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Examining the relationships between walkability and physical activity among older persons: what about stairs?

ABSTRACT: Walkability is considered an important dimension of healthy communities. However, variable associations between measures of walkability and physical activity have been observed, particularly among older persons. Given the challenges older persons may have navigating stairs on walking routes, the presence of stairs may be an explanatory factor for these mixed associations. The purposes of this scoping review were to determine whether studies examining the relationship between walkability and physical activity included items that assessed stairs and what relationships were found.Systematic reviews were identified by entering search terms into five database search engines. Eligibility criteria were: a) published between 2008 and 2017, b) examined the relationship between walkability and physical activity, c) included a focus on persons aged 65 years and older, and d) written in English. The full articles for all primary studies included in eligible systematic reviews were then retrieved. Duplicates were removed. Information about where the study took place, walkability measures used, types of walkability data obtained (objective and/or subjective) and questions asked about stairs were extracted from the full text articles.Eleven systematic reviews were identified; seven were eligible. After removing duplicates, 289 primary studies remained for review. Measures of neighborhood walkability were present in 205 studies; a minority (n?=?5, 2.4%) included items about stairs. No information was obtained on the structural features of the stairs.The presence of stairs may deter older persons (and others) from walking outdoors. Standard measures to document the presence and characteristics of stairs, and sampling approaches to select stairs for assessment are needed. The inclusion of these measures would augment the utility and comparability of studies examining relationships between walkability and physical activity and better inform planning and policy decisions.

SUBMITTER: Edwards N

PROVIDER: S-EPMC6098658 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Examining the relationships between walkability and physical activity among older persons: what about stairs?

Edwards Nancy N Dulai Joshun J

BMC public health 20180817 1

<h4>Background</h4>Walkability is considered an important dimension of healthy communities. However, variable associations between measures of walkability and physical activity have been observed, particularly among older persons. Given the challenges older persons may have navigating stairs on walking routes, the presence of stairs may be an explanatory factor for these mixed associations. The purposes of this scoping review were to determine whether studies examining the relationship between w ...[more]

PMID: 30119657

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Project description:BackgroundEngaging in regular physical activity (PA) as an older adult has been associated with numerous physical and mental health benefits. The aim of this study is to directly compare how individual-level cognitive factors (self-efficacy for PA, self-determined motivation for PA, self-concept for PA) and neighborhood perceptions of the social factors (neighborhood satisfaction, neighborhood social life) impact moderate-to-vigorous physical activity (MVPA) longitudinally among older African American adults.MethodsData were analyzed from a sub-set of older African American adults (N = 224, M age = 63.23 years, SD = 8.74, 63.23% female, M Body Mass Index = 32.01, SD = 7.52) enrolled in the Positive Action for Today's Health trial. MVPA was assessed using 7-day accelerometry-estimates and psychosocial data (self-efficacy for PA, self-determined motivation for PA, self-concept for PA, neighborhood satisfaction, neighborhood social life) were collected at baseline, 12-, 18-, and 24-months.ResultsMultilevel growth modeling was used to examine within- and between-person effects of individual-level cognitive and social environmental factors on MVPA. At the between-person level, self-concept (b = 0.872, SE = 0.239, p < 0.001), and neighborhood social life (b = 0.826, SE = 0.176, p < 0.001) predicted greater MVPA, whereas neighborhood satisfaction predicted lower MVPA (b = -0.422, SE = 0.172, p = 0.015). Among the between-person effects, only average social life was moderated by time (b = 0.361, SE = 0.147, p = 0.014), indicating that the impact of a relatively positive social life on MVPA increased across time. At the within-person level, positive increases in self-concept (b = 0.294, SE = 0.145, p = 0.043) and neighborhood social life (b = 0.270, SE = 0.113, p = 0.017) were associated with increased MVPA.ConclusionsThese results suggest that people with a higher average self-concept for PA and a more positive social life engaged in greater average MVPA. Additionally, changes in perceptions of one's neighborhood social life and one's self-concept for PA were associated with greater MVPA over 2 years. These factors may be particularly relevant for future interventions targeting long-term change and maintenance of MVPA in older African Americans.Trial registrationClinicalTrials.Gov # NCT01025726 registered 1 December 2009.

Project description:The study aimed to investigate if psychosocial factors moderate the association between objective walkability and different domains of children's physical activity (PA). A second aim of the study was to investigate the direct associations between psychosocial factors and children's PA. Based on previous literature, it was hypothesized that walkability would be more strongly related to PA among children with negative psychosocial profiles.Data were collected between December 2011 and May 2013 as part of the Belgian Environmental Physical Activity Study in children (BEPAS-child). In total, data from 494 children and one of their parents were included in the study. Children wore an accelerometer for 7 consecutive days and together with one of their parents, they completed the Flemish Physical Activity Questionnaire. Parents filled out a questionnaire concerning their child's psychosocial factors toward PA (i.e. parental attitude toward their child's PA, parental social norm toward their child's PA, parental support, friend support, children's self-efficacy, and perceived benefits and barriers toward sports and PA). Neighborhood walkability was calculated using geographical information systems (GIS). Multilevel cross-classified analyses were conducted.Of the 42 investigated interactions between neighborhood walkability and psychosocial factors in relation to PA among children, only 7 significant interactions were found of which 3 were only significant among children from low-income neighborhoods. Parental support and self-efficacy were positive correlates of children's PA in high- and low-income neighborhoods independent of the level of walkability, but effect sizes were small.The hypothesis that walkability would be more strongly related to PA among children with negative psychosocial profiles could not be confirmed and in general, psychosocial factors and objective walkability did not interact in relation to children's PA. Focusing on parental support and self-efficacy towards PA can possibly cause small effects on children's PA in both high- and low-walkable neighborhoods, as well as in high- and low-income neighborhoods.

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Examining the relationships between walkability and physical activity among older persons: what about stairs?

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Examining the relationships between walkability and physical activity among older persons: what about stairs?

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