Eduardo Simoes, MD, MSc, MPHDirector, Prevention Research Centers Program

Healthy Aging Research Network MeetingMarch 8, 2011

Project GUIA Understanding and promoting physical

activity in Brazil and Latin America

National Center for Chronic Disease Prevention and Health Promotion

Division of Adult and Community Health

Purpose of Today’s Presentation

Project GUIA: Understanding and promoting physical activity in Brazil and Latin America www.projectguia.org

Describe the partnerships and outcomes related to Project GUIA that may be helpful to HAN members

Identify lessons learned and recommendations from the GUIA partnership

Context

By 2020, chronic diseases will account for 80% of deaths in developing countries (WHO)

Regular physical activity can decrease the burden of chronic disease

Physical activity interventions in Latin America have not been systematically evaluated

Methods used by CDC have applicability in Latin America The Guide to Community Preventive Services (The

Community Guide) Observational methods

Why Brazil?

CDC, WHO, and World Bank global health priorities

Size, influence, and public health system Epidemiologic, lifestyle, and demographic

transitions Potential applicability of the Community

Guide to developing countries Public health issues similar to those in other

countries of the Americas From 2005 to 2009

Brazil’s Ministry of Health invested more than $70 million in infrastructure for surveillance, evaluation and public health programs for non-communicable diseases

Four Project Aims

Aim 1 (2006): Establish and build cross-national, collaborative relationships with

researchers, practitioners, and institutions in Brazil to enhance capacity to determine and implement evidence-based interventions that promote physical activity.

Aim 2 (2006): Synthesize literature on community-based strategies to promote

physical activity in Latin America.

Aim 3 (2007-2008): Evaluate two ongoing community interventions in Brazil based on the

review accomplished in Aim 2.

Aim 4 (2009): Disseminate the products from the review process and intervention

evaluations to communities, institutions, and public health professionals in Latin America.

Aim 1: Partnerships

Building a powerful and cohesive network for research

GUIA CollaboratorsUniversities Government Non-Government

Washington University in St. Louis – U.S.A.

Centers for Disease Control and Prevention – U.S.A.

CELAFISCS – Brazil

Saint Louis University –U.S.A.

Ministry of Health –Brazil Pan American Health Organization

Federal University of Sao Paulo – Brazil

Municipal Secretaries of Health – Brazil

Fundacion FES Social – Bogota, Colombia

Pontiff Catholic University of Parana – Curitiba, Brazil

Municipal Sports and Recreation Secretaries – Brazil

Federal University of Pelotas – Brazil

Los Andes University – Bogota, Colombia

Aim 2: Systematic Review

Used Community Guide methods to conduct a review of literature published in Portuguese or Spanish

Evaluation Results: Systematic Review

Very few PA intervention studies in Latin America (19)

Sufficient data to recommend school PE for increasing physical activity in children in Latin America

Three new community intervention types identified Informational approaches

• Delivery of short physical activity-related messages Behavioral and social approaches

• Physical activity classes in community settings Environmental and policy approaches

• Community-wide policy and planning

Possible to carry out evidence-based reviews in Latin America

Replicating an effective program with the San Diego PRC

Evaluation results from community-wide program Academia da Cidade

Children Teenager Adult Senior0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

37.3%

49.7% 48.3%

28.7%

62.7%

50.3% 51.7%

71.3%

No ACP (control)ACP (Intervention)

Accomplishments thus far High quality science and publications

On par with highly-funded U.S. trials U.S. - Brazil public health research and

practice collaboration Complex and highly effective partnerships

• Universities • Public health agencies / ministries• WHO / PAHO

Leveraged funding Not without challenges

Time & historical relationships require flexibility and trust-building

Lessons Learned from the Experience of Project GUIA

Suggested first steps

Experiences to repeat

Land mines to avoid

For more information please contact Centers for Disease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: cdcinfo@cdc.gov Web: www.cdc.gov

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Questions and Discussion

National Center for Chronic Disease Prevention and Health Promotion

Division of Adult and Community Health