 2013-2014. RESULTS: Women reported encountering an interconnected web of institutional processes that used racializing markers to infer legal status and eligibility to access health-promoting resources. Our findings highlight women's use of both individual and collective action to navigate exclusionary policies and processes, working to: (1) maintain access to health-promoting resources; (2) limit labeling and stigmatization; and (3) mitigate adverse impacts of immigrant policing on health and well-being. The strategies women engaged were shaped by both the immigration processes and structures they confronted, and the resources to which they had access to within their social network. CONCLUSIONS: Our findings suggest a complex interplay of immigration-related policies and processes, social networks, and health-relevant resources. They highlight the importance of inclusive policies to promote health for immigrant communities. These findings illuminate women's agency in the context of structural violence facing immigrant women and are particularly salient in the face of anti-immigrant rhetoric and exclusionary immigration and immigrant policies.

Promoção da saúde: compreensão de idosos participantes de atividades remotas em grupos / Health promotion: understanding of elderly people participating in remote group activities / Promoción de la salud: comprensión de las personas mayores que participan en actividades grupales a distancia

Introdução: A longevidade é uma conquista na sociedade e dessa forma, é indispensável o apoio dos profissionais da saúde, a fim de ressignificar o envelhecimento. A promoção da saúde do idoso pode ser realizada por meio de ações em grupos. Objetivo: Compreender as ações promotoras da saúde, que são praticadas pelas pessoas idosas, participantes de atividades remotas em grupo. Metodologia: Estudo descritivo, exploratório de caráter qualitativo. Foram convidados idosos participantes de um projeto de extensão universitária. Os critérios de inclusão foram idade igual ou superior a 60 anos, independente do gênero, e grau de escolaridade. O grupo remoto ocorreu semanalmente, durante 13 encontros, com uma hora de duração. Os dados foram coletados através de uma entrevista semiestruturada contendo questões sobre a compreensão referente às ações promotoras da saúde que realizavam em seu cotidiano. As respostas foram categorizadas através da Análise de Conteúdo, modalidade temática. Resultados: Participaram 11 pessoas idosas, com idade entre 60 e 81 anos, predominantemente mulheres e viúvas. Três categorias emergiram das análises sendo elas: 1. Autocuidado: ações promotoras da saúde, 2. Dificuldades vivenciadas para promover a saúde; 3. Percepção sobre a qualidade de vida e satisfação quanto à saúde. Conclusão: A compreensão do grupo abarcou a promoção da saúde em seus aspectos físico, mental e o social, distanciando-se do pensamento focado na ausência de doença. Cada pessoa idosa maneja, a seu modo, as formas de se manter saudável. (AU)

Introduction: Longevity is an achievement in society and, therefore, the support of health professionals is essential to give new meaning to aging. Promoting the health of the elderly can be carried out through group actions. Objective: To understand health-promoting actions, which are practiced by elderly people, participants in a group of remote activities. Methodology: Descriptive, exploratory study of qualitative nature. Elderly people participating in a university extension project were invited. The inclusion criteria were age equal to or over 60 years old, regardless of gender, and level of education. The remote group took place weekly, for 13 meetings, lasting one hour. Data were collected through a semi-structured interview containing questions about understanding regarding the health-promoting actions they carried out in their daily lives. The responses were categorized using Content Analysis, thematic modality. Results: 11 elderly people participated, aged between 60 and 81 years, predominantly women and widows. Three categories emerged from the analyses: 1. Self-care: health-promoting actions, 2. Difficulties experienced to promote health; 3. Perception of quality of life and health satisfaction. Conclusion: The group's understanding encompassed the promotion of health in its physical, mental and social aspects, moving away from thinking focused on the absence of disease. Elderly people manage, in their own way, ways to stay healthy. (AU)

Introducción: La longevidad es un logro en la sociedad y, por ello, el apoyo de los profesionales de la salud es fundamental para darle un nuevo significado al envejecimiento. La promoción de la salud de las personas mayores se puede realizar a través de acciones grupales. Objetivo: Comprender acciones de promoción de la salud, practicadas por las personas mayores, participantes de un grupo de actividades a distancia. Metodología: Estudio descriptivo, exploratorio, de carácter cualitativo. Se invitó a personas mayores que participan en un proyecto de extensión universitaria. Los criterios de inclusión fueron edad igual o mayor a 60 años, independientemente del sexo y nivel de estudios. El grupo remoto se desarrolló semanalmente, durante 13 reuniones, con una duración de una hora. Los datos fueron recolectados a través de una entrevista semiestructurada que contenía preguntas sobre la comprensión de las acciones de promoción de la salud que realizaban en su vida diaria. Las respuestas fueron categorizadas mediante Análisis de Contenido, modalidad temática. Resultados: Participaron 11 personas mayores, con edades entre 60 y 81 años, predominantemente mujeres y viudas. De los análisis surgieron tres categorías: 1. Autocuidado: acciones promotoras de la salud, 2. Dificultades vividas en la promoción de la salud; 3. Percepción de calidad de vida y satisfacción con la salud. Conclusión: La comprensión del grupo abarcó la promoción de la salud en sus aspectos físicos, mentales y sociales, alejándose del pensamiento centrado en la ausencia de enfermedad. Cada persona mayor logra, a su manera, maneras de mantenerse saludable. (AU)

[How to improve active mobility in São Paulo, Brazil? Survey with leaders of nongovernmental organizations and public and private sector managers]. / Como melhorar a mobilidade ativa em São Paulo, Brasil? Inquérito com lideranças de organizações não governamentais e com gestores públicos e privados.

This study aimed to describe a quantitative survey conducted with leaders to investigate effective and feasible actions that can be evaluated in computational models to inform policies to promote active mobility based in the city of São Paulo, Brazil. In 2022, an online survey was conducted during the Health Survey in São Paulo (Physical Activity and Environment study), which is monitored by representatives of nongovernmental organizations and public and private sector managers. A questionnaire was elaborated with three questions with 13 alternative answers about actions to promote walking and/or cycling. Leaders should select up to three alternatives based on their potential regarding: (1) effectiveness; (2) feasibility or ease of implementation; and (3) desire to verify tests in computational models to inform policies. The survey was answered by 18 leaders from 16 institutions, comprising 13 (72%) women and 12 (67%) representatives of the third sector, whose average age was 48 years and all had complete higher education. Reducing the speed of motor vehicles was the most cited option in all three questions. Other actions mentioned refer to controlling the traffic of vehicles in central areas, improving pedestrian safety, reducing the distances between homes and places of employment, conducting educational campaigns, and expanding and enhancing structures such as bicycle lanes and sidewalks. The results are relevant to support evidence-based decision-making in public management and to provide subsidies for the development of computational models with a view to promoting active mobility.

Este estudo teve como objetivo descrever um inquérito quantitativo realizado com lideranças para investigar ações efetivas, viáveis e que podem ser testadas em modelos computacionais para informar políticas de promoção da mobilidade ativa, tendo como base a cidade de São Paulo, Brasil. Em 2022, foi realizado um inquérito online no contexto da pesquisa de Atividade Física e Ambiente do Inquérito de Saúde de São Paulo, acompanhada por representantes de organizações não governamentais, gestores públicos e de entidades privadas. Foi elaborado questionário com três perguntas com 13 alternativas de respostas sobre ações para promoção da caminhada ou uso de bicicleta. As lideranças deveriam selecionar até três alternativas a partir de seu potencial em termos de (1) efetividade; (2) viabilidade ou facilidade de implementação; e (3) desejo de realizar testes em modelos computacionais para informar políticas. O inquérito foi respondido por 18 lideranças de 16 instituições, sendo 13 (72%) mulheres e 12 (67%) representantes do terceiro setor, cuja média de idade era 48 anos, todos com nível superior de escolaridade. A redução da velocidade dos veículos motorizados foi a opção mais citada nas três questões. Outras ações citadas referem-se ao controle de circulação de veículos em regiões centrais, à segurança de pedestres, à diminuição das distâncias entre residências e locais de emprego, às campanhas educativas e à ampliação e melhoria de estruturas como ciclovias e calçadas. Os resultados são relevantes para apoiar a tomada de decisões baseadas em evidências na gestão pública e oferecer subsídios para a elaboração de modelos computacionais com vistas à promoção da mobilidade ativa.

Este estudio tuvo como objetivo presentar una encuesta cuantitativa realizada con líderes para investigar las acciones efectivas, viables y que puedan probarse en modelos informáticos para orientar las políticas que promuevan la movilidad activa en la ciudad de São Paulo, Brasil. En 2022 se realizó una encuesta en línea en el contexto de la Encuesta de Salud de São Paulo (Actividad Física y Medio Ambiente), que es monitoreada por representantes de organizaciones no gubernamentales, gestores públicos y entidades privadas. Se elaboró un cuestionario de tres preguntas con 13 respuestas alternativas sobre acciones para promover la caminata o el uso de la bicicleta. Los líderes podían seleccionar hasta tres alternativas en función de su potencial en términos de (1) efectividad; (2) viabilidad o facilidad de implementación; y (3) deseo de verificar las pruebas en modelos informáticos para orientar las políticas. La encuesta fue respondida por 18 líderes de 16 instituciones; de los cuales 13 (72%) eran mujeres y 12 (67%) representaban el tercer sector; la edad promedio de ellos fue de 48 años y todos contaban con educación superior. Reducir la velocidad de los vehículos de motor fue la opción más citada en las tres preguntas. Otras acciones mencionadas se refieren al control de la circulación de vehículos en las regiones centrales, la seguridad de los peatones, la reducción de las distancias entre los hogares y los lugares de trabajo, las campañas educativas y la expansión y mejora de estructuras como carriles bici y aceras. Los resultados son relevantes para apoyar la toma de decisiones basada en la evidencia en la gestión pública y ofrecer subsidios para la elaboración de modelos computacionales destinados a promover la movilidad activa.

[Digital educational materials on culinary skills as a health promotion strategy in Primary Health Care]. / Materiais educativos digitais sobre habilidades culinárias como estratégia de promoção de saúde na Atenção Primária.

This study aims to report on the development and validation of digital educational materials based on the dimensions of home cooking skills (HCS) assessed on a scale destined for PHC professionals, following the recommendations of The Dietary Guidelines for the Brazilian Population and on The Food and Nutrition Education Framework (FNE) for Public Policies. Five videos and graphic materials were developed with proposals for activities to develop HCS and encourage its implementation in actions and guidelines in the community and in professional care. The content of the materials was evaluated by experts using the Two-Round Delphi-based technique and statistical analyses for evidence of consensus. Specialists presented comments to improve the products and their applicability. The materials presented decoded language and playful illustrations with characters representative of the target population. Evidence of satisfactory content validity was presented and can be used in permanent education actions, seeking the qualification of the workforce and in FNE actions within the scope of the law. The graphic materials make it possible to associate the content of the videos with practice in contexts consistent with the reality of the individuals.

Este estudo visa reportar desenvolvimento e validação de materiais educativos digitais baseados nas dimensões de habilidades culinárias domésticas (HCD) avaliadas por escala destinada aos profissionais da APS, nas recomendações do Guia Alimentar Para a População Brasileira e no Marco de Educação Alimentar e Nutricional (EAN) para Políticas Públicas. Foram desenvolvidos 5 vídeos e materiais gráficos com propostas de atividades para desenvolvimento de HCD e estímulo à sua implementação em ações e orientações junto à comunidade e em atendimentos profissionais. O conteúdo dos materiais foi avaliado por especialistas utilizando técnica Delphi de 2 rounds e análises estatísticas para evidência de consenso. Especialistas proferiram comentários para aprimoramento dos produtos e sua aplicabilidade. Os materiais apresentaram linguagem decodificada, ilustrações lúdicas, com personagens representativos da população-alvo. Apresentaram evidência de validade de conteúdo satisfatória e podem ser utilizados em ações de educação permanente, visando a qualificação da força de trabalho, e em ações de EAN junto aos sujeitos de direito. Os materiais gráficos possibilitam associar o conteúdo dos vídeos à prática, em contextos condizentes com a realidade dos sujeitos.

Popular education in the SUS: current challenges from the perspective of the Observatory of Popular Health Education and the Brazilian Reality. / Educação popular no SUS: desafios atuais no olhar do Observatório de Educação Popular em Saúde e Realidade Brasileira.

This paper aims to bring reflections and notes for strengthening Brazilian structuring public policies, focusing on Popular Health Education in the Unified Health System (SUS) from the perspectives built in the Observatory of Popular Health Education and the Brazilian Reality. The Observatory is a valuable space for sharing health professionals' and popular educators' interpretations and experiences about local and Brazilian realities from the perspective of Popular Health Education. During its two years of activity, the Observatory has gathered summary interpretations of Popular Health Education for the crises that traverse the country's recent history in a dialogical and participatory way. In a panoramic view, the shared statements point to challenges for valuing the human approach to health promotion, including respecting local and community knowledge and social practices. Moreover, we underscore the importance of social participation in constructing participatory social processes in public health toward citizen autonomy and expanded democratic dynamics in the Brazilian State and its social equipment.

Este trabalho se propõe a trazer reflexões e apontamentos para o fortalecimento de políticas públicas estruturantes no Brasil, com foco na Educação Popular em Saúde no Sistema Único de Saúde (SUS), a partir das perspectivas construídas no Observatório de Educação Popular em Saúde e Realidade Brasileira. O Observatório é um espaço profícuo para o compartilhamento de interpretações e experiências de profissionais de saúde e educadores populares sobre a realidade local e realidade brasileira, a partir da ótica da Educação Popular em Saúde. De forma dialógica e participativa, ao longo de seus 2 anos de atividade, o Observatório foi capaz de reunir interpretações sintéticas da Educação Popular em Saúde para as crises que atravessam a história recente do país. De maneira panorâmica, as falas compartilhadas apontam desafios para valorização da abordagem humana na promoção da saúde, com a inclusão e o respeito aos saberes e práticas sociais locais e comunitárias. Além disso, destaca-se a importância da participação social na construção de processos sociais participativos na saúde pública, visando à autonomia do cidadão e à ampliação da dinâmica democrática no Estado brasileiro e em seus equipamentos sociais.