Name: Haysla Xavier Martins
Type: MSc dissertation
Publication date: 10/02/2021

Namesort descending Role
Maria del Carmen Bisi Molina Advisor *

Examining board:

Namesort descending Role
Jose Geraldo Mill Internal Examiner *
Márcia Cristina Teixeira Martins External Alternate *
Maria del Carmen Bisi Molina Advisor *
Nagela Valadão Cade Internal Alternate *
Rafael de Oliveira Alvim External Examiner *
Taísa Sabrina Silva Pereira Co advisor *

Summary: This is a master's dissertation addressing the theme of health conditions of Community
Health Agents (CHA) in the city of Vitória/ES. Data from the research entitled “Impact
of the Training of Community Health Agents in Food Education - CACEA” were
analyzed and the dissertation was structured in two manuscripts (both original). The
first aimed to assess the health conditions, care and life habits of CHA active in
Vitória/ES and the second aimed to identify the discriminatory power of adiposity
indicators for diabetes mellitus (DM) in female CHA. A questionnaire was applied to
obtain sociodemographic, lifestyle and health data. Clinical, anthropometric,
biochemical tests (fasting glucose and after 75 g dextrose overload, insulin, total
cholesterol and fractions, and triglycerides) and hemodynamic tests were performed.
Data analysis was performed using the statistical program Statistical Package for the
Social Sciences - SPSS 21.0, adopting a significance level of p ≤ 5%. In the first
manuscript, descriptive and association analyzes were performed. The sample
consisted of 262 CHA (mean age 46.1 ± 9.3 years) mostly female, of mixed race/brown
color, with high school, married marital status and belonging to socioeconomic class
C. The CHA had high percentages of pre-diabetes, DM, arterial hypertension (AH),
obesity, high cholesterol, hypertriglyceridemia, and metabolic syndrome. About 41%
have 3 or more associated morbidities, and of those who had a previous diagnosis of
DM and/or AH, a fifth did not use medication for such conditions. The use of anxiolytics
and/or antidepressants was high and was associated with worse self-perception of
health status. In the second manuscript, association analyzes were performed and
ROC (Receiver Operational Characteristic) curves were constructed to evaluate the
performance models, and the area under the curve (AUC) was used to measure the
discriminatory power of DM. At AUC, the ROC curves between the markers were

compared using a parametric method, using the GraphROC for Windows software.
The sensitivity and specificity values for each adiposity measure were determined by
analysis of ROC curves. The ideal cutoff points for Body Mass Index (BMI), Waist
circumference (WC), Body Adiposity Index (BAI) and Visceral Adiposity Index (VAI)
were established based on the greatest combination of sensitivity and specificity. Using
data from 247 female CHAs, a frequency of DM of 17% (95%CI 12.4-22.1). is
observed. WC (AUC = 0.79) has greater power to discriminate DM compared to BAI
(AUC = 0.66), VAI (AUC = 0.67), and BMI (AUC = 0.74). Considering that the CHA's
adherence to the study corresponds to 70% of these professionals in the city of
Vitória/ES, it is possible to establish that the results found are representative of the set
of professionals.

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