This study aims to describe the adequacy of basic health units (UBS) in Brazil regarding structure and work process for obesity management and to evaluate user satisfaction with primary health care services. This cross-sectional study was conducted with data from the 2013-2014 National Program for Improving Primary Care Access and Quality (PMAQ) - an initiative to assess primary health care teams’ performance. Data were collected between 2013 and 2014 through interviews with primary health care teams and users. All indicators of adequate care for obesity were defined within the article scope, based on data from the PMAQ. Of the 24,055 UBS analyzed, located in 4,845 different cities, only 7.6% had adequate structure for obesity management. Likewise, only 26.6% of the 114,615 users interviewed reported adequate access, and 27.8% of the UBS showed adequate service organization. Healthcare was considered as “good” or “very good” by 82.4% of users. These indicators varied according to geographic region, showing better results for the South and Southeast. Our results suggest that the country may still be at the initial stage of systematizing care with obesity, presenting significant disparities among regions.

This study aimed to develop community educational activities in Brazilian primary health care settings. A randomized controlled community trial was conducted to encourage fruit and vegetable consumption (FV-RCT) in a representative sample of consumers aged 20 years or older in a Brazilian city. The fruit and vegetable consumption was classified according to the transtheoretical model's stages of change, reflecting different degrees of readiness for change. The educational activities were based on the transtheoretical model and a problematizing-dialogic pedagogy, planned by an interdisciplinary team, using information collected in a qualitative pilot study. The actions were conducted over seven months, and baseline data were collected from 1483 participants. The educational strategies included workshops interspersed with motivational messages conveyed via postcard, interactive environment-based activities, and informative material. In the workshops, different techniques were used - conversation circles, image theatre, self-portraits, cooking and art as experience. The applied intervention based on the chosen theories implied in a refinement of the intervention, but, nevertheless, proved to be feasible for large population groups and to the scenario of health services. Thus, this interdisciplinary FV-RCT study represents an effort to advance methodological issues and provide theoretical subsidies for actions.

Introdução: Ações de promoção da alimentação adequada e saudável (PAAS) vêm ganhando espaço nas agendas das políticas públicas devido à urgência do cuidado das condições crônicas não transmissíveis. Para implementação dessas ações no cotidiano de trabalho, é fundamental que os profissionais de saúde sejam qualificados visando o seu empoderamento e autonomia. Objetivo: Avaliar atividade de qualificação profissional para o desenvolvimento de ações coletivas de PAAS na Atenção Primária à Saúde (APS). Métodos: Estudo prospectivo e descritivo conduzido para avaliar qualificação profissional ofertada à distância, com carga horária de 30 horas. Foram ofertadas três turmas para profissionais da APS de todas as macrorregiões brasileiras. Foram utilizados questionários quantitativos on-line, aplicados imediatamente após a conclusão do curso e após três meses. Os resultados foram estratificados por macrorregião do país e conclusão do curso. Resultados: Dos 3.957 inscritos, cerca de mil profissionais concluíram o curso (taxa de conclusão: 25,3%), a maioria mulheres e nutricionistas. A qualificação profissional foi considerada como muito relevante para a prática profissional (99,2%) e com adequada qualidade metodológica (99,6%). O principal obstáculo para a não conclusão do curso foi a falta de tempo (78,1%), sendo os não concluintes mais velhos, enfermeiros, com maior tempo de atuação no SUS, aqueles que acessaram o curso pelo celular e com participação prévia em qualificação profissional sobre o tema. Conclusões: A qualificação profissional foi capaz de desenvolver competências e habilidades para a condução de ações coletivas de PAAS entre os profissionais de saúde. Entretanto, estratégias precisam ser propostas para ampliar a taxa de conclusão.

Este estudo teve como objetivo avaliar a coexistência entre insegurança alimentar (IA) e acesso irregular à água potável no Brasil, bem como sua relação com características sociodemográficas e econômicas no primeiro ano da pandemia de Covid-19. Estudo transversal, com dados do I Inquérito Nacional sobre Insegurança Alimentar no contexto da pandemia de Covid-19 no Brasil, realizado em 2.180 domicílios de 128 municípios de todos os estados brasileiros, em 2020. A IA foi avaliada pela Escala Brasileira de Insegurança Alimentar. O acesso à água potável foi classificado em diário e não diário/irregular. As prevalências isoladas e combinadas destas condições foram calculadas, com investigação dos fatores associados a partir dos testes qui-quadrado e regressão logística múltipla (p<0,05). Cerca de 16% da população estava em situação concomitante de IA e acesso não diário à água potável. Agricultores familiares e produtores rurais, chefes de família de baixa renda e aqueles que residiam no Norte e Nordeste apresentaram as maiores magnitudes de coexistência. Foi preocupante a prevalência da coocorrência das duas condições de escassez avaliadas, acometendo desigualmente localidades e segmentos populacionais, com destaque para as áreas rurais, os lares com piores condições socioeconômicas e as regiões Norte e Nordeste.

This study presents the guideline and preliminary results of a randomized controlled community trial of group-based nutrition interventions for obesity management in Brazilian Primary Health Care (PHC), occurring between 2022 and 2023. Belo Horizonte PHC units were randomly sampled and allocated to the control (CG) or intervention group (IG). Participants were those in preparation with high self-efficacy, action, or maintenance stages of change for weight reduction who were willing to participate in groups. CG participants received usual care, while IG participants were allocated into two therapeutic groups (TGs): non-severe (TG1) or severe obesity (TG2). We analyzed demographics data, stages of change and self-efficacy for weight reduction, and intervention adherence. The six-month theory-based interventions included face-to-face groups (TG1:7; TG2:9) and phone messages and postcards delivered (TG1:4; TG2:5). There were 1120 participants. Most were women, with a median age of 61.4 years; 45.4% were in the maintenance stage of change for weight reduction, and 76.1% had high self-efficacy. A total of 350 groups were held, 13,473 phone calls made, and 1973 postcards delivered. The median adherence was 52.4%. The reach and adherence to groups demonstrate their viability and scalable potential for the treatment of obesity in Brazilian PHC, contributing to the strengthening of chronic disease management actions.

Objective To analyze factors associated with dropout from a distance professional qualification course on promoting adequate and healthy eating in Brazil. Methods This is a cross-sectional study with professionals from the Brazilian National Health System (Sistema Único de Saúde - SUS) enrolled in a distance learning course, provided between 2019 and 2020, based on Ministry of Health educational materials. Sociodemographic and professional data associated with dropout from the course were assessed, using multiple logistic regression (p-value<0.05). Results Dropout prevalence was 30.6%. It was was associated with living in the Northern macroregion (p-value 0.009) and the Northeast macroregion (p-value<0.001), being a nurse (p-value<0.001), having lower levels of higher education (degree: p-value 0.004; specialization/residency: p-value 0.025), having worked in the SUS for longer (p-value 0.004), having taken the course using a cell phone or tablet (p-value 0.024), having previous training on adequate and healthy eating (p-value 0.007) and not having previously used the course materials (p-value 0.021). Conclusion Dropout was greater among nurses, professionals from the North and Northeast macroregions, those with a lower level of higher education, longer experience in the SUS, and among those who accessed the course mainly via cell phone or tablet, those who had previously participated in professional training on the theme and those who had not previously used the materials presented during the course. Changing these factors requires institutional support, with integration of the country’s federative units, aiming to overcome local challenges faced by professionals in completing continuing education activities.