摘要：Objectives . We evaluated the effects of a community-based intervention, the Academia da Cidade program (ACP), on increasing leisure-time physical activity among residents of Recife, Brazil. Methods . We used the International Physical Activity Questionnaire to assess leisure-time physical activity and transport physical activity (i.e., activities involved in traveling from place to place) levels in a random sample of 2047 Recife residents surveyed in 2007. We also examined factors related to exposure to ACP (participation in the intervention, residing near an intervention site, hearing about or seeing intervention activities). We estimated prevalence odds ratios (ORs) of moderate to high leisure-time and transport physical activity levels via intervention exposures adjusted for sociodemographic, health, and environmental variables. Results . Prevalence ORs for moderate to high levels of leisure-time physical activity were higher among former (prevalence OR = 2.0; 95% confidence interval [CI] = 1.0, 3.9) and current (prevalence OR = 11.3; 95% CI = 3.5, 35.9) intervention participants and those who had heard about or seen an intervention activity (prevalence OR = 1.8; 95% CI = 1.3, 2.5). Transport physical activity levels were inversely associated with residing near an ACP site. Conclusions . The ACP program appears to be an effective public health strategy to increase population-level physical activity in urban developing settings. The global burden of chronic diseases is large 1 – 3 and growing. 4 , 5 Given that regular physical activity has a strong preventive effect against chronic disease, 6 , 7 the Ministry of Health of Brazil began a program in 2003 designed to promote healthful living among the country's population. 8 , 9 An important component of this program is the promotion of leisure-time physical activity and better nutrition together with the prevention of tobacco use and injuries. Still in its early phases, the physical activity component of this program is already funding 201 Brazilian cities in their efforts to promote physical activity. However, the prevalence of moderate to high levels of leisure-time physical activity in Brazil's population is low, with rates across the 26 state capitals and the Federal District of Brasília ranging from 10.5% (São Paulo) to 14.7% (Recife) and 21.5% (Brasília). 10 The US Guide to Community Services provides recommendations for physical activity programs in the United States and Europe, but it is unclear whether these recommendations apply to or can be adapted for use in other regions of the world. 11 – 13 Thus, a transdisciplinary, multisector partnership was established in Brazil to review evidence supporting strategies to promote physical activity in Latin America. 14 In its categorization of innovative physical activity interventions, this evidence-based review identified the Academia da Cidade program (ACP), an ongoing community-based program designed to promote leisure-time physical activity in the city of Recife, in northeastern Brazil. 15 ACP fits the profile of providing “physical activity classes in community settings,” 1 of 3 new categories of community-based physical activity interventions identified in the Latin American evidence-based review. 14 We used a cross-sectional design to evaluate the effects of ACP on levels of leisure-time physical activity in the adult population of Recife. Our primary interest was in examining whether past or current participation in ACP activities, seeing or hearing about ACP activities, and living in a neighborhood near an ACP site were directly associated with moderate to high levels of leisure-time physical activity and inversely associated with transport physical activity (i.e., activities involved in traveling from place to place, including to destinations such as workplaces, stores, and movies).
