Physical Activity and Body Practices developed in Primary Health Care in Brazil from 2013-2021

Physical Activity and Body Practices developed in Primary Health Care in Brazil from 2013-2021 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Physical Activity and Body Practices developed in Primary Health Care in Brazil from 2013-2021 Rinelly Pazinato Dutra, Alan Goularte Knuth This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3143626/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Physical activity and body practices (PCAF) are important strategies for health promotion, and widely recognized as a form of care within the Brazilian Unified Health System (SUS). The aim of the study was to map records of PCAF developed in Primary Health Care in Brazil, from 2013 to 2021. Method: This cross-sectional and descriptive study used the Primary Care Health Information System (SISAB) data. Year-by-year PCAF records were presented in absolute and relative values in states, regions, and the country by team type and target audience. Results: In total, 2,664,288 PCAF actions were recorded nationally throughout the period. A growth of 19,977.5% was observed in records from 2013 to 2019, but they dropped by 75.5% from 2020 and the COVID-19 pandemic. The regions that most recorded PCAF were the Southeast and Northeast, and the states of Minas Gerais, São Paulo, Rio de Janeiro, Bahia, Ceará, Goiás, and Santa Catarina. PCAF actions were directed mainly at the general community, women, older adults, and people with chronic diseases. The Expanded Family Health Center and Family Health were the health teams with the most records. Conclusions: A significant increase in PCAF records was observed from 2013 to 2019. However, a substantial decrease was identified from 2020, linked to the pandemic. The distribution of actions is still unequal at the state and regional levels, which makes intersectoral strategies necessary to promote public policies and strengthen the PCAF and health promotion in the SUS. Motor Activity Unified Health System Electronic Health Records Health Information Systems Figures Figure 1 Figure 2 Background The National Health Promotion Policy (PNPS) is a milestone in the institutionalization of physical activity and body practices (PCAF) in the Primary Health Care (PHC) setting since it included this type of care among its priority axes ( 1 ). Including the PCAF as a priority in the PNPS is based on the understanding that physical inactivity is one of the main risk factors for early mortality in the world ( 2 , 3 ) as it is associated with a higher incidence of chronic noncommunicable diseases (NCDs). During the pandemic, research also showed that being physically active was associated reduction in mortality and the likelihood of both severe cases of COVID-19 and symptoms related to Long COVID ( 4 , 5 ). The PCAF trajectory in the health field places it as a form of care within the SUS, especially in PHC ( 3 , 6 ). However, fiscal austerity measures such as Constitutional Amendment N° 95/2016, the Previne Brasil Program, which covers the new PHC financing, and the disqualification of the Expanded Family Health Center (NASF) teams caused by the change in the transfer of resources at the federal level, can considerably affect the provision of such services, which needs to be monitored and analyzed ( 7 , 8 ). From this perspective, health information systems (SIS) include standardized monitoring and data collection instruments and aim to provide information for analysis and a better understanding of critical health problems of the population and follow-up and evaluation of services ( 9 ). In PHC, the current SIS is the Primary Care Health Information System (SISAB), which integrates the strategy called e-SUS Primary Health Care (e-SUS APS) ( 9 ). Mapping PCAF actions developed in PHC at national, regional, and state levels can identify existing disparities. This information can support public managers in decision-making and directing policies to expand the supply of these actions. However, studies have not grouped and analyzed these data, although such records have been available for public consultation in the SISAB since 2013. Given the above, this study aims to map the records of PCAF developed in the PHC in Brazil, from 2013 to 2021 on the SISAB platform. This mapping intends to describe these records by Brazilian region and state, type of health team, and target audience. It will also be possible to compare the before/after period of the COVID-19 pandemic. Methods This cross-sectional and descriptive study used the production records stored in the SISAB regarding health practices called “Physical Activity and Body Practices” from 2013 to 2021, in all Brazilian states and also in each geographic region. The other variables used were: Target audience: Community in general, children (0–3 years old; 4–5 years old; 6–11 years old); adolescents, women, pregnant women, men, family members, older adults, people with chronic diseases, alcohol users, tobacco users, users of other drugs, people with mental distress or disorder, education professionals, and others. Children were grouped in a single category for better data presentation, and alcohol, tobacco, and other drug users were grouped in the category of alcohol and other drug users. Team type: Family Health Team (eSF), Expanded Family Health Center (NASF), PHC Team (eAB), Oral Health Team (eSB), Street Office Team (eCR), Prison PHC Team (eABP), and PHC Team (eAP). We used the Collective Primary Care Activity Report stored on the SISAB platform to extract PCAF data. The variables in this report originate from the records processed by the different health professionals in the Collective Activity Form (FAC), applications Simplified Data Collection (CDS), Electronic Citizen Record (PEC), or other proprietary systems attached by SISAB ( 9 , 10 ). When issuing the reports, we decided to employ the filters corresponding to the Geographical Unit, where Brazil was chosen first, then the states, and finally the regions. We determined the period for each geographic unit, which refers to the month of each year (from April 2013 to December 2021, depending on the availability of platform data at collection time), and also the target audience and team type filters. The same filter, “Body Practices/Physical Activities”, was used for the “Health Practices” item in every search. The records were first tabulated in the Microsoft Excel® program. The initial analysis consisted of a descriptive statistics procedure, presenting anually PCAF data in absolute (n) and relative (%) values in the country, regions, and states. Based on this information, a calculation of the percentage variation of the records between 2013 and 2019, and between 2019 and 2021, was performed. As a result, we managed to describe the PCAF records in the pre-pandemic period and during the COVID-19 pandemic. We opted for a map format to illustrate the distribution of records, and the percentage increments over the years, to present data at the state level. The annual records of the health teams were also tabulated and analyzed descriptively, and the quantity of activities was described according to the target audience. The statistical analysis was performed through Stata® 16 software, and the map was constructed with QGIS® software version 3.22.7. The present study was not submitted to the Research Ethics Committee since it adopts public domain data available in electronic media and, therefore, fits the criteria of Resolution 510/2016 of the National Health Council. Results Data in Table 1 show 2,664,288 records of PCAF developed in the PHC nationwide from 2013 to 2021. A significant increase was noted in the number of actions recorded annually, starting from 3,075 in 2013 and reaching 617,383 in 2019, a growth of around 19,977.5%. From 2020, linked to the pandemic period, we observed a decline of approximately 75.5% in the number of PCAF records in Brazil. Furthermore, the records (n = 151,156 and n = 164,977) are even lower than those in 2015 (n = 214,275) in 2020 and 2021, the pandemic’s peak. The Southeast and Northeast had the highest records of PCAF throughout the years studied at the regional level, totaling more than 70% of the production of these activities in the country. In comparison, the North region represented less than 5%. At the beginning of the analyzed period, the Northeast had the highest number (n = 1,907), corresponding to 62% of the total PCAF activities conducted in the country in 2013 and about 43% in 2014 (n = 32,970). The Southeast has shown a considerable increase in the number of records over the years and, as of 2015, it has taken the place of the Northeast as the region with the highest number of PCAF developed in the PHC (n = 85,555) and was responsible for more than 50% of the records of these activities by 2021 (n = 89,061) (Table 1 ). By tracing a timeline, we can observe growth in all regions until 2016, stability in the 2016–2017 period, and again an increase in the 2017–2019 period, and this last year recorded more PCAF actions in the PHC, with 43,230 in the Midwest, 139,227 in the Northeast, 26,159 in the North, 342,736 in the Southeast, and 66,031 in the South. In percentage terms, the growth in the number of PCAF records between 2013 and 2019 was higher in the Southeast (59,299.7%) and North (33,012.7%) (Table 1 ). Furthermore, as seen nationally, a decrease in the number of records was observed in all regions from 2020 onwards, ranging from 73.8% in the Southeast to 79.5% in the North. Table 1 Records of Physical Activities and Body Practices by region between 2013–2021 and growth percentage. Region 2013 2014 2015 2016 2017 2018 2019 2020 2021 Growth 2013–2019 n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%) Midwest 206 (6.7) 3 943 (5.1) 19 644 (9.2) 31 562 (7.2) 27 474 (6.1) 39 276 (7.2) 43 230 (7.0) 9 985 (6.6) 9 006 (5.5) 20 885.4% Northeast 1 907 (62.0) 32 970 (43.0) 65 840 (30.7) 91 774 (20.8) 86 209 (19.2) 113 502 (20.7) 139 227 (22.6) 29 530 (19.5) 36 491 (22.1) 7 200.8% North 79 (2.6) 3 424 (4.5) 10 296 (4.8) 19 337 (4.4) 13 615 (3.0) 21 451 (3.9) 26 159 (4.2) 5 366 (3.5) 7 983 (4.8) 33 012.7% Southeast 577 (18.8) 27 307 (35.6) 85 555 (39.9) 235 081 (53.4) 268 675 (59.8) 312 219 (57.0) 342 736 (55.5) 89 715 (59.4) 89 061 (54.0) 59 299.7% South 306 (10.0) 9 014 (11.8) 32 940 (15.4) 62 600 (14.2) 52 984 (11.8) 61 005 (11.1) 66 031 (10.7) 16 560 (11.0) 22 436 (13.6) 21 478.8% Total Country 3 075 76 658 214 275 440 354 448 957 547 453 617 383 151 156 164 977 19 977.5% Captions : Growth 2013–2019: Percentage of growth of PCAF records from 2013 to 2019 The state overview shows that the places that most recorded PCAF in the PHC in the entire period investigated were Minas Gerais (n = 964,577), São Paulo (n = 323,939), Rio de Janeiro (155,306), Bahia (138,773), and Santa Catarina (n = 124,987). Regarding the distribution over time, we observed that in 2013 the records ranged from zero in the Federal District, Mato Grosso do Sul, Acre, Rondônia, Roraima, Tocantins, and Espírito Santo, to 515 in Bahia. This number was much higher in 2019, from 530 in Roraima to 230,522 in Minas Gerais. In 2021, the last year analyzed, the records ranged from 40 in Roraima to 59,574 in Minas Gerais (Table 2 ). Table 2 Records of Physical Activity and Body Practices by state in the 2013–2021 period. State 2013 2014 2015 2016 2017 2018 2019 2020 2021 Acre 0 45 303 1 373 1 551 1 611 1 828 435 391 Alagoas 248 2 096 3 721 8 335 6 335 10 792 12 828 2 633 2 801 Amapá 13 230 454 1 285 925 642 557 145 474 Amazonas 13 478 1 967 3 598 2 098 4 335 5 970 754 1 018 Bahia 515 9 055 16 536 21 365 18 911 27 925 32 530 5 515 6 421 Ceará 71 1 353 8 864 14 816 14 545 18 286 27 807 6 057 8 250 Federal District 0 0 1 163 516 1 835 1 551 340 498 Espírito Santo 0 57 446 1 017 820 1 813 2 103 301 547 Goiás 202 2 731 15 840 20 052 13 919 23 056 25 508 6 200 5 184 Maranhão 167 4 072 6 156 6 973 7 368 9 334 13 090 2 352 3 709 Mato Grosso 4 496 1 894 6 514 7 192 8 216 8 329 1 834 1 408 Mato Grosso do Sul 0 716 1 909 4 833 5 847 6 169 7 842 1 611 1 916 Minas Gerais 378 17 786 53 829 154 120 174 496 212 381 230 522 61 491 59 574 Pará 53 1 119 2 384 4 503 4 126 7 559 9 714 2 395 3 157 Paraíba 229 5 360 12 060 12 219 11 379 12 247 12 340 3 340 4 391 Paraná 65 2 935 10 807 15 531 15 129 16 342 17 984 5 519 6 884 Pernambuco 262 5 770 7 433 12 768 11 229 16 128 18 250 3 929 3 736 Piauí 30 1 317 4 414 7 399 7 003 7 938 8 475 2 070 2 906 Rio de Janeiro 1 621 6 904 28 055 33 775 32 542 34 970 8 167 10 271 Rio Grande do Norte 347 3 617 5 594 6 570 7 644 8 644 10 341 2 833 2 564 Rio Grande do Sul 41 2 972 12 597 21 333 16 540 18 710 22 953 5 193 7 354 Rondônia 0 12 213 1 486 374 733 944 153 1 135 Roraima 0 1 139 163 402 534 530 45 40 Santa Catarina 200 3 107 9 536 25 736 21 315 25 953 25 094 5 848 8 198 São Paulo 198 8 843 24 376 51 889 59 584 65 483 75 141 19 756 18 669 Sergipe 38 330 1 062 1 329 1 795 2 208 3 566 801 1 713 Tocantins 0 1 539 4 836 6 929 4 139 6 037 6 616 1 439 1 768 Figure 1 illustrates the percentage variation in PCAF records in the Brazilian states between 2013 and 2019, before the COVID-19 pandemic. All states showed significant growth; however, the most significant percentage increases were in Minas Gerais (23,052,100%), which increased from 378 records in 2013 to 230,522 in 2019, São Paulo (7,514,000%), which went from 198 records in 2013 to 75,141 in 2019, Rio de Janeiro (3,490,900%), which had only one record in 2013 to 34,970 in 2019, Bahia (3,252,900%), which increased from 515 records in 2013 to 32,530 in 2019, Ceará (2,780,600%), which increased from 71 records in 2013 to 27,807 in 2019, Goiás (2,550,700%), which increased from 202 records in 2013 to 25,508 in 2019, and Santa Catarina (2,509,300%), which increased from 200 records in 2013 to 25,094 in 2019, indicated by darker colors on the map. The states with the lowest percentage of growth (below 100,000%) were Roraima (53,000%), which had no records in 2013 and recorded 530 in 2019; Amapá (55,600%), which had 13 records in 2013 and 557 in 2019, and Rondônia (94,300%), which had no records in 2013 and recorded 944 in 2019. (Table 2 and Fig. 1 ). It should be noted that these percentages, although of a significant magnitude, accurately reflect the reality of records in these locations, considering that many states started from small figures in 2013 and reached a substantial record volume in 2019. The PCAF are developed by different types of teams in the PHC. The eSF and NASF teams have the most expressive numbers, totaling 2,645,045 activities recorded in Brazil. In 2013, the eSF and NASF teams recorded 1,685 and 1,361 PCAF, respectively. In 2019, the year with the highest recorded productivity, 122,369 actions were developed by the eSF and 490,840 by the NASF, the latter being the most prominent promoter of PCAF in PHC throughout the analyzed period, reaching 77.1% of records across the country in 2020 and 67.8% in total activities in the period. Although serving a considerably smaller population, the Prison Primary Care and Street Office teams still record few PCAF actions, representing less than 1% of what is developed across the country (Table 3 ). How data are shown in SISAB changed in 2020 when the PHC team ceased to exist and became known as the Primary Care team from 2021 onwards. Table 3 Records of Physical Activities and Body Practices by type of team between 2013–2021. Team type 2013 2014 2015 2016 2017 2018 2019 2020 2021 n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%) eAB 0 8 (0.01) 105 (0.04) 274 (0.05) 228 (0.04) 355 (0.06) 688 (0.1) 82 (0.05) 0 eABp 0 0 9 (0.004) 105 (0.02) 85 (0.02) 72 (0.01) 70 (0.01) 9 (0.01) 46 (0.03) eACS 40 (0.9) 652 (0.7) 2 109 (0.8) 2 794 (0.6) 2 164 (0.4) 2 030 (0.3) 3 266 (0.5) 385 (0.2) 0 eAP 0 0 0 0 0 0 0 83 (0.05) 1 455 (0.9) eCR 0 7 (0.01) 29 (0.01) 212 (0.04) 76 (0.01) 89 (0.01) 160 (0.02) 15 (0.01) 53 (0.03) eSB 1 346 (30.4) 17 757 (18.8) 38 726 (15.3) 65 974 (13.0) 60 274 (11.8) 67 327 (10.9) 79 449 (11.4) 10 405 (6.4) 1 519 (0.9) eSF 1 685 (38.0) 24 075 (25.5) 59 954 (23.7) 115 397 (22.8) 103 864 (20.4) 107 961 (17.6) 122 369 (17.6) 25 970 (16.1) 44 729 (27.1) NASF 1 361 (30.7) 51 917 (54.9) 152 086 (60.1) 321 596 (63.5) 342 546 (67.2) 436 979 (71.1) 490 840 (70.4) 124 541 (77.1) 117 175 (71.0) Total Country 4 432 94 416 253 018 506 352 509 237 614 813 696 842 161 490 164 977 Captions : eAB = PHC Team; eSF = Family Health Team; NASF = Expanded Family Health Center; eACS = Community Health Workers Team; eCR = Street Office Team; eSB = Oral Health Team; eABp = Prison PHC Team; eAP = PHC Figure 2 shows the percentages of PCAF records in each target audience accumulated throughout the period. We can observe that the most significant number of PCAF was directed to the community in general (22.9%), followed by women (19.5%), older adults (18.3%), people with NCDs (12.0%), and men (11.1%). The public of children and adolescents shows a low percentage of records, 4.7%, and 4.4%, respectively. The rest of the target audience does not represent 10% of the total activities in the analyzed period. Discussion We identified a growth of 19,977.5% in the PCAF records developed in the PHC across the country between 2013 and 2019. However, a sharp drop was observed in the number of records (75.5%) from 2020. Regionally, the Southeast and Northeast stand out as major PCAF promoters, and the North region has the lowest numbers. In the Brazilian states Minas Gerais, São Paulo, Rio de Janeiro, Bahia, Ceará, Goiás, and Santa Catarina remained the places with the highest production of PCAF in the country with the highest percentage growth observed. Regarding the target audience, the activities mainly covered the general community, followed by women, older adults and people with NCDs, who accounted for 72.7% of the total number of records. The health teams that recorded PCAF the most were from the eSF and NASF, and the latter is the team that most promotes PCAF in PHC, around 67.8% throughout the analyzed period. The PCAF gained space in health promotion actions in the PHC in the investigated period, which seems to be associated with the creation of public policies, especially the inaugural publication of the PNPS in 2006 that demarcated the axis of the PCAF as a priority and, thus, enabled the expanded offer of these activities as a care form in the SUS ( 3 , 7 ). Moreover, several movements and actions occurred mainly from 2005 to 2018 at the three levels of SUS management to strengthen PHC and health promotion, expand the PCAF axis in the Health Care Network, and include physical education professionals, especially in multidisciplinary teams ( 3 , 6 , 7 ). The decline in PCAF records in 2020 and 2021, observed in all Brazilian regions and states, is linked to the pandemic context experienced since March 2020. Given the alarming epidemiological situation imposed by the pandemic and following the World Health Organization (WHO) recommendations, health services suspended group activities and directed their efforts towards preventive actions against COVID-19 and care for patients with respiratory symptoms ( 11 ). This troubling setting is concurrent with changes in the PHC policy, with the Previne Brasil model, and contributed to the significant drop in PCAF actions developed in the PHC ( 7 , 8 ). However, although the number of records has reduced considerably, we should consider that, even in an adverse context, the health teams sought alternatives, whether with teleassistance, video classes, or messaging groups, to maintain such activities and preserve the bond with clients ( 12 , 13 ). It is even recommended that these strategies continue to be promoted in health services since it allows expanding the offer of these actions and people’s access ( 13 ). Besides the conditions imposed by the pandemic, the decrease in health promotion actions and, in this case, the PCAF supply is implicated in the neoliberal measures intensified between the years 2016 and 2022, primarily ( 7 ). On the other hand, government actions were promoted as guides and recommendations that encourage individuals to care for themselves, from an individual perspective and with a popular motivation agenda ( 14 , 15 ). Furthermore, the new PHC financing model and the revocation of federal funding for NASF teams among priority programs ( 7 , 8 ), are clear examples of the regression in health policies. We can observe a logic where the social policy no longer enforces rights but expands existing inequalities and regulates access to services through the purchasing power of individuals ( 8 ). Such measures must improve in preserving, continuing, and promoting the policies and programs discussed here. The persistent social inequalities in the country are potentialized through the neoliberal rationale of dismantling health policies in a general scope, which affects the PCAF. We can see through such actions articulated movements that aim at underfunding and dismantling the SUS, or a SUS reduced to a small basket of services ( 17 ). Given the deteriorated social indicators observed in the country, we should note that the PCAF are not out of place in this setting, as they are complex manifestations and traversed by socioeconomic, cultural and political conditions, and ways of living ( 17 ). More populous regions, such as the Northeast and Southeast, were the ones that most recorded PCAF in the PHC. The North, with a lower demographic density, remained the location with the lowest number of records, albeit with a considerable growth percentage. The states showed significant growth in PCAF records over the years, emphasizing São Paulo, Minas Gerais, Rio de Janeiro, and Bahia, which, respectively, are the states with the largest population sizes in the country. Besides demographic issues, part of the explanation for these aspects permeates the historical existence in these locations with greater productivity and programs aimed at promoting PCAF that were provenly successful experiences in expanding the population’s access to these spaces and increasing PA population levels ( 18 ). As an example, in the Southeast region, the Agita São Paulo (SP), the Exercise Guidance Service in Vitória (ES), the Saúde Ativa Rio Claro (SP), and the City Gym Program in Belo Horizonte (MG) stand out. In the Northeast region, the City Gym Program occurs in Recife (PE) and Aracaju (SE) ( 18 – 20 ). The Health Gym Program (PAS) ( 21 ) created in 2011, is in place in 48% of the 5,570 Brazilian municipalities and has 3,821 qualified centers in all states. PAS regional data indicate that the regions with the highest percentage of qualified centers regarding the number of municipalities were the North (55.3%) and Northeast (54.7%), and the region with the lowest percentage was the Southeast (37.9%) ( 21 ). Furthermore, National Health Survey data show that PA in public programs is higher in the North, Northeast, and Midwest. However, the population coverage of programs, in general, is still low (1.9%) ( 18 ). Although the number of PCAF programs and the participation of the population is higher in the regions mentioned earlier, we observe a discrepancy in the number of records produced in the SISAB, which leads us to question whether there is a gap between doing and recording or if PCAF actions are indeed offered on a smaller scale in these locations. The target audience of group activities involving PCAF identified in the present study is similar to the profile of users of public PCAF programs outlined in previous research, who are women, over 50, and with NCD history ( 22 , 23 ). In this sense, we observe that the targeting of PCAF actions is directed to the public that needs it most and is most benefited since it expands women’s access to the PCAF since they are less physically active than men, reduces NCD-derived conditions, and provides autonomy and improved quality of life in older adults and other populations ( 18 , 23 ). The NASF and eSF teams were the leading promoters of PCAF in PHC. These findings corroborate the study by Florindo et al. (2016) ( 24 ), which identified a higher prevalence of PA promotion actions in municipalities with broader eSF coverage and that had NASF with physical education professionals in their teams. Since its creation in 2008, the NASF has expanded the scope, quality, and resolution of PHC actions in a comprehensive healthcare rationale ( 25 , 26 ). However, the withdrawal of federal funding that led to the disqualification of these teams imposes significant weaknesses and discontinuity of a work, which, while with limitations, structured and strengthened PHC in Brazil ( 25 , 26 ). The General Coordination for the Promotion of Physical Activity and Intersectoral Actions (CGPROFI) and the federal financial incentive for funding were established between 2019 and 2022 to implement PA actions in PHC ( 7 , 27 ). The initial analyses on the Physical Activity Incentive (IAF) show a potential to expand people’s access to the PCAF developed in the PHC ( 27 ). Even so, creating coordination and implementing the incentive demand attention since the movements alone cannot guarantee to strengthen the PCAF agenda in the SUS ( 7 , 27 ) as the IAF is a model that has yet to be evaluated in the face of the Brazilian reality ( 27 ). Furthermore, little progress will be made if health promotion notions remain linked to an individual motivation perspective without considering the social, political, economic, and cultural contexts of the individuals ( 7 , 16 , 17 ). Thus, specific studies should address the budget, conceptual delimitation, and actions of CGPROFI, IAF monitoring, and its consequences in the health portfolio. The present study is not without limitations. Firstly, the PCAF records, pandemic context, and changes in PHC policy are contemporary events. Notwithstanding this, this research cannot establish cause and effect analyses but focuses on describing these events. Therefore, this is an exploratory analysis. Moreover, we should consider that information systems may have weaknesses in operational terms of the platforms, such as information standardization, normalization, and compatibility ( 28 ) and about the professionals’ recording difficulty, given the insufficient computerization in health units, and lack of knowledge about how to complete and correctly handle data in the systems ( 29 ). The e-SUS PHC strategy in Brazil was fully implemented in only 20.2% of Brazilian municipalities by 2019, and most are between the initial and partial implementation stages ( 30 ). The SIS must talk and try to converge to avoid overlaps or gaps in the records. Still, an effort is needed so that the locations have the same quality internet access and equipment, and the records reflect the services rather than technical and operational difficulties. Although SISAB may present possible inaccuracies due to the points mentioned earlier, it is a system linked to DATASUS that collects, processes, and disseminates official information from the Ministry of Health ( 9 ). Developing studies in this scope qualifies the information obtained and allows the SISAB platform to become a research source for future studies. Moreover, when investigating SUS-related data, we can identify it as a locus for care and knowledge production. Conclusion The results could contribute to identifying the distribution of PCAF records and the existing disparities at regional and state levels. We observed increases in all regions and states until 2019, with declining actions from 2020 onwards, possibly related to the pandemic context and the federal government’s adoption of neoliberal measures. These findings reinforce the need to build strategies at the three SUS management levels that aim at more significant investments in public policies, to preserve and establish proposals and programs to expand the offer of PCAF actions in the Brazilian territory and favor the access of the population to this type of health care. Finally, this study is limited to presenting the number of PCAF records produced in the PHC. Future research should evaluate whether these records reflect effective actions and the population coverage of these activities. Abbreviations PCAF: Physical Activities and Body Practices SUS: Unified Health System SISAB: Primary Care Health Information System NCDs: Noncommunicable diseases PNPS: National Health Promotion Policy PHC: Primary Health Care NASF: Expanded Family Health Center SIS: Health Information Systems e-SUS APS: e-SUS Primary Health Care eSF: Family Health Team eAB: Primary Health Care Team eSB: Oral Health Team eCR: Street Office Team eABP: Prison PHC Team eAP: Primary Health Care Team FAC: Collective Activity Form CDS: Simplified Data Collection PEC: Electronic Citizen Record PAS: Health Gym Program CGPROFI: Promotion of Physical Activity and Intersectoral Actions IAF: Physical Activity Incentive Declarations Ethics approval and consent to participate Not applicable as it uses public domain data that does not require ethical approval. Consent for publication Not applicable Availability of data and materials The datasets used and/or analyzed during the study are available on the public platform of the Primary Care Health Information System (SISAB) through the electronic address: https://sisab.saude.gov.br/. Competing interests The authors declare that they have no competing interests. Funding The research did not have funding for its execution. Authors' contributions R.P.D was responsible for designing, collecting and analyzing data, as well as conducting the writing and preparing the manuscript. A.G.K contributed to data analysis, writing and revision of the article. All authors reviewed and approved the manuscript content. Acknowledgements The author R.P.D are social demand fellow from the Coordination for the Improvement of Higher Education Personnel (CAPES), case number 88887.628163/2021-00. References Brasil, Ministério da Saúde, Secretaria de Vigilância em Saúde. Secretaria de Atenção à Saúde. Política Nacional de Promoção da Saúde: PNPS: Anexo I da Portaria de Consolidação no 2, de 28 de setembro de 2017, que consolida as normas sobre as políticas nacionais de saúde do SUS. 2018. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. The Lancet. 2012;380(9838):219-229. doi:10.1016/S0140-6736(12)61031-9 Malta DC, Silva M, Albuquerque G, Amorim R, Rodrigues G, Silva T, et al. Política Nacional de Promoção da Saúde, descrição da implementação do eixo atividade física e práticas corporais, 2006 a 2014. Rev Bras Ativ Fís Saúde, 2014; 19:286-99.2014;19(3). doi:10.12820/rbafs.v.19n3p286 Latorre-Román PÁ, Guzmán-Guzmán IP, Delgado-Floody P, et al. Protective role of physical activity patterns prior to COVID-19 confinement with the severity/duration of respiratory pathologies consistent with COVID-19 symptoms in Spanish populations. Research in Sports Medicine 2021:1-12. doi:10.1080/15438627.2021.1937166 Jimeno-Almazán A, Pallarés JG, Buendía-Romero Á, et al. Post-COVID-19 Syndrome and the Potential Benefits of Exercise. Int J Environ Res Public Health. 2021;18(10):5329. doi:10.3390/ijerph18105329 Carvalho FFB de, Nogueira JAD. Práticas corporais e atividades físicas na perspectiva da Promoção da Saúde na Atenção Básica. Cien Saude Colet. 2016;21(6):1829-1838. doi:10.1590/1413-81232015216.07482016 Carvalho FFB de, Almeida ER de, Loch MR, Knuth AG. As práticas corporais e atividades físicas na gestão tripartite do SUS: estrutura organizacional, financiamento e oferta. Cien Saude Colet. 2022;27(6):2163-2174. doi:10.1590/1413-81232022276.15242021 Menezes AP do R, Moretti B, Reis AAC dos. O futuro do SUS: impactos das reformas neoliberais na saúde pública – austeridade versus universalidade. Saúde em Debate. 2019;43(spe5):58-70. doi:10.1590/0103-11042019s505 Brasil. Ministério da Saúde. Secretaria de Atenção Primária à. e-SUS Atenção Primária à Saúde: Manual do Sistema com Prontuário Eletrônico do Cidadão PEC – Versão 4.2 [Internet]. Ministério da Saúde, Secretaria de Atenção Primária à Saúde, Secretaria Executiva. 2021 [cited 2022 Nov 3]. Available from: https://cgiap-saps.github.io/Manual-eSUS-APS/ Brasil. Ministério da Saúde. Secretaria de Atenção Primária à Saúde. Sistema De Informação em Saúde para a Atenção Básica. Nota Técnica Explicativa – Relatório De Saúde (Atividade Coletiva) [Internet]. Ministério da Saúde, Secretaria de Atenção Primária à Saúde, Departamento de Saúde da família Coordenação Geral de Informação da Atenção Primária. 2021 [cited 2022 Nov 3]. Available from: http://189.28.128.100/dab/docs/portaldab/documentos/esus/sisab_nota_tecnica_relatorio_atividade_coletiva.pdf http://189.28.128.100/dab/docs/portaldab/documentos/esus/sisab_nota_tecnica_relatorio_atividade_coletiva.pdf World Health Organization (WHO). COVID-19: Operational Guidance for Maintaining Essential Health Services during an Outbreak. [Internet]. 2020. [cited 2023 jan 4]. Available from: https://apps.who.int/iris/bitstream/handle/10665/331561/WHO-2019-nCoV-essential_health_services-2020.1-eng.pdf?sequence=1&isAllowed=y Novaes CRM da N, Wanderley FAC, Falcão IM, Alves RB, Lima AT, Soares MCB. Protocolo de atividade física remoto para grupos de Academia da Saúde e Estratégia de Saúde da Família. Rev Bras Ativ Fís Saúde. 2020;25:1-6. doi:10.12820/rbafs.25e0167 Oliveira G da S, Pajeú RB, Lemos EC de, et al. Implementation of the remote activities of the Programa Academia da Cidade in times of COVID-19. Rev Bras Ativ Fís Saúde 2020;25:1-6. doi:10.12820/rbafs.25e0158 Knuth AG, Carvalho FFB de, Freitas DD. Discursos de instituições de saúde brasileiras sobre atividade física no início da pandemia de COVID-19. Rev Bras Ativ Fís Saúde. 2020; 14;25:1–9. doi:10.12820/rbafs.25e0122 Brasil. Ministério da Saúde. Secretaria de Atenção Primária à Saúde. Departamento de Promoção da Saúde. Guia de Atividade Física para a População Brasileira. Ministério da Saúde, Brasília; 2021. 54 p. Cruz DKA, Silva KS da, Lopes MVV, Parreira FR, Pasquim HM. Iniquidades socioeconômicas associadas aos diferentes domínios da atividade física: resultados da Pesquisa Nacional de Saúde 2019. Epidemiol. Serv. Saude. 2022;31(spe1). doi:10.1590/ss2237-9622202200015.especial Knuth AG, Antunes P de C. Práticas corporais/atividades físicas demarcadas como privilégio e não escolha: análise à luz das desigualdades brasileiras. Saúde e Sociedade. 2021;30(2):1-11. doi:10.1590/s0104-12902021200363 Ferreira RW, Caputo EL, Häfele CA, et al. Acesso aos programas públicos de atividade física no Brasil: Pesquisa Nacional de Saúde, 2013. Cad Saude Publica. 2019;35(2):1-13. doi:10.1590/0102-311x00008618 Vieira LA, Albuquerque SBG, Venturim FO, Carvalho FFB, Almeida UR. 30 anos do Serviço de Orientação ao Exercício em Vitória/ES: pioneirismo nas práticas corporais e atividades físicas no Sistema Único de Saúde. Movimento. 2020; 9;26:e26086. doi:10.22456/1982-8918.103142 Becker L, Gonçalves P, Reis R. Programas de promoção da atividade física no Sistema Único de Saúde brasileiro: revisão sistemática. Rev Bras Ativ Fís Saúde. 2016; 1;21(2):110. doi:10.12820/rbafs.v.21n2p110-122 Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância de Doenças e Agravos não Transmissíveis e Promoção da Saúde. Panorama nacional de implementação do Programa Academia da Saúde: monitoramento do Programa Academia da Saúde: Ciclo 2017. 2018 Silva CR de M, Bezerra J, Soares FC, Mota J, Barros MVG de, Tassitano RM. Percepção de barreiras e facilitadores dos usuários para participação em programas de promoção da atividade física. Cad Saude Publica. 2020;36(4). doi:10.1590/0102-311x00081019 Souza Neto JM, Brito GEG, Loch MR, Silva SS, Costa FF. Aconselhamento para atividade física na Atenção Primária à Saúde: Uma revisão integrativa. Movimento 2020;26:e26075. doi:10.22456/1982-8918.104360 Florindo AA, Nakamura PM, Farias Jr. JC, Siqueira FV, Reis RS, Cruz DKA, et al. Promoção da atividade física e da alimentação saudável e a saúde da família em municípios com academia da saúde. Rev Bras Educ Fís Esporte 2016; 30:913-24. doi:10.1590/1807-55092016000400913 Almeida ER de, Medina MG. A gênese do Núcleo de Apoio à Saúde da Família (NASF) na agenda da atenção primária à saúde brasileira. Cad Saude Publica. 2021;37(10). doi:10.1590/0102-311x00310820 Brocardo D, Andrade CLT de, Fausto MCR, Lima SML. Núcleo de Apoio à Saúde da Família (Nasf): panorama nacional a partir de dados do PMAQ. Saúde em Debate. 2018;42(spe1):130-144. doi:10.1590/0103-11042018s109 Carvalho FFB de, Sposito LAC, Rodrigues PAF, Vieira LA. Promoção das práticas corporais e atividades físicas no Sistema Único de Saúde: mudanças à vista, mas em qual direção? Cad Saude Publica. 2022;38(8). doi:10.1590/0102-311xpt095722 Almeida MF de, Alencar GP. Informações em saúde: Necessidade de introdução de mecanismos de gerenciamento dos sistemas. Informe Epidemiológico do SUS. 2000;9(4):241-249. doi:10.5123/S0104-16732000000400003 Pinheiro ALS, Andrade KTS, Silva DO, Zacharias FCM, Gomide MFS, Pinto IC. Health management: The use of Information Systems and knowledge sharing for the decision making process. Texto & Contexto - Enfermagem. 2016;25(3):1–9. doi:10.1590/0104-07072016003440015 Cielo AC, Raiol T, Silva EN da, Barreto JOM. Implantação da Estratégia e-SUS Atenção Básica: uma análise fundamentada em dados oficiais. Rev Saude Publica. 2022;56:5. doi:10.11606/s1518-8787.2022056003405 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3143626","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":218633263,"identity":"86725a54-1c25-4bbc-8bc1-584781da9802","order_by":0,"name":"Rinelly Pazinato Dutra","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9UlEQVRIiWNgGAWjYDACZiB+UAAkDoB4FWCS4cADQloSDEDKQKwzBxh4QOwEQjbBtTC2QbQw4NNi3s578EGCwWEGvhv5xz78nHdHzl7s8EOgLXZyug3Ytcgc5ks2AGmRvJHMPLN32zNjHuk0A6CWZGOzA9i1SDDzmEmAtBgAtTDwbjuc2COdANJyIHEbbi3mP2BaGP/OAWlJ/0BIixkDTAszbwNISw5BW4yBDktnkDzz2JhZ5thhY57bOQUHEgzw+IX/jOGHDxXWDHzHEx8zvqk5LMc+O30zUMRODpcWKGiub0AVMMCrHATqCKoYBaNgFIyCEQwA4PFd9MVz9lkAAAAASUVORK5CYII=","orcid":"","institution":"Federal University of Rio Grande","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Rinelly","middleName":"Pazinato","lastName":"Dutra","suffix":""},{"id":218633264,"identity":"9b2ccdac-82ca-4c4c-9e5d-f208328af052","order_by":1,"name":"Alan Goularte Knuth","email":"","orcid":"","institution":"Federal University of Rio Grande","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Alan","middleName":"Goularte","lastName":"Knuth","suffix":""}],"badges":[],"createdAt":"2023-07-05 19:59:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3143626/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3143626/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":40259515,"identity":"430521ec-2f38-48b7-a7a5-8a15eecaf027","added_by":"auto","created_at":"2023-07-19 14:34:23","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":84602,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eMap of the percentage variation of Physical Activities and Body Practices records in the Brazilian states from 2013-2019.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-3143626/v1/24163b29be9531b1eea094be.png"},{"id":40257470,"identity":"1db31b82-fa61-4f30-9cba-d76b6e6d18b8","added_by":"auto","created_at":"2023-07-19 14:26:23","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":51163,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eAccumulated percentage of Physical Activities and Body Practices records by target audience.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-3143626/v1/1280f7154b1e491369be108b.png"},{"id":42280070,"identity":"79aeb8e3-fa70-4096-a75c-88ef486a409f","added_by":"auto","created_at":"2023-08-29 05:52:29","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":483275,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3143626/v1/15259fe4-7a18-4e12-b337-4e31684f058f.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Physical Activity and Body Practices developed in Primary Health Care in Brazil from 2013-2021","fulltext":[{"header":"Background","content":"\u003cp\u003eThe National Health Promotion Policy (PNPS) is a milestone in the institutionalization of physical activity and body practices (PCAF) in the Primary Health Care (PHC) setting since it included this type of care among its priority axes (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Including the PCAF as a priority in the PNPS is based on the understanding that physical inactivity is one of the main risk factors for early mortality in the world (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) as it is associated with a higher incidence of chronic noncommunicable diseases (NCDs). During the pandemic, research also showed that being physically active was associated reduction in mortality and the likelihood of both severe cases of COVID-19 and symptoms related to Long COVID (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe PCAF trajectory in the health field places it as a form of care within the SUS, especially in PHC (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). However, fiscal austerity measures such as Constitutional Amendment N\u0026deg; 95/2016, the Previne Brasil Program, which covers the new PHC financing, and the disqualification of the Expanded Family Health Center (NASF) teams caused by the change in the transfer of resources at the federal level, can considerably affect the provision of such services, which needs to be monitored and analyzed (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFrom this perspective, health information systems (SIS) include standardized monitoring and data collection instruments and aim to provide information for analysis and a better understanding of critical health problems of the population and follow-up and evaluation of services (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). In PHC, the current SIS is the Primary Care Health Information System (SISAB), which integrates the strategy called e-SUS Primary Health Care (e-SUS APS) (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMapping PCAF actions developed in PHC at national, regional, and state levels can identify existing disparities. This information can support public managers in decision-making and directing policies to expand the supply of these actions. However, studies have not grouped and analyzed these data, although such records have been available for public consultation in the SISAB since 2013.\u003c/p\u003e \u003cp\u003eGiven the above, this study aims to map the records of PCAF developed in the PHC in Brazil, from 2013 to 2021 on the SISAB platform. This mapping intends to describe these records by Brazilian region and state, type of health team, and target audience. It will also be possible to compare the before/after period of the COVID-19 pandemic.\u003c/p\u003e \u003cp\u003eMethods\u003c/p\u003e \u003cp\u003eThis cross-sectional and descriptive study used the production records stored in the SISAB regarding health practices called \u0026ldquo;Physical Activity and Body Practices\u0026rdquo; from 2013 to 2021, in all Brazilian states and also in each geographic region. The other variables used were:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eTarget audience: Community in general, children (0\u0026ndash;3 years old; 4\u0026ndash;5 years old; 6\u0026ndash;11 years old); adolescents, women, pregnant women, men, family members, older adults, people with chronic diseases, alcohol users, tobacco users, users of other drugs, people with mental distress or disorder, education professionals, and others. Children were grouped in a single category for better data presentation, and alcohol, tobacco, and other drug users were grouped in the category of alcohol and other drug users.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eTeam type: Family Health Team (eSF), Expanded Family Health Center (NASF), PHC Team (eAB), Oral Health Team (eSB), Street Office Team (eCR), Prison PHC Team (eABP), and PHC Team (eAP).\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eWe used the Collective Primary Care Activity Report stored on the SISAB platform to extract PCAF data. The variables in this report originate from the records processed by the different health professionals in the Collective Activity Form (FAC), applications Simplified Data Collection (CDS), Electronic Citizen Record (PEC), or other proprietary systems attached by SISAB (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWhen issuing the reports, we decided to employ the filters corresponding to the Geographical Unit, where Brazil was chosen first, then the states, and finally the regions. We determined the period for each geographic unit, which refers to the month of each year (from April 2013 to December 2021, depending on the availability of platform data at collection time), and also the target audience and team type filters. The same filter, \u0026ldquo;Body Practices/Physical Activities\u0026rdquo;, was used for the \u0026ldquo;Health Practices\u0026rdquo; item in every search.\u003c/p\u003e \u003cp\u003eThe records were first tabulated in the Microsoft Excel\u0026reg; program. The initial analysis consisted of a descriptive statistics procedure, presenting anually PCAF data in absolute (n) and relative (%) values in the country, regions, and states. Based on this information, a calculation of the percentage variation of the records between 2013 and 2019, and between 2019 and 2021, was performed. As a result, we managed to describe the PCAF records in the pre-pandemic period and during the COVID-19 pandemic. We opted for a map format to illustrate the distribution of records, and the percentage increments over the years, to present data at the state level. The annual records of the health teams were also tabulated and analyzed descriptively, and the quantity of activities was described according to the target audience. The statistical analysis was performed through Stata\u0026reg; 16 software, and the map was constructed with QGIS\u0026reg; software version 3.22.7.\u003c/p\u003e \u003cp\u003eThe present study was not submitted to the Research Ethics Committee since it adopts public domain data available in electronic media and, therefore, fits the criteria of Resolution 510/2016 of the National Health Council.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eData in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e show 2,664,288 records of PCAF developed in the PHC nationwide from 2013 to 2021. A significant increase was noted in the number of actions recorded annually, starting from 3,075 in 2013 and reaching 617,383 in 2019, a growth of around 19,977.5%. From 2020, linked to the pandemic period, we observed a decline of approximately 75.5% in the number of PCAF records in Brazil. Furthermore, the records (n\u0026thinsp;=\u0026thinsp;151,156 and n\u0026thinsp;=\u0026thinsp;164,977) are even lower than those in 2015 (n\u0026thinsp;=\u0026thinsp;214,275) in 2020 and 2021, the pandemic\u0026rsquo;s peak.\u003c/p\u003e \u003cp\u003eThe Southeast and Northeast had the highest records of PCAF throughout the years studied at the regional level, totaling more than 70% of the production of these activities in the country. In comparison, the North region represented less than 5%. At the beginning of the analyzed period, the Northeast had the highest number (n\u0026thinsp;=\u0026thinsp;1,907), corresponding to 62% of the total PCAF activities conducted in the country in 2013 and about 43% in 2014 (n\u0026thinsp;=\u0026thinsp;32,970). The Southeast has shown a considerable increase in the number of records over the years and, as of 2015, it has taken the place of the Northeast as the region with the highest number of PCAF developed in the PHC (n\u0026thinsp;=\u0026thinsp;85,555) and was responsible for more than 50% of the records of these activities by 2021 (n\u0026thinsp;=\u0026thinsp;89,061) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eBy tracing a timeline, we can observe growth in all regions until 2016, stability in the 2016\u0026ndash;2017 period, and again an increase in the 2017\u0026ndash;2019 period, and this last year recorded more PCAF actions in the PHC, with 43,230 in the Midwest, 139,227 in the Northeast, 26,159 in the North, 342,736 in the Southeast, and 66,031 in the South. In percentage terms, the growth in the number of PCAF records between 2013 and 2019 was higher in the Southeast (59,299.7%) and North (33,012.7%) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Furthermore, as seen nationally, a decrease in the number of records was observed in all regions from 2020 onwards, ranging from 73.8% in the Southeast to 79.5% in the North.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRecords of Physical Activities and Body Practices by region between 2013\u0026ndash;2021 and growth percentage.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRegion\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2013\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2014\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2015\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2016\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2017\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2018\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2019\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2020\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2021\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGrowth\u003c/p\u003e \u003cp\u003e2013\u0026ndash;2019\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMidwest\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e206 (6.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 943 (5.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19 644 (9.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31 562 (7.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e27 474 (6.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e39 276 (7.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e43 230 (7.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e9 985 (6.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e9 006 (5.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e20 885.4%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNortheast\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 907 (62.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 970 (43.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65 840 (30.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e91 774 (20.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e86 209 (19.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e113 502 (20.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e139 227 (22.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e29 530 (19.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e36 491 (22.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e7 200.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNorth\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e79\u003c/p\u003e \u003cp\u003e(2.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 424 (4.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 296 (4.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19 337 (4.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e13 615 (3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e21 451 (3.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e26 159 (4.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5 366 (3.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e7 983 (4.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e33 012.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSoutheast\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e577 (18.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27 307 (35.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e85 555 (39.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e235 081 (53.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e268 675 (59.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e312 219 (57.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e342 736 (55.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e89 715 (59.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e89 061 (54.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e59 299.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSouth\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e306 (10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 014 (11.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32 940 (15.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e62 600 (14.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e52 984 (11.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e61 005 (11.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e66 031 (10.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e16 560 (11.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e22 436 (13.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e21 478.8%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal Country\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 075\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e76 658\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e214 275\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e440 354\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e448 957\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e547 453\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e617 383\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e151 156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e164 977\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e19 977.5%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"11\" nameend=\"c11\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCaptions\u003c/b\u003e: Growth 2013\u0026ndash;2019: Percentage of growth of PCAF records from 2013 to 2019\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe state overview shows that the places that most recorded PCAF in the PHC in the entire period investigated were Minas Gerais (n\u0026thinsp;=\u0026thinsp;964,577), S\u0026atilde;o Paulo (n\u0026thinsp;=\u0026thinsp;323,939), Rio de Janeiro (155,306), Bahia (138,773), and Santa Catarina (n\u0026thinsp;=\u0026thinsp;124,987). Regarding the distribution over time, we observed that in 2013 the records ranged from zero in the Federal District, Mato Grosso do Sul, Acre, Rond\u0026ocirc;nia, Roraima, Tocantins, and Esp\u0026iacute;rito Santo, to 515 in Bahia. This number was much higher in 2019, from 530 in Roraima to 230,522 in Minas Gerais. In 2021, the last year analyzed, the records ranged from 40 in Roraima to 59,574 in Minas Gerais (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRecords of Physical Activity and Body Practices by state in the 2013\u0026ndash;2021 period.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eState\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2013\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2014\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2015\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2016\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2017\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2018\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2019\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2020\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2021\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAcre\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e303\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 373\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 551\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1 611\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1 828\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e435\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e391\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlagoas\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e248\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 096\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 721\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8 335\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6 335\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e10 792\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e12 828\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2 633\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2 801\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAmap\u0026aacute;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e230\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e454\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 285\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e925\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e642\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e557\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e474\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAmazonas\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e478\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 967\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3 598\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 098\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4 335\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e5 970\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e754\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1 018\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBahia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e515\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 055\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16 536\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21 365\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18 911\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e27 925\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e32 530\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5 515\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e6 421\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCear\u0026aacute;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 353\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 864\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14 816\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e14 545\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e18 286\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e27 807\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e6 057\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e8 250\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFederal District\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e163\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e516\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1 835\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1 551\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e340\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e498\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEsp\u0026iacute;rito Santo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e446\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e820\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1 813\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2 103\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e301\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e547\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGoi\u0026aacute;s\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e202\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 731\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15 840\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20 052\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e13 919\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23 056\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e25 508\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e6 200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e5 184\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaranh\u0026atilde;o\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 072\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6 973\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7 368\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e9 334\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e13 090\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2 352\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3 709\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMato Grosso\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e496\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 894\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6 514\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7 192\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8 216\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e8 329\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1 834\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1 408\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMato Grosso do Sul\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e716\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 909\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4 833\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5 847\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6 169\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e7 842\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1 611\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1 916\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMinas Gerais\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e378\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 786\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53 829\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e154 120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e174 496\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e212 381\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e230 522\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e61 491\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e59 574\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePar\u0026aacute;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 119\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 384\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4 503\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4 126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7 559\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e9 714\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2 395\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3 157\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePara\u0026iacute;ba\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e229\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 360\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 060\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12 219\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11 379\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e12 247\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e12 340\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3 340\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e4 391\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParan\u0026aacute;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 935\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10 807\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15 531\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e15 129\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16 342\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e17 984\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5 519\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e6 884\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePernambuco\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e262\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 770\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 433\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12 768\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11 229\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16 128\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e18 250\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3 929\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3 736\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePiau\u0026iacute;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 317\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 414\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7 399\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7 003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7 938\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e8 475\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2 070\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2 906\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRio de Janeiro\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e621\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 904\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28 055\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e33 775\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e32 542\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e34 970\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e8 167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e10 271\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRio Grande do Norte\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e347\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 617\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 594\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6 570\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7 644\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8 644\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e10 341\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2 833\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2 564\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRio Grande do Sul\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 972\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 597\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21 333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e16 540\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e18 710\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e22 953\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5 193\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e7 354\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRond\u0026ocirc;nia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 486\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e374\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e733\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e944\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e153\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1 135\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRoraima\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e163\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e402\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e534\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e530\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSanta Catarina\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 107\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9 536\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25 736\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21 315\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e25 953\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e25 094\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5 848\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e8 198\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eS\u0026atilde;o Paulo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e198\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 843\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24 376\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e51 889\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e59 584\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e65 483\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e75 141\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e19 756\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e18 669\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSergipe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e330\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 062\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 329\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 795\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2 208\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3 566\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e801\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1 713\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTocantins\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 539\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 836\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6 929\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4 139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6 037\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6 616\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1 439\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1 768\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e illustrates the percentage variation in PCAF records in the Brazilian states between 2013 and 2019, before the COVID-19 pandemic. All states showed significant growth; however, the most significant percentage increases were in Minas Gerais (23,052,100%), which increased from 378 records in 2013 to 230,522 in 2019, S\u0026atilde;o Paulo (7,514,000%), which went from 198 records in 2013 to 75,141 in 2019, Rio de Janeiro (3,490,900%), which had only one record in 2013 to 34,970 in 2019, Bahia (3,252,900%), which increased from 515 records in 2013 to 32,530 in 2019, Cear\u0026aacute; (2,780,600%), which increased from 71 records in 2013 to 27,807 in 2019, Goi\u0026aacute;s (2,550,700%), which increased from 202 records in 2013 to 25,508 in 2019, and Santa Catarina (2,509,300%), which increased from 200 records in 2013 to 25,094 in 2019, indicated by darker colors on the map. The states with the lowest percentage of growth (below 100,000%) were Roraima (53,000%), which had no records in 2013 and recorded 530 in 2019; Amap\u0026aacute; (55,600%), which had 13 records in 2013 and 557 in 2019, and Rond\u0026ocirc;nia (94,300%), which had no records in 2013 and recorded 944 in 2019. (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). It should be noted that these percentages, although of a significant magnitude, accurately reflect the reality of records in these locations, considering that many states started from small figures in 2013 and reached a substantial record volume in 2019.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe PCAF are developed by different types of teams in the PHC. The eSF and NASF teams have the most expressive numbers, totaling 2,645,045 activities recorded in Brazil. In 2013, the eSF and NASF teams recorded 1,685 and 1,361 PCAF, respectively. In 2019, the year with the highest recorded productivity, 122,369 actions were developed by the eSF and 490,840 by the NASF, the latter being the most prominent promoter of PCAF in PHC throughout the analyzed period, reaching 77.1% of records across the country in 2020 and 67.8% in total activities in the period. Although serving a considerably smaller population, the Prison Primary Care and Street Office teams still record few PCAF actions, representing less than 1% of what is developed across the country (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). How data are shown in SISAB changed in 2020 when the PHC team ceased to exist and became known as the Primary Care team from 2021 onwards.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRecords of Physical Activities and Body Practices by type of team between 2013\u0026ndash;2021.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTeam type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2013\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2014\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2015\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2016\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2017\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2018\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2019\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2020\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2021\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"1\" nameend=\"c11\" namest=\"c11\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"1\" nameend=\"c11\" namest=\"c11\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eeAB\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003cp\u003e(0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e105\u003c/p\u003e \u003cp\u003e(0.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e274\u003c/p\u003e \u003cp\u003e(0.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e228\u003c/p\u003e \u003cp\u003e(0.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e355\u003c/p\u003e \u003cp\u003e(0.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e688\u003c/p\u003e \u003cp\u003e(0.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e82\u003c/p\u003e \u003cp\u003e(0.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c11\" namest=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eeABp\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003cp\u003e(0.004)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e105\u003c/p\u003e \u003cp\u003e(0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e85\u003c/p\u003e \u003cp\u003e(0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e72\u003c/p\u003e \u003cp\u003e(0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e70\u003c/p\u003e \u003cp\u003e(0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e9\u003c/p\u003e \u003cp\u003e(0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e46\u003c/p\u003e \u003cp\u003e(0.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c11\" namest=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eeACS\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40\u003c/p\u003e \u003cp\u003e(0.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e652\u003c/p\u003e \u003cp\u003e(0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 109\u003c/p\u003e \u003cp\u003e(0.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 794\u003c/p\u003e \u003cp\u003e(0.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 164\u003c/p\u003e \u003cp\u003e(0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2 030\u003c/p\u003e \u003cp\u003e(0.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3 266\u003c/p\u003e \u003cp\u003e(0.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e385\u003c/p\u003e \u003cp\u003e(0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c11\" namest=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eeAP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e83\u003c/p\u003e \u003cp\u003e(0.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1 455\u003c/p\u003e \u003cp\u003e(0.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c11\" namest=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eeCR\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003cp\u003e(0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29\u003c/p\u003e \u003cp\u003e(0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e212\u003c/p\u003e \u003cp\u003e(0.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e76\u003c/p\u003e \u003cp\u003e(0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e89\u003c/p\u003e \u003cp\u003e(0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e160\u003c/p\u003e \u003cp\u003e(0.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e15\u003c/p\u003e \u003cp\u003e(0.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e53\u003c/p\u003e \u003cp\u003e(0.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c11\" namest=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eeSB\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 346 (30.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 757\u003c/p\u003e \u003cp\u003e(18.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38 726\u003c/p\u003e \u003cp\u003e(15.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e65 974\u003c/p\u003e \u003cp\u003e(13.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e60 274\u003c/p\u003e \u003cp\u003e(11.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e67 327\u003c/p\u003e \u003cp\u003e(10.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e79 449\u003c/p\u003e \u003cp\u003e(11.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e10 405\u003c/p\u003e \u003cp\u003e(6.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1 519\u003c/p\u003e \u003cp\u003e(0.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c11\" namest=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eeSF\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 685\u003c/p\u003e \u003cp\u003e(38.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24 075\u003c/p\u003e \u003cp\u003e(25.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59 954\u003c/p\u003e \u003cp\u003e(23.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e115 397\u003c/p\u003e \u003cp\u003e(22.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e103 864\u003c/p\u003e \u003cp\u003e(20.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e107 961\u003c/p\u003e \u003cp\u003e(17.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e122 369\u003c/p\u003e \u003cp\u003e(17.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e25 970\u003c/p\u003e \u003cp\u003e(16.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e44 729\u003c/p\u003e \u003cp\u003e(27.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c11\" namest=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNASF\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 361\u003c/p\u003e \u003cp\u003e(30.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51 917\u003c/p\u003e \u003cp\u003e(54.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e152 086\u003c/p\u003e \u003cp\u003e(60.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e321 596\u003c/p\u003e \u003cp\u003e(63.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e342 546\u003c/p\u003e \u003cp\u003e(67.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e436 979\u003c/p\u003e \u003cp\u003e(71.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e490 840\u003c/p\u003e \u003cp\u003e(70.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e124 541\u003c/p\u003e \u003cp\u003e(77.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e117 175\u003c/p\u003e \u003cp\u003e(71.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c11\" namest=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal Country\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 432\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e94 416\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e253 018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e506 352\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e509 237\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e614 813\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e696 842\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e161 490\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e164 977\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c11\" namest=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"11\" nameend=\"c11\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCaptions\u003c/b\u003e: eAB\u0026thinsp;=\u0026thinsp;PHC Team; eSF\u0026thinsp;=\u0026thinsp;Family Health Team; NASF\u0026thinsp;=\u0026thinsp;Expanded Family Health Center; eACS\u0026thinsp;=\u0026thinsp;Community Health Workers Team; eCR\u0026thinsp;=\u0026thinsp;Street Office Team; eSB\u0026thinsp;=\u0026thinsp;Oral Health Team; eABp\u0026thinsp;=\u0026thinsp;Prison PHC Team; eAP\u0026thinsp;=\u0026thinsp;PHC\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the percentages of PCAF records in each target audience accumulated throughout the period. We can observe that the most significant number of PCAF was directed to the community in general (22.9%), followed by women (19.5%), older adults (18.3%), people with NCDs (12.0%), and men (11.1%). The public of children and adolescents shows a low percentage of records, 4.7%, and 4.4%, respectively. The rest of the target audience does not represent 10% of the total activities in the analyzed period.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eWe identified a growth of 19,977.5% in the PCAF records developed in the PHC across the country between 2013 and 2019. However, a sharp drop was observed in the number of records (75.5%) from 2020. Regionally, the Southeast and Northeast stand out as major PCAF promoters, and the North region has the lowest numbers. In the Brazilian states Minas Gerais, S\u0026atilde;o Paulo, Rio de Janeiro, Bahia, Cear\u0026aacute;, Goi\u0026aacute;s, and Santa Catarina remained the places with the highest production of PCAF in the country with the highest percentage growth observed. Regarding the target audience, the activities mainly covered the general community, followed by women, older adults and people with NCDs, who accounted for 72.7% of the total number of records. The health teams that recorded PCAF the most were from the eSF and NASF, and the latter is the team that most promotes PCAF in PHC, around 67.8% throughout the analyzed period.\u003c/p\u003e \u003cp\u003eThe PCAF gained space in health promotion actions in the PHC in the investigated period, which seems to be associated with the creation of public policies, especially the inaugural publication of the PNPS in 2006 that demarcated the axis of the PCAF as a priority and, thus, enabled the expanded offer of these activities as a care form in the SUS (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Moreover, several movements and actions occurred mainly from 2005 to 2018 at the three levels of SUS management to strengthen PHC and health promotion, expand the PCAF axis in the Health Care Network, and include physical education professionals, especially in multidisciplinary teams (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe decline in PCAF records in 2020 and 2021, observed in all Brazilian regions and states, is linked to the pandemic context experienced since March 2020. Given the alarming epidemiological situation imposed by the pandemic and following the World Health Organization (WHO) recommendations, health services suspended group activities and directed their efforts towards preventive actions against COVID-19 and care for patients with respiratory symptoms (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). This troubling setting is concurrent with changes in the PHC policy, with the Previne Brasil model, and contributed to the significant drop in PCAF actions developed in the PHC (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eHowever, although the number of records has reduced considerably, we should consider that, even in an adverse context, the health teams sought alternatives, whether with teleassistance, video classes, or messaging groups, to maintain such activities and preserve the bond with clients (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). It is even recommended that these strategies continue to be promoted in health services since it allows expanding the offer of these actions and people\u0026rsquo;s access (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eBesides the conditions imposed by the pandemic, the decrease in health promotion actions and, in this case, the PCAF supply is implicated in the neoliberal measures intensified between the years 2016 and 2022, primarily (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). On the other hand, government actions were promoted as guides and recommendations that encourage individuals to care for themselves, from an individual perspective and with a popular motivation agenda (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Furthermore, the new PHC financing model and the revocation of federal funding for NASF teams among priority programs (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e), are clear examples of the regression in health policies. We can observe a logic where the social policy no longer enforces rights but expands existing inequalities and regulates access to services through the purchasing power of individuals (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSuch measures must improve in preserving, continuing, and promoting the policies and programs discussed here. The persistent social inequalities in the country are potentialized through the neoliberal rationale of dismantling health policies in a general scope, which affects the PCAF. We can see through such actions articulated movements that aim at underfunding and dismantling the SUS, or a SUS reduced to a small basket of services (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Given the deteriorated social indicators observed in the country, we should note that the PCAF are not out of place in this setting, as they are complex manifestations and traversed by socioeconomic, cultural and political conditions, and ways of living (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMore populous regions, such as the Northeast and Southeast, were the ones that most recorded PCAF in the PHC. The North, with a lower demographic density, remained the location with the lowest number of records, albeit with a considerable growth percentage. The states showed significant growth in PCAF records over the years, emphasizing S\u0026atilde;o Paulo, Minas Gerais, Rio de Janeiro, and Bahia, which, respectively, are the states with the largest population sizes in the country. Besides demographic issues, part of the explanation for these aspects permeates the historical existence in these locations with greater productivity and programs aimed at promoting PCAF that were provenly successful experiences in expanding the population\u0026rsquo;s access to these spaces and increasing PA population levels (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). As an example, in the Southeast region, the Agita S\u0026atilde;o Paulo (SP), the Exercise Guidance Service in Vit\u0026oacute;ria (ES), the Sa\u0026uacute;de Ativa Rio Claro (SP), and the City Gym Program in Belo Horizonte (MG) stand out. In the Northeast region, the City Gym Program occurs in Recife (PE) and Aracaju (SE) (\u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe Health Gym Program (PAS) (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e) created in 2011, is in place in 48% of the 5,570 Brazilian municipalities and has 3,821 qualified centers in all states. PAS regional data indicate that the regions with the highest percentage of qualified centers regarding the number of municipalities were the North (55.3%) and Northeast (54.7%), and the region with the lowest percentage was the Southeast (37.9%) (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Furthermore, National Health Survey data show that PA in public programs is higher in the North, Northeast, and Midwest. However, the population coverage of programs, in general, is still low (1.9%) (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Although the number of PCAF programs and the participation of the population is higher in the regions mentioned earlier, we observe a discrepancy in the number of records produced in the SISAB, which leads us to question whether there is a gap between doing and recording or if PCAF actions are indeed offered on a smaller scale in these locations.\u003c/p\u003e \u003cp\u003eThe target audience of group activities involving PCAF identified in the present study is similar to the profile of users of public PCAF programs outlined in previous research, who are women, over 50, and with NCD history (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). In this sense, we observe that the targeting of PCAF actions is directed to the public that needs it most and is most benefited since it expands women\u0026rsquo;s access to the PCAF since they are less physically active than men, reduces NCD-derived conditions, and provides autonomy and improved quality of life in older adults and other populations (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe NASF and eSF teams were the leading promoters of PCAF in PHC. These findings corroborate the study by Florindo et al. (2016) (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e), which identified a higher prevalence of PA promotion actions in municipalities with broader eSF coverage and that had NASF with physical education professionals in their teams. Since its creation in 2008, the NASF has expanded the scope, quality, and resolution of PHC actions in a comprehensive healthcare rationale (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). However, the withdrawal of federal funding that led to the disqualification of these teams imposes significant weaknesses and discontinuity of a work, which, while with limitations, structured and strengthened PHC in Brazil (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe General Coordination for the Promotion of Physical Activity and Intersectoral Actions (CGPROFI) and the federal financial incentive for funding were established between 2019 and 2022 to implement PA actions in PHC (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). The initial analyses on the Physical Activity Incentive (IAF) show a potential to expand people\u0026rsquo;s access to the PCAF developed in the PHC (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). Even so, creating coordination and implementing the incentive demand attention since the movements alone cannot guarantee to strengthen the PCAF agenda in the SUS (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e) as the IAF is a model that has yet to be evaluated in the face of the Brazilian reality (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). Furthermore, little progress will be made if health promotion notions remain linked to an individual motivation perspective without considering the social, political, economic, and cultural contexts of the individuals (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Thus, specific studies should address the budget, conceptual delimitation, and actions of CGPROFI, IAF monitoring, and its consequences in the health portfolio.\u003c/p\u003e \u003cp\u003eThe present study is not without limitations. Firstly, the PCAF records, pandemic context, and changes in PHC policy are contemporary events. Notwithstanding this, this research cannot establish cause and effect analyses but focuses on describing these events. Therefore, this is an exploratory analysis. Moreover, we should consider that information systems may have weaknesses in operational terms of the platforms, such as information standardization, normalization, and compatibility (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e) and about the professionals\u0026rsquo; recording difficulty, given the insufficient computerization in health units, and lack of knowledge about how to complete and correctly handle data in the systems (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). The e-SUS PHC strategy in Brazil was fully implemented in only 20.2% of Brazilian municipalities by 2019, and most are between the initial and partial implementation stages (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). The SIS must talk and try to converge to avoid overlaps or gaps in the records. Still, an effort is needed so that the locations have the same quality internet access and equipment, and the records reflect the services rather than technical and operational difficulties.\u003c/p\u003e \u003cp\u003eAlthough SISAB may present possible inaccuracies due to the points mentioned earlier, it is a system linked to DATASUS that collects, processes, and disseminates official information from the Ministry of Health (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Developing studies in this scope qualifies the information obtained and allows the SISAB platform to become a research source for future studies. Moreover, when investigating SUS-related data, we can identify it as a locus for care and knowledge production.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe results could contribute to identifying the distribution of PCAF records and the existing disparities at regional and state levels. We observed increases in all regions and states until 2019, with declining actions from 2020 onwards, possibly related to the pandemic context and the federal government\u0026rsquo;s adoption of neoliberal measures. These findings reinforce the need to build strategies at the three SUS management levels that aim at more significant investments in public policies, to preserve and establish proposals and programs to expand the offer of PCAF actions in the Brazilian territory and favor the access of the population to this type of health care. Finally, this study is limited to presenting the number of PCAF records produced in the PHC. Future research should evaluate whether these records reflect effective actions and the population coverage of these activities.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003ePCAF: Physical Activities and Body Practices\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSUS: Unified Health System\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSISAB:\u0026nbsp;Primary Care Health Information System\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNCDs: Noncommunicable diseases\u003c/p\u003e\n\u003cp\u003ePNPS: National Health Promotion Policy\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePHC: Primary Health Care\u003c/p\u003e\n\u003cp\u003eNASF: Expanded Family Health Center\u003c/p\u003e\n\u003cp\u003eSIS:\u0026nbsp;Health Information Systems\u003c/p\u003e\n\u003cp\u003ee-SUS APS: e-SUS Primary Health Care\u003c/p\u003e\n\u003cp\u003eeSF: Family Health Team\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eeAB:\u0026nbsp;Primary Health Care\u0026nbsp;Team\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eeSB: Oral Health Team\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eeCR: Street Office Team\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eeABP: Prison PHC Team\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eeAP:\u0026nbsp;Primary Health Care\u0026nbsp;Team\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFAC: Collective Activity Form\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCDS: Simplified Data Collection\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePEC: Electronic Citizen Record\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePAS: Health Gym Program\u003c/p\u003e\n\u003cp\u003eCGPROFI: Promotion of Physical Activity and Intersectoral Actions\u003c/p\u003e\n\u003cp\u003eIAF: Physical Activity Incentive\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable as it uses public domain data that does not require ethical approval.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the study are available on the public platform of the Primary Care Health Information System (SISAB) through the electronic address: https://sisab.saude.gov.br/.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe research did not have funding for its execution.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eR.P.D was responsible for designing, collecting and analyzing data, as well as conducting the writing and preparing the manuscript. A.G.K contributed to data analysis, writing and revision of the article. All authors reviewed and approved the manuscript content.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author R.P.D are social demand fellow from the Coordination for the Improvement of Higher Education Personnel (CAPES), case number 88887.628163/2021-00.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBrasil, Minist\u0026eacute;rio da Sa\u0026uacute;de, Secretaria de Vigil\u0026acirc;ncia em Sa\u0026uacute;de. Secretaria de Aten\u0026ccedil;\u0026atilde;o \u0026agrave; Sa\u0026uacute;de. Pol\u0026iacute;tica Nacional de Promo\u0026ccedil;\u0026atilde;o da Sa\u0026uacute;de: PNPS: Anexo I da Portaria de Consolida\u0026ccedil;\u0026atilde;o no 2, de 28 de setembro de 2017, que consolida as normas sobre as pol\u0026iacute;ticas nacionais de sa\u0026uacute;de do SUS. 2018.\u003c/li\u003e\n\u003cli\u003eLee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. The Lancet. 2012;380(9838):219-229. doi:10.1016/S0140-6736(12)61031-9\u003c/li\u003e\n\u003cli\u003eMalta DC, Silva M, Albuquerque G, Amorim R, Rodrigues G, Silva T, et al. Pol\u0026iacute;tica Nacional de Promo\u0026ccedil;\u0026atilde;o da Sa\u0026uacute;de, descri\u0026ccedil;\u0026atilde;o da implementa\u0026ccedil;\u0026atilde;o do eixo atividade f\u0026iacute;sica e pr\u0026aacute;ticas corporais, 2006 a 2014. 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Informe Epidemiol\u0026oacute;gico do SUS. 2000;9(4):241-249. doi:10.5123/S0104-16732000000400003\u003c/li\u003e\n\u003cli\u003ePinheiro ALS, Andrade KTS, Silva DO, Zacharias FCM, Gomide MFS, Pinto IC. Health management: The use of Information Systems and knowledge sharing for the decision making process. Texto \u0026amp; Contexto - Enfermagem. 2016;25(3):1\u0026ndash;9. doi:10.1590/0104-07072016003440015\u003c/li\u003e\n\u003cli\u003eCielo AC, Raiol T, Silva EN da, Barreto JOM. Implanta\u0026ccedil;\u0026atilde;o da Estrat\u0026eacute;gia e-SUS Aten\u0026ccedil;\u0026atilde;o B\u0026aacute;sica: uma an\u0026aacute;lise fundamentada em dados oficiais. Rev Saude Publica. 2022;56:5. doi:10.11606/s1518-8787.2022056003405\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Motor Activity, Unified Health System, Electronic Health Records, Health Information Systems","lastPublishedDoi":"10.21203/rs.3.rs-3143626/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3143626/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Physical activity and body practices (PCAF) are important strategies for health promotion, and widely recognized as a form of care within the Brazilian Unified Health System (SUS). The aim of the study was to map records of PCAF developed in Primary Health Care in Brazil, from 2013 to 2021.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod:\u003c/strong\u003e This cross-sectional and descriptive study used the Primary Care Health Information System (SISAB) data. Year-by-year PCAF records were presented in absolute and relative values in states, regions, and the country by team type and target audience.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e In total, 2,664,288 PCAF actions were recorded nationally throughout the period. A growth of 19,977.5% was observed in records from 2013 to 2019, but they dropped by 75.5% from 2020 and the COVID-19 pandemic. The regions that most recorded PCAF were the Southeast and Northeast, and the states of Minas Gerais, São Paulo, Rio de Janeiro, Bahia, Ceará, Goiás, and Santa Catarina. PCAF actions were directed mainly at the general community, women, older adults, and people with chronic diseases. The Expanded Family Health Center and Family Health were the health teams with the most records.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e A significant increase in PCAF records was observed from 2013 to 2019. However, a substantial decrease was identified from 2020, linked to the pandemic. The distribution of actions is still unequal at the state and regional levels, which makes intersectoral strategies necessary to promote public policies and strengthen the PCAF and health promotion in the SUS.\u003c/p\u003e","manuscriptTitle":"Physical Activity and Body Practices developed in Primary Health Care in Brazil from 2013-2021","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-07-19 14:26:18","doi":"10.21203/rs.3.rs-3143626/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d1dc85fa-e85f-4e19-a020-f02faedc429e","owner":[],"postedDate":"July 19th, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2023-08-29T05:44:24+00:00","versionOfRecord":[],"versionCreatedAt":"2023-07-19 14:26:18","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3143626","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3143626","identity":"rs-3143626","version":["v1"]},"buildId":"FbvkV6FR0MCFSLy54lSbu","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}