Monitorização da Atividade Física em Portugal: Em Busca de um Sistema de Vigilância

Abstract

Introduction: Physical inactivity is one of the main risk factors for non-communicable diseases and premature mortality. The latest available international data indicates that, in 2022, around 30% of the global adult population (≥18 years) was insufficiently active. Portugal was among the 10 countries (out of 163) where the prevalence exceeded 50%. Surveillance systems are crucial for monitoring the health profile of a country's population and assessing public policies. This study aims to diagnose the physical activity (PA) surveillance systems implemented in Portugal. To achieve this general objective, the following specific objectives were defined: 1) Identify and characterize the existing studies that monitor PA, conducted in Portugal; 2) Assess the quality of the identified studies according to the essential characteristics of a PA surveillance system; 3) Compare the levels of PA reported by the different epidemiological studies for the same population in the same time period. Methods: This observational, cross-sectional, and descriptive study began with a literature review to identify the studies in this area conducted in Portugal. A characterization of the ES was subsequently carried out based on their latest edition. The studies were evaluated for compliance (in %) with 10 essential characteristics of a PA surveillance system, according to the literature: 1) Use a scientifically validated instrument; 2) Perform repeated measures over time; 3) Assess different age groups representative of the entire life cycle; 4) Use a population-representative sample for the national territory; 5) Use a combination of self-reported data (questionnaire) and accelerometer data; 6) Assess PA contexts; 7) Collect data on sedentary behavior; 8) Use cut-off points defined by the World Health Organization for sufficient PA levels; 9) Interpret the results according to the sociodemographic variables of the sample; 10) Make the results publicly accessible and disseminate them. A comparison of the PA levels reported by the studies for the same period and population was then conducted. Results: Ten studies were identified, with the following results (compliance proportion with the main identified characteristics; prevalence to be compared, if applicable): Barómetro da Atividade Física (60%; 78%, 18-65 years old, 2017); Childhood Obesity Surveillance Initiative (COSI; 70%); Eurobarometer: Sport and Physical Activity (70%; 35%, 15+ years old, 2017); Health Behaviour in School-aged Children study (HBSC; 60%); Inquérito Alimentar Nacional e de Atividade Física (IAN-AF; 90%; 56.5%, 10-14 years old; 27.3%, 22-64 years old; 21.8%, 65-84 years old, 2015/2016); Inquérito aos Hábitos Desportivos da População Escolar Portuguesa (50%); Inquérito Nacional de Saúde (INS) - data used for the European Health Interview Survey (70%); Inquérito Nacional de Saúde com Exame Físico (INSEF, 50%); SClínico - Primary Health Care (PA assessment tool, 60%); Sistema Nacional de Vigilância e Monitorização da Atividade Física e Desportiva (70%; 15.2%, 10-14 years old; 71.2%, adults; 30.6%, elderly, 2018). Conclusion: A large number of studies evaluating the PA levels of the population are conducted in Portugal. Some of these studies collect data in very similar contexts, but with different samples and methodologies, leading to significantly divergent and difficult-to-compare results. None of the studies possesses all the essential characteristics of a PA surveillance system. There is an urgent need to implement a unified surveillance system that monitors this behavior and assesses the impact of health promotion policies.