Post on 29-Mar-2015
Eduardo Simoes, MD, MSc, MPHDirector, Prevention Research Centers Program
Healthy Aging Research Network MeetingMarch 8, 2011
Project GUIA Understanding and promoting physical
activity in Brazil and Latin America
National Center for Chronic Disease Prevention and Health Promotion
Division of Adult and Community Health
Purpose of Today’s Presentation
Project GUIA: Understanding and promoting physical activity in Brazil and Latin America www.projectguia.org
Describe the partnerships and outcomes related to Project GUIA that may be helpful to HAN members
Identify lessons learned and recommendations from the GUIA partnership
Context
By 2020, chronic diseases will account for 80% of deaths in developing countries (WHO)
Regular physical activity can decrease the burden of chronic disease
Physical activity interventions in Latin America have not been systematically evaluated
Methods used by CDC have applicability in Latin America The Guide to Community Preventive Services (The
Community Guide) Observational methods
Why Brazil?
CDC, WHO, and World Bank global health priorities
Size, influence, and public health system Epidemiologic, lifestyle, and demographic
transitions Potential applicability of the Community
Guide to developing countries Public health issues similar to those in other
countries of the Americas From 2005 to 2009
Brazil’s Ministry of Health invested more than $70 million in infrastructure for surveillance, evaluation and public health programs for non-communicable diseases
Four Project Aims
Aim 1 (2006): Establish and build cross-national, collaborative relationships with
researchers, practitioners, and institutions in Brazil to enhance capacity to determine and implement evidence-based interventions that promote physical activity.
Aim 2 (2006): Synthesize literature on community-based strategies to promote
physical activity in Latin America.
Aim 3 (2007-2008): Evaluate two ongoing community interventions in Brazil based on the
review accomplished in Aim 2.
Aim 4 (2009): Disseminate the products from the review process and intervention
evaluations to communities, institutions, and public health professionals in Latin America.
Aim 1: Partnerships
Building a powerful and cohesive network for research
GUIA CollaboratorsUniversities Government Non-Government
Washington University in St. Louis – U.S.A.
Centers for Disease Control and Prevention – U.S.A.
CELAFISCS – Brazil
Saint Louis University –U.S.A.
Ministry of Health –Brazil Pan American Health Organization
Federal University of Sao Paulo – Brazil
Municipal Secretaries of Health – Brazil
Fundacion FES Social – Bogota, Colombia
Pontiff Catholic University of Parana – Curitiba, Brazil
Municipal Sports and Recreation Secretaries – Brazil
Federal University of Pelotas – Brazil
Los Andes University – Bogota, Colombia
Aim 2: Systematic Review
Used Community Guide methods to conduct a review of literature published in Portuguese or Spanish
Evaluation Results: Systematic Review
Very few PA intervention studies in Latin America (19)
Sufficient data to recommend school PE for increasing physical activity in children in Latin America
Three new community intervention types identified Informational approaches
• Delivery of short physical activity-related messages Behavioral and social approaches
• Physical activity classes in community settings Environmental and policy approaches
• Community-wide policy and planning
Possible to carry out evidence-based reviews in Latin America
Replicating an effective program with the San Diego PRC
Evaluation results from community-wide program Academia da Cidade
Children Teenager Adult Senior0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
37.3%
49.7% 48.3%
28.7%
62.7%
50.3% 51.7%
71.3%
No ACP (control)ACP (Intervention)
Accomplishments thus far High quality science and publications
On par with highly-funded U.S. trials U.S. - Brazil public health research and
practice collaboration Complex and highly effective partnerships
• Universities • Public health agencies / ministries• WHO / PAHO
Leveraged funding Not without challenges
Time & historical relationships require flexibility and trust-building
Lessons Learned from the Experience of Project GUIA
Suggested first steps
Experiences to repeat
Land mines to avoid
For more information please contact Centers for Disease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: cdcinfo@cdc.gov Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Questions and Discussion
National Center for Chronic Disease Prevention and Health Promotion
Division of Adult and Community Health