Vigilância de fatores de risco e proteção para doenças crônicas não transmissíveis no Brasil: performance e resultados

Abstract

The occurrence of noncommunicable diseases is related to a common set of risk factors, such as inadequate diet, smoking, alcohol abuse and physical inactivity. The Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel) stands out, which, after 16 years of implementation, has not yet evaluated the quality of the data collection process. The objective was to analyze Vigitel data between 2006 and 2021, with emphasis on its data collection indicators and on inequality related to education in the frequency of risk factors. Article 1: Scope review with the objective of gathering, organizing and critically analyzing information on the quality of Vigitel data from 2006 to 2019. Article 2: The temporal trend of eligibility, success and refusal rates between 2006 and 2021 was analyzed, using Prais-Winsten regressions. Article 3: We analyzed the temporal trend of: smoking, abusive consumption of alcoholic beverages, inadequate consumption of fruits and vegetables, insufficient practice of physical activity and obesity. Prais-Winsten regression models, using linear splines, were used to identify variations in isolated indicators and in the form of agglomeration of three or more risk factors. The indices (Slope Index of Inequality (SII) and Concentration Index (CIX)) were used to analyze the temporal trends of inequalities in the prevalence of accumulation of risk factors according to education. The results were: Article 1: From 2006 to 2019, Vigitel completed 14 editions, with 730,309 interviews carried out, maintaining the response rate above 60%. The sampling process has maintained similar characteristics since the beginning, as well as the questionnaire, maintaining essential and rotating questions, ranging from 76 questions in 2006 to 132 in 2019. Article 2: Between 2006 and 2021, the rate of eligible Vigitel lines reduced from 72.5% to 15.9%, and the success rate from 71.5% to 61.2%. These results together suggest a potential bias that should not be ignored in the estimates calculated by Vigitel. Article 3: In the period from 2016 to 2021, there was an increase in the inadequate consumption of fruits and vegetables and obesity, in addition to the stability of alcohol abuse and insufficient physical activity. There was stability in the accumulation of risk factors between 2009 and 2021, despite the increase from 2016 onwards, and a reduction in inequality in terms of education between men and women and in the set of less developed capitals in the country. With a robust and effective strategy, Vigitel, in its 16 years of implementation, has enabled the annual monitoring of the health situation of the Brazilian population. A reduction in the rates of eligible and successful lines was observed over the years, which may impose biases on the estimates calculated by the survey. Even so, through Vigitel, it was possible to verify the increase in the prevalence of the accumulation of risk factors in a more recent period and the reduction of inequalities related to schooling.