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Open Access Highly Accessed Research article

Physical activity counseling in primary health care in Brazil: a national study on prevalence and associated factors

Alex Antonio Florindo1*, Gregore Iven Mielke2, Grace Angélica de Oliveira Gomes3, Luiz Roberto Ramos4, Mário Maia Bracco5, Diana C Parra6, Eduardo J Simoes7, Felipe Lobelo8 and Pedro Curi Hallal29

Author Affiliations

1 School of Arts, Sciences and Humanities, University of Sao Paulo, São Paulo, SP, Brazil

2 Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil

3 Gerontology Department, Federal University of Sao Carlos, São Carlos, SP, Brazil

4 Department of Preventive Medicine, Federal University of Sao Paulo, São Paulo, SP, Brazil

5 Hospital Israelita Albert Einstein, São Paulo, SP, Brazil

6 Prevention Research Center in St. Louis, George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri, USA

7 School of Medicine, Department of Health Management and Informatics at University of Missouri, Columbia, Missouri, USA

8 Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers For Disease Control and Prevention, Atlanta, GA, Georgia

9 School of Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil

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BMC Public Health 2013, 13:794  doi:10.1186/1471-2458-13-794

Published: 31 August 2013



The aim of this study was to determine the prevalence and correlates of physical activity counseling among physicians and nurses working in primary health care in Brazil.


A phone survey was carried out in 2011 with professionals working in primary health care in Brazil. The target sample consisted of 1,600 randomly selected primary care units covering all regions of the country. We successfully interviewed 529 professionals within the sampled units; 182 physicians and 347 nurses. The overall response rate was 49.6%. Multivariable logistic regression was used to estimate correlates of counseling in the whole sample and separately for physicians and nurses.


The prevalence of regular physical activity counseling for at least six months was 68.9% (95% CI 64.9; 72.8) and was significantly higher among physicians compared to nurses (p < 0.05). Most professionals (93.2%) interviewed were unfamiliar with current physical activity recommendations for health. In the adjusted analysis, physical activity counseling was more frequent among those who report assessing patient’s physical activity (OR = 2.16; 95% CI 1.41; 3.29), those reporting that lack of time was not a barrier for counseling (OR = 0.62 95% CI 0.42-0.93), those who felt prepared to provide physical activity counseling (OR = 2.34; 95% CI 1.50-3.66), and those working at primary care units offering physical activity programs for patients (OR = 2.06; 95% CI 1.33-3.20). In the stratified analysis, only assessing patient’s physical activity was a significant correlate among physicians whereas assessing patient’s physical activity, feeling prepared to provide counseling and working in units with physical activity interventions were significant correlates among nurses.


Physicians and nurses deemed physical activity counseling of great importance in primary health care in Brazil. However, in order to increase the quality of counseling and the number of professionals engaging in this activity, these health teams require greater knowledge about physical activity (global recommendations for health) as well as training on the application of instruments for assessing physical activity. Moreover, sufficient time must be allowed during consultations for the counseling process, and physical activity promotion programs should be implemented within the primary health care units.

Physical activity promotion; Physical activity counseling; Primary health care; Physicians; Nurses; Knowledge; Associated factors