Five-year Impact Of An Intervention Program On Physical Activity Levels Of Sao Paulo Metropolitan Region

Introduction
Since 1996 the promotion of physical activity (PA) has been one of the most important strategies used by the São Paulo State Secretary for Health to promote health among adults. For that reason it was launched the Agita São Paulo a multi-level intervention program, using cognitive, social-facility, media, and ecological tools, in a mobile management approach. The program has been evaluating its impact through determining the evaluation PA level in the target population, of 37 million inhabitants.
Purpose
to analyse the evolution of PA level in São Paulo metropolitan area (about 16 million inhabitants) after 3 to 7 years of PA intervention program (1999 to 2003).

Methods
a sample of 2575 people was taken in 1999 (n:641), 2000 (n:645), 2002 (n:627), and 2003 (n:662). Sample was randomised by sex, age, and socio-economic status. Males and females over 18 years of age living in Sao Paulo Metropolitan Region participated in a home-interview, answering questions related to frequency and duration of walking, moderate and vigorous physical activities, using the International PA Questionnaire-IPAQ. Active people were considered anyone who participated in recommended physical activity (moderate physical activity or walking performed at least for 30 minutes per day, 5 times a week; and/or very active: vigorous physical activity at least 20 minutes, 3 times per week). Inactive people were considered the ones that reported any involvement with PA in the usual or last week, and irregularly active who were not inactive but that did not do enough to reach the PA recommendation. Statistical analysis used was Chi-square test, and significance level adopted was p<.05. Percent delta (%) was calculated to determine the differences among the years of evaluation.

Results
The prevalence(%)of inactive, irregular active and active after people 3(1999) to 7 (2003) years of intervention:
Data showed a significant change across the years with decreasing in the percentage of irregularly active (30.3 x 25.2%) comparing 1999 and 2003. It represented a 16.8% relative decrease in irregularly active and 3.4% in active people. Considering the insufficiently active people (inactive + irregularly active) there was a decline in values from 45.2% in 1999 to 39.6% in 2003. The percentage of active people, those who got the PA recommendation for health increased 11% in relation to 1999 figures. There was maintenance in the percentage of inactive people in around 15%

Discussion/Conclusion
To decline sedentariness and increase physical activity is a challenge, even higher when considering large populations. The absolute decline of 5.6% (12.4% relative decline) in insufficiently active people (inactive+ irregularly active), and an absolute increase of 5.6% (10.2% relative increase) in active people, observed between 1999 to 2003 support the conclusion of a positive impact of Agita São Paulo intervention.

References
[1]. Matsudo V, Matsudo S, Andrade D, Araújo T, Andrade E, Oliveira L, Braggion G. Promotion of physical activity in a developing country: the Agita São Paulo Experience. Public Health Nutr 2002;5(1A):253-261.
[2]. Matsudo SMM, Matsudo VKR, Araújo TL, Andrade DR, Andrade EL, Oliveira LC, Braggion GF. The Agita São Paulo Program as a model for using physical activity to promote health. Pan Am J Public Health 2003;14(4):265-272
[3]. Matsudo V, Guedes J, Matsudo S, Andrade D, Araújo T, Oliveira L, Andrade E, Braggion G and Ribeiro M. Policy intervention: the experience of Agita São Paulo in using the "mobile management" of the ecological model. Perspective 2004 in press.

NOTA: O texto com a iconografia está no anexo.

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