Introduction Addressing childhood obesity risk factors like home environment, parental roles, excess weight, physical activity and healthy eating among Latino/Hispanic (L/H) families living in rural communities is an important priority. However, evidence supporting these interventions among L/H families living in rural communities is missing. Our trial will use cultural adaptation and implementation science frameworks to evaluate the feasibility of delivering a culturally appropriate family-based childhood obesity (FBCO) programme via an automated telephone system (interactive voice response) to L/H families in rural Nebraska. Methods and analysis A mixed-methods feasibility trial for L/H families with overweight or obese children. Aim 1 will focus on collaboratively adapting and evaluating all intervention materials to fit the rural L/H community profile better, including translation of materials to Spanish, culturally relevant content and images, and use of health communication strategies to address different levels of health literacy. In aim 2, a 6-month feasibility trial with contextual evaluation will randomise 48 dyads (parent and child) to either Family Connections (FC; n=29) or a waitlist standard-care group (n=29) to determine overall study reach, preliminary effectiveness in reducing child body mass index (BMI) z-scores, potential for programme adoption, implementation and sustainability through local health departments (RE-AIM outcomes). We will also evaluate health department perceptions of the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) constructs (innovation, context, recipient characteristics) and FC participants’ view of the intervention (ie, relative advantage, observability, trialability, complexity, compatibility). The study will answer three critical questions: (1) is a telephone-delivered FBCO programme in rural Nebraska culturally relevant, usable and acceptable by L/H families?; (2) is a telephone-delivered FBCO programme effective at reducing BMI z-scores in L/H children living in rural Nebraska? and (3) what real-world institutional and contextual factors influence the impact of the intervention and might affect its potential ability to sustainably engage a meaningful population of L/H families who stand to benefit? Ethics and dissemination This protocol was approved by the University of Nebraska Medical Center Institutional Review Board (IRB#:0745-20-EP). Dissemination of findings will occur through ClinicalTrials.gov, in scientific forums and to the local rural communities, pilot data to inform the design of a larger clinical trial. Trial registration number NCT04731506.

A pandemia da COVID-19 foi mandatória para a busca por novas formas de se pensar saúde. Assim, o objetivo do trabalho foi relatar as ações nutricionais desenvolvidas na Atenção Primária à Saúde durante o período pandêmico. Trata-se de um relato das atividades realizadas entre maio e julho de 2020, em uma Unidade de Saúde da Família localizada no sul da Bahia. Foram atendidos, majoritariamente, idosos em situação de vulnerabilidade social, com quadro clínico de descompensação de doenças crônicas não transmissíveis (DCNT). Os atendimentos nutricionais se direcionaram para o aconselhamento nutricional presencial utilizando o My plate adaptado com alimentos regionais (valorizando a escuta e as potencialidades dos usuários) e a presença da família. Conclui-se que o aconselhamento nutricional com base na realidade do usuário e do apoio familiar permitiram empoderamento dos indivíduos e maior controle das DCNT.

O aperfeiçoamento das técnicas utilizadas nas revisões é importante para sistematizar todo o aumento do conhecimento na Educação Física (EF); entretanto são escassos os artigos que as esclarecem. O objetivo do estudo é apresentar os principais elementos da metassíntese (qualitativo), metanálise (quantitativo) e síntese da pesquisa mista (qualitativo e quantitativo), destacando seus caminhos na EF. Utilizou-se a revisão de literatura para verificar em artigos científicos os métodos apresentam estrutura organizacional que, imparcialmente, promovem atualizações do conhecimento. Conclui-se que raros são os estudos que apresentam elementos das revisões. Além disso, são incipientes as revisões que envolvem a abordagem qualitativa na área da EF, aspecto fundamental para emergir um novo paradigma para as revisões.

Negative health behaviors incorporated into lifestyle are considered the main risk factors for chronic non-communicable diseases (NCDs) in adults and the elderly. However, the relationship between the aggregation of these factors and the sociodemographic conditions of the elderly needs to be better elucidated. The aim of this study was to analyze the simultaneity of the five risk factors for NCDs in the elderly with low economic status living in a rural city in Brazil, and their association with sociodemographic variables. Cross-sectional study was conducted with elderly people from Family Health Units of the city of Ibicui-Bahia, Brazil, where 310 elderly were enrolled. Rates of physical inactivity in leisure (PIL), alcohol consumption, sedentary behavior, overweight/obesity and tobacco consumption were collected through a questionnaire in an individual interview. The average age among participants was 71.62 (± 8.16) years. The group presenting the five behaviors had high scores in both sexes (men O/E = 242.5; women O/E = 161.7). Among men and women, the highest scores found through clustering of simultaneous NCD risk factors were for the consumption of alcohol with smoking, and physical inactivity with smoking. When analyzing the association between groups and sociodemographic characteristics, men were more physically inactive than women (OR = 0.96, CI = 0.92-0.98) and concomitantly had unhealthy habits (smoking). In conclusion, the elderly are exposed to health risk factors for concurrent CNCDs and the accumulation of these risk factors was not associated with sociodemographic variables, it is suggested that further studies be carried out with the prevalent variables as well as to analyze why the elderly population presents these levels.

Type 2 diabetes mellitus (T2DM) is a major global public-health problem, and physical inactivity contributes to poor disease control. In settings with limited access to health services, as in the Brazilian Amazon, interventions delivered by Community Health Workers (CHWs) within Primary Health Care (PHC) may offer a pragmatic strategy to increase physical activity (PA). We aimed to evaluate the effect of a CHW-led, theory-based intervention on PA among adults with T2DM in PHC in a cluster-randomized, community-based trial. A total of 274 participants were enrolled (intervention: n = 140, control: n = 134). CHWs in the intervention group completed a blended training (e.g., asynchronous modules, printed educational materials, and hands-on guidance). They conducted six home visits over six months to support behavior change, including increased PA. PA was measured using the International PA Questionnaire (IPAQ-LF), which assessed active commuting, walking, moderate-to-vigorous PA (MVPA), and total PA. Group-by-time effects were examined using mixed-effects zero-inflated Gamma models. No significant intervention effects were observed for the conditional mean of minutes or the probability of participation in active commuting, walking, or total PA. However, for MVPA, the zero-inflated Gamma model revealed a significant intervention effect on the probability of engaging in activity. The intervention group showed a marked reduction in the likelihood of remaining at zero minutes of MVPA (Odds Ratio = 0.08; 95% CI = 0.01–0.79; p = 0.001) compared to the control group, indicating effective behavioral activation among previously inactive participants. These findings suggest that empowering CHWs to deliver structured, theory-driven interventions within PHC can reduce inactivity among high-risk adults with T2DM in underserved communities.

Há em nosso país leis e decretos sobre acessibilidade espacial nas escolas, mas como está a realidade para que ocorra as aulas de educação física? O objetivo deste estudo foi analisar a infraestrutura de escolas públicas estaduais de um município baiano no que diz respeito a acessibilidade arquitetônica, em especial àquela destinada as aulas de Educação Física. Foram analisadas todas as escolas de Ensino Fundamental (anos finais) e Ensino Médio utilizando a adaptação do “Manual de Acessibilidade Espacial” do Ministério da Educação. Avaliou-se da chegada a escola até a quadra/pátio. Observou-se que apenas duas escolas atenderam um máximo de 50% dos itens investigados, estando as demais com valores inferiores. Para as aulas de Educação Física, itens como piso tátil direcional, quadra com espaço adaptado e bebedouro adaptado próximo à quadra não foram contemplados. Conclui-se que a acessibilidade arquitetônica nessas escolas é precária, dificultando a inclusão nas aulas de Educação Física.