Dataset Information

Older Adults' Outdoor Walking: Inequalities in Neighbourhood Safety, Pedestrian Infrastructure and Aesthetics.

ABSTRACT: Older adults living in high-deprivation areas walk less than those living in low-deprivation areas. Previous research has shown that older adults' outdoor walking levels are related to the neighbourhood built environment. This study examines inequalities in perceived built environment attributes (i.e., safety, pedestrian infrastructure and aesthetics) and their possible influences on disparities in older adults' outdoor walking levels in low- and high-deprivation areas of Birmingham, United Kingdom. It applied a mixed-method approach, included 173 participants (65 years and over), used GPS technology to measure outdoor walking levels, used questionnaires (for all participants) and conducted walking interviews (with a sub-sample) to collect data on perceived neighbourhood built environment attributes. The results show inequalities in perceived neighbourhood safety, pedestrian infrastructure and aesthetics in high- versus low-deprivation areas and demonstrate that they may influence disparities in participants' outdoor walking levels. Improvements of perceived neighbourhood safety, pedestrian infrastructure and aesthetic in high-deprivation areas are encouraged.

SUBMITTER: Zandieh R

PROVIDER: S-EPMC5201320 | biostudies-literature | 2016 Nov

REPOSITORIES: biostudies-literature

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Older Adults' Outdoor Walking: Inequalities in Neighbourhood Safety, Pedestrian Infrastructure and Aesthetics.

Zandieh Razieh R Martinez Javier J Flacke Johannes J Jones Phil P van Maarseveen Martin M

International journal of environmental research and public health 20161125 12

Older adults living in high-deprivation areas walk less than those living in low-deprivation areas. Previous research has shown that older adults' outdoor walking levels are related to the neighbourhood built environment. This study examines inequalities in perceived built environment attributes (i.e., safety, pedestrian infrastructure and aesthetics) and their possible influences on disparities in older adults' outdoor walking levels in low- and high-deprivation areas of Birmingham, United King ...[more]

PMID: 27898023

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Project description:Background:Limited outdoor walking is a marker of frailty and a risk factor for decline in mobility and self-care functioning, social isolation, and reduced health-related quality of life (HRQL). Objectives were to evaluate the safety, feasibility, and preliminary effect of a supervised outdoor walking group and interactive workshop compared to the workshop alone in increasing outdoor walking activity and identify an optimal method for estimating outdoor walking activity among older adults who infrequently walk outdoors. Methods:A pilot 2-parallel-group randomized controlled trial was conducted. Adults aged ??65?years who reported walking ??20?min/week outdoors were randomized in a 2:1 ratio to receive the GO-OUT program (1-day workshop and 9-week outdoor walking group), or the workshop alone. An external site conducted the randomization after workshop completion. The eight workshop activity stations aimed to build knowledge and skills to safely walk outdoors. The group-based outdoor walking program consisted of repetitive practice of mobility tasks at local parks. The primary outcome of outdoor walking activity used an activity monitor and GPS; secondary outcomes included aerobic, balance, and walking capacity; physical activity; participation; mood; and HRQL. Blinded outcome assessors evaluated participants at 0, 3, and 6?months. Qualitative interviews occurred after 3?months; data were analyzed with qualitative description. Quantitative data were summarized using descriptive statistics. Results:Forty-eight individuals were screened; 9 were eligible and randomized to the GO-OUT (n =?6) or workshop (n =?3) group. Data from 9 participants were analyzed. Mean age was 77 and 74?years in the GO-OUT and workshop groups, respectively. No falls occurred during the workshop and outdoor walking program. Average attendance of the walking group was 61%. All participants attended the evaluations and workshop. An analysis method combining data from activity monitors and GPS was developed to estimate outdoor walking. Themes from the qualitative analysis included the barriers to outdoor walking, impact of the workshop and GO-OUT walking group, and feasibility and acceptance of the assessment and intervention strategies. Conclusions:The trial protocol was deemed safe and feasible. Results were used to inform changes to the protocol to conduct a full-scale study. Trial registration:Clinical Trials.gov: NCT02339467.

Project description:Background:Outdoor walking groups are widely-used programmes aimed at improving physical activity and health outcomes. Despite being promoted as accessible and inclusive, emerging work highlights participation biases based on gender, age and socioeconomic status, for example. To explicate the impact of outdoor walking groups on physical activity inequities, we conducted a scoping review of published outdoor walking group literatures. Specifically, we critically examined: (a) equity integration strategies; (b) intervention reach; (c) effectiveness; and (d) potential social determinants of engagement relating to the World Health Organization's conceptual framework. Methods:Arksey and O'Malley's scoping review protocol was used to develop a comprehensive search strategy and identify relevant academic and grey literatures, which were screened using pre-defined inclusion and exclusion criteria. Data were organised by Cochrane PROGRESS-Plus equity characteristics and a narrative summary was presented for each thematic area. Findings:Sixty-two publications were included. Key findings were: (a) some evidence of targeted intervention trials. Large-scale national programmes were tailored to regional activity and health needs, which may contribute toward addressing inequities. However, participant demographics seldom informed reported analyses; (b) participation was more likely among white, more socioeconomically advantaged, middle-to-older aged, female and able-bodied adults; (c) positive physical and psychological outcomes were unlikely to extend along social gradients; and (d) interventions primarily addressed intermediary determinants (e.g. psychosocial barriers; material resource). Social capital (e.g. friend-making) was identified as potentially important for addressing physical activity inequalities. Conclusions:The published literature on outdoor walking groups leaves unanswered questions regarding participation inequalities, with implications for future physical activity promotion. Currently, participation in outdoor walking groups is typically more prevalent among advantaged subpopulations. We make recommendations for research and practice to address these issues, as well as aid the translation of existing knowledge into practice. We advocate increased focus on the social determinants of engagement. A more consistent approach to collecting and analysing participant socio-demographic data is required. Our findings also support recommendations that appropriate tailoring of universal programmes to community needs and embedding strategies to increase social cohesion are important in developing equitable programmes.

Project description:IntroductionA theory-based, task-oriented, community walking programme can increase outdoor walking activity among older adults to optimise functional independence, social participation and well-being. The study objective is to determine if there is a difference in the change in outdoor walking activity from baseline to 10 weeks, 5.5 months and 12 months after receiving a 1-day interactive workshop and outdoor walking programme (Getting Older Adults Outdoors (GO-OUT)) compared with the workshop and weekly reminders (WR) in older adults with difficulty walking outdoors.Methods and analysisA randomised controlled trial is being conducted in four urban Canadian communities. We will stratify 240 individuals by site and participant type (ie, individual vs spousal/friend pair) and randomise to either the GO-OUT or WR intervention. The GO-OUT intervention involves a 1-day workshop, where participants complete eight interactive stations to build knowledge and skills to walk outside, followed by a 10-week group outdoor walking programme (two 1-hour sessions/week) led by a physiotherapist or kinesiologist in parks. The WR intervention consists of the same workshop and 10 weekly telephone reminders to facilitate outdoor walking. The primary outcome measure is mean outdoor walking time in minutes/week derived from accelerometry and global positioning system data. GO-OUT is powered to detect an effect size of 0.4, given α=0.05, β=0.20, equal number of participants/group and a 20% attrition rate. Secondary outcomes include physical activity, lifespace mobility, participation, health-related quality of life, balance, leg strength, walking self-efficacy, walking speed, walking distance/endurance and mood.Ethics and disseminationGO-OUT has received ethics approval at all sites. A Data Safety Monitoring Board will monitor adverse events. We will disseminate findings through lay summaries, conference presentations and journal articles.Trial registration numberNCT03292510 (Pre-results).

Dataset Information

Older Adults' Outdoor Walking: Inequalities in Neighbourhood Safety, Pedestrian Infrastructure and Aesthetics.

Publications

Older Adults' Outdoor Walking: Inequalities in Neighbourhood Safety, Pedestrian Infrastructure and Aesthetics.

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