Feature:
Healthy Living Move for Health
No.49
January 2007
 
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Promoting Physical Activity Around the World:
The Role of the Agita Mundo Network
Victor KR Matsudo, Erinaldo Andrade, Timoteo Araújo & Sandra Matsudo

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Abstract
The purpose of the Agita Mundo Network is to promote physical activity as a healthy behavior for people of all ages, nations and characteristics. The Agita Mundo will stimulate research, encourage the dissemination of information on the health benefits of physical activity and effective strategies to increase physical activity, advocate for physical activity and health and support the development of national and local programs and networks for physical activity promotion. A group of International and National Institutions met at the XXV International Symposium on Sports Sciences in São Paulo and agreed that an independent network was needed to stimulate global physical activity promotion and coordinate the World Day of Physical Activity. The gathered institutions strongly recommend forming a network focused on physical activity promotion to carry out these goals.

     

Introduction
Two million deaths worldwide each year are attributed to physical inactivity with the major consequences being morbidity from obesity, hypertension, diabetes and depression (WHO, 2004). The direct medical costs of physical inactivity have been calculated in different countries. In the United States this value reaches about US$76 billion per year. Even in developing countries such as Brazil this figure is high. Data from Sao Paulo State (population approximately 40 million people) shows that the figure has reached around US$34.7 million, which represents 2% to 3% of total medical costs.
Agita Sao Paulo Program is a multilevel intervention program to promote physical activity and health benefits of an active life-style in a population of over 40 million inhabitants, distributed in 645 cities, in the state of Sao Paulo, Brazil. It was launched on December 1996, by the Physical Fitness Research Center from Sao Caetano do Sul (Centro de Estudos do Laboratório de Aptidao Física de Sao Caetano do Sul - CELAFISCS) and the Sao Paulo State Health Secretariat. The main message used by the Program to promote the adoption of an active lifestyle was recommended in 1995 by the American College of Sports Medicine (ACSM) and the Centres for Disease Control (CDC) (Pate et al. 1995). The World Health Organization (WHO) has praised it as a model for other developing countries. The Program became a role model for similar programs in other states of Brazil, in other Latin American countries, and in 2002 led to the launch of the Physical Activity Network of the Americas (PANA).
The Agita Mundo - World Day of Physical Activity has been organised since 2002, comprising of more than 1000 events, in more than 100 countries in the five continents, every year. The outcomes of this day inspired the creation of an International Network to promote physical activity around the world. The creation of the network also considered the following relevant issues:
  1. The high prevalence (over 50%) of physical inactivity in the developing and developed countries
  2. The contributions of physical inactivity to total mortality, and especially morbidity due to cardiovascular disease and cancer
  3. That physical inactivity, combined with tobacco use and poor diet, cause 75% of non communicable disease (NCD) mortality
  4. That 79% of the deaths attributable to non communicable diseases occur in the developing countries
  5. That NCD account for approximately 60% of all deaths and 43% of the global burden of disease, and are expected to rise to 73% of all deaths and 60% of the global burden of disease by 2020
  6. That approximately 2 million deaths worldwide each year are attributable to physical inactivity
  7. The major consequences of physical inactivity is morbidity from obesity, hypertension, diabetes, and depression
  8. The benefits of physical activity to biological health, controlling body weight, improving glucose tolerance, bone density, cholesterol levels, reducing blood pressure
  9. The psychosocial benefits of physical activity, increasing self-esteem, self-image, well-being, mental agility, reducing loneliness, stress, anxiety and depression
  10. The potential indirect benefits of physical activity in lowering rates of violence among young people, promoting tobacco-free lifestyles and decreasing other risky behaviors such as unsafe sex or illicit drug use
  11. The high direct medical costs of physical inactivity: $76 billion per year in the United States, $34.7 million in Sao Paulo in 2002, and 2% to 3% of total medical costs in many developed countries
  12. The impact of World Health Day 2002 celebrations, consisting of 1987 events, in 148 countries on the five continents, with messages translated to 63 languages, involving the general public, policy makers and health promotion networks
  13. The unanimous decision of World Health Assembly 2002 in approving WHA Resolution 55/23 urging all Member States to celebrate “Move for Health Day” each year to promote physical activity as essential for health and well-being
  14. That WHA Resolution 55/23 also called for developing a Global Strategy on Diet, Physical Activity and Health for the prevention and control of noncommunicable diseases
  15. The impact of local, regional, national and continental initiatives
  16. That international scientific institutions such as WHO, PAHO, ACSM, FIMS, COPAMED, among others, have already developed position statements to promote regular physical activity, as an important tool for health.
The Agita Mundo Network Creation
During the XXV International Symposium of Sports Science organised by CELAFISCS and annually held in Sao Paulo, Brazil, a meeting was planned and many international programs for physical activity promotion representatives were invited.
Considering the institutions’ positions, they agreed to launch the Agita Mundo Network, that has among its purposes the roles to: a - stimulate global physical activity promotion, and, b - coordinate World Day for Physical Activity celebrations.
An international advisory board provides guidance and oversight to the Network. Agita Mundo has the support of national and international institutions (universities, sports institutions, research centers, private sector, governmental and non-governmental). At this point, more than 200 groups from 59 countries are taking part in a strategic coalition approach, by using a so called “two hats approach”, where governmental, or non-governmental channels are taken to maximise efficacy and increase the impact of Network actions.

Purpose of Agita Mundo Network
Agita Mundo Network purposes include, among others: to stimulate research and encourage the dissemination of information on the health benefits of physical activity and effective strategies to increase physical activity; to advocate for physical activity and health; to support the development of national and local programs and networks for physical activity promotion.
The gathered institutions strongly recommended forming a nongovernmental organisation (NGO) focused on physical activity promotion to carry out the following goals:
  1. Advocate for physical activity and health through an annual World Day for Physical Activity, other community-based and community wide events, and informing policy makers about the importance of physical activity to public policy.
  2. Disseminate a clear, simple and consistently delivered message on the health and social benefits of at least 30 minutes of moderate physical activity every day.
  3. Stimulate the creation of regional and international networks for physical activity promotion and to establish linkages among networks.
  4. Promote and disseminate innovative approaches to developing alliances around the world to promote physical activity and good health.
  5. Share good practices and effective strategies and programs through websites, meetings, workshops and publications.
Developing Activities
The Agita Mundo meetings have defined a 5-year agenda, summarised in the Agita Mundo Global Map. Activities comprise:
  1. Publishing a list of interventions programs in physical activity in different countries and different strategies
  2. Publishing a list of the most important physical activity websites
  3. Organising a list of fundamental papers on physical activity in health promotion
  4. Incentive surveillance to estimate the prevalence of sedentary behaviour in different countries and continents
  5. Identifying leaders (researchers or practitioners in physical activity around) the World
  6. Listing Allied Institutions in Promoting PA.
World Day for Physical Activity
The strategies to celebrate World Day for Physical Activity include:
  • Invitation to community sectors to organise a focal event
  • On-line conferences can be planned to involve communities from schools, health services and companies to encourage partners and their networks to participate in the event
  • Develop a folder to disseminate information about the event and the theme for the year.
This day has been celebrated since 2002 in many countries around the world, mobilising thousands of people regarding the benefits of regular physical activity.

  
Agita Mundo – Bogotá, Colômbia Agita Mundo – São Paulo, Brazil

International Agita Mundo Courses
To increase human resources in the sector to promote physical activity, the International Course on Physical Activity and Public Health-Agita Mundo was planned, with the support of CDC and IUHPE (International Union of Health Promotion and Education). At this moment, six courses have been organised in:
  1. Ilhabela – São Paulo, Brazil in July 2004
  2. Cartagena - Colombia in April 2005
  3. Heredia - Costa Rica in August 2005
  4. Puerto Vallarta - Mexico in January 2006
  5. Kuala Lampur - Malaysia in May 2006
  6. Viña del Mar - Chile in October 2006
  Brazil– Ihabela-SP
Costa Rica México

More than 260 professionals have participated the first four courses, representing 14 countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Cuba, Ecuador, Guatemala, Honduras, México, Nicaragua, Peru, Portugal, and Venezuela. In Malaysia, more 60 professionals from 20 different countries took part.



Countries Participants in Agita Mundo Network
Partners of the Agita Mundo Network sign an official letter of adhesion (see example below). The countries that are part of the network include: Argentina, Australia, Brazil, Canada, Chile, Colombia, Congo, Costa Rica, Cuba, Ecuador, England, France, Ghana, Germany, Greece, India, Indonesian, Iran, Ireland, Italy, Kenya, Malaysia, Mexico, Netherlands, Nigeria, Panama, Poland, Portugal, Romania, Serbia and Montenegro, Slovenia, South Africa, Spain, Switzerland, United States, Uruguay.


Agita Mundo & the Global Strategy of Diet and Physical Activity
The Agita Mundo Network in its Annual Meeting in 2005 decided to contribute to implementate the WHO Global Strategy on Diet and PA. Some of the decisions are sumarized in Table 1.

Table 1. Actions proposed for Agita Mundo Netwrok to implementate the WHO Global Startegy on Diet and Physical Activity, 2005.
1. To sensitive governments (national, state and municipal level) and community about PA and healthy diet 5. Coalisions with governmental, non-governmental and private institutions
2. Mobilization across the generations 6. Include PA and healthy diet among criteria of social responsability certification for companies.
3. To promote PA in the public,private companies, and community to employees and families 7. Creation of difusion strategy to disseminate PA and healthy diet message to the networks
4. To publish local and national experiences about good practices in physical activity (PA) 8. Launching of printed material (pyramid) to promote the message of PA and healthy diet (see below- Figure).

Figure 1. Pyramid of PA and Healthy Diet Launched by Agita Mundo Network in Spanish and Portuguese


References
AGITA MUNDO NETWORK (2005, cited 17.05.2006) The Agita Mundo Network Report, São Paulo, 2004 (report on internet) available at: www.agitasp.org.br
Blair, S.N., Cheng, Y., & Holder, J.S. (2001) Is physical activity or physical fitness more important in defining health benefits? Med Sci Sports Exercise: 33(6 Suppl):S379-399.
Celafiscs and Center for Disease Control. (2006.) Best practices for physical activity promotion around the world. São Paulo, Brazil.
Gunn, S.M., Brooks, A.G., Withers, R.T., Gore, C.J., Owen, N., Booth, M.L. et al. (2002). Determining energy expenditure during some household and garden tasks. Med Sci Sports Exercise:34(2):895-902.
HEPA Europe (2005, cited 17.05.2006) The European Network for the Promotion of Physical Activity (report on Internet). Available at: www.euro.who.int/hepa
Matsudo, V., Matsudo, S., Andrade, D., Araújo, T., Andrade, E., Oliveira, L. & Braggion, G. (2002). Promotion of physical activity in a developing country: the Agita São Paulo Experience. Public Health Nutrition: 5(1A):253-261.
Matsudo, V.K.R., Matsudo, S., Andrade, D., Araujo, T., Andrade, E., Oliveira, L.C. et al. (2003). ‘The Agita São Paulo’ model in promoting physical activity. In Medeiros-Neto, G., Halpern, A. & Bouchard, C. (Eds.). Progress in Obesity Resarch:9:870-880.
Matsudo, S.M., Matsdo, V.K.R., Andrade, D.R., Araújo, T.L., Andrade, E., Oliveira, L. & Braggion, G. (2004). Physical Activity Promotion: Experiences and evaluation of the Agita Sào Paulo Program using ecological mobile model. J. Phys. Act. Health 1: 81-9.7
Matsudo, S.M. & Matsudo, V.K.R. (2005). Agita São Paulo: Encouraging physical activity as a way of life in Brazil. In Freire, W.B. Nutrition and an active life from knowledge to action, Scientific and Technical Publication n. 162 pan American Health Organization.
Matsudo, S.M. & Matsudo, V.K.R. (2006). Coalitions and networks: facilitating global physical activity promotion. Promotion and Education, v.13 133-138.
Matsudo V, Guedes J, Matsudo S, Andrade D, Araújo T, Oliveira L, Andrade, E and Ribeiro M. (2004). Policy intervention: The experience of Agita São Paulo in using “Mobile Management” of the ecological model to promote physical activity. Perspectives The multidisciplinary series of physical education and sports science, ICSSPE. Meyer & Meyer Sports v. 6 1-23.
Michael, P., Roux, L., Yanagawa, T., Tengs, T., Akhavan, D., Araújo, T., Andrade, E., Andrade, E., Matsudo, S. & Matsudo, V. (in press) A Cost Effectiveness Analysis of the Agita São Paulo Comprehensive Community Campaign to Promote Physical Activity Promotion and Education. IUHPE, 2006 In press
Pate, R., Pratt, M., Blair, S., Haskell, W., Macera, C., Bouchard, C., et al. (1995). Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA:273(5):402.
RAFA/PANA (2001, cited 17.05.2006) Physical Activity Network of Americas (reported on Internet) available at: www.rafapana.org
Vuori, I.M. (2001). Health benefits of physical activity with special reference to interaction with diet. Public Health Nutrition: 4(2B):517-528.
WHO (accessed 17.05.2006) Global Strategy on Diet, Physical Activity and Health (document on the internet) World Health Organization. Avaliable at:
http://www.who.int/dietphysicalactivity/publications/facts/pa/en/index.html
World Bank. (2005.) Brazil addressing the challenge of Non-communicable diseases in Brazil.
RAFA/PANA (2001, cited 17.05.2006) Physical Activity Network of Americas (reported on Internet) available at: www.rafapana.org

Contact
Victor KR Matsudo
Center of Studies from the Physical Fitness Research Laboratory
São Caetano do Sul (CELAFISCS)
São Paulo, Brazil
matsudo@celafiscs.org

Agita Mundo
CELAFISCS
Caixa Postal 168
São Caetano do Sul
09501-000
São Paulo
BRAZIL
agitamundo@rafapana.org
Internet: www.rafapana.org




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