Abstract Physical inactivity and sedentary behavior are associated with poor physical and mental health. The article aims to assess the changes in the habits of the Brazilian participants engaged in physical activities in relation to their practices, due the measures of social distancing during the COVID-19 epidemic in 2020. The secondary objective was to describe their levels of anxiety and depression. The questionnaire used in this online survey included demographic information, questions about self-perceptions of the impact of the COVID-19 in the life routines and the 14-item Hospital Anxiety Depression Scale. A total of 1,613 adults completed the questionnaire between May 11 and 15, 2020. Of those, 79.4% reported that the measures to contain the epidemic had any impact on their physical activities, and many had to interrupt or decrease the frequency of their practices. Participants who felt a higher impact of quarantine on their physical activities tend to have higher prevalence of anxiety and depression symptoms. Individuals who practiced physical activities reported that social distance had a high influence on their practices. Furthermore, changes in these habits are associated with high levels of poor mental health.

Resumo Inatividade física e sedentarismo são associados com baixa saúde física e mental. O objetivo deste artigo é avaliar as mudanças nos hábitos dos participantes brasileiros praticantes de atividades físicas em relação às suas práticas, devido às medidas de distanciamento social durante a epidemia COVID-19 em 2020. O objetivo secundário foi descrever seus níveis de ansiedade e depressão. O questionário utilizado nesta pesquisa on-line incluiu informações demográficas, questões sobre a autopercepção do impacto do COVID-19 nas rotinas da vida e a Escala de Depressão de Ansiedade Hospitalar de 14 itens. Um total de 1.613 adultos completou o questionário entre 11 e 15 de maio de 2020. Destes, 79,4% relataram que as medidas para conter a epidemia tiveram algum impacto em suas atividades físicas e muitos tiveram que interromper ou diminuir a frequência de suas práticas. Os participantes que sentiram um maior impacto da quarentena em suas atividades físicas tendem a ter maior prevalência de sintomas de ansiedade e depressão. Os indivíduos que praticavam atividades físicas relataram que o distanciamento social teve alta influência em suas práticas. Além disso, as mudanças destes hábitos são associadas com altos níveis de precária saúde mental.

Abstract Physical inactivity and sedentary behavior are associated with poor physical and mental health. The article aims to assess the changes in the habits of the Brazilian participants engaged in physical activities in relation to their practices, due the measures of social distancing during the COVID-19 epidemic in 2020. The secondary objective was to describe their levels of anxiety and depression. The questionnaire used in this online survey included demographic information, questions about self-perceptions of the impact of the COVID-19 in the life routines and the 14-item Hospital Anxiety Depression Scale. A total of 1,613 adults completed the questionnaire between May 11 and 15, 2020. Of those, 79.4% reported that the measures to contain the epidemic had any impact on their physical activities, and many had to interrupt or decrease the frequency of their practices. Participants who felt a higher impact of quarantine on their physical activities tend to have higher prevalence of anxiety and depression symptoms. Individuals who practiced physical activities reported that social distance had a high influence on their practices. Furthermore, changes in these habits are associated with high levels of poor mental health.

Resumo Inatividade física e sedentarismo são associados com baixa saúde física e mental. O objetivo deste artigo é avaliar as mudanças nos hábitos dos participantes brasileiros praticantes de atividades físicas em relação às suas práticas, devido às medidas de distanciamento social durante a epidemia COVID-19 em 2020. O objetivo secundário foi descrever seus níveis de ansiedade e depressão. O questionário utilizado nesta pesquisa on-line incluiu informações demográficas, questões sobre a autopercepção do impacto do COVID-19 nas rotinas da vida e a Escala de Depressão de Ansiedade Hospitalar de 14 itens. Um total de 1.613 adultos completou o questionário entre 11 e 15 de maio de 2020. Destes, 79,4% relataram que as medidas para conter a epidemia tiveram algum impacto em suas atividades físicas e muitos tiveram que interromper ou diminuir a frequência de suas práticas. Os participantes que sentiram um maior impacto da quarentena em suas atividades físicas tendem a ter maior prevalência de sintomas de ansiedade e depressão. Os indivíduos que praticavam atividades físicas relataram que o distanciamento social teve alta influência em suas práticas. Além disso, as mudanças destes hábitos são associadas com altos níveis de precária saúde mental.

Abstract INTRODUCTION This study investigated the prevalence of blood donors’ test-seeking behavior and related factors among health sciences undergraduate students. METHODS A total of 750 students were invited. Data regarding sociodemographic and behavioral characteristics, blood donation practices, and test-seeking behavior were collected. RESULTS: Of the invited students, 341 (45.5%) agreed to participate and answered questions regarding test-seeking behavior. The sample comprised 83.1% females, 96.8% singles, 87.2% heterosexuals, and 32.6% of them had previously donated blood. A high prevalence of blood donor test-seeking behavior (14.4%; 95% CI: 10.8%-18.5%) was observed and associated with blood donation practices. CONCLUSIONS: Test-seeking behavior was common among the interviewed students, thereby highlighting the importance of developing a better understanding of its determinants to prevent this behavior in key populations.

Abstract INTRODUCTION: Acquired immunodeficiency syndrome (AIDS) remains a major public health issue in Brazil. This ecological study aimed to evaluate the spatiotemporal distribution of notified new AIDS cases in Brazil between 2012 and 2016. METHODS: A Bayesian spatiotemporal model based on the Poisson distribution was used to obtain smoothed incidence estimates of AIDS in each of the 133 Brazilian intermediate regions. RESULTS: Spatial distribution of new AIDS cases is highly heterogeneous. Regions with higher gross domestic product per capita tend to have higher incidence rates of AIDS. CONCLUSIONS: Strategies to prevent and control AIDS should consider regional differences.

Abstract Objective To assess the psychometric properties of the Medical Outcomes Study Social Support Survey (MOS-SSS) considering a sample of elderly users of the primary healthcare facilities of Ribeirão Preto, state of São Paulo, southeast Brazil. Methods The MOS-SSS is a widely used measurement of social support in different contexts, consisting of 19 items with answer categories that range on a 7-point rating scale. Data collection regarding the psychometric properties of the MOS-SSS was performed in a stratified sample of elderly users of primary healthcare facilities of Ribeirão Preto. Data were collected at five district basic health units located in the city through face-to-face interviews. Polychoric correlation matrix and exploratory (EFA) and confirmatory (CFA) factor analyses were performed. Results A total of 357 elderly subjects aged 60 years or older participated in the study (62.7% females). According to the polychoric correlation matrix, higher coefficients of correlation (> 0.90) were detected among 12 pairs of items and grouped into four factors, as suggested for EFA. The results of the CFA confirmed the construct validity of the four-factor structure of the MOS-SSS when applied to our sample, as well as the stability of this model in distinct subsamples. Conclusion The four-factor structure of the MOS-SSS was found to be suitable and presented adequate construct validity for the assessment of social support in elderly users of primary healthcare facilities.

Resumo Objetivo Avaliar as propriedades psicométricas do Medical Outcomes Study Social Support Survey (MOS-SSS), considerando uma amostra de idosos usuários das unidades de atenção primária à saúde de Ribeirão Preto, São Paulo, sudeste do Brasil. Métodos O MOS-SSS é uma escala para investigação do suporte social amplamente utilizada e aplicável a diferentes contextos. A escala é composta por 19 itens com categorias de respostas que variam em uma escala de 7 pontos. A coleta de dados foi realizada em uma amostra estratificada de idosos usuários de serviços de atenção primária à saúde de Ribeirão Preto. Os dados foram coletados em cinco unidades distritais básicas de saúde (UBDS) do município por meio de entrevistas pessoais. A análise dos dados foi feita utilizando-se matriz de correlações policóricas e análise fatorial exploratória (AFE) e confirmatória (AFC). Resultados Participaram do estudo 357 idosos com 60 anos ou mais (62,7% do sexo feminino). De acordo com a matriz de correlações policóricas, maiores coeficientes de correlação (> 0,90) foram detectados em 12 pares de itens e agrupados em quatro fatores, conforme sugerido pela AFE. Os resultados da AFC confirmaram a validade de construto da estrutura de quatro fatores do MOS-SSS quando aplicado à amostra do estudo, bem como a estabilidade desse modelo em subamostras distintas. Conclusão A estrutura de quatro fatores do MOS-SSS mostrou-se apropriada para a população estudada e apresentou validade de construto adequada para a avaliação do suporte social em idosos usuários de serviços de atenção primária à saúde.

Abstract Introduction: Instruments aimed to investigate general aspects of quality of life are scarce in the literature. Flanagan's Quality of Life Scale (QoLS) is an alternative instrument which provides a more comprehensive evaluation of quality of life in different contexts. Objective: To investigate some psychometric properties of the QoLS and discuss the measurement of quality of life using this scale in heterogeneous and large populations. Methods: The QoLS comprises 16 items divided into five dimensions. Responses were measured using a 7-point rating scale. Data were collected from a stratified sample of primary health care users in the municipality of Ribeirão Preto, state of São Paulo, Brazil. Polychoric correlation matrix and exploratory and confirmatory factor analyses were performed. Results: A total of 1,054 primary health care users in 12 health care facilities were interviewed: 79.7% female; mean age = 36.97 years (standard deviation = 15.1). Moderate to low correlation coefficients were observed between almost all pairs of QoLS items. Items 7 and 9 as well as items 14 and 15 were the pairs presenting the highest correlation coefficient. The original structure of the QoLS, with five dimensions, showed adequate psychometric properties regarding the data collected. The inclusion of a single item on life satisfaction was proposed. Conclusion: The original structure of the QoLS was validated and found to be reliable when applied to primary health care users. A new general item was suggested for future studies to improve the interpretations and associations regarding general aspects of quality of life in large and heterogeneous populations.

Resumo Introdução: Instrumentos destinados a investigar aspectos gerais da qualidade de vida são escassos na literatura. A Escala de Qualidade de Vida de Flanagan (Flanagan's Quality of Life Scale – QoLS) é um instrumento alternativo que fornece uma avaliação mais abrangente da qualidade de vida em diferentes contextos. Objetivo: Investigar propriedades psicométricas da QoLS e discutir a mensuração da qualidade de vida utilizando essa escala em populações amplas e heterogêneas. Métodos: A QoLS é composta de 16 itens divididos em cinco dimensões, cujas categorias de resposta variam em uma escala de 7 pontos. Os dados foram coletados em uma amostra estratificada de usuários da atenção primária do município de Ribeirão Preto, SP. Matriz de correlação policórica e análise fatorial exploratória e confirmatória foram realizadas. Resultados: Foram entrevistados 1.054 usuários da atenção primária em 12 unidades de saúde: 79,7% mulheres; idade média = 36,97 anos (desvio padrão = 15,1). Coeficientes de correlação moderados a baixos foram observados entre quase todos os pares de itens da escala. Os pares de itens 7 e 9, e 14 e 15 foram os que apresentaram o maior coeficiente de correlação. A estrutura original da QoLS, com cinco dimensões, apresentou propriedades psicométricas adequadas em relação aos dados coletados. A inclusão de um item único sobre satisfação com a vida foi proposto. Conclusão: A estrutura original da QoLS foi considerada válida e confiável quando aplicada a usuários da atenção primária. Um novo item geral foi sugerido para estudos futuros, a fim de melhorar as interpretações e associações sobre aspectos gerais da qualidade de vida em populações amplas e heterogêneas.

Resumo O objetivo deste estudo transversal foi estimar a prevalência auto-reportada de hipertensãoe diabetes entre idosos usuários das unidades de atenção primária à saúde de Ribeirão Preto, Brasil, e investigar a associação entre estas condições crônicas e a atividade física e o grau de independência na realização das atividades da vida diária. O estudo incluiu 357 participantes com idade de 60 anos ou mais. A classificação da atividade física baseou-se no International Physical Activity Questionnaire (IPAQ), e o Pfeffer Functional Activities Questionnaire (PFAQ) foi aplicado para avaliar a realizaçãodas atividades da vida diária. Prevalência de diabetes foi associada com o nível de atividade física, a autopercepção da saúde e o grau de independência na realização das atividades da vida diária. Não foram encontradas associações significantes entre a prevalência de hipertensão e estas variáveis. Estes achados reforçam a relevância de estratégias contínuas de manejo da diabetes nas unidades de atenção primária à saúde, baseadas na promoção de atividades físicas e ocupacionais.

Abstract The aim of this cross-sectional study was to estimate the prevalence of self-reportedhypertension and diabetes among elderly users of primary healthcare facilities in Ribeirão Preto, Brazil, and to investigate the association between these chronic conditions and physical activity and the degree of independence on the performance of activities of daily living. The study included 357 subjects aged 60 years or older. The classification of physical activity was based on the International Physical Activity Questionnaire (IPAQ) and the Pfeffer FunctionalActivities Questionnaire (PFAQ) was applied to assess activities of daily living. Prevalence of diabetes was associated with the level of physical activity, the self-perception of health and the degree of independence on the performance of activities of daily living. No significant associations were found between the prevalence of hypertension and these variables. These findings reinforce the relevance of continuous strategies of management of diabetes in the primary healthcare facilities based on the promotion of physical and occupational activities.

Abstract INTRODUCTION: Although congenital syphilis is preventable, its incidence has increased in Brazil. METHODS: In this ecological study, a Bayesian spatio-temporal model was used to estimate the attributable fraction of congenital syphilis cases due to the lack of prenatal care recorded between 2010 and 2015 in the state of São Paulo, Southeast Brazil. RESULTS: For the year 2016, it was estimated that between 79.4% and 95.3% of the congenital syphilis cases among women who did not have prenatal care could have been prevented. CONCLUSIONS: A significant proportion of congenital syphilis cases can be prevented if prenatal care coverage is expanded.

Resumo Introdução Vários estudos têm mostrado o papel da religiosidade nas crenças e comportamentos em saúde. Objetivo O objetivo deste estudo transversal é examinar a associação entre envolvimento religioso e padrões de consumo de álcool em uma amostra representativa de usuários de unidades de atenção primária à saúde de Ribeirão Preto, Brasil. Método Os dados foram obtidos por entrevistas pessoais. A religiosidade foi mensurada usando o Duke University Religion Index (DUREL) e o consumo de álcool foi mensurado pelo Alcohol Use Disorders Identification Test (AUDIT). Modelos de regressão logística multinomiais foram usados para avaliar as associações entre as características dos participantes, os níveis do AUDIT e os grupos de consumo de álcool. Resultados A amostra foi composta por 841 mulheres com idade média de 39,5 anos e 214 homens com média de idade de 45,1 anos. Foram evidenciadas associações significativas entre padrões de consumo de álcool e as múltiplas dimensões da religiosidade, como afiliação religiosa, práticas religiosas, autopercepção do nível de religiosidade e os componentes do DUREL. Baixos níveis de ingestão de álcool foram detectados entre indivíduos religiosos e entre aqueles que praticam sua religião, comparados com aqueles que não possuem uma religião e/ou não praticam uma religião, respectivamente. Conclusão Um estilo de vida motivado por interesses religiosos é associado com os hábitos de uso de álcool entre os usuários de unidades de atenção primária à saúde.

Abstract Background A number of studies have been reported on the role of religiosity in health beliefs and behaviors. Objective The objective of this cross-sectional study is to examine the association between religious involvement and patterns of alcohol consumption in a large representative sample of users of primary healthcare facilities in Ribeirão Preto, Southeast Brazil. Method Data were collected through personal interviews. Religiosity was measured using the Duke University Religion Index (DUREL) and the alcohol consumption was measured using the Alcohol Use Disorders Identification Test (AUDIT) questionnaire. Multinomial logistic regression models were used to evaluate the associations between the participant characteristics, the AUDIT risk levels, and the drinking groups. Results The sample was composed of 841 women with a mean age of 39.5 years old and 214 men with a mean age of 45.1 years old. A significant relationship between patterns of alcohol consumption and the multiple dimensions of religiosity was detected, such as religious affiliation, religious practices, self-perception of the level of religiosity and the ORA, NORA and IR components of DUREL. Lower levels of drinking risk were detected among religious individuals and among those who practice their religions compared to individuals who have no religion and/or non-practicing individuals, respectively. Conclusion A lifestyle motivated by religious concerns is associated with alcohol use habits among the Brazilian users of the public healthcare facilities.

ABSTRACT Reevaluation of the deferral from voluntary blood donation by men who have sex with men (MSM) is being discussed in several countries, motivated by the need to ensure a blood supply free from transfusion-transmissible infections (e.g., HIV, syphilis). Policies being considered include: permanent exclusion for any male-male sexual encounter, temporary deferral (3 months, 12 months, 5 years) from the last encounter, or specifying behaviors that differentiate MSM at high risk from those at low risk. Current Brazilian regulations defer MSM from blood donation for 12-months after the last male-male sexual encounter. Broad epidemiological evidence indicates that many MSM are at increased risk for HIV in the present era, and few data exist to distinguish which men are likely to be in the immunological window for detection of these infections. A multicenter study developed in Brazil demonstrated that the history of male-male sex was the most strongly associated with being an HIV-positive blood donor. Meanwhile, the blanket deferral of MSM from blood donation has generated considerable controversy. Rejection of the deferral policies stems in part from perspectives defending human rights, promoting equality and citizenship, and alleging bias and discrimination. The objective of this report is to discuss the current situation of blood donation among MSM in Brazil. We highlight the lack of evidence for a true risk profile for male-male sex in the context of blood donation upon which to base sound policy. We recommend research to establish effective and acceptable criteria for blood donation by MSM and other blood donors.

ABSTRACT Background: To present the results of the application of the Blood Donation Knowledge Questionnaire in a large and representative sample of users of primary care services in order to extend the evaluation of the metrics of the items and to assess knowledge about blood donation in association with sociodemographic variables. Method: The Blood Donation Knowledge Questionnaire is composed of 24 items based on blood donation requirements of the Brazilian Ministry of Health and on some popular beliefs and concepts of the Brazilian population regarding the blood donation process. Data collection was carried out in 12 healthcare facilities of Ribeirão Preto, São Paulo. The analysis of items was performed using classical test theory with associations being assessed using the multivariate Tobit regression model. Results: A total of 1055 individuals participated (79.7% females and a mean age of 40.6 years). Previous blood donation was reported by 246 (23.3%) participants, 669 (63.4%) had never donated, and 140 (13.3%) reported being ineligible to donate blood. This questionnaire is comprised of items considered easy-to-understand, with a facility level of medium to high and generally an adequate capability of discrimination. Higher means of correct answers were detected among females, individuals with more schooling, and subjects who had already donated blood. Conclusion: The Blood Donation Knowledge Questionnaire is an instrument that aims to measure some general aspects of knowledge regarding blood donation and can be used in different contexts. There is evidence that knowledge of primary healthcare users regarding blood donation is correlated to sex, educational level, and previous blood donation.

Abstract Background Blood/injection phobia may have important consequences for health. These phobic individuals, in most cases, avoid contact with health systems, postpone or avoid medical procedures, avoid invasive treatments and do not participate in health promotion and early detection of disease initiatives such as vaccination, consultations, preventive exams or blood donation. Thus, specific and validated instruments are necessary to assess this variable. In addition, a lack of studies on this theme may be associated with the low availability of instruments. This study aimed to propose a Portuguese version of the Blood/Injection Fear Scale (BIFS-P) and assess its psychometric properties. Methods Translation and back-translation were performed. Content validity was assessed in two steps by a panel of 20 experts. The psychometric properties were assessed in a stratified and representative sample of primary health care service users of Ribeirão Preto, southeastern Brazil. Exploratory and confirmatory factor analyses were conducted using a polychoric correlation matrix. Results A total of 1054 primary health care users participated; 79.7% were female and the mean age was 40.6 (standard deviation = 15.16) years. According to the exploratory factor analysis, the items can be grouped into three or five factors with best fits being detected for the three- and five-factor models in confirmatory factor analysis. Conclusion Blood/Injection Fear Scale (Portuguese version) is easy to understand and apply in the general population, showed adequate psychometric properties, and represents an alternative in the assessment of blood/injection phobia for future studies.

A religiosidade é uma variável importante para a pesquisa em saúde, considerando suas conhecidas associações com o processo saúde-doença e questões importantes sobre o bem-estar, atitudes, práticas e satisfação em relação a cuidados e serviços. No entanto, na pesquisa em Saúde Coletiva, é frequentemente usada a afiliação religiosa como única dimensão da religiosidade. O presente estudo objetivou investigar a adequação do uso do instrumento Duke Religious Index (DUREL) no âmbito da pesquisa em Saúde Coletiva, ao avaliar as capacidades psicométricas do instrumento quando aplicado a uma população representativa de usuários dos serviços de atenção primária à saúde de um município de porte médio do interior do Estado de São Paulo. Foi encontrada uma adequada consistência interna para o instrumento e validade convergente-discriminante. Os resultados sugerem que o uso do DUREL não é restrito à pesquisa em saúde mental e que sua utilização pode trazer novas perspectivas para o entendimento de eventos de interesse na área da Saúde Coletiva.

Religiosity is an important variable in health research, given its known association with the health-disease process and important questions about the well-being, attitudes, practices and satisfaction with care and services. However, in the research in Public Health, it is often used religious affiliation as the only dimension of religiosity. This study aims to investigate the appropriateness of using the Duke Religious Index scale (DUREL) in the context of the Public Health research, evaluating the psychometric capabilities of the instrument when applied to a representative sample of users of primary care services to health in a medium-sized city of the interior of São Paulo State, Southeast Brazil. It was found an adequate internal consistency for the instrument and satisfactory convergent-discriminant validity. The results suggest that the use of DUREL is not restricted to research in mental health, and that its use can bring new perspectives for the understanding of events of interest in the field of Public Health.

The aim of this study was to estimate the reliability, validity and factorial invariance of the Portuguese version of the Geriatric/General Oral Health Assessment Index (GOHAI) as applied to Brazilian women. A total 701 women over 18 years of age participated in this study. Telephone interviews were conducted. We evaluated the construct-related validity through factorial, convergent and discriminant validity. We carried out a confirmatory factor analysis using the χ2/df, CFI, GFI and RMSEA indexes. The invariance of the model in a second independent sample was estimated by multi-group analysis and internal consistency using Cronbach’s alpha coefficient. Items 5 and 9 presented factor weights below the adequate value and were removed. The three-dimensional and unifactorial model presented an adequate fit. We observed strong factorial invariance of the models in two independent samples (three-factor: ρλ = 0.62; pCov = 0.89, one-factor: ρλ = 0.81; pCov = 0.68) and weak factorial invariance between users and nonusers of dental prosthetics (three-factor: ρλ = 0.55; pCov = 0.01, one-factor: ρλ = 0.51; pCov = 0.02). The convergent validity was suboptimal. Internal consistency was adequate. The GOHAI applied to the study sample showed adequate reliability, factorial validity and stability in independent samples and between users and nonusers of dental prosthetics in both the three-dimensional and the unifactorial structures.