Características das intervenções realizadas com adolescentes em condição de sobrepeso e obesidade: uma revisão integrada
DOI:
https://doi.org/10.15649/cuidarte.v10i3.681Palavras-chave:
Adolescente, Sobrepeso, Obesidade Pediátrica, Estudos Controlados Antes e Depois, Estilo de Vida SaudávelResumo
Introdução: Uma vez que o sobrepeso e a obesidade na população adolescente estão aumentando, é aconselhável identificar intervenções necessárias para a prevenção e o controle dessas condições no grupo de jovens. Objetivo: Apresentar as evidências encontradas em relação às características das intervenções publicadas em periódicos científicos indexados sobre prevenção e controle do sobrepeso e da obesidade, e sobre a nutrição e a atividade física, a serem utilizadas na tomada de decisão no que diz respeito a políticas e programas para promover e prevenir esta condição de saúde. Materiais e Métodos: A revisão sistemática de estudos qualitativos e quantitativos (de descritivos a experimentais, incluindo tanto revisões sistemáticas, quanto metanálises), publicados no período entre 2005 y 2017, foi realizada por meio do PubMed e do ScienceDirect, das bibliotecas virtuais Ovid e SciELO e do compêndio de revisão da Cochrane. Resultados: Existe uma grande variedade na concepção e na aplicação de intervenções, em termos de componentes, teorias, cenários, avaliação dos efeitos, da dose, do tempo e do acompanhamento, que têm um efeito sobre os hábitos nutricionais, na atividade física, na auto eficácia e no índice de massa corporal (IMC) da população estudada. Discussão: A efetividade das intervenções varia, dependendo dos componentes e da fidelização em sua aplicação, portanto deve ser revista à luz dos melhores efeitos encontrados. Conclusões: 47 estudos atenderam aos requisitos de inclusão. As intervenções são fortalecidas com o uso de uma teoria que direcione e fundamente os achados que permitam maiores e melhores resultados. Os componentes das intervenções incluem: duração, dose, intensidade da intervenção, resposta e acompanhamento. Os adolescentes preferem metodologias participativas e interativas, no entanto, ainda não existe uma intervenção concreta e claramente definida que possa ser padronizada para fazer frente a esse problema de saúde.
Como citar este artigo: Bonilla CP, Díaz LP. Características de las intervenciones realizadas con adolescentes en condición de sobrepeso y obesidad: una revisión integrativa. Rev Cuid. 2019; 10(3): e681. http://dx.doi.org/10.15649/cuidarte.v10i3.681
Referências
OMS. Desarrollo en la adolescencia. Salud de la madre, el recién nacido, del niño y del adolescente. Organización Mundial de la Salud.
Canada: Human Resources and Skills Development Canada (HRSDC). Indicators of well-being in Canada. 2013.
Rivera J, González de Cossío T, Pedraza L, Aburto T, Sánchez T, Martorell R. Childhood and adolescent overweight and obesity in Latin America: a systematic review. Lancet. 2014; 2(4): 321-32. https://doi.org/10.1016/S2213-8587(13)70173-6
Instituto Nacional de Salud Pública. Encuesta Nacional de Salud y Nutrición (ENSANUT). 2012.
Bastidas R, Castaño J, Enríquez DM, Giraldo J, González J, Güependo D, et al. Relación entre hipertensión arterial y obesidad en pacientes hipertensos atendidos en ASSBASALUD E.S.E. Manizales (Colombia) 2010. Arch Med. 2011; 11(2):150-8. https://doi.org/10.30554/archmed.11.2.822.2011
Magallanes M, Gallegos E, Carrillo A, Sifuentes D, Olvera M. Sobrepeso, obesidad y dislipidemias en población universitaria del noreste de México. Invest Educ Enferm. 2010; 28(1):101-7.
OMS. Obesidad y sobrepeso. Organización Mundial de la Salud. 2017.
Alegría E, Castellano J, Alegría A. Obesidad, síndrome metabólico y diabetes: implicaciones cardiovasculares y actuación terapéutica. Rev Esp Cardiol. 2008; 61(7):752-64. https://doi.org/10.1157/13123996
Mafort TT, Rufino R, Costa CH, Lopes AJ. Obesity: systemic and pulmonary complications, biochemical abnormalities, and impairment of lung function. Multidiscip Respir Med. 2016. 12(11): 28. https://doi.org/10.1186/s40248-016-0066-z
Sánchez C, Ibáñez C, Klaassen J. Obesidad y cáncer: la tormenta perfecta. Rev Med Chile. 2014; 142(2). https://doi.org/10.4067/S0034-98872014000200010
Simkin-Silverman L, Conroy M, King W. Treatment of overweight and obesity in primary care practice: current evidence and future directions. Am J Lifestyle Med. 2008; 2(4): 296-304. https://doi.org/10.1177/1559827608317287
Instituto Colombiano de Bienestar Familiar (ICBF). Encuesta Nacional de la Situación Nutricional en Colombia 2010 ENSIN. 2010.
CASPe. Programa de Habilidades en Lectura Crítica CASPe.
Vandenbroucke J, Von E, Altman D, Gøtzsche P, Mulrow C, Pocock S, et al. Mejorar la comunicación de estudios observacionales en epidemiología (STROBE): explicación y elaboración. Gac Sanit. 2009; 23(2). https://doi.org/10.1016/j.gaceta.2008.12.001
Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med. 2009; 6: e1000097 https://doi.org/10.1371/journal.pmed.1000097
Cobos-Carbó A, Augustovski F. Declaración CONSORT 2010: actualización de la lista de comprobación para informar ensayos clínicos aleatorizados de grupos paralelos. Med Clin. 2011; 137(5): 213-5. https://doi.org/10.1016/j.medcli.2010.09.034
Landa-Ramírez E, Arredondo-Pantaleón AJ. Herramienta pico para la formulación y búsqueda de preguntas clínicamente relevantes en la psicooncología basada en la evidencia. Psicooncología. 2014; 11(2-3): 259-70. https://doi.org/10.5209/rev_PSIC.2014.v11.n2-3.47387
Dunton G, Schneider M, Cooper D. An investigation of psychosocial factors related to changes in physical activity and fitness among female adolescents. Psychol Heal. 2007; 22(8): 929-44. https://doi.org/10.1080/14768320601124915
Haerens L, Bourdeaudhuij I, Maes L, Vereecken C, Brug J, Deforche B. The effects of a middle-school healthy eating intervention on adolescents’ fat and fruit intake and soft drinks consumption. Public Heal Nutr. 2007; 10(5): 443-9. https://doi.org/10.1017/S1368980007219652
Whittemore R, Jeon S, Grey M. An internet obesity prevention program for adolescents. J Adolesc Heal. 2013; 52(4): 439-47. https://doi.org/10.1016/j.jadohealth.2012.07.014
Covelli M. Efficacy of a school-based cardiac health promotion intervention program for African-American adolescents. Appl Nurs Res. 2008; 21(4): 173-80. https://doi.org/10.1016/j.apnr.2006.12.004
Webber L, Catellier D, Lytle L, Murray D, Pratt C, Young D, et al. Promoting physical activity in middle school girls: trial of activity for adolescent girls. Am J Prev Med. 2008; 34(3):173-84. https://doi.org/10.1016/j.amepre.2007.11.018
Araújo-Soares V, McIntyre T, MacLennan G, Sniehotta F. Development and exploratory cluster-randomised opportunistic trial of a theory-based intervention to enhance physical activity among adolescents. Psychol Heal. 2009; 24(7): 805-22. https://doi.org/10.1080/08870440802040707
Singh AS, Chin A Paw MJM, Brug J, van Mechelen W. Dutch obesity intervention in teenagers: effectiveness of a school-based program on body composition and behavior. Arch Pediatr Adolesc Med. 2009; 163(4): 309-17. https://doi.org/10.1001/archpediatrics.2009.2
Taymoori P, Niknami S, Berry T, Lubans D, Ghofranipour F, Kazemnejad A. A school-based randomized controlled trial to improve physical activity among Iranian high school girls. Int J Behav Nutr Phys Act. 2008; 5(18). https://doi.org/10.1186/1479-5868-5-18
Robbins L, Gretebeck K, Kazanis A, Pender N. Girls on the move program to increase physical activity participation. Nurs Res. 2006; 55(3): 206-16. https://doi.org/10.1097/00006199-200605000-00007
Tuuri G, Zanovec M, Silverman L, Geaghan J, Solmon M, Holston D, et al. “Smart Bodies” school wellness program increased children’s knowledge of healthy nutrition practices and self-efficacy to consume fruit and vegetables. Appetite. 2009; 52(2): 445-51. https://doi.org/10.1016/j.appet.2008.12.007
Silveira J, Taddei J, Guerra P, Nobre M. Effectiveness of school-based nutrition education interventions to prevent and reduce excessive weight gain in children and adolescents: a systematic review. J Pediatr. 2011; 87(5): 382-92. https://doi.org/10.2223/JPED.2123
Tirlea L, Truby H, Haines T. Investigation of the effectiveness of the “Girls on the Go!” program for building self-esteem in young women: trial protocol. Springerplus. 2013; 2(1): 683. https://doi.org/10.1186/2193-1801-2-683
Hoying J, Mazurek BM, Arcoleo K. Effects of the COPE cognitive behavioral skills building TEEN program on the healthy lifestyle behaviors and mental health of appalachian early adolescents. J Pediatr Heal Care. 2016; 30(1): 65-72. https://doi.org/10.1016/j.pedhc.2015.02.005
Jemmott JB, Jemmott LS, O’Leary A, Ngwane Z, Icard L, Bellamy S, Jones S, et al. Cognitive-behavioral health-promotion intervention increases fruit and vegetable consumption and physical activity among South African adolescents: a cluster-randomized controlled trial. Psychol Health. 2011; 26(2):167-85. https://doi.org/10.1080/08870446.2011.531573
Peirson L, Fitzpatrick-Lewis D, Morrison K, Warren R, Usman M, Raina P. Treatment of overweight and obesity in children and youth: a systematic review and meta-analysis. C Open. 2015; 3(1): E35-46. https://doi.org/10.9778/cmajo.20140047
Webb T, Joseph J, Yardley L, Michie S. Using the internet to promote health behavior change: a systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. J Med Internet Res. 2010; 12(1). https://doi.org/10.2196/jmir.1376
Forneris T, Fries E, Meyer A, Buzzard M, Uguy S, Ramakrishnan R, et al. Results of a rural school-based peer-led intervention for youth: goals for health. J Sch Heal. 2010; 80(2):57-65. https://doi.org/10.1111/j.1746-1561.2009.00466.x
Gonzalez-Suarez C, Worley A, Grimmer-Somer K, Dones V. School-based interventions on childhood obesity: a meta-analysis. Am J Prev Med. 2009; 37(5): 418-27. https://doi.org/10.1016/j.amepre.2009.07.012
Arroyo-López PE, Carrete-Lucero L. Alcance de las acciones para prevenir el sobrepeso y la obesidad en adolescentes. El caso de las escuelas públicas mexicanas. Rev. Gerenc. Polít. Salud. 2015; 14(28):142-60. https://doi.org/10.11144/Javeriana.rgyps18-28.aaps
Long J, Stevens K. Using technology to promote self-efficacy for healthy eating in adolescents. J Nurs Sch. 2004; 36(2):134-9. https://doi.org/10.1111/j.1547-5069.2004.04026.x
Moore SM, Borawski EA, Cuttler L, Ievers-Landis CE, Love TE. IMPACT: a multi-level family and school intervention targeting obesity in urban youth. Contemp Clin Trials. 2013; 36(2): 574-86. https://doi.org/10.1016/j.cct.2013.08.009
Vanhelst J, Marchand F, Fardy P, Zunquin G, Loeuille G, Renaut H, et al. The CEMHaVi program: control, evaluation, and modification of lifestyles in obese youth. J Cardiopulm Rehabil Prev. 2010; 30(3):181-5. https://doi.org/10.1097/HCR.0b013e3181d0c2ba
Brown T, Summerbell C. Systematic review of school-based interventions that focus on changing dietary intake and physical activity levels to prevent childhood obesity: an update to the obesity guidance produced by the National Institute for Health and Clinical Excellence. Obes Rev. 2009; 10(1): 110-41. https://doi.org/10.1111/j.1467-789X.2008.00515.x
Lissau I. Prevention of overweight in the school arena. Acta Paediatr. 2007; 96(454): 12-8. https://doi.org/10.1111/j.1651-2227.2007.00164.x
Katz D, O’Connell M, Njike V, Yeh M, Nawaz H. Strategies for the prevention and control of obesity in the school setting: systematic review and meta-analysis. Int J Obes. 2008; 32(12):1780-9. https://doi.org/10.1038/ijo.2008.158
González-Jiménez E, Cañadas G, Fernández-Castillo R, Cañadas-De la Fuente G. Analysis of the life-style and dietary habits of a population of adolescents. Nutr Hosp. 2013; 28(6):1937-42. https://doi.org/10.5294/aqui.2014.14.4.9
Doak C, Visscher T, Renders C, Seidell J. The prevention of overweight and obesity in children and adolescents: a review of interventions and programmes. Obes Rev. 2006; 7(1):111-36. https://doi.org/10.1111/j.1467-789X.2006.00234.x
McVey G, Tweed S, Blackmore E. Healthy Schools-Healthy Kids: a controlled evaluation of a comprehensive universal eating disorder prevention program. Body Image. 2007; 4(2):115-36. https://doi.org/10.1016/j.bodyim.2007.01.004
Friedrich R, Schuch I, Wagner M. Effect of interventions on the body mass index of school-age students. Rev Saude Publica. 2012; 46(3): 551-60. https://doi.org/10.1590/S0034-89102012005000036
Branscum P, Sharma M. After-school based obesity prevention interventions: a comprehensive review of the literature. Int J Env Res Public Heal. 2012; 9(4): 1438-57. https://doi.org/10.3390/ijerph9041438
Nguyen B, Komman K, Baur L. A review of electronic interventions for prevention and treatment of overweight and obesity in young people. Obes Rev. 2011; 12(501): e298-314. https://doi.org/10.1111/j.1467-789X.2010.00830.x
Casazza K, Ciccazzo M. The method of delivery of nutrition and physical activity information may play a role in eliciting behavior changes in adolescents. Eat Behav. 2007; 8(1): 73-82. https://doi.org/10.1016/j.eatbeh.2006.01.007
Vries H, Mudde A, Leijs I, Charlton A, Vartiainen E, Buijs G, et al. The European Smoking Prevention Framework Approach (EFSA): an example of integral prevention. Heal Educ Res. 2003; 18(5): 611-26. https://doi.org/10.1093/her/cyg031
Mauriello L, Ciavatta M, Sherman K, Castle P, Johnson J, Prochaska J. Results of a multi-media multiple behavior obesity prevention program for adolescents. Prev Med. 2010; 51(6): 451-6. https://doi.org/10.1016/j.ypmed.2010.08.004
Ariza C, Nebot M, Tomás Z, Giménez E, Valmayor S, Tarilonte V, et al. Longitudinal effects of the European smoking prevention framework approach (ESFA) project in Spanish adolescents. Eur J Public Heal. 2008; 18(5): 491-7. https://doi.org/10.1093/eurpub/ckn050
Vitória PD, Silva S, Vries H. Longitudinal evaluation of a smoking prevention program for adolescents. Rev Saúde Pública. 2011; 45(2). https://doi.org/10.1590/S0034-89102011000200013
Chatzisarantis NL, Hagger MS. Effects of an intervention based on self-determination theory on self-reported leisure-time physical activity participation. Psychol Heal. 2009; 24(1): 29-48. https://doi.org/10.1080/08870440701809533
Lima-Serrano M, Lima-Rodríguez J. Impacto de las intervenciones escolares de promoción de la salud dirigidas a diferentes áreas de conducta: una revisión sistemática. Gac Sanit. 2014; 28(5): 411-7. https://doi.org/10.1016/j.gaceta.2014.05.003
Summerbell CD, Waters E, Edmunds LD, Kelly S, Brown T, Campbell KJ. Interventions for preventing obesity in children. Cochrane Database Syst Rev. 2005; 20(3). https://doi.org/10.1002/14651858.CD001871.pub2
Swaim RC, Kelly K. Efficacy of a randomized trial of a community and school-based anti-violence media intervention among small-town middle school youth. Prev Sci. 2008; 9(3): 202-14. https://doi.org/10.1007/s11121-008-0096-7
Lemieux A, Fisher J, Pratto F. A music-based HIV prevention intervention for urban adolescents. Heal Psychol. 2008; 27(3): 349-57. https://doi.org/10.1037/0278-6133.27.3.349
Bere E, Veierød M, Skare Ø, Klepp K. Free School Fruit-sustained effect three years later. Int J Behav Nutr Phys Act. 2007; 19(4). https://doi.org/10.1186/1479-5868-4-5
Fridrici M, Lohaus A. Stress‐prevention in secondary schools: online‐ versus face‐to‐face‐training. Heal Educ. 2009; 109(4): 299-313. https://doi.org/10.1108/09654280910970884
Shek D, Siu A, Lee T, Cheung C, Chung R. Effectiveness of the Tier 1 Program of Project P.A.T.H.S.: objective outcome evaluation based on a randomized group trial. Sci World J. 2008; 14(8): 4-12. https://doi.org/10.1100/tsw.2008.16
Haerens L, Bourdeaudhuij I, Maes L, Cardon G, Deforche B. School-based randomized controlled trial of a physical activity intervention among adolescents. J Adolesc Health. 2007; 40(3): 258-65. https://doi.org/10.1016/j.jadohealth.2006.09.028
Ascencio-Díaz MJ, Daza A, Jiménez-Pino M, Nájera Y, Suarez-Villa M. Estilos de vida saludable en adolescentes relacionados con alimentación y actividad física: una revisión integrativa. Rev. Salud mov. 2016; 8(1): 25-39.
Hamid R. Can knowledge alone predict vegetable and fruit consumption among adolescents? A transtheoretical model perspective. J Egypt Public Heal Assoc. 2011; 86(5-6):95-103. https://doi.org/10.1097/01.EPX.0000407136.38812.55
Feliu A, París N, Zaragoza-Jordana M, Ferré N, Chiné M, Sabench F, et al. Eficacia clínica y metabólica de una nueva terapia motivacional (OBEMAT) para el tratamiento de la obesidad en la adolescencia. An Pediatr. 2013; 78(3): 157-66. https://doi.org/10.1016/j.anpedi.2012.06.006
Robbins LB, Pfeiffer KA, Maier KS, Lo YJ, Wesolek Ladrin SM. Pilot intervention to increase physical activity among sedentary urban middle school girls: a two-group pretest-posttest quasi-experimental design. J Sch Nurs. 2012; 28(4): 302-15. https://doi.org/10.1177/1059840512438777
Spruijt-Metz D, Nguyen-Michel S, Goran M, Chou C, Huang T. Reducing sedentary behavior in minority girls via a theory-based, tailored classroom media intervention. Int J Pediatr Obes. 2008; 3(4): 240-8. https://doi.org/10.1080/17477160802113415
Guedes N, Moreira R, Cavalcante T, Araujo T, Ximenes L. Students’ physical activity: an analysis according to Pender’s health promotion model. Rev Esc Enferm USP. 2009; 43(4): 774-80. https://doi.org/10.1590/S0080-62342009000400006
Costa-Dias J, Luciana Rodrigues-Silva L, Priscila Ribas de Farias P. Revisión The effectiveness of intervention programs in the prevention and control of obesity in infants: a systematic review. Nutr Hosp. 2015; 31(4):1455-64.
Gao Y, Griffiths S, Chan E. Community-based interventions to reduce overweight and obesity in China: a systematic review of the Chinese and English literature. J Public Heal. 2008; 30(4):436-48. https://doi.org/10.1093/pubmed/fdm057
Aguilar MJ, Ortegón-Piñero N. Mur-Villar JC, Sánchez-García JJ, García-Verazaluce I, García-García I, et al. Programas de actividad física para reducir sobrepeso y obesidad en niños y adolescentes; revisión sistemática. Nutr Hosp. 2014; 30(4):727-40.
Klijn P, Baan-Slootweg O, Stel H. Aerobic exercise in adolescents with obesity: preliminary evaluation of a modular training program and the modified shuttle test. BMC Pediatr. 2007; 7(19). https://doi.org/10.1186/1471-2431-7-19
Wang D, Stewart D, Chang C. A holistic school-based nutrition program fails to improve teachers’ nutrition-related knowledge, attitudes and behaviour in rural China. Heal Educ. 2016; 116(5): 467-75. https://doi.org/10.1007/s12199-015-0456-4
Amini M, Djazayery A, Majdzadeh R, Taghdisi M, Jazayeri S. Effect of school-based interventions to control childhood obesity: a review of reviews. Int J Prev Med. 2015; 3(6). https://doi.org/10.4103/2008-7802.162059
Murray M, Dordevic A, Bonham M. Systematic Review and Meta-Analysis: The Impact of Multicomponent Weight Management Interventions on Self-Esteem in Overweight and Obese Adolescents. J Pediatr Psychol. 2017; 42(4): 379-94. https://doi.org/10.1093/jpepsy/jsw101
Walpole B, Dettmer E, Morrongiello B, McCrindle B, Hamilton J. Motivational interviewing as an intervention to increase adolescent self-efficacy and promote weight loss: methodology and design. BMC Public Health. 2011; 11(459). https://doi.org/10.1186/1471-2458-11-459
Chen X, Wang Y. Is ideal body image related to obesity and lifestyle behaviours in African American adolescents? Child Care Heal Dev. 2012; 38(2): 219-28. https://doi.org/10.1111/j.1365-2214.2011.01227.x
Kanekar A, Sharma M. Meta-analysis of school-based childhood obesity interventions in the U.K. and U.S. Int Q Community Heal Educ. 29(3): 241-56. https://doi.org/10.2190/IQ.29.3.d
Schwartz M, Brownell K. Obesity and body image. Body Image. 2004; 1(1):43-56. https://doi.org/10.1016/S1740-1445(03)00007-X
Lai W. Gender perspectives on adolescent eating behaviors: a study on the eating attitudes and behaviors of junior secondary students in Hong Kong. J Nutr Educ Behav. 2010; 42(4): 250-8. https://doi.org/10.1016/j.jneb.2009.05.008
Dzewaltowski D, Estabrooks P, Welk G, Hill J, Milliken G, Karteroliotis K, et al. Healthy youth places: a randomized controlled trial to determine the effectiveness of facilitating adult and youth leaders to promote physical activity and fruit and vegetable consumption in middle schools. Heal Educ Behav. 2009; 36(3): 583-600. https://doi.org/10.1177/1090198108314619
Trejo P, Jasso S, Mollinedo F, Lugo L. Relación entre actividad física y obesidad en escolares. Rev Cuba Med Gen Integr. 2012; 28(1): 34-41.
Gaete J, Olivares E, Rojas-Barahona C, Labbé N, Rengifo M, Silva M, et al. Factores asociados a conductas promotoras de salud en adolescentes chilenos. Rev Med Chile. 2014; 142(4). https://doi.org/10.4067/S0034-98872014000400002
Cuenca-García M, Ortega F, Huybrechts I, Ruiz J, González-Gross M, Ottevaere C, et al. Cardiorespiratory fitness and dietary intake in European adolescents: the healthy lifestyle in Europe by nutrition in adolescence study. Br J Nutr. 2012; 107(12):1850-9. https://doi.org/10.1017/S0007114511005149
Chen JL, Weiss S, Heyman MB, Cooper B, Lustig RH. The efficacy of the web-based childhood obesity prevention program in Chinese American adolescents (Web ABC study). J Adolesc Heal. 2011; 49(2): 148-54. https://doi.org/10.1016/j.jadohealth.2010.11.243
Chen JL, Weiss S, Heyman MB, Cooper B, Lustig RH. The efficacy of the web-based childhood obesity prevention program in Chinese American adolescents (Web ABC study). J Adolesc Heal. 2011; 49(2):148-54. https://doi.org/10.1016/j.jadohealth.2010.11.243
Jackson N, Waters E. Criteria for systematic review of Health Promotion and public Health interventions. Health Promot Int. 2005; 20: 367-74. https://doi.org/10.1093/heapro/dai022
Publicado
Como Citar
Edição
Seção
Altmetrics
Downloads
Licença
A Revista Cuidarte é um acesso aberto publicação científica, distribuído sob os termos da Creative Commons Atribuição (CC BY-NC 4.0), que permite uso irrestrito, distribuição e reprodução em qualquer meio, desde que o autor ea fonte original eles estão devidamente citada.
Qualquer outro uso, como reprodução, transformação, comunicação pública ou de distribuição, com fins lucrativos, requer a aprovação prévia da Universidade de Santander UDES.
Os nomes e endereços informados na Revista Cuidarte serão usados exclusivamente para os serviços prestados por esta publicação, não estará disponível para qualquer outro propósito ou outra pessoa.
Os artigos publicados na Revista Cuidarte representam os critérios da responsabilidade dos autores e não representam necessariamente a posição oficial da Universidade de Santander UDES.
