Evaluating the impact of a walking program in a disadvantaged area: using the RE-AIM framework by mixed methods

• Processo: 17/18324-8
• Modalidade de apoio: Auxílio à Pesquisa - Publicações científicas - Artigo
• Data de Início da vigência: 01 de outubro de 2017
• Data de Término da vigência: 31 de março de 2018
• Área do conhecimento: Ciências da Saúde - Educação Física
• Pesquisador responsável: Grace Angélica de Oliveira Gomes
• Beneficiário: Grace Angélica de Oliveira Gomes
• Instituição Sede: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brasil
• Município da Instituição Sede: São Carlos
• Assunto(s): Saúde pública Geriatria Envelhecimento Gestão em saúde Atividade física Publicações de divulgação científica Artigo científico
• Palavra(s)-Chave do Pesquisador: aging | gerontology | Health Management | physical activity | Process evaluation | Public Health | Atividade Física e Saúde Pública

Resumo

Background: The positive health impact of physical activity (PA) is well known, yet a large proportion of the world´s population remains sedentary. General PA programs are common as health promotion initiatives. However, effectiveness evaluations of such PA programs on individual and organizational aspects, which could inform the decision-making process of public health bodies are still lacking, particularly in the most socially disadvantaged areas, where health promotion schemes are particularly needed. The aim of this study was to assess the effectiveness of a Guided Walking Program in a high social vulnerability context.Methods: A quasi-experimental, mixed methods study was conducted. The program had a duration of six months and 6-month follow-up period after intervention. Session frequency was five times a week, where sessions consisted of supervised PA combined with educational sessions. The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework was followed to assess the program. The International Physical Activity Questionnaire (IPAQ) and accelerometers were used to measure levels of PA. Focus groups were employed to gain a comprehensive insight on the implementation domain.Results: Most subjects in the intervention (IG) (n=74) and control (CG) (n=74) groups were female (IG:90.5%; CG:95.9%), aged 18-49 years (IG:44.6%; CG:43.2%), received less than 1 minimum wage (IG:74.3%; CG:83.7%) and had 0-4 years of formal education (IG:52.1%; CG:46.1%). The reach of the intervention was 0.3%. The IG showed increased levels of PA at post-intervention and 6-month follow-up. However, the difference between groups was not statistically significant. Adoption data revealed that 89.5% of the professionals in the Primary Health Care Center (health center) team perceived the benefits of the program for the population. The program was independently promoted by the health center team for a further four months post-intervention. The qualitative data revealed that the program was discontinued due to participants' low adherence and human resource limitations in the unit's operational dynamics. (AU)