ABC | Volume 114, Nº5, May 2020

Short Editorial Marques & Gouveia Physical activity knowledge and levels Arq Bras Cardiol. 2020; 114(5):793-794 required for people tomake health decisions. 13 Therefore, it can be conjectured that knowledge of physical activity guidelines can be a step towards behavioral change, with respect to adopting and/or maintaining an active lifestyle. Studies have supported this assumption, showing that knowledge of health- related physical activity is linked with increased physical activity among children, adolescents, and young adults. 14 The results of the present study, 11 and other previously performed studies, 12,14 highlight the importance of educational programs to increase knowledge about health. Providing the physical activity recommendation message, especially among young people, might increase the physical activity levels. However, research developed in a variety of patients 15 suggests that providing knowledge, materials and professional support is not sufficient for patients to accomplish changes regarding healthy behaviors. Therefore, alternative strategies should be considered. Strategies based on self-monitoring of behaviors, risk communication and the use of social support seem to be the most effective for behavioral changes. Present evidence suggest that physical activity recommendations for children with CHD have been widely implemented and medical doctors’ and health professionals’ advice have been given regarding the potential health benefits of physical activity for people with CHD, including children. Moreover, and perhaps the most important, this also means that the message of the importance of physical activity 3 has been well accepted. This is important because, among children with CHD, physical activity is not related to an increased risk of adverse events, and particular restrictions only apply to situations with specific medical issues. 3 For children and adolescents with CHD, physical activity is even more important due to the decreased levels of physical fitness that often occur because of the time they might have to spend at the hospital. Physical activity, mainly from moderate to vigorous intensity, is independently associated with better quality of life, improved physical fitness, and better body composition in children with CHD. 1-3 1. USDHHS. 2018 Physical activity guidelines advisory committee scientific report. Washington, DC: U.S. Department of Health and Human Services; 2018. 2. Dean PN, Gillespie CW, Greene EA, Pearson GD, Robb AS, Berul CI, et al. Sports participation and quality of life in adolescents and young adults with congenital heart disease. Congenit Heart Dis. 2015;10(2):169-79. 3. TakkenT,GiardiniA,ReybrouckT,GewilligM,Hovels-GurichHH,Longmuir PE, et al. Recommendations for physical activity, recreation sport, and exercise training in paediatric patients with congenital heart disease: a report from the Exercise, Basic & Translational Research Section of the European Association of Cardiovascular Prevention and Rehabilitation, the European CongenitalHeartandLungExerciseGroup,andtheAssociation forEuropean Paediatric Cardiology. Eur J Prev Cardiol. 2012;19(5):1034-65. 4. Adams FH, Moss AJ. Physical activity of children with congenital heart disease. Am J Cardiol. 1969;24(5):605-6. 5. Voss C, Duncombe SL, Dean PH, de Souza AM, Harris KC. Physical activity and sedentary behavior in childrenwith congenital heart disease. J AmHeart Assoc. 2017; 6(3):pii:e004665 6. Cohen M, Mansoor D, Langut H, Lorber A. Quality of life, depressed mood, and self-esteem in adolescents with heart disease. PsychosomMed. 2007;69(4):313-8. 7. Brudy L, Hock J, Hacker AL, Meyer M, Oberhoffer R, Hager A, et al. Children with congenital heart disease are active but need to keepmoving: A cross-sectional study using wrist-worn physical activity trackers. J Pediatr. 2020;217:13-9. 8. McCrindle BW, Williams RV, Mital S, Clark BJ, Russell JL, Klein G, et al. Physical activity levels in children and adolescents are reduced after the Fontan procedure, independent of exercise capacity, and are associated with lower perceived general health. Arch Dis Child. 2007;92(6):509-14. 9. Moola F, Faulkner GE, Kirsh JA, Kilburn J. Physical activity and sport participation in youthwith congenital heart disease: perceptions of children and parents. Adapted physical activity quarterly : APAQ. 2008;25(1):49-70. 10. Moola F, Fusco C, Kirsh JA. The perceptions of caregivers toward physical activity and health in youth with congenital heart disease. Qual Health Res. 2011;21(2):278-91. 11. Campos E, Perin L, Assmann M, Lucchese F, Pellanda L. Knowledge about the disease and the practice of physical activity in children and adolescents with congenital heart disease. Arq Bras Cardiol. 2020; 114(5):786-792. 12. Goossens E, Fieuws S, Van Deyk K, Luyckx K, Gewillig M, Budts W, et al. Effectiveness of structured education on knowledge and health behaviors in patients with congenital heart disease. J Pediatr. 2015;166(6):1370-6 e1. 13. McGuire WJ. Public communication as a strategy for inducing health- promoting behavioral change. Prev Med. 1984;13(3):299-319. 14. Harrison M, Burns C, McGuinness M, Heslin J, Murphy N. Influence of a health education intervention on physical activity and screen time in primary school children: ‘Switch Off--Get Active’. J Sci Med Sport. 2006;9(5):388-94. 15. van Achterberg T, Huisman-de Waal GG, Ketelaar NA, Oostendorp RA, Jacobs JE, Wollersheim HC. How to promote healthy behaviours in patients? An overviewof evidence for behaviour change techniques. Health promotion international. 2011;26(2):148-62. References This is an open-access article distributed under the terms of the Creative Commons Attribution License 794