Evaluating the impact of Brazil’s central audit program on municipal provision of health services

We evaluate the success of Brazil’s Corregedoria-Geral da União’s (CGU) anti-corruption program in fostering better outcomes in the health sector using panel data from 5560 Brazilian municipalities over the period from 2000 to 2011. Since 2003, the program has randomly selected municipalities to be investigated each year, and immediately disclosed its findings. We examine two mechanisms through which this program could matter: a deterrent effect whereby municipalities react to the threat of being audited, and an auditing effect, whereby municipalities change behavior only when actually audited. A regression discontinuity approach on four outcomes likely to react quickly to corruption changes finds no improvement due to the deterrent or auditing effect, while difference-in-difference models suggest statistically significant but a small short-run effect of actually being audited on the infant mortality rate. Overall, we do not find any meaningful effect of the anticorruption audit program on the health indicators studied

Physical activity and nutrition program for seniors (PANS): protocol of a randomized controlled trial

Background Along with reduced levels of physical activity, older Australian's mean energy consumption has increased. Now over 60% of older Australians are considered overweight or obese. This study aims to confirm if a low-cost, accessible physical activity and nutrition program can improve levels of physical activity and diet of insufficiently active 60-70 year-olds. Methods/Design This 12-month home-based randomised controlled trial (RCT) will consist of a nutrition and physical activity intervention for insufficiently active people aged 60 to 70 years from low to medium socio-economic areas. Six-hundred participants will be recruited from the Australian Federal Electoral Role and randomly assigned to the intervention (n = 300) and control (n = 300) groups. The study is based on the Social Cognitive Theory and Precede-Proceed Model, incorporating voluntary cooperation and self-efficacy. The intervention includes a specially designed booklet that provides participants with information and encourages dietary and physical activity goal setting. The booklet will be supported by an exercise chart, calendar, bi-monthly newsletters, resistance bands and pedometers, along with phone and email contact. Data will be collected over three time points: pre-intervention, immediately post-intervention and 6-months post-study. Discussion This trial will provide valuable information for community-based strategies to improve older adults' physical activity and dietary intake. The project will provide guidelines for appropriate sample recruitment, and the development, implementation and evaluation of a minimal intervention program, as well as information on minimising barriers to participation in similar programs