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Abstract Objective: This study had the purpose investigate the physical activity (PA) and sedentary time profile of children with cerebral palsy and its association with body composition. Methods: A cross-sectional study evaluated 53 children, between 2 and 10 years old, enrolled in three health services Recife-city, northeast of Brazil. Sedentary and PA were measured for a week using the ActiGraph GTX3 accelerometer. Body composition was assessed by anthropometry and an electrical bioimpedance device. Results: Time on PA was one hour longer among the mild/moderate CP compared to severe ones, but, sedentary time is similar. Dyskinetic children spent more time in PA, but also in sedentary activities (15.5 hours a day) than spastic ones (12.8). Stunting occurred in 15 (30%) of the sample, all children with stunting had severe impairment. Underweight occurred in 25% of the severe group and 11.8% in the mild/moderate group. Overweight affected 3% of the sample; no overweight children were in the severe group. Body fat% was inversely related to time spent in moderate to vigorous PA. Conclusions: Children with CP spend more than a half of their daily time in sedentary activity. In contrast, children with mild to moderate CP spent twice as much time in moderate to vigorous PA and had a tendency (p = 0.07) to spend 50% more time in light PA. Moreover, time spent on moderate to vigorous activity was inversely related to fat mass.

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OBJECTIVE: This study had the purpose investigate the physical activity (PA) and sedentary time profile of children with cerebral palsy and its association with body composition. METHODS: A cross-sectional study evaluated 53 children, between 2 and 10 years old, enrolled in three health services Recife-city, northeast of Brazil. Sedentary and PA were measured for a week using the ActiGraph GTX3 accelerometer. Body composition was assessed by anthropometry and an electrical bioimpedance device. RESULTS: Time on PA was one hour longer among the mild/moderate CP compared to severe ones, but, sedentary time is similar. Dyskinetic children spent more time in PA, but also in sedentary activities (15.5 hours a day) than spastic ones (12.8). Stunting occurred in 15 (30%) of the sample, all children with stunting had severe impairment. Underweight occurred in 25% of the severe group and 11.8% in the mild/moderate group. Overweight affected 3% of the sample; no overweight children were in the severe group. Body fat% was inversely related to time spent in moderate to vigorous PA. CONCLUSIONS: Children with CP spend more than a half of their daily time in sedentary activity. In contrast, children with mild to moderate CP spent twice as much time in moderate to vigorous PA and had a tendency (p = 0.07) to spend 50% more time in light PA. Moreover, time spent on moderate to vigorous activity was inversely related to fat mass.

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The present study aimed to map the profile of professionals actively working in physical activity intervention programs for health promotion within the primary health care system in the State of Pernambuco, according to sociodemographic characteristics, education, continuous education and permanent education. Cross-sectional study conducted in the State with 511 professional (59.1% women). Time since formal education was achieved, type of employment, curricular experiences in initial education, participation in events, lectures and courses focusing in physical education, as well as the social and demographic characteristics were collected through a built and previously validated questionnaire. Descriptive and inferential analysis were conducted, and chi-square test considered a p value of <0.05. Most professionals (92.8%) have completed higher education, being 61.2% in Physical Education, 64.3% with up to six years of work in primary health care and 67.3% employed temporarily. A larger proportion of professional with State employment within the Health Secretary was observed for Physical Education rather than other areas of education (p<0.05). About 37.8% of professionals reported not having educational experience in primary health care while in undergraduate education and 69.2% participated in events, courses and lectures related to physical activity. It is possible to identify frailty in primary education of professionals as well as continued education. Investments in training may strengthen professional work in public policy programs emphasizing in physical activity.

O presente estudo teve como objetivo realizar um mapeamento do perfil quanto às características sociodemográficas, de formação inicial, formação continuada e educação permanente dos profissionais que atuam em programas de promoção da saúde com intervenções em atividade física da atenção básica do Estado do Pernambuco. Estudo transversal de abrangência estadual com 511 profissionais (59,1% de mulheres). Tempo de formação, de atuação profissional, tipo de vínculo, experiências curriculares na formação inicial, participação em eventos, palestras e cursos com foco na atividade física, bem como as características sociais e demográficas foram coletadas através de um questionário construído e previamente validado. Foram realizadas análises descritivas e para as análises inferenciais o teste de Qui-quadrado, considerando um p< 0,05. A maioria dos profissionais (92,8%) tem formação superior completa, sendo 61,2% em Educação Física, 64,3% com até seis anos de atuação na atenção básica e 67,3% contratado de forma temporária. Uma maior proporção de profissionais com vínculo estatutário na Secretaria de Saúde foi observada entre os licenciados plenos em Educação Física quando comparado às demais formações iniciais (p<0,05). Cerca 37,8% dos profissionais relataram não terem nenhuma experiência curricular na graduação relacionada à atenção básica e 69,2% participou no último ano de cursos, palestras ou eventos relacionados à atividade física. É possível identificar fragilidade tanto na formação inicial quanto na participação desses profissionais em cursos de formação continuada. Investimentos na formação pode fortalecer a atuação profissional nos programas de políticas públicas com ênfase na atividade física.

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BACKGROUND: To examine the reliability of heart rate variability (HRV) parameters in adolescents and to analyse the inter- and intra-observer reliability of data analysis. METHODS: The sample included 27 adolescents aged 14-19 years old. RR intervals were obtained for 10 min in the supine position on two different days (Day 1 and Day 8) with an interval of 7 days to analyse intra-individual reliability. The signals obtained on Day 1 were used to analyse the inter- and intra-observer reliability of HRV parameters. The RR intervals, standard deviation of all RR intervals (SDNN), root mean square of the squared differences between adjacent normal RR intervals (RMSSD), the percentage of adjacent intervals over 50 ms (PNN50), and low (LF) and high (HF) frequencies were obtained. Frequency-domain variables were analysed using the autoregressive (AR) and fast Fourier transform (FFT) methods. RESULTS: There were no intra-individuals difference in RR intervals between Day 1 and Day 8 (P>0·05). The intraclass correlation coefficient (ICC) ranged from 0·647 to 0·913, whereas the coefficient of variation (CV) was lower than 20% for all parameters, except PNN50 and LF/HF. The inter- and intra-observer reliability ranged from 0·915 to 0·996 and 0·990 to 0·993, respectively. In addition, the CV was lower than 20% (inter-observer) and 7% (intra-observer) to all HRV parameters. CONCLUSION: Indicators of reproducibility obtained in this study suggest that HRV can be used in adolescents; however, the analysis of HRV parameters should be performed by the same person.

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Objective: To analyze the prevalence and factors associated with the co-occurrence of health risk behaviors in adolescents. Methods: A cross-sectional study was performed with a sample of high school students from state public schools in Pernambuco, Brazil (n=4207, 14-19 years old). Data were obtained using a questionnaire. The co-occurrence of health risk behaviors was established based on the sum of five behavioral risk factors (low physical activity, sedentary behavior, low consumption of fruits/vegetables, alcohol consumption and tobacco use). The independent variables were gender, age group, time of day attending school, school size, maternal education, occupational status, skin color, geographic region and place of residence. Data were analyzed by ordinal logistic regression with proportional odds model. Results: Approximately 10% of adolescents were not exposed to health risk behaviors, while 58.5% reported being exposed to at least two health risk behaviors simultaneously. There was a higher likelihood of co-occurrence of health risk behaviors among adolescents in the older age group, with intermediate maternal education (9-11 years of schooling), and who reported living in the driest (semi-arid) region of the state of Pernambuco. Adolescents who reported having a job and living in rural areas had a lower likelihood of co-occurrence of risk behaviors. Conclusions: The findings suggest a high prevalence of co-occurrence of health risk behaviors in this group of adolescents, with a higher chance in five subgroups (older age, intermediate maternal education, the ones that reported not working, those living in urban areas and in the driest region of the state).

Objetivo: Analisar a prevalência e os fatores associados à simultaneidade de comportamentos de risco à saúde em adolescentes. Métodos: Estudo transversal feito com amostra representativa de estudantes do ensino médio da rede pública estadual de Pernambuco (n=4.207, 14-19 anos). Os dados foram obtidos mediante questionário. A simultaneidade de comportamentos de risco à saúde foi determinada pelo somatório da exposição dos adolescentes a cinco comportamentos de risco (baixo nível de atividade física, comportamento sedentário, consumo ocasional de frutas/hortaliças, consumo de bebidas alcoólicas e tabagismo). As variáveis independentes foram sexo, faixa etária, turno, porte da escola, escolaridade materna, situação ocupacional, cor da pele, região geográfica e local de residência. Os dados foram analisados por meio de regressão logística ordinal com modelo de odds proporcionais. Resultados: Aproximadamente 10% dos adolescentes não estavam expostos a comportamentos de risco, enquanto 58,5% apresentaram dois ou mais comportamentos de forma simultânea. Verificou-se elevação da simultaneidade de comportamentos de risco com aumento da faixa etária, com escolaridade materna intermediária (9-11 anos de estudo) e residência na Região Semiárido. Adolescentes que referiram trabalhar e aqueles que residiam em área rural apresentaram menor chance de simultaneidade de comportamentos de risco. Conclusões: Os achados indicam uma alta prevalência de exposição simultânea a comportamentos de risco à saúde nesse grupo de adolescentes. Identificaram-se cinco subgrupos de maior chance de exposição (faixa etária mais alta, escolaridade materna intermediária, aqueles que referiram não trabalhar, residir em área urbana e na Região Semiárido).

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OBJECTIVE: To analyze the prevalence and factors associated with the co-occurrence of health risk behaviors in adolescents. METHODS: A cross-sectional study was performed with a sample of high school students from state public schools in Pernambuco, Brazil (n=4,207, 14-19 years old). Data were obtained using a questionnaire. The co-occurrence of health risk behaviors was established based on the sum of five behavioral risk factors (low physical activity, sedentary behavior, low consumption of fruits/vegetables, alcohol consumption and tobacco use). The independent variables were gender, age group, time of day attending school, school size, maternal education, occupational status, skin color, geographic region and place of residence. Data were analyzed by ordinal logistic regression with proportional odds model. RESULTS: Approximately 10% of adolescents were not exposed to health risk behaviors, while 58.5% reported being exposed to at least two health risk behaviors simultaneously. There was a higher likelihood of co-occurrence of health risk behaviors among adolescents in the older age group, with intermediate maternal education (9-11 years of schooling), and who reported living in the driest (semi-arid) region of the state of Pernambuco. Adolescents who reported having a job and living in rural areas had a lower likelihood of co-occurrence of risk behaviors. CONCLUSIONS: The findings suggest a high prevalence of co-occurrence of health risk behaviors in this group of adolescents, with a higher chance in five subgroups (older age, intermediate maternal education, the ones that reported not working, those living in urban areas and in the driest region of the state).

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Lifestyle characteristics can modify the self-rated health of young people, but additional prospective evidence is needed. This study examined the association between changes in lifestyle and self-rated health among students. A secondary analysis of the "Saúde na Boa" project was performed, considering data from 984 students (14-24 years old, 56.9% girls) who were randomly selected from 20 public schools in Recife and Florianopolis, Brazil. Two sets of data 9-months apart were collected, and self-reported data about lifestyle characteristics (physical activity practices, TV watching time, dietary habits, alcohol and tobacco consumption, and sleep time) and self-rated health (poor, fair, good, very good and excellent) were obtained. Differences in self-rated health between collections were categorized as negative changes, stable (no changes) or positive changes. Adjusted multinomial logistic regression analysis was used (p < 0.05). After adjustment for confounding variables, increasing the weekly frequency of active commuting to school (adjusted odds ratio [aOR] = 2.06) and intake of fruits/fruit juice (aOR = 1.81), as well as reducing the monthly frequency of alcohol consumption (aOR = 2.17), was significantly associated with positive changes in self-rated health. Consumption of sweets was also associated with stable self-rated health. In conclusion, our prospective evidence demonstrated that changes in lifestyle characteristics appear to be essential to ensure or generate positive self-rated health in youth.

O estilo de vida pode modificar a percepção da saúde em jovens, porém evidências prospectivas são necessárias. Este estudo analisou a associação entre mudanças no estilo de vida e na percepção da saúde em estudantes. Análise secundária do projeto "Saúde na Boa", com uma amostra de 984 estudantes (14 a 24 anos, 56,9% de meninas), selecionados aleatoriamente, em 20 escolas públicas de Recife e Florianópolis, Brasil. Duas coletas foram realizadas com nove meses de diferença para obter self-reported dados do estilo de vida (prática de atividade física, tempo de TV, hábitos alimentares, consumo de álcool e tabaco, e duração do sono) e da percepção da saúde (ruim, regular, boa, muito boa e excelente). A percepção da saúde foi categorizada em três níveis, considerando as alterações entre os intervalos das coletas: mudou negativamente, manteve ou mudou positivamente. A regressão logística multinominal ajustada foi utilizada, com p<0.05. Após ajuste para variáveis de confusão, aumentar a frequência semanal de deslocamento ativo para escola (odds ratio ajustado [ORa] = 2.06) e de consumo de frutas/suco de frutas (ORa = 1.81), bem como reduzir a frequência mensal de consumo de álcool (ORa = 2.17) estiveram significativamente associados à alterações positivas na percepção da saúde após os nove meses de acompanhamento. O consumo de doces também mostrou associação com a manutenção na percepção da saúde. Em conclusão, evidências prospectivas demonstraram que mudanças do estilo de vida em diferentes componentes parecem ser fundamentais para garantir ou gerar uma percepção positiva da saúde na juventude.

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O objetivo deste relato foi descrever uma experiência curricular inovadora realizada no curso de bacharelado em Educação Física da Universidade de Pernambuco. A disciplina "Atividade Física e Saúde Mental" foi implantada no referido curso para suprir a lacuna existente entre a formação inicial e a intervenção profissional no campo da saúde mental. A proposta desta disciplina foi discutir o papel da atividade física na prevenção e tratamento dos transtornos mentais, bem com a intervenção profissional na rede de saúde mental. As ações realizadas na disciplina foram pautadas por uma perspectiva crítica no sentido de provocar nos estudantes um olhar diferenciado acerca desse campo de atuação. A disciplina possibilitou ainda a observação e a vivência da intervenção da Educação Física nos Centros de Atenção Psicossocial, aspecto diferencial na organização do componente curricular.

The aim of this report was to describe an innovative curricular experience that was performed in the bachelor in Physical Education offered by the University of Pernambuco (Brazil). A course entitled "Physical Activity and Mental Health" was offered to the bachelor students with the idea of fulfill the existing gap between the professional preparation and the intervention in the mental health care area. The course was organized to discuss the role of physical activity in the prevention and control of mental illness as well as the professional intervention of physical educators in this field. Activities performed during the lessons were guided by a critical pedagogy approach which means the students were challenged to think about this field of intervention in different ways. In addition, the course offered the opportunity for extramural observational and experiential activities in specialized centers of primary mental health care, a differential characteristic of this proposed curricular component.

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O objetivo deste estudo transversal foi analisar a associação entre a participação nas aulas de Educação Física (EF) e indicadores de violência em estudantes. Um questionário foi usado para coletar dados pessoais, da participação nas aulas de EF e de indicadores de violência em 4.210 adolescentes (14-19 anos) estudantes do ensino médio do estado de Pernambuco, Brasil. A prevalência de ?envolvimento em brigas? e de ?envolvimento em episódios de violência física como vitima? foi, respectivamente, de 21,2% e 10,7%. Verificou-se que 64,9% dos estudantes relataram não participar das aulas de EF. A prevalência dos indicadores de violência foi maior entre os rapazes, enquanto a não participação nas aulas de EF foi maior entre as moças. Independentemente do sexo e de outras covariáveis, verificou-se que a participação nas aulas de EF foi um fator diretamente associado a envolvimento em brigas. Concluiu-se que a participação nas aulas de EF está associada a envolvimento em brigas em estudantes adolescentes, contrariando, neste caso específico, a hipótese de que a participação nessas aulas está associada a condutas de saúde.

The aim of this cross-sectional study was to analyze the association between enrollment in physical education classes and violence indicators among students. A questionnaire was used to gather personal data, participation in physical education lessons, and violence indicators from 4,210 adolescents (14-19 years) high school students from the state of Pernambuco, Brazil. The prevalence of involvement in physical fights and being victim of physical violence was, respectively, of 21.2% and 10.7%. It was verified that 64.9% of the students reported have not been enrolled in physical education classes. The prevalence of violence indicators was higher among males while no enrollment in PE classes was higher among females. Independently of gender and other covariates, it was verified that enrollment in PE classes was directly associated with physical fights. It was concluded that enrollment in PE classes is associated with physical fights among adolescents students, which contradicts, in this particular, the hypothesis that participation in PE classes is associated with positive health behaviors.

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O objetivo deste estudo foi analisar a associação entre prática de atividades físicas no lazer (PAFL) e participação nas aulas de Educação Física (PAEF) com indicadores de comportamento sexual de risco (CSR) em estudantes adolescentes. Para tanto, adotou-se estudo transversal mediante análise secundária de dados de uma amostra representativa de estudantes do ensino médio da rede pública estadual de Pernambuco. Dados de 4.207 estudantes (14-19 anos) foram coletados mediante aplicação de questionário. Os adolescentes que relataram não ter usado preservativo na última relação sexual ou ter três ou mais parceiros ao longo da vida foram considerados expostos aos CSR. Nas análises de regressão logística o CSR foi definido como desfecho enquanto a PAFL e PAEF foram consideradas variáveis independentes. Sexo, faixa etária, afiliação religiosa, morar com os pais, consumo de álcool e tabagismo foram fatores incluídos nas análises como covariáveis. Observou-se que os adolescentes que relataram participar de pelo menos uma aula de Educação Física tinham chance 25% inferior de intercurso sexual sem uso de preservativo quando comparados àqueles que não participavam das aulas. Aqueles que referiram praticar AFL tinham chance 67% superior de relatarem experiência de intercurso sexual com três ou mais parceiros. A PAEF e a PAFL foram identificados como fatores associados a indicadores de CSR, mas o inesperado sentido da ligação entre PAFL e números de parceiros na vida exige aprofundamento da investigação nesta área.

The aim of this study was to analyze the association between physical activity during leisure time (PAL) and participation in physical education classes (PEC) with indicators of sexual risk behavior (SRB) in adolescents. It was a cross-sectional study using secondary analysis of data from a representative sample of high school students attended at the state public education system in Pernambuco. Data from 4,207 students (14-19 years) were collected by applying a previously validated questionnaire. Students who reported not have used a condom in the last intercourse and had three or more partners during their life were considered exposed to SRB. Logistic regression was performed with SRB set as dependent variable, PAL and PEC defined as independent variables, and sex, age group, religious affiliation, living with parents, alcohol consumption and smoking as potential confounders. It was observed that adolescents who reported have participated of PEC at least one time per week were 25% less likely to refer have not used condom in the last sexual intercourse in comparison with those who never participated in physical education classes. In relation to sexual intercourse, those who reported practice of PAL have a 67% higher likelihood to have had three or more partners in their lifetime sexual experience. It was concluded that PEC and PAL were associated with sexual risk behaviors, but the surprising direct association between PAL practice and number of sexual partners needs to be further investigated to elucidate causal pathways.

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O objetivo desse estudo foi identificar os fatores parentais associados ao baixo nível de atividade física (AF) em crianças pré-escolares. Trata-se de um estudo transversal (base escolar), realizado com uma amostra de 1.042 crianças pré-escolares da cidade do Recife (PE). Um questionário administrado na forma de entrevista face a face com os pais foi utilizado para obtenção de dados demográficos, socioeconômicos, percepção dos pais quanto à importância da AF para a criança, participação em AF com o filho e nível de AF dos pais e das crianças. A análise dos dados foi realizada mediante regressão logística binária, considerando modelagem hierárquica na entrada das variáveis e o baixo nível de AF da criança como desfecho. Observou-se que 81,9% dos pais eram fisicamente ativos, enquanto 69,7% referiram participar de AF com os filhos e a quase totalidade (99,1%) dos pais consideraram importante que os filhos participem em AF. O baixo nível de AF foi verificado em 30,3% das crianças, identificando-se que a participação dos pais em AF com os filhos foi um fator inversamente associado a baixo nível de AF nos pré-escolares (OR=0,54; IC95%: 0,40-0,73). A prevalência de baixo nível de AF foi significativamente menor entre os filhos de pais que referiram participar de AF (26,1% versus 40,2%; p<0,01). Concluiu-se que a participação em AF com os filhos foi o único fator parental associado ao nível de AF das crianças. Estimular a adoção deste tipo de comportamento pode ser uma estratégia útil na promoção da atividade física infantil, hipótese que precisa ser confirmada em estudo de intervenção.

The aim of this study was to identify parental factors associated with low level of physical activity (PA) among preschoolers. It was a school-based cross-sectional study performed with a sample of 1,042 children from the city of Recife (PE), Brazil. A questionnaire administered by face-to-face interview was used to gather demographic and socioeconomic data, measures of the parental factors (considering important that their children take participation in PA; participating in PA with their children; and, being physically active) and children?s level of PA. Logistic regression was performed by considering a hierarchical approach for data entry and children?s low level of PA as the outcome. It was observed that 81.9% of the parents were physically actives, 69.7% reported to participate in PA with their children, and almost all of them referred to consider important that their children take participation in PA. The prevalence of low level of PA was 30.3%, lower among preschoolers whose parents reported to participate in PA with their children (26.1% versus 40.2%; p<0.01). Parents? participation in PA with their children was inversely associated with low level of PA among preschoolers (OR=0.54; 95%CI 0.40, 0.73). It was concluded that parents? participation in PA with their children was associated with preschoolers? level of PA. Stimulating parents to participate in PA with their children might be useful as a strategy to promote PA during childhood; however this hypothesis needs to be assessed in further studies.

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