Counseling on physical activity and sedentary behavior in primary health care: cross-sectional study with professionals and users
DOI:
https://doi.org/10.47197/retos.v81.118176Keywords:
Motor activity , sedentary behavior, counseling, health promotion, unified health systemAbstract
Introduction: Counseling can encourage healthy behaviors in the population.
Aim: To compare the prevalence and strategies of counseling on physical activity (PA) and sedentary behavior (SB) provided by professionals and received by users of Primary Health Care (PHC).
Methods: Between 2019 and 2020, an observational, cross-sectional study was conducted with a representative sample of 148 professionals and 779 users from all PHC units in the urban area of a city in the Southern region of Brazil. The questions about counseling were paired and similar for professionals and users and evaluated based on the “5As” method. Data were analyzed using a chi-square test for heterogeneity in SPSS 30.0 software (p<0.05).
Results: A difference of 18 and 37 percentage points (p.p.) was found between the perception of counseling provided by professionals and that received by users on PA and SB, respectively (p<0.001). Differences were identified in 75% and 50% of the evaluated counseling strategies for PA and SB, respectively (p<0.05). Regarding strategies for PA counseling, the variation ranged from 4 to 32 Δ p.p., while for strategies for SB counseling, the variation ranged from 0 to 29 Δ p.p.
Discussion/Conclusion: There are differences between PA and SB counseling provided by professionals and that received by PHC users. The findings of this study highlight a communication gap in PHC. Future educational training could increase professional competence in counseling, fostering mutual understanding between both parties.
References
Associação Brasileira de Empresas de Pesquisa. (2019). Critério de classificação econômica no Brasil. http://www.abep.org/criterio-brasil
AuYoung, M., Linke, S. E., Pagoto, S., Buman, M. P., Craft, L. L., Richardson, C. R., Hutber, A., Marcus, B. H., Estabrooks, P., & Sheinfeld Gorin, S. (2016). Integrating physical activity in primary care prac-tice. The American Journal of Medicine, 129(10), 1022–1029. https://doi.org/10.1016/j.amjmed.2016.02.008
Brasil. Ministério da Saúde. (2006). Política nacional de promoção da saúde. https://bvsms.saude.gov.br/bvs/publicacoes/politica_nacional_promocao_saude.pdf
Brasil. Ministério da Saúde. (2018). Política nacional de educação permanente em saúde: O que se tem produzido para o seu fortalecimento? https://busqueda.bvsalud.org/portal/resource/pt/biblio-1538253
Brasil. Ministério da Saúde. (2021a). Guia de atividade física para a população brasileira. https://bvsms.saude.gov.br/bvs/publicacoes/guia_atividade_fisica_populacao_brasileira.pdf
Brasil. Ministério da Saúde. (2021b). Plano de ações estratégicas para o enfrentamento das doenças crônicas e agravos não transmissíveis no Brasil 2021–2030. https://pesquisa.bvsalud.org/bvsms/resource/pt/biblio-1291679
Brasil. Ministério da Saúde. (2022). Guia de orientação para o aconselhamento breve sobre atividade física na atenção primária à saúde do Sistema Único de Saúde. https://www.gov.br/saude/pt-br/acesso-a-informacao/participacao-social/consultas-publicas/2022
Craig, C. L., Marshall, A. L., Sjöström, M., Bauman, A. E., Booth, M. L., Ainsworth, B. E., Pratt, M., Ekelund, U., Yngve, A., Sallis, J. F., & Oja, P. (2003). International physical activity questionnaire: 12-country reliability and validity. Medicine & Science in Sports & Exercise, 35(8), 1381–1395. https://doi.org/10.1249/01.MSS.0000078924.61453.FB
Dogra, S., Copeland, J. L., Altenburg, T. M., Heyland, D. K., Owen, N., & Dunstan, D. W. (2022). Start with reducing sedentary behavior: A stepwise approach to physical activity counseling in clinical practice. Patient Education and Counseling, 105(6), 1353–1361. https://doi.org/10.1016/j.pec.2021.09.019
Estabrooks, P. A., Glasgow, R. E., & Dzewaltowski, D. A. (2003). Physical activity promotion through primary care. Journal of the American Medical Association, 289(22), 2913–2916. https://doi.org/10.1001/jama.289.22.2913
Florindo, A. A., Mielke, G. I., Gomes, G. A. O., Ramos, L. R., Bracco, M. M., Parra, D. C., Simões, E. J., Lobelo, F., & Hallal, P. C. (2013). Physical activity counseling in primary health care in Brazil: A national study on prevalence and associated factors. BMC Public Health, 13(1), 794. https://doi.org/10.1186/1471-2458-13-794
Glasgow, R. E., Emont, S., & Miller, D. C. (2006). Assessing delivery of the five “As” for patient-centered counseling. Health Promotion International, 21(3), 245–255. https://doi.org/10.1093/heapro/dal017
Gomes, B. L. A., Sousa, R. S. B., Mota, R. F. N., Nunes, C. A. B., Vieira, N. F., Oliveira, N. F., Gonzalez, R. I. C., & Pagotto, V. (2024). Attributes of primary health care in the view of health professionals: A scop-ing review. Revista da Escola de Enfermagem da USP, 58, e20240149. https://doi.org/10.1590/1980-220x-reeusp-2024-0149en
Häfele, V., & Siqueira, F. V. (2016). Aconselhamento para atividade física e mudança de comportamento em Unidades Básicas de Saúde. Revista Brasileira de Atividade Física & Saúde, 21(6), 581–592. https://doi.org/10.12820/rbafs.v.21n6p581-592
Häfele, V., & Siqueira, F. V. (2019). Interventions with health professionals of primary care about physi-cal activity counseling: Systematic review. Journal of Physical Education, 30(1). https://doi.org/10.4025/jphyseduc.v30i1.3021
Instituto Brasileiro de Geografia e Estatística. (2025). São José dos Pinhais. https://cidades.ibge.gov.br/brasil/pr/sao-jose-dos-pinhais/panorama
Katzmarzyk, P. T., Friedenreich, C., Shiroma, E. J., & Lee, I.-M. (2022). Physical inactivity and non-communicable disease burden in low-income, middle-income and high-income countries. Brit-ish Journal of Sports Medicine, 56(2), 101–106. https://doi.org/10.1136/bjsports-2020-103640
Matsudo, S., Araújo, T., Matsudo, V., Andrade, D., Andrade, E., Oliveira, L. C., & Braggion, G. (2001). Ques-tionário internacional de atividade física (IPAQ): Estudo de validade e confiabilidade no Brasil. Revista Brasileira de Atividade Física & Saúde, 6(2), 5–18. https://doi.org/10.12820/rbafs.v.6n2p5-18
Moraes, S. Q., Loch, M. R., & Rech, C. R. (2021). Counseling strategies for physical activity used by the Expanded Nucleus of Family Health in Florianópolis. Journal of Physical Education, 32(1). https://doi.org/10.4025/jphyseduc.v32i1.3210
Moraes, S. Q., Paiva-Neto, F. T., Loch, M. R., Fermino, R. C., & Rech, C. R. (2024). Characteristics and counseling strategies for physical activity used by Primary Health Care professionals. Ciência & Saúde Coletiva, 29(1). https://doi.org/10.1590/141381232024291.00692023
Moraes, S. Q., Souza, J. H., Araújo, P. A. B., & Rech, C. R. (2019). Prevalência de aconselhamento para ati-vidade física na Atenção Básica à Saúde: Uma revisão sistemática. Revista Brasileira de Ativida-de Física & Saúde, 24(e0073), 1–12. https://doi.org/10.12820/rbafs.24e0073
Oliveira, B. G. (2020). Fatores associados ao aconselhamento para a atividade física realizado por pro-fissionais da atenção primária à saúde [Dissertação de Mestrado, Universidade Tecnológica Fe-deral do Paraná]. https://repositorio.utfpr.edu.br/jspui/handle/1/23660
Orrow, G., Kinmonth, A. L., Sanderson, S., & Sutton, S. (2012). Effectiveness of physical activity promo-tion based in primary care: Systematic review and meta-analysis of randomised controlled tri-als. British Medical Journal, 344, (e1389). https://doi.org/10.1136/bmj.e1389
Passos, F., Santos, L. P., Santos, T. G., Silva, A. T., Rodriguez-Añez, C. R., & Fermino, R. C. (2025). Compe-tência profissional e aconselhamento breve sobre atividade física na Atenção Primária à Saúde [Apresentação em congresso]. 15º Congresso Brasileiro de Atividade Física e Saúde, Recife, Bra-sil.
Prefeitura Municipal de São José dos Pinhais. (2019). Saúde transparente. http://saudetransparente.sjp.pr.gov.br
Prince, S. A., Saunders, T. J., Gresty, K., & Reid, R. D. (2014). A comparison of the effectiveness of physi-cal activity and sedentary behaviour interventions in reducing sedentary time in adults: A sys-tematic review and meta-analysis of controlled trials. Obesity Reviews, 15(11), 905–919. https://doi.org/10.1111/obr.12215
Santos, L. P. (2020). Aconselhamento para a atividade física recebido por adultos atendidos em unida-des básicas de saúde [Dissertação de Mestrado, Universidade Tecnológica Federal do Paraná]. https://repositorio.utfpr.edu.br/jspui/handle/1/5039
Santos, L. P., Silva, A. T., Rech, C. R., & Fermino, R. C. (2021). Physical activity counseling among adults in primary health care centers in Brazil. International Journal of Environmental Research and Public Health, 18(10), 5079. https://doi.org/10.3390/ijerph18105079
Santos, A. C., Willumsen, J., Meheus, F., Ilbawi, A., & Bull, F. (2023). The cost of inaction on physical inac-tivity to public health-care systems: A population-attributable fraction analysis. The Lancet Global Health, 11(1), e32–e39. https://doi.org/10.1016/S2214-109X(22)00464-8
Shrestha, N., Pedišić, Z., Jurakić, D., Biddle, S. J. H., & Parker, A. (2021). Physical activity and sedentary behaviour counselling: Attitudes and practices of mental health professionals. PLOS ONE, 16(7), e0254684. https://doi.org/10.1371/journal.pone.0254684
Silva, M. P., Silva, A. T., & Fermino, R. C. (2025). Conhecimento do “Guia de Atividade Física para a Popu-lação Brasileira” e aconselhamento para crianças de 0 a 5 anos na Atenção Primária à Saúde [Apresentação em congresso]. 15º Congresso Brasileiro de Atividade Física e Saúde, Recife, Bra-sil.
Snége, A., Silva, A. A. P., Mielke, G. I., Rech, C. R., Siqueira, F. V., Rodriguez-Añez, C. R., & Fermino, R. C. (2022). Sedentary behavior counseling received from healthcare professionals: An exploratory analysis in adults at primary health care in Brazil. International Journal of Environmental Re-search and Public Health, 19(16), 9963. https://doi.org/10.3390/ijerph19169963
Souza, A. L., Santos, L. P., Rech, C. R., Rodriguez-Añez, C. R., Alberico, C., Borges, L. J., & Fermino, R. C. (2022). Barriers to physical activity among adults in primary healthcare units in the National Health System: a cross-sectional study in Brazil. São Paulo Medical Journal, 140(5), 658-667. https://doi.org/10.1590/1516-3180.2021.0757.R1.20122021
Souza Neto, J. M. (2018). Prevalência e fatores associados à prática do aconselhamento para a ativida-de física em profissionais de saúde [Dissertação de Mestrado, Universidade Federal da Paraíba]. https://repositorio.ufpb.br/jspui/handle/123456789/13058
Souza Neto, J. M., Brito, G. E. G., Loch, M. R., Silva, S. S., & Costa, F. F. (2020). Aconselhamento para ativi-dade física na atenção primária à saúde: Uma revisão integrativa. Revista Movimento, 26, e26075. https://doi.org/10.22456/1982-8918.104360
Sposito, L. A. C., Guerra, P. H., & Kokubun, E. (2023). Brief counseling strategies on physical activity de-veloped by health professionals. Revista Brasileira em Promoção da Saúde, 36(12), 13577. https://doi.org/10.5020/18061230.2023.13577
Sposito, L. A. C., Santos, L. P., Silva, A. T., Guerra, P. H., Loch, M. R., Rech, C. R., Rodriguez-Añez, C. R., & Fermino, R. C. (2025). Counseling strategies on the physical activity practice received by adults in Primary Health Care. Ciência & Saúde Coletiva, 30(7). https://doi.org/10.1590/1413-81232025307.05232023en
Shuval, K., DiPietro, L., Skinner, C. S., Barlow, C. E., Morrow, J., Goldsteen, R., & Kohl, H. W., III. (2014). Sedentary behaviour counselling: The next step in lifestyle counselling in primary care; pilot findings from the Rapid Assessment Disuse Index (RADI) study. British Journal of Sports Medi-cine, 48(19), 1451–1455. https://doi.org/10.1136/bjsports-2012-091357
Wattanapisit, A., Lapmanee, S., Chaovalit, S., Lektip, C., & Chotsiri, P. (2023). Prevalence of physical ac-tivity counseling in primary care: A systematic review and meta-analysis. Health Promotion Perspectives, 13(4), 254–266. https://doi.org/10.34172/hpp.2023.31
World Health Organization. (2006). WHO global database on body mass index (BMI): An interactive surveillance tool for monitoring nutrition transition. Public Health Nutrition, 9(5), 658–660. https://doi.org/10.1079/PHN2006967
World Health Organization. (2018). Global action plan on physical activity 2018–2030: More active people for a healthier world. https://www.who.int/publications/i/item/9789241514187
World Health Organization. (2020). Guidelines on physical activity and sedentary behaviour. https://www.who.int/publications/i/item/9789240015128
World Health Organization. (2022). Global status report on physical activity 2022. https://www.who.int/publications/i/item/9789240059153
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Copyright (c) 2026 Alice Tatiane da Silva, Josue Mendes dos Santos, Letícia Pechnicki dos Santos, Ketlyn Camile Fuchs Vieira, Paulo Henrique Guerra, Cassiano Ricardo Rech, Ciro Romelio Rodriguez-Añez, Rogério César Fermino
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