Adaptation of a pan-Canadian chronic disease prevention intervention to promote health behaviour change in Brazilian adults

Background: Due to the high prevalence of preventable unhealthy behaviours, chronic diseases are the major health problem worldwide. These diseases and common risk factors such as physical inactivity, unhealthy diet, and smoking impose a high burden on both individuals and governments. Considering this scenario, the World Health Organization has recently established as a research priority preventive interventions in low- and middle-income countries, such as Brazil. Objective: The main purpose of this research was to examine the effectiveness of a comprehensive pan-Canadian lifestyle program adapted to Brazilians and to verify the reproducibility of the Brazilian Portuguese version of the Physical Activity Questionnaire for Everyone (PAR-Q+). Methods: A 12-week program called ACCELERATION, focused on health behaviour change, was translated and culturally adapted to Brazilians. A quasi-randomized controlled trial was designed, consisting of weekly emails and educational videos addressing physical activity, healthy eating and smoking cessation. The main outcomes of the study were changes in the proportion of individuals participating in ≥ 150 min of moderate-to-vigorous physical activity (MVPA) per week, eating ≥ five daily servings of fruits/vegetables, and quitting smoking. The translation and cultural adaptation of the PAR-Q+ followed the guidelines of the PAR-Q+ Collaboration. Results: The Brazilian experimental group had an increase of 68.3% in the number of participants engaging in physical activity and of 48.8% in the total of participants adopting a healthy diet. Also, the only smoker quit smoking. Additionally, this group had increments of 185.2% in the total of weekly minutes spent in MVPA (medium to large effect size) and of 108.7% in the number of fruits/vegetables consumed daily (large effect size). These results were equivalent to that of Canadian participants with similar demographics in the original program. Regarding the Brazilian version of the PAR-Q+, the translated questionnaire had an almost perfect agreement in 93.8% of the questions, and a substantial agreement in the other items. Conclusion: The Brazilian version of the ACCELERATION program was as effective as the Canadian intervention, and the PAR-Q+ in Brazilian Portuguese had a strong reproducibility. Both initiatives have the potential to contribute to the fight against chronic diseases in Brazil.Medicine, Faculty ofExperimental Medicine, Division ofGraduat