Agita Sao Paulo Policy And Delivery To Promote Physical Activity Among Women

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A sedentary lifestyle, which affects as much as 50% to 80% of the women world’s population (1-3), is associated with the main risk factors for chronic diseases. The Agita São Paulo Program was developed to address this problem. The Program is a multilevel plan that promotes messages about the health benefits of PA and coordinates activities and interventions for broader PA opportunities among more than 37 million inhabitants of the state of São Paulo, Brazil. "Agita" is a proper name that means more than just to move your body; it suggests also activating your mind, your social health, and even asking for active citizenship. The Program was launched in December 1996, by CELAFISCS. The Program became a role model for similar programs in other states of Brazil and in other Latin

American countries. The World Health Organization (WHO) has praised it as a model for other developing countries. The main goal of the Program is to change the general population’s PA behavior. The main message used by the Program to promote the adoption of an active lifestyle was recommended in 1995 by the ACSM and the CDC (8). Those two groups recommended that adults accumulate 30 minutes of moderate intensity physical activity per day that could be done in one session or in multiple sessions lasting at least 10 minutes each. Factors that are the key elements of the of the program’s success include:

a- Scientifically based information: all the activities and messages are supported by epidemiological and scientific information available in the international literature of the last decades.

b- Clear and simple message: "at least 30-min of PA per day" is the key message used to promote an active lifestyle; it is very easy to disseminate and understand.

c- Intellectual partnerships: more than 50 national and international advisors from the scientific PA, sports, and health areas are involved regularly to evaluate the program and suggest actions.

d- Institution partnership/coalitions: The Program has over 300 partner institutions comprising the Executive Board that carry out program activities. The main mission of these partners is to disseminate the program message throughout their own network systems. These groups include both governmental and non-governmental organizations and sectors ranging from media, health, education, and sports organizations to industries, workers, and environmental groups. Furthermore, the Program has avoided inflexible, formalistic mechanisms for adding new partner organizations. A "letter of intent" may be signed by any group that is willing to contribute to the Program’s objectives without making a rigid commitment.
e- Political and Technical Support: support was obtained from the state governors of Sao Paulo during the last three terms, as well as from National Health Authorities, Pan American Health Organization, WHO, and the Centers for Disease Control and Prevention.

f- Stakeholders: besides institutions, the Program seeks to acquire stakeholders who gain by helping to disseminate the message as well as organizing events and permanent activities in their areas.

g- Inclusion Principle: the Program promotes inclusion in several ways. It uses inclusion in its two boards, the Scientific Board, comprising prominent researchers from Brazil and overseas, and the Executive Board, comprising over 300 governmental, non-governmental, and private sector entities; furthermore, the Program emphasizes moderate and accumulation messages, carefully selected PA settings, and targeting messages to diverse groups, such as students, workers, and the elderly; the message itself is inclusive by offering PA to individuals and groups anytime and everywhere. The inclusion principle also allows cultural and regional diversity.

h- "Mobile Management": this style of management administers and balances the multiple components of the ecological model, whose three main parts are the Interpersonal, Social Environment and Physical Environment factors. The Program is successful in large part because of the multi-sectoral support of strategic coalitions that this management style permits.

Other key elements that contribute to the success of the Program are:
a- the appropriateness of the settings where PA interventions have taken place (leisure time, occupational time, and household activities)

b- the pleasure of participants in choosing the type of PA to be involved in and receiving support for improvement

c- the cultural links that allow each community to develop its own activities according to its social and cultural factors and environment

d- specific messages for target groups that respect the Intrapersonal factors associated with the PA level

e- accurate qualitative and quantitative evaluation of events, activities and PA levels in local and state settings

f- linking PA promotion with existing policies to control risk factors.
Although the Program is aimed at the whole community, the activities devised to promote PA for the population are planned and carried out toward three specific target groups: women, students, workers, and older adults. These targets have been chosen because, according to the scientific information available, those groups can reap all the benefits of an active lifestyle. To reach these targets, the Program has been performing three main types of activities: 1) mega-events, 2) specific activities with partner institutions, and 3) partnerships with community organizations. Considering factors related to gender, the Program created specific material and a logo to disseminate the message of the importance of being physically active among women (Figure 1).

NOTA: O texto com a iconografia está no anexo.

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