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Abstract

Purpose: The health care environment is recognized as a promising setting in which to promote physical activity (PA). Nearly 40% of Mexican adults are inactive and whether Mexican health care environments are promoting PA is unknown. The purpose of this study was to describe and compare the PA promotion environment in Guadalajara, Mexico. Methods: Forty primary care clinics and hospitals from the three health care systems in Guadalajara were sampled: 15 from the Secretary of Health, 14 from the Social Security Institutes and 11 from the private sector. A tool for measuring the PA environment of health care settings, including the availability of written PA materials, was developed. Face validity and inter-rater reliability of the tool were established (kappa=.75). Level of care (primary, secondary, and tertiary), number of floors and type of health care system of each clinic and hospital were also recorded. The tool was then used to assess the availability, accessibility, visibility, signage, cleanliness, and safety of all stairs, elevators, and green spaces at each health care setting and to record the presence of written PA materials including posters, brochures, leaflets, flyers, articles, and ‘cartels’ (hand-made posters) in the foyer and one waiting room of each clinic and hospital. Results: Thirty (75%) clinics and hospitals had stairs, 17 (42%) had elevators, 22 (55%) had green spaces and 11 (28%) had promotional PA materials (only posters or cartels). The availability of PA posters/cartels was significantly associated with health care system type (X2(2)=8.11, p<.05) and with level of care (X2(2)=6.68, p<.05), where primary care clinics from the Secretary of Health had significantly more PA promotional materials than clinics and hospitals from the other two systems. The health care PA environment score reflected by the stair, elevator, and green space indicators was not significantly different between the three Mexican health care systems (p>.05); the score was low across the three systems (Mean=3.7, SD=2.7, Range=-2-10). Conclusions: Mexican health care settings are not PA friendly. Interventions to enhance the PA promotion environment in the three Mexican health care systems are needed to reach inactive patients.

 

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