Examining aspects of the built environment: an evaluation of a community walking map project

Walking trail access, exercise behavior, and going out-of-home among older adults: Examining longitudinal associations and mediators

AIM

Although the presence of a walking trail within a neighborhood would be an important environmental determinant of health behaviors, such as exercise and going out-of-home, their longitudinal associations and mediators are still unconfirmed. This study examined the longitudinal associations of walking trail access with exercise behavior and going out-of-home and mediating roles of awareness and use of walking trails on their associations among older adults.

METHODS

A four-wave questionnaire-based longitudinal survey was conducted among Japanese older adults (Wave 1: baseline; Wave 2: after one year; Wave 3: after three years; and Wave 4: after five years). Each survey measured weekly exercise time and frequency of going out-of-home. Wave 4 survey also measured awareness and use of walking trails. This study calculated distance to nearest walking trail using geographic information systems. This study analyzed the data from all waves (n = 834) for longitudinal associations and the data from Wave 4 (n = 567) for mediated associations.

RESULTS

Latent growth modeling showed insignificant longitudinal associations of walking trail access with weekly exercise time and frequency of going out-of-home. The path analyses showed that a shorter distance to the walking trail was indirectly and significantly associated with longer weekly exercise time (standardized indirect effect=-0.03, p<.001) and a higher weekly frequency of going out-of-home (standardized indirect effect=-0.03, p<.001), mediated by awareness and use of walking trails.

CONCLUSIONS

These findings indicate that the influence of walking trail access on exercise behavior and going out-of-home would be attenuated by awareness and use of walking trails among older adults.

Innovative solutions to enhance safe and green environments for ageing well using co-design through patient and public involvement

BACKGROUND

There is a need to develop innovative solutions to enhance safe and green physical environments, which optimise health, wellbeing and community participation among older adults. To develop solutions that meet the needs of a diverse ageing population, an interdisciplinary approach is needed. Our aim was to identify the needs of older people in relation to ageing well in the environment by bringing together knowledge from different perspectives using Patient and Public Involvement.

METHODS

An international consortium (Retrofit living For ageing well through Understanding and Redesign of Built environments consortium: ReFURB) was established in April 2018, including ten core members, to (i) explore cutting-edge solutions to safe living for ageing populations and (ii) develop innovative approaches to everyday physical environments, which bring about health benefits. We used a co-design, interdisciplinary framework involving older adults, carers, physiotherapists, geriatricians, engineers, human movement experts, geographers and psychologists from the UK and Australia. This engaged people in a 1 day workshop that comprised a series of presentations from international speakers on urban design, social connectedness, hazards and injury prevention, and the physical environment. Small group discussions (facilitated by consortium members) followed presentations to consider the opportunities, challenges and barriers encountered with ageing, which included the use of creative engagement activities (LEGO® Serious Play, mind maps, poster gallery walk), to help participants share personal stories and reflect on the issues raised. Thematic coding was used to synthesise the outputs of the small group work.

RESULTS

Five themes were identified across the workshops: access and transport; involvement of the whole community; restoration rather than redesign; assistive and digital technology; and intergenerational approaches. These dimensions related to the physical, social and nature-based qualities of everyday environments, as they pertain to ageing well.

CONCLUSIONS

Co-design was a valuable tool that helped understand the perceptions of participants and essential to develop effective interventions and solutions. Participants highlighted several issues affecting people as they age and key environmental considerations to promote wellbeing, activity, and participation. The consortium identified gaps in the existing evidence base and are now planning activities to further develop research ideas in collaboration with our co-design participants.

A Community-Wide Walking Promotion Using Maps and Events for Japanese Older Adults

Objective: This study evaluated the effect of a community-wide walking intervention (involving walking maps and events) on older residents’ walking and environmental perceptions. Method: In this nonrandomized quasi-panel study, older adults living in an intervention and control site were recruited at baseline and follow-up. All households in the intervention site received maps and were invited to participate in a walking event monthly. The intervention lasted for 21 months. The outcomes were walking frequency, duration, and perceptions of local environments. Results: We did not find a significant improvement in walking frequency or duration in the intervention site relative to the control site. However, there was a significant increase in the awareness of others being active and a marginal increase in the perception of aesthetics in the intervention site. Discussion: The increased awareness of others being active may be a positive step in the stages of change toward engagement in physical activity.

Environments favorable to healthy lifestyles: A systematic review of initiatives in Canada

BACKGROUND

In recent years, a number of initiatives aimed at promoting healthy lifestyles in health-friendly environments have been implemented. The purpose of this review is to synthesize initiatives conducted in Canada and documented in publications for the period 1995-2015 in order to gain a better understanding of their objectives and impacts.

METHODS

A systematic review of Canadian initiatives published over the past 20 years was conducted from multiple databases (i.e., Scopus, SPORTDiscus, PubMed, Academic search complete, Reseausante.com, Cairn, and Erudit). In total, 264 publications were identified and retained for the final analysis based on 5 criteria: (1) publication between 1995 and 2015, (2) online availability, (3) research conducted in Canada, (4) main topic related to environments favorable to healthy lifestyles (EFHL), and (5) publication in French or English.

RESULTS

A sharp increase in the number of studies on EFHL was observed between 2010 and 2015 (57%). Two major lifestyle components-physical activity and nutrition-and 2 environmental aspects-neighborhood and built environment-were the elements most frequently examined regarding adults (48%), young people (34%), and seniors (9%), using quantitative (60%) and qualitative (18%) methods. Furthermore, the analysis reveals a greater focus on the municipal (53%) than the national or provincial levels (31%).

CONCLUSION

This work is a first map of Canadian studies related to EFHL. It clarifies the definition of EFHL and classifies its components. As well, it documents the issues raised, the research methods employed, and the role of stakeholders, while outlining a new research agenda that includes dimensions of EFHL formerly neglected by researchers, namely, political and sociocultural spheres of action.