Associations Between Social and Physical Environments and Older Adults' Walking for Transportation and Recreation

Understanding the barriers and facilitators of urban greenway use among older and disadvantaged adults: A mixed-methods study in Québec city

Urban greenways are multipurpose and multi-user trails that provide a range of socio-ecological and health benefits, including active transportation, social interactions, and increased well-being. However, despite their numerous benefits, barriers exist that limit urban greenway access and use, particularly among older and disadvantaged adults. This study addresses a significant research gap by examining the nuanced factors that influence the choices and experiences of these specific user groups in Québec City, Canada. We use a mixed-methods' approach to explore the facilitators of and barriers to access and use of two urban greenway trails among older and disadvantaged adults. Our methods included a greenway user count, 96 observation time slots, and 15 semi-structured user interviews. The results revealed significant use of greenway trails by older adults for afternoon walks in both seasons studied (autumn and winter). We also observed variations in use patterns, such as higher levels of solitary walking, reduced levels of winter cycling, and the impracticality of the secondary greenway trail owing to snow conditions. In addition, the findings revealed a wide range of factors that influence greenway access and use, categorized as individual or personal, physical or built environment, social environment, and meteorological or climatic dimensions. Future research can build on these insights to design and assess interventions that capitalize on the facilitators and address any barriers, enhancing the value of urban greenways for older and disadvantaged adults.

A Scoping Review of Personal, Financial, and Environmental Determinants of Mobility Among Older Adults

OBJECTIVE

To synthesize available evidence of factors comprising the personal, financial, and environmental mobility determinants and their association with older adults' self-reported and performance-based mobility outcomes.

DATA SOURCES

PubMed, EMBASE, PsychINFO, Web of Science, AgeLine, Sociological Abstract, Allied and Complementary Medicine Database, and Cumulative Index to Nursing and Allied Health Literature databases search for articles published from January 2000 to December 2021.

STUDY SECTION

Using predefined inclusion and exclusion criteria, multiple reviewers independently screened 27,293 retrieved citations from databases, of which 422 articles underwent full-text screening, and 300 articles were extracted.

DATA EXTRACTION

The 300 articles' information, including study design, sample characteristics including sample size, mean age and sex, factors within each determinant, and their associations with mobility outcomes, were extracted.

DATA SYNTHESIS

Because of the heterogeneity of the reported associations, we followed Barnett et al's study protocol and reported associations between factors and mobility outcomes by analyses rather than by article to account for multiple associations generated in 1 article. Qualitative data were synthesized using content analysis. A total of 300 articles were included with 269 quantitative, 22 qualitative, and 9 mixed-method articles representing personal (n=80), and financial (n=1), environmental (n=98), more than 1 factor (n=121). The 278 quantitative and mixed-method articles reported 1270 analyses; 596 (46.9%) were positively and 220 (17.3%) were negatively associated with mobility outcomes among older adults. Personal (65.2%), financial (64.6%), and environmental factors (62.9%) were associated with mobility outcomes, mainly in the expected direction with few exceptions in environmental factors.

CONCLUSIONS

Gaps exist in understanding the effect of some environmental factors (eg, number and type of street connections) and the role of gender on older adults' walking outcomes. We have provided a comprehensive list of factors with each determinant, allowing the creation of core outcome set for a specific context, population, or other forms of mobility, for example, driving.

Individual characteristics, perceived neighborhood, and walking for transportation among older Brazilian people residing in a large urban area

This study aimed to investigate the association of individual and environmental characteristics with walking for transportation among older Brazilian people living in a large urban area. Data from 825 participants (≥ 60 years) from a multistage household survey in Belo Horizonte, Brazil, were used. Walking for transportation was evaluated using the International Physical Activity Questionnaire. The environmental variables included six perceived neighborhood scales (walkability, quality of services, physical disorder, safety, social disorder, and social cohesion). A Poisson regression analysis with robust variance was performed. The walking for transportation was significantly associated with walkability scale, lower family income (up to four minimum wages), very good/good self-rated health, and high social participation. Our results suggest that promoting adequate conditions for walkability in urban areas, expanding the opportunities for social participation, and improving general health is essential to increase walking levels for transportation among this older Brazilian population.

Physically Constructed and Socially Shaped: Sociomaterial Environment and Walking for Transportation in Later Life

The predictive power of three intersecting environmental dimensions (built structures, social infrastructure, and social capital) on late-life walking was investigated, conceptually based on the ecological framework of place, which posits that a living environment is simultaneously a physical place, a social place, and a set of social bonds. Multilevel models were used to examine the extent to which environments, defined as interactions of the social and material environmental dimensions, reliably predicted walking for transportation among U.S. adults aged 60 years or older in the 2015 National Health Interview Survey (n = 11,180). Random intercepts representing 221 environments showed an intraclass correlation of 21%, indicating high levels of between-environment variance in walking. Social infrastructure had the highest predictive power for walking, followed by material structures and social capital. Synergistic interventions that incorporate the intersecting nature of the sociomaterial environment may be most effective in promoting physical activity in later life.

Association between socio-ecological factors and leisure time physical activity (LTPA) among older adults in Sichuan, China: a structural equation modeling analysis

Background

Few studies examined socio-ecological factors and leisure time physical activities (LTPA) and rarely focused on self-regulation and social capital, which might play a significant role in impacting people’s physical activity behavior. This study aimed to examine the direct and indirect effects of individual level (perceived benefits, perceived barriers, and self-efficacy), interpersonal level (self-regulation), social level (social capital), and environmental level factors (perceived physical environment) on LTPA among older adults.

Methods

A cross-sectional study was conducted in 737 older adults from Sichuan, China. Structural equation modeling (SEM) analysis was used to examine the associations of individual, interpersonal, social, and environmental level factors with LTPA.

Results

The mean age of all participants was 71.22 (range, 60–97), and 56.1% of them were women. The SEM results showed that individual level variables (β = 0.32, ρ < 0.001), self-regulation (β = 0.18, ρ < 0.001) and social capital (β = 0.14, ρ < 0.001) could all directly affect LTPA while there was no significant association of perceived physical environment with LTPA. Self-regulation served as a bridge linking social capital and LTPA. Individual level variables contributed the largest total effect (0.32) on LTPA. Self-regulation and social capital had the same total effect (0.18) on LTPA.

Conclusions

Factors on three levels were all significantly associated with LTPA. Interventions that incorporate individual, interpersonal, social factors may be considered to promote LTPA in older adults. Self-regulation should receive more attention in future interventions.

Older Adults' Perceptions toward Walking: A Qualitative Study Using a Social-Ecological Model

Objectives: In this study, we aimed to investigate older adults’ perceptions of their walking experiences, using the social-ecological model as a guiding framework and to propose future walking intervention content. Methods: Thirty-eight participants (19 women; 47% from private elderly centers; mean age = 72.8 (SD = 7.4 years) took part in semi-structured interviews. Qualitative data analysis software QSR-NVivo was used for thematic coding. Results: Thematic deductive analysis revealed pertinent themes at the individual level (health benefits and barriers, fall risk, perseverance, and walking as a suitable activity for older adults), social environment level (social support and social interaction), physical environment level (density, land-use mix, and connectivity; perceived safety, pedestrian facilities (benches, quality of walking paths and sidewalks, and aesthetics), other pedestrian behaviors, and weather, and policy level (lack of walking programs in the community, and supportive culture for an active lifestyle). Discussion: Our findings provide insights for the planning of future multilevel walking intervention programs for older adults in Hong Kong. It is suggested that future walking intervention should include professionals (e.g., physiotherapist or coach) in a group setting, practical walking recommendations such as proper walking posture, and additional fun activities for older adults.

Perceived Neighborhood Environment Associated With Older Adults' Walking and Positive Affect: Results From the Health and Retirement Study

The current study examined how a perceived neighborhood environment was associated with older adults' walking activity and the experience of positive affect. Study sample comprised 10,700 older adults, aged 65+, sampled from the Health and Retirement Study 2014-2015 in the United States. Results indicated that neighborhood social cohesion was significantly predicting older adults' walking and positive affect. It was also revealed that walking engagement significantly contributed to the measure of positive affect. However, perceived neighborhood physical disorder did not account for additional variance in walking and positive affect. Final structural model involved three latent factors-neighborhood social cohesion, walking, and positive affect-and the goodness-of-fit indices of the model indicated an acceptable fit to the sample data. Public health and physical activity intervention in the context of neighborhood environment should facilitate social integration and informal social support that the neighborhood creates.

Perceived Neighborhood and Walking Among Older Brazilian Adults Living in Urban Areas: A National Study (ELSI-Brazil)

The study goal was to examine the association between perceived neighborhood characteristics and walking in urban older adults in Brazil. A cross-sectional study including 4,027 older adults from the baseline of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) was performed. Walking was measured using the International Physical Activity Questionnaire. Neighborhood characteristics were questions about physical disorder, noise pollution, safety, violence, social cohesion, services, concerns with community mobility, and pleasantness. Multinomial logistic regression was used. Concern about taking the bus, subway, or train was inversely associated with walking for men. Violence (victim of theft, robbery, or had home broken into) and social cohesion (trust in neighbors) were positively and inversely associated with walking for women, respectively. A significant interaction term between social cohesion and number of chronic diseases was observed for women. These findings demonstrate the need for sex-specific interventions and policies to increase the walking levels among older Brazilian adults.