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Eisenberg Y, Hofstra A, Twardzik E. Quantifying active travel among people with disabilities in the US. Disabil Health J 2024; 17:101615. [PMID: 38565481 PMCID: PMC11194152 DOI: 10.1016/j.dhjo.2024.101615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 03/08/2024] [Accepted: 03/08/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND People with disabilities have higher rates of physical inactivity than people without. Active travel (e.g., walking/wheeling to nearby destinations or transit) is a recommended approach to increasing total physical activity (PA) but limited research has examined active travel among people with disabilities. OBJECTIVE To describe active travel among a nationally representative sample of people with disabilities, analyze variation between sub-groups, and examine factors associated with active travel. METHODS Using the 2017 National Household Travel Survey, our cross-sectional analysis summarized counts and duration of walking/wheeling trips for people with four different types of disabilities. We examined which factors were associated with doing any active travel and the duration of active travel, using zero inflated negative binomial regression models. RESULTS Our analysis identified that 14.55% of people with disabilities took a mean of 2.56 (95%CI = 2.42-2.69) walking/wheeling trips per day. Compared to non-active travelers, a higher proportion of active travelers were low-income, lived alone, had no-vehicle, and were Black or Hispanic. For active travelers, daily walking minutes, on average, were 46.41 (95%CI = 40.25-52.57) among people who used ambulatory devices, 41.55 (95%CI = 24.61-58.49) among people who were blind/low-vision, 39.93 (95%CI = 35.41-44.45) among people who used no device, and 29.58 (95%CI = 23.53-35.64) among people who used chair devices. Our analysis identified individual, household, and community factors associated with the likelihood and duration of walking/wheeling for travel and variation across disability types. CONCLUSIONS Understanding the multiple identities of active travelers with disabilities can inform walking/wheeling intervention strategies. Infrastructure improvements that support less reliance on automobiles could increase active travel among people with disabilities.
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Affiliation(s)
- Yochai Eisenberg
- Department of Disability and Human Development, University of Illinois- Chicago, Chicago, IL, 1640 Roosevelt Road, Chicago, 60608, United States.
| | - Amy Hofstra
- Department of Disability and Human Development, University of Illinois- Chicago, Chicago, IL, 1640 Roosevelt Road, Chicago, 60608, United States; College of Urban Planning and Public Affairs, University of Illinois-Chicago, Chicago, IL, 412 S. Peoria St., Chicago, 60607, United States.
| | - Erica Twardzik
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, United States.
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Gripko M, Joseph A. The Role of the Built Environment in Supporting Older Adults' Engagement: A Narrative Literature Review. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024; 17:329-353. [PMID: 38738947 DOI: 10.1177/19375867241250320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
OBJECTIVE This literature review aimed to summarize the existing knowledge surrounding the role of the built environment in supporting older adults' physical and social engagement and identify opportunities for future research and design that facilitates older adults' engagement at multiple environmental scales: from interior spaces to neighborhoods. BACKGROUND Physical environments can support or impede older adults' physical and social engagement: willful, motivated involvement in meaningful activity or occupation. Research shows that engagement is a core component of health and well-being and relates to positive health outcomes, including reduced disease risk, better mental health, and improved physical and cognitive function. Thus, designing supportive built environments for engagement can yield significant, positive health and well-being impacts. METHODS A systematized search of five databases, a hand search, and an iterative screening process identified 55 studies for inclusion in this review. Through inductive thematic analysis, this review summarizes findings regarding the built environment's role in physical and social engagement in older age and design strategies to facilitate engagement and support health and well-being. RESULTS Evidence indicates that built environment characteristics can influence older people's physical and social engagement in homes, neighborhoods, and care settings. The thematic analysis of the included studies identified three key themes concerning the relationships of built environment characteristics to older adults' engagement across multiple environmental scales: connection, access, and security. CONCLUSIONS Built environments influence older people's physical and social engagement, significantly affecting their health, well-being, abilities, and longevity. Numerous design strategies can support older adults' engagement, but more research is needed.
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Affiliation(s)
- Monica Gripko
- Center for Health Facilities Design and Testing, Clemson University, Clemson, SC, USA
| | - Anjali Joseph
- Center for Health Facilities Design and Testing, Clemson University, Clemson, SC, USA
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Choi J, Park J. Developing Problematic Performance Value Scores: Binding Routine Activity Performance, Environmental Barriers, and Health Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:764. [PMID: 38929010 PMCID: PMC11203909 DOI: 10.3390/ijerph21060764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Community design features, such as sidewalks and street crossings, present significant challenges for individuals with disabilities, hindering their physical performance and social integration. However, limited research has been conducted on the application of Universal Design (UD) to address these challenges, particularly concerning specific demographic groups and population cohorts. Understanding the influence of environmental features on physical performance is crucial for developing inclusive solutions like UD, which can enhance usability and social integration across diverse populations. OBJECTIVE This study aims to bridge this gap by investigating the complex relationships between environmental barriers, health conditions, and routine activity performance. An index was developed to evaluate users' UD performance based on functional capacity, providing scientifically rigorous and objectively measured evidence of UD effectiveness in creating inclusive built environments. METHOD Using data from the Problematic Activities Survey (PAS) conducted in the U.S., Canada, and Australia and targeting individuals with and without functional limitations, multinomial logit models were employed to estimate the probabilities of encountering performance problems. This analysis led to the development of the Problematic Performance Value (PPV) score. RESULTS The results demonstrated significant disparities in PPVs across various health conditions, particularly concerning curb ramps. Individuals facing mobility issues in their legs/feet, arms/hands, or back/neck encounter more pronounced challenges, especially when curb ramps lack proper design elements. Similarly, individuals with vision impairments face heightened difficulties with traffic signals, particularly due to issues with audible signal systems. These findings underscore the importance of addressing micro-level environmental challenges to accommodate individuals with varying functional capacities effectively. CONCLUSIONS By providing insights into the most problematic daily activities encountered by diverse populations, the PPV score serves as a valuable indicator for guiding environmental design improvements and promoting equitable space usage. This can be used to guide improved UD solutions and decide areas of concentration by providing generalized information on specific environmental features that contribute to user performance.
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Affiliation(s)
- Jimin Choi
- Center for Inclusive Design & Environmental Access, School of Architecture & Planning, University at Buffalo, SUNY, Buffalo, NY 14214, USA;
| | - JiYoung Park
- Department of Urban and Regional Planning, University at Buffalo, SUNY, Buffalo, NY 14214, USA
- MUREPA Korea, Seoul 13640, Republic of Korea
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Mou Y, Qin Y, Niu S. "I Go Outdoors for Activities Every Day": Go-Along With Seniors With Slow Walking Speeds to Explore Environmental Factors Influencing Mobility. Int J Public Health 2024; 69:1607033. [PMID: 38895106 PMCID: PMC11182988 DOI: 10.3389/ijph.2024.1607033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Objectives This study aims to: 1) Explore the mobility experiences of seniors with slow walking speeds (SSWS) in urban neighborhoods; and 2) Investigate their environmental barriers and supports. Methods Go-along interviews were conducted with 36 SSWS residing in urban neighborhoods of Chongqing City, China. The mobility patterns and built environment factors influencing their mobility were revealed through cartographic analysis and thematic analysis. Results SSWS primarily focused their activities within a 400-meter radius of their homes. Built environment themes included topography, neighborhood services, sidewalks, seating, traffic safety, weather, greenery, and lighting. Significant mobility barriers included long stairs, steep slopes, fast-moving objects on sidewalks, road crossings, and fast traffic. Available handrails, nearby food-service places, ample seating, and greenery were identified as supportive factors for their mobility. Conclusion This study stands out as the first to specifically examine the mobility of SSWS within the built environment. We suggest that SSWS should be taken into account when establishing a benchmark for general design frameworks. These improvements not only contribute to the mobility of slow walkers but also have positive impacts on the broader population.
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Affiliation(s)
- Yanchuan Mou
- School of Architecture and Urban Planning, Chongqing University, Chongqing, China
- Key Laboratory of Monitoring, Evaluation and Early Warning of Territorial Spatial Planning Implementation, Ministry of Natural Resources, Chongqing, China
| | - Yu Qin
- School of Architecture and Urban Planning, Chongqing University, Chongqing, China
| | - Shaofei Niu
- College of Architecture and Environment, Sichuan University, Chengdu, Sichuan, China
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Walia AS, King AC, Campero MI, Garcia DM, Lee RE, Zamora AN. Exploring the Relationship between Built Environment Attributes and Physical Activity in Lower-Income Aging Adults: Preliminary Insights from a Multi-Level Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:607. [PMID: 38791821 PMCID: PMC11121044 DOI: 10.3390/ijerph21050607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024]
Abstract
The built environment has been linked to physical activity (PA) behaviors, yet there is limited knowledge of this association among lower-income midlife and older adults who are insufficiently active. The present cross-sectional study utilized baseline data collected between October 2017 and November 2019 from a clustered randomized controlled trial to determine how built environment attributes were associated with PA behaviors among midlife and older adults (n = 255) residing in or near affordable housing sites (n = 10). At each site, perceptions of the built environment were collected and scored at the participant level via the abbreviated Neighborhood Environment Walkability Survey (NEWS-A), while objective built environment attributes were measured and scored by trained research staff using the Physical Activity Resource Assessment (PARA). Multiple PA behaviors-walking, total PA, and moderate-to-vigorous PA (MVPA) (min/wk)-were measured using the validated Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire. Adjusted linear regression models examined associations between NEWS-A measures and PA behaviors, and site-level correlations between PARA measures and PA behaviors were examined using Spearman's rank correlations. At the participant level, adjusted models revealed that a one point increase in the NEWS-A aesthetics score was associated with a 57.37 min/wk increase in walking (β = 57.37 [95% CI: 20.84, 93.91], p = 0.002), with a similar association observed for street connectivity and MVPA (β = 24.31 min/wk [95% CI: 3.22, 45.41], p = 0.02). At the site level, MVPA was positively correlated with the quality of the features of local, PA-supportive environmental resources (ρ = 0.82, p = 0.004). Findings indicate that participant- and site-level measures of the built environment may play a role in promoting PA behavior among this demographic and similar populations. Results also suggest that improvements in aesthetic attributes and street connectivity, along with enhancing the quality of local, PA-supportive environmental resources, may be effective strategies for promoting physical activity among lower-income midlife and older adults.
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Affiliation(s)
- Arjan S. Walia
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA 94304, USA; (A.S.W.)
| | - Abby C. King
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA 94304, USA; (A.S.W.)
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA 94304, USA; (M.I.C.)
| | - Maria I. Campero
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA 94304, USA; (M.I.C.)
| | - Dulce M. Garcia
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA 94304, USA; (M.I.C.)
| | - Rebecca E. Lee
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Tempe, AZ 85004, USA
| | - Astrid N. Zamora
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA 94304, USA; (A.S.W.)
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Orellano-Colón EM, Rivero-Méndez M, Ralat-Fonseca BN, Varas-Díaz N, Lizama-Troncoso M, Jiménez-Velázquez IZ, Jutai JW. Multilevel barriers to using assistive technology devices among older hispanics from poor and disadvantaged communities: the relevance of a gender analysis. Disabil Rehabil Assist Technol 2024; 19:682-698. [PMID: 36170426 PMCID: PMC10043044 DOI: 10.1080/17483107.2022.2117427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 06/28/2022] [Accepted: 08/19/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE To get a rich description of the barriers to using assistive technology (AT) among men and women ≥65 years living in poor and disadvantaged communities in Puerto Rico, an issue not well described among older people. METHODS We conducted qualitative interviews assisted by videos of AT and guided by the Matching Person and Technology Model and the Gender Analysis Framework with a purposive sample of 23 men and women. Participants were asked questions regarding reasons for not using AT, willingness for using AT, their identified gender roles and gender-related activities, and bargaining positions. They were also asked about their access to resources to acquire AT, bargaining positions, the stigma associated with AT use, and the characteristics of AT. Directed content analysis with input from a Community Advisory Board was used for the interpretation of the results. RESULTS The predominant barrier (for both men and women) to using AT devices were: lack of information about AT s and access to money for their purchase, lack of availability and cost of such devices, and (self)-stigma. More women than men experienced limited access to AT services, limited access to and control of money, limited skills for using AT, and less bargaining power for making independent decisions. More men than women expressed a lack of functional need and personal preferences other than using AT devices for managing difficulties in activities. CONCLUSION There are gender differences concerning the multilevel barriers to using AT devices among older Hispanics residing in low-income communities.IMPLICATIONS FOR REHABILITATIONOlder Hispanic men and women in this study experienced different obstacles to using assistive technology (AT) they need for compensating their functional disabilities in daily living activities.Women in this study reported having less access to money and AT services, diminished skills for using AT devices, and less power to make independent decisions to access AT devices compared to men.To ensure the equitable provision of AT, cultural as well as gender-related factors concerning AT use need to be considered.Future research should focus on women's functional health, also should focus on the development of gender-sensitive and culturally competent AT interventions to improve older Hispanics from poor communities function and opportunities for ageing at their homes and in their communities.
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Affiliation(s)
- Elsa M Orellano-Colón
- Occupational Therapy Program, School of Health Professions, University of Puerto Rico, San Juan, PR, USA
| | | | | | - Nelson Varas-Díaz
- Global and Sociocultural Studies, Florida International University, Miami, FL, USA
| | | | | | - Jeffrey W Jutai
- Interdisciplinary School of Science, University of Ottawa, Ontario, Canada
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Firkin CJ, Rechner L, Obrusnikova I. Paving the Way to Active Living for People with Disabilities:: Evaluating Park and Playground Accessibility and Usability in Delaware. Dela J Public Health 2024; 10:74-83. [PMID: 38572138 PMCID: PMC10987020 DOI: 10.32481/djph.2024.03.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Objectives To evaluate the accessibility and usability of parks and playgrounds in New Castle County, Delaware, for people with disabilities, with a particular focus on identifying environmental barriers that may impede access to these public spaces and potentially affect physical activity (PA) participation for the chronic disease prevention and mitigation. Methods Using a cross-sectional observational design, teams of trained University of Delaware students utilized the Community Health Inclusion Index (CHII) Tool to assess the accessibility of ten suburban and urban parks and playgrounds from April to November 2023. The tool evaluated various elements of public spaces, including public transit, parking, pathways and multi-use trails, entrances, playground equipment, and health promotional materials. Descriptive statistics were calculated for the accessibility and usability of each element. Results Significant barriers to accessibility and usability were identified. Over half of the sites lacked nearby public transit stops, and many trails and playgrounds were not fully accessible to people with disabilities. While some areas demonstrated good accessibility, such as well-maintained pathways and appropriately designed crosswalks, barriers like uneven surfaces, insufficient curb cuts, and inadequate van-accessible parking spaces were common. Most playgrounds lacked equitable play equipment, with less than half having ground materials suitable for mobility devices. Conclusions The study underscores the need for substantial improvements in the design, construction, and maintenance of Delaware parks and playgrounds to better support people with disabilities. Enhancing accessibility is crucial for promoting PA participation. The findings support the development of inclusive recreational and PA environments, aligning with the Americans with Disabilities Act, to reduce chronic disease health disparities faced by people with disabilities. Policy Implications This study highlights the need for revised policy measures to enhance park accessibility, advocating for infrastructure improvements and inclusive designs to ensure equitable recreation and physical activity opportunities for people with disabilities.
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Affiliation(s)
- Cora J Firkin
- Department of Health Behavior and Nutrition Sciences, University of Delaware
| | | | - Iva Obrusnikova
- Department of Health Behavior and Nutrition Sciences, University of Delaware
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8
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Clina JG, Sayer RD, Gorczyca AM, Das SK, Friedman JE, Chui TK, Roberts SB, Hill JO. Weight history of individuals with and without physical disability in the International Weight Control Registry. Obes Sci Pract 2024; 10:e733. [PMID: 38187122 PMCID: PMC10766035 DOI: 10.1002/osp4.733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 01/09/2024] Open
Abstract
Background People with physical disabilities (PWD) have an increased risk of obesity and related comorbidities compared with people without physical disabilities (PWoD). Previously identified contributors to weight loss maintenance pose challenges to PWD. However, it is not known if PWD experience less success in weight management. Methods Six hundred and nine participants in the International Weight Control Registry (IWCR) were eligible for this analysis (PWD, n = 174; PWoD, n = 435). Self-reported weight history metrics were compared using general linear models. Perceived weight history category was compared using Chi-squared tests. Importance of diet and physical activity strategies for weight management were compared using Wilcoxon rank-signed tests. Results PWD reported higher current body mass index (BMI) (36.1 ± 0.7 vs. 31.0 ± 0.5; p < 0.0001) and more weight loss attempts (9.1 ± 0.7 vs. 7.1 ± 0.4; p = 0.01) than PWoD. Current weight loss percentage (PWD 13.0 ± 1.0; PWoD, 13.0 ± 0.6; p = 0.97) and weight loss category (χ 2 [3, N = 609] = 2.9057, p = 0.41) did not differ between the groups. There were no differences in any weight strategy between PWD who were successful and those who regained. Conclusions PWD and PWoD in the IWCR achieved similar levels of weight maintenance success. However, higher BMI and more weight loss attempts suggest that PWD may face challenges with weight management. More research is needed to identify strategies leading to success for PWD.
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Affiliation(s)
- Julianne G. Clina
- Department of Nutrition SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - R. Drew Sayer
- Department of Family and Community MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Anna M. Gorczyca
- Division of Physical Activity and Weight ManagementDepartment of Internal MedicineUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Sai Krupa Das
- Jean Mayer USDA Human Nutrition Center on AgingTufts UniversityBostonMassachusettsUSA
| | - James E. Friedman
- Department of Nutrition SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Tsz Kiu Chui
- Department of Nutrition SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Susan B. Roberts
- Geisel School of MedicineDartmouth CollegeHanoverNew HampshireUSA
| | - James O. Hill
- Department of Nutrition SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
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Willingham TB, Stowell J, Collier G, Backus D. Leveraging Emerging Technologies to Expand Accessibility and Improve Precision in Rehabilitation and Exercise for People with Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:79. [PMID: 38248542 PMCID: PMC10815484 DOI: 10.3390/ijerph21010079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/20/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024]
Abstract
Physical rehabilitation and exercise training have emerged as promising solutions for improving health, restoring function, and preserving quality of life in populations that face disparate health challenges related to disability. Despite the immense potential for rehabilitation and exercise to help people with disabilities live longer, healthier, and more independent lives, people with disabilities can experience physical, psychosocial, environmental, and economic barriers that limit their ability to participate in rehabilitation, exercise, and other physical activities. Together, these barriers contribute to health inequities in people with disabilities, by disproportionately limiting their ability to participate in health-promoting physical activities, relative to people without disabilities. Therefore, there is great need for research and innovation focusing on the development of strategies to expand accessibility and promote participation in rehabilitation and exercise programs for people with disabilities. Here, we discuss how cutting-edge technologies related to telecommunications, wearables, virtual and augmented reality, artificial intelligence, and cloud computing are providing new opportunities to improve accessibility in rehabilitation and exercise for people with disabilities. In addition, we highlight new frontiers in digital health technology and emerging lines of scientific research that will shape the future of precision care strategies for people with disabilities.
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Affiliation(s)
- T. Bradley Willingham
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
- Department of Physical Therapy, Georgia State University, Atlanta, GA 30302, USA
| | - Julie Stowell
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
- Department of Physical Therapy, Georgia State University, Atlanta, GA 30302, USA
| | - George Collier
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
| | - Deborah Backus
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
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Chao SF, Yu MH, Tung YH. Environment profiles, social participation patterns, depressive symptoms and quality of life of disabled older adults: a longitudinal investigation. Aging Ment Health 2024; 28:62-72. [PMID: 37646779 DOI: 10.1080/13607863.2023.2249834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 03/29/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVES This study used the World Health Organization's healthy ageing framework to explore longitudinal influences of environment profiles and social participation (SP) patterns on depressive symptoms (DSs) and on quality of life (QOL). METHODS Data were collected from a sample of community-dwelling older adults in Taiwan in 2018 (T1; N = 1,314) and a follow-up survey in 2020 (T2; N = 831). Latent class analysis was conducted to obtain environment and SP profiles. Multilevel modeling was carried out to explicate the hypothesized associations. RESULTS Three unique environment profiles, labeled as Highly- (Highly-FE), Moderately- (Moderately-FE) and Weakly-Facilitative Environment (Weakly-FE), were identified from T1 data. The three SP classes that were obtained from T1 and T2 data denoted High-, Moderate- and Low-SP. Participants in the 'Highly-FE' class were more likely to belong to the 'High-SP' and 'Moderate-SP' subgroups and exhibited significantly fewer DSs and better QOL. The associations were confirmed both cross-sectionally and longitudinally. CONCLUSION Interventions should be developed to promote or maintain preferred SP to maximize the current and future mental health and subjective well-being of disabled older adults.
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Affiliation(s)
- Shiau-Fang Chao
- Department of Social Work, National Taiwan University, Taipei, Taiwan
| | - Meng-Hsuan Yu
- Department of Social Work, National Taiwan University, Taipei, Taiwan
| | - Yi-Hsuan Tung
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
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Kalu ME, Bello-Haas VD, Griffin M, Boamah S, Harris J, Zaide M, Rayner D, Khattab N, Abrahim S. A Scoping Review of Personal, Financial, and Environmental Determinants of Mobility Among Older Adults. Arch Phys Med Rehabil 2023; 104:2147-2168. [PMID: 37119957 DOI: 10.1016/j.apmr.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 05/01/2023]
Abstract
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.
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Affiliation(s)
- Michael E Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Canada
| | - Sheila Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Mashal Zaide
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Daniel Rayner
- Department of Health Science, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Nura Khattab
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
| | - Salma Abrahim
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Canada
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Fields NL, Dabelko-Schoeny H, Murphy IE, Highfill C, Cao Q, White K, Sheldon M, Jennings C, Kunz-Lomelin A. Social Cognitive Theory, Driving Cessation, and Alternative Transportation in Later Life. J Appl Gerontol 2023; 42:2252-2260. [PMID: 37230489 PMCID: PMC10583478 DOI: 10.1177/07334648231177215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Having viable alternative transportation options could help individuals stop driving when appropriate. This study employs the Social Cognitive Theory (SCT) to understand the barriers and facilitators of alternative transportation among a sample of adults aged 55 and older (N = 32). Using a daily transportation data collection app, MyAmble, the research team asked participants questions structured around environmental, individual, and behavioral factors as outlined in the SCT framework. Responses were analyzed using directed content analysis. Findings suggest a substantial reliance on motor vehicles and it was evident that many participants had never seriously considered what they would do if they could no longer drive. We posit that SCT principles may be applied to help older adults build self-efficacy to transition to driving cessation when needed.
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Affiliation(s)
- Noelle L. Fields
- School of Social Work, University of Texas at Arlington, Arlington, TX, USA
| | | | - Ian E. Murphy
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Christine Highfill
- School of Social Work, University of Texas at Arlington, Arlington, TX, USA
| | - Qiuchang Cao
- Pepper Institute on Aging and Public Policy& Claude Pepper Center, Florida State University, Tallahassee, FL, USA, USA
| | - Katie White
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Marisa Sheldon
- College of Social Work, The Ohio State University, Columbus, OH, USA
| | | | - Alan Kunz-Lomelin
- School of Social Work, University of Texas at Arlington, Arlington, TX, USA
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Li Y, Spini D. Earlier-life individual and spatial socioeconomic conditions and later-life physical activity. Health Place 2023; 83:103068. [PMID: 37390666 DOI: 10.1016/j.healthplace.2023.103068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 07/02/2023]
Abstract
This study investigated the association between earlier-life (before age 16) individual and spatial socioeconomic conditions and later-life (mean age 61) physical activity (PA), and the role of later-life characteristics. Contemporary and historical Census data as well as three bi-annual waves of nationally representative panel data from the Understanding America Study (N = 1,981) were used. Multilevel growth curve models were estimated to address the research questions. Father's education in respondents' earlier life was positively associated with light and moderate PA in respondents' later life. Growing up in a higher-poverty area was negatively associated with moderate and vigorous later-life PA. Findings underscore the long-term ramifications of earlier-life circumstances for later-life PA. Consideration should be given to socioeconomic conditions at both individual and spatial levels over the life course to promote PA at older ages.
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Affiliation(s)
- Yang Li
- Swiss Centre of Expertise in Life Course Research LIVES, University of Lausanne, Switzerland.
| | - Dario Spini
- Swiss Centre of Expertise in Life Course Research LIVES, University of Lausanne, Switzerland
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Forster GK, Aarø LE, Alme MN, Hansen T, Nilsen TS, Vedaa Ø. Built Environment Accessibility and Disability as Predictors of Well-Being among Older Adults: A Norwegian Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105898. [PMID: 37239625 DOI: 10.3390/ijerph20105898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/05/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Knowledge about the influence environmental factors have on well-being is important to deliver policies supporting healthy ageing and sustainable health equity. An under-researched question is whether and how the built environment plays a role on well-being among older adults with disabilities. This study explores the relationship between built environment accessibility and disability on psychosocial well-being among older adults. Data were used from the Norwegian Counties Public Health Survey collected during February 2021 in Møre and Romsdal county (N = 8274; age = 60-97, mean = 68.6). General linear modelling was performed to examine the relationship and interaction between built environment accessibility (services, transportation, and nature) and disability on psychosocial well-being (quality of life, thriving, loneliness, and psychological distress). Higher levels of disability and poorer accessibility were each significantly related to lower psychosocial well-being across all variables (p < 0.001). Significant interaction effects were observed between disability and built environment accessibility on thriving (F(8, 5936) = 4.97, p < 0.001, η2 = 0.006) and psychological distress (F(8, 5957) = 3.09, p = 0.002, η2 = 0.004). No significant interaction effects were found for quality of life and loneliness. These findings indicate good built environment accessibility is associated with thriving and reduces psychological distress among older adults with disabilities. This study supports and extends previous findings on the importance of accessible and equipped environments for well-being and may aid policy makers when planning built environments to foster healthy ageing among this population group.
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Affiliation(s)
- Grace Katharine Forster
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, NTNU, NO-7047 Trondheim, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, NIPH, NO-5015 Bergen, Norway
- Department of Health and Functioning, Western Norway University of Applied Sciences, HVL, NO-5063 Bergen, Norway
| | - Leif Edvard Aarø
- Department of Health Promotion, Norwegian Institute of Public Health, NIPH, NO-5015 Bergen, Norway
| | - Maria Nordheim Alme
- Department of Health and Functioning, Western Norway University of Applied Sciences, HVL, NO-5063 Bergen, Norway
| | - Thomas Hansen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, NIPH, NO-0456 Oslo, Norway
- Centre for Welfare and Labour Research, Oslo Metropolitan University, NO-0170 Oslo, Norway
- Promenta Research Center, University of Oslo, NO-0317 Oslo, Norway
| | - Thomas Sevenius Nilsen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, NIPH, NO-0456 Oslo, Norway
- Promenta Research Center, University of Oslo, NO-0317 Oslo, Norway
| | - Øystein Vedaa
- Department of Health Promotion, Norwegian Institute of Public Health, NIPH, NO-5015 Bergen, Norway
- Department of Psychosocial Science, University of Bergen, UiB, NO-5015 Bergen, Norway
- Voss District Psychiatric Hospital NKS Bjørkeli, NO-5705 Voss, Norway
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Hennah C, Doumas M. Dual-task walking on real-world surfaces: Adaptive changes in walking speed, step width and step height in young and older adults. Exp Gerontol 2023; 177:112200. [PMID: 37160198 DOI: 10.1016/j.exger.2023.112200] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/21/2023] [Accepted: 05/05/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVES Age-related changes in dual-task walking are well established, but research in this topic is based on evidence from laboratory rather than real-world studies. We investigated how dual-task walking on real-world surfaces affects young and older adults' gait characteristics and cognitive resource allocation. METHOD Sixteen young (aged 19-35, 12 female) and fifteen older adults (aged 70-85, 7 female) with no major neurological or musculoskeletal disorders walked at a self-selected speed on forty-metre outdoor paths that had asphalt or grass surface. They walked with or without a cognitive task (counting backwards). Cognitive task difficulty was individually adjusted at 80 % accuracy. Participants performed the three tasks in Single Task (ST Asphalt, ST Grass, ST Cognitive) and Dual Task context (DT Asphalt-Cognitive, DT Grass-Cognitive). RESULTS The two groups showed similar dual task effects in cognition and walking speed, both of which were slower when dual-task walking. Older adults' steps were wider overall but only young adults widened their step width when dual-task walking on grass compared to asphalt. Similarly, young adults' step height increased from single to dual-task walking when on grass, where older adults' did not. DISCUSSION The lack of adaptation of step width and height when dual-task walking may leave older adults vulnerable to tripping or falling in common real-world conditions, such as while walking on grass, gravel, or uneven city sidewalks. Considering this, the built environment should be made more accessible to facilitate older adults' safe walking.
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Affiliation(s)
| | - Michail Doumas
- School of Psychology, Queen's University Belfast, Belfast, UK
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16
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Kim J, Lee J, Kim Y, Nuseibeh B, Han S. The Effects of a Nature-based Virtual Reality Program on Emotional Health and Quality of Life among Older Adults with Dementia. Am J Health Behav 2023; 47:3-12. [PMID: 36945101 DOI: 10.5993/ajhb.47.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Objectives: In this pilot study, we focused on the health benefits of a nature-based virtual reality (VR) intervention for older adults with dementia, primarily Alzheimer's Disease (AD). Our main objective was to assess pre-post changes in the emotional health and quality of life of older adults with AD after participating in a 5-week nature-based VR program. Methods: Using in-depth interviews with VR participants and facility staff, we explored the health outcomes of participants as well as challenges to their participation. We recruited 11 participants. Results: We found an increase in participants' mean scores for pleasure and alertness and a decrease in mean scores for anxiety, sadness, and anger. In addition, we found that the quality-of-life mean scores significantly increased after program participation. In qualitative findings, we identified 3 main themes as possible mental health outcomes of the nature-based VR program: (1) enjoyment, (2) novel experience, and (3) reminiscence. On the other hand, participants experienced some challenges related to the VR gear and manipulating the VR controllers and goggles while engaged in the program. Conclusion: The nature-based VR program was instrumental in promoting emotional health and quality of life among older adults with AD.
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Affiliation(s)
- Junhyoung Kim
- Junhyoung Kim, Assistant Professor, Department of Health & Wellness Design, Osan University, South Korea
| | - Jungjoo Lee
- Jungjoo Lee, doctoral candidate, Department of Health & Wellness Design, Osan University, South Korea
| | - Yongseop Kim
- Yongseop Kim, doctoral candidate, Department of Health & Wellness Design, Osan University, South Korea
| | - Betsey Nuseibeh
- Betsey Nuseibeh, doctoral student, Department of Health & Wellness Design, Osan University, South Korea
| | - Sua Han
- Sua Han Osan University, South Korea;,
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17
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Balkman GS, Hafner BJ, Rosen RE, Morgan SJ. Mobility experiences of adult lower limb orthosis users: a focus group study. Disabil Rehabil 2022; 44:7904-7915. [PMID: 34807780 PMCID: PMC10111250 DOI: 10.1080/09638288.2021.2002437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 10/15/2021] [Accepted: 11/01/2021] [Indexed: 01/18/2023]
Abstract
PURPOSE People with lower limb impairments are often prescribed orthoses to preserve or enhance their mobility. Exploration of mobility experiences common among orthosis users may provide insights into how orthoses, and other mobility aids, are utilized and regarded. The objective of this study was to broadly explore how lower limb orthosis users describe their mobility. MATERIALS AND METHODS Four focus groups were held online with participants who lived in the U.S. or Canada. Participants had at least six months of experience using an ankle-foot- and/or a knee-ankle-foot-orthosis for one or both legs. All discussions were transcribed and coded. Thematic analysis was used to identify cross-cutting themes. RESULTS Participants included 29 orthosis users with a variety of health conditions. Inter-related themes, including personal factors, situational contexts, and assistance were identified as elements that influenced participants' mobility. Participants described a process of modifying their mobility through the use and non-use of one or more mobility aids. CONCLUSIONS The current study findings may assist clinicians in developing strategies to optimize orthosis users' mobility in different situations. Experiences described by participants in this study may also help researchers identify aspects of mobility most pertinent to orthosis users and inform the development of new outcome measures.Implications for RehabilitationPeople who use lower-limb orthoses share common mobility experiences, despite differences in health diagnoses.Orthosis users often have opportunities to modify their mobility by choosing to use or not use their brace(s) and/or handheld mobility aids.When providing mobility aid interventions, clinicians should consider how each patient's individual characteristics, including physical characteristics (e.g., the health condition and how it presents, pain, fatigue) and psychosocial characteristics (e.g., fear and confidence, self-motivation, emotional responses), can affect mobility.Clinicians may be able to help patients optimize their mobility by asking about environmental obstacles they regularly encounter and recommending strategies for utilization of mobility aids, including simultaneous use of multiple aids, use of one aid, or choosing not to use any aids, depending on the activity and situation.Clinicians should inquire about all mobility aids available to a patient at home and in the community, including fixed objects, and consider how new mobility aid interventions might affect the patient's mobility when used alone and in combination with other forms of assistance.
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Affiliation(s)
- Geoffrey S. Balkman
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Brian J. Hafner
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Rachael E. Rosen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Sara J. Morgan
- Gillette Children’s Specialty Healthcare, St. Paul, MN, USA
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18
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Khalili M, Jonathan C, Hocking N, Van Der Loos M, Mortenson B, Borisoff JF. Perception of autonomy among people who use wheeled mobility assistive devices: Dependence on the type of wheeled assistive technology. Assist Technol 2022; 34:725-733. [PMID: 34029174 DOI: 10.1080/10400435.2021.1934611] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
We evaluated perceived autonomy among users of different types of wheeled mobility assistive devices (WMADs) across five environments and identified the effect on user autonomy due to specific device characteristics. A study-specific questionnaire was used to assess satisfaction with autonomy of WMAD users in the Home, Buildings Outside of the Home, Outdoor Built, Outdoor Natural Environment, and Transportation. For each environment, 15 contextual factors were rated for their impact on participants' autonomy. Our results revealed that manual wheelchair with add-on (MWC+AO) users had higher overall satisfaction with their autonomy compared to other WMAD users. MWC+AO users reported higher satisfaction with autonomy due to their health conditions compared to other WMAD users across all environments. In Outdoor Natural Environments, MWC+AO users had the highest satisfaction with autonomy across all factors except for negotiating hills. When performing activities in Buildings, MWC users with and without add-ons reported higher satisfaction for all factors compared to power wheelchair users, except for maneuverability on different surfaces. Satisfaction with autonomy regarding contextual factors varied among WMAD users, however, MWC+AO(s) appeared to provide a more balanced sense of autonomy across most factors and environments. More in-depth investigations are required to evaluate impacts of add-on use on autonomy.
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Affiliation(s)
- Mahsa Khalili
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Chelsea Jonathan
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Nicole Hocking
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Mike Van Der Loos
- Department of Mechanical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada.,International Collaboration on Repair Discoveries, Vancouver, BC, Canada
| | - Jaimie F Borisoff
- International Collaboration on Repair Discoveries, Vancouver, BC, Canada.,British Columbia Institute of Technology, Vancouver, BC, Canada
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19
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Joshi R, Joseph A, Mihandoust S, Madathil KC, Cotten SR. A mobile application-based home assessment tool for patients undergoing joint replacement surgery: A qualitative feasibility study. APPLIED ERGONOMICS 2022; 103:103796. [PMID: 35605308 DOI: 10.1016/j.apergo.2022.103796] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Most adults prefer to age in place. However, the majority of homes are not designed to support resident needs, especially for adults undergoing joint replacement surgeries such as total knee arthroplasty (TKA) or total hip arthroplasty (THA). It is of paramount importance to proactively assess and modify the homes of adults undergoing TKA/THA such that they can safely transition home following surgery. Several tools utilize emerging technology like virtual reality, augmented reality, or teleconferencing to assess home environments. These are meant to be used by professionals like occupational therapists. However, the acceptance and uptake of simple technology like mobile applications for assessing homes proactively by residents has not been explored. OBJECTIVE A qualitative exploratory study was conducted to evaluate the feasibility and potential acceptance of a mobile application for resident-initiated home assessment. METHODS Semi-structured interviews were conducted with 22 patient-care partner dyads before and after THA/TKA to understand the perceived usefulness, likelihood of using a mobile application-based home assessment tool, and perceived barriers and facilitators of using the tool. RESULTS About 68% of the patient-care partner dyads interviewed for this study perceived benefits of using a mobile application-based tool. All the participants who perceived the tool to be useful showed high likelihood of using it. A comparison of responses between pre-and post-surgery interviews revealed that around 50% of participants showed an increased intention of using an assessment tool after experiencing challenges in their homes post-surgery. Participants provided recommendations for key content, potential features to include in the assessment tool, and preferred formats (e.g., checklists, visuals, and videos). CONCLUSIONS To increase acceptance of a mobile application-based home assessment tool, it is crucial that residents are made aware of the home environment challenges and the importance of an assessment tool to improve their safety and independence. The content, features, formats, and usability suggestions from the participants in this study provide a framework for health mobile application and interface developers to design a home assessment tool.
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Affiliation(s)
- Rutali Joshi
- HKS, 235 E Main St # 102C, Northville, MI 48167, USA
| | - Anjali Joseph
- Center for Health Facilities Design and Testing, Lee 2-141, Clemson University, Clemson, SC, 29634, USA.
| | - Sahar Mihandoust
- Center for Health Facilities Design and Testing, Lee 2-105, Clemson University, Clemson, SC, 29634, USA
| | - Kapil Chalil Madathil
- Departments of Industrial and Civil Engineering, 212 Lowry Hall, Clemson University, Clemson, SC, 29634, USA
| | - Shelia R Cotten
- Clemson University Office of Research Development, 230 Kappa Street, Clemson University, Clemson, SC, 29634, USA
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The Effects of Pedestrian Environment on Ambulation with a Walking Frame in Elderly Individuals: A Survey and Experimental Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159327. [PMID: 35954684 PMCID: PMC9368263 DOI: 10.3390/ijerph19159327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 02/04/2023]
Abstract
Understanding the effects of sloped roads in the pedestrian environment on the body during ambulation with a walking frame can help design friendlier living environments for elderly individuals. A survey of the characteristics of walking frames used in different pedestrian environments was investigated in five communities, and a controlled study of the effects of a sloped road on a subject with different walking frames was carried out as foundational research in the laboratory. A synchronous acquisition system consisting of a wireless motion capture module and a physiological information recording module was applied to collect data on the motion of the shoulder joint and skin conductance response (SCR) of fingers in one participant. Force data were collected from sensors placed on the four legs of the walking frame. The experimental data obtained during different tasks were quantitatively analyzed. Compared to flat ground, the shoulder joint rotated in the opposite direction in horizontal and internal/external planes when using a wheeled walking frame on an uphill road, and the supportive force decreased on both uphill and downhill roads. The range of motion of the shoulder joint reduced and the direction of the shoulder joint motion changed when using a footed walking frame on both uphill and downhill roads. Additionally, the peak value of the supportive force on the uphill road appeared in the first 50% of the gait cycle, which was earlier than in the other cases. In addition, walking on the uphill road with a walking frame had a maximum SCR value, which means a greater impact of psychological arousal. Biomechanics of the shoulder joint and psychological arousal are closely related to the ease of walking on a sloped road with a walking frame. These findings are beneficial for designing more appropriate environments for elderly individuals who walk with aids.
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21
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Feasibility of DRNN for Identifying Built Environment Barriers to Walkability Using Wearable Sensor Data from Pedestrians’ Gait. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Identifying built environment barriers to walkability is the first step toward monitoring and improving our walking environment. Although conventional approaches (i.e., surveys by experts or pedestrians, walking interviews, etc.) to identify built environment barriers have contributed to improving the walking environment, these approaches may require time and effort. To address the limitations of conventional approaches, wearable sensing technologies and data analysis techniques have recently been adopted in the investigation of the built environment. Among various wearable sensors, an inertial measurement unit (IMU) can continuously capture gait-related data, which can be used to identify built environment barriers to walkability. To propose a more efficient method, the author adopts a cascaded bidirectional and unidirectional long short-term memory (LSTM)-based deep recurrent neural network (DRNN) model for classifying human gait activities (normal and abnormal walking) according to walking environmental conditions (i.e., normal and abnormal conditions). This study uses 101,607 gait data collected from the author’s previous study for training and testing a DRNN model. In addition, 31,142 gait data (20 participants) have been newly collected to validate whether the DRNN model is feasible for newly added gait data. The gait activity classification results show that the proposed method can classify normal gaits and abnormal gaits with an accuracy of about 95%. The results also indicate that the proposed method can be used to monitor environmental barriers and improve the walking environment.
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Amaya V, Moulaert T, Gwiazdzinski L, Vuillerme N. Assessing and Qualifying Neighborhood Walkability for Older Adults: Construction and Initial Testing of a Multivariate Spatial Accessibility Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031808. [PMID: 35162830 PMCID: PMC8834981 DOI: 10.3390/ijerph19031808] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/28/2022] [Accepted: 02/02/2022] [Indexed: 12/10/2022]
Abstract
Population aging and urban development pose major challenges for societies today. Joining the literature assessing urban accessibility, the present exploratory research developed a multivariate accessibility model based on four independent variables—related to formal and structural urban space—that influence walkability for older adults (pedestrian network; facilities and shops; public benches; and slopes and gradients). The model used ArcGIS software. For the accessibility calculations, we selected two suburban neighborhoods in the conurbation of Grenoble (France) and selected three types of older adults’ profiles to reflect the variety of aging: an older adult in good health, an older adult with a chronic disease, and an older adult with reduced mobility. The results suggest that the accessibility of a neighborhood depends not only on its physical and urban characteristics, but it is also influenced by the physical and health characteristics of its inhabitants. The originality of the model lies mainly in its ability to estimate the spatial accessibility of a territory by taking into account, firstly, objective data such as the physical characteristics and the built environment of the neighborhood through objectification variables that consider such original variables as the presence of benches or the slopes and gradients and, secondly, specific data such as the physical and/or health characteristics of the study population. The measurement of geospatial accessibility could be of great value for public health in urban contexts, which is why relevant tools and methodologies are needed to objectively examine and intervene in public spaces in order to make them age-friendly.
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Affiliation(s)
- Valkiria Amaya
- AGEIS (Autonomie, Gérontologie, E-santé, Imagerie et Société), Université Grenoble Alpes, 38000 Grenoble, France;
- PACTE (Laboratoire de Sciences Sociales), Sciences Po Grenoble, Université Grenoble Alpes, CNRS, 38000 Grenoble, France
- Correspondence: (V.A.); (T.M.)
| | - Thibauld Moulaert
- PACTE (Laboratoire de Sciences Sociales), Sciences Po Grenoble, Université Grenoble Alpes, CNRS, 38000 Grenoble, France
- Correspondence: (V.A.); (T.M.)
| | - Luc Gwiazdzinski
- LRA (Laboratoire de Recherche en Architecture), École Nationale Supérieure d’Architecture de Toulouse, Université Fédérale de Toulouse, 31106 Toulouse, France;
| | - Nicolas Vuillerme
- AGEIS (Autonomie, Gérontologie, E-santé, Imagerie et Société), Université Grenoble Alpes, 38000 Grenoble, France;
- Institut Universitaire de France, 75005 Paris, France
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Vanderschuren MJWA, Nnene OA. Inclusive planning: African policy inventory and South African mobility case study on the exclusion of persons with disabilities. Health Res Policy Syst 2021; 19:124. [PMID: 34503537 PMCID: PMC8428119 DOI: 10.1186/s12961-021-00775-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 08/24/2021] [Indexed: 01/27/2023] Open
Abstract
Background The Sustainable Development Goals (SDGs) and universal design (UD) principles call for inclusive planning. Within the transportation field, this includes the development or improvement of facilities that accommodate people with disabilities. Between 10% and 20% of the African population is affected by disabilities. A lack of understanding of the needs of people with disabilities leads to isolation. Within the transportation field, isolation manifests itself as a reduction in trip-making. Methods This paper investigates the availability of transport policies and guidelines in 29 different African countries, focusing on the inclusion of persons with disabilities. A desktop study was conducted creating heat maps for 29 African countries, followed by the analysis of secondary data in the case study area, South Africa, demonstrating that the lack of adequate policies, guidelines, and appropriate implementation leads to a lack of accessibility, opportunities, and social isolation, measured through trip frequencies. Results The data analysed revealed that many African countries omit, or only superficially include, people with disabilities in their transport policy framework. Ghana has the most inclusive People with Disabilities Act, while South Africa is most inclusive regarding their planning and design of transport facilities and services. In South Africa, 4.5% of the population did not travel at all in the 7 days before the interview, as disability or age prevented them from doing so, or due to a lack of appropriate travel services. When comparing the trip rates per week, people with disabilities travel significantly less, between 27.2% and 65.8%, than their abled counterparts. Conclusions The study reveals that people with disability live less integrated, more isolated lives due to the lack of acknowledgement in the transport policy framework and accommodation in infrastructure and services. The results underpin the need for disability-inclusive planning in the African context and provide recommendations for actions that mitigate the isolation challenges faced by people with disabilities. Municipalities play a crucial role in improving the quality of life for people with disabilities. Supplementary Information The online version contains supplementary material available at 10.1186/s12961-021-00775-1.
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Affiliation(s)
- Marianne J W A Vanderschuren
- Centre for Transport Studies, Department of Civil Engineering, University of Cape Town, Private Bag X3, Rondebosch, Cape Town, 7700, South Africa.
| | - Obiora A Nnene
- Centre for Transport Studies, Department of Civil Engineering, University of Cape Town, Private Bag X3, Rondebosch, Cape Town, 7700, South Africa
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Schmidt T, Pawlowski CS, Kerr J, Schipperijn J. Investigating the WHAT and WHY on older adults' use of neighborhood open spaces following an environmental intervention. Transl Behav Med 2021; 11:582-596. [PMID: 32044982 DOI: 10.1093/tbm/ibaa004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Using neighborhood open spaces (NOS) may be an easy way for older adults to maintain healthy aging through physical activity and social interaction. Little is known about older adults' use of NOS, their preferences, and barriers to using them. This paper presents older adults' use of NOS in a deprived neighborhood before and after an intervention and factors promoting or inhibiting their use using convergent mixed methods design. Participatory research was employed involving older adults in the intervention. The System for Observing Play and Recreation in Communities was used to observe older adults' use of 13 NOS in spring 2017 (baseline) and spring 2018 (follow-up). Ten interviews were conducted in 2018 to identify barriers and facilitators for using NOS. Two NOS had a pavilion built and, in one NOS, benches were renovated, including building raised flower beds and small tables. At baseline, 209 older adults were observed, whereas 329 were observed at follow-up. More (44%) older adults were observed at follow-up in the NOS with the renovated benches. No use of the two pavilions was observed. The interviews identified six factors important for older adults' use of NOS: weather, support for social caretakers, support for resourceful volunteers, organized activities, social interaction, and sense of ownership. Organizational resources, such as social caretakers and volunteers, are important to promote older adults' use of NOS. Social interaction is a key factor for older adults' use of NOS and should be prioritized by health promoters.
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Affiliation(s)
- Tanja Schmidt
- Research Unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Charlotte Skau Pawlowski
- Research Unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Jacqueline Kerr
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, USA
| | - Jasper Schipperijn
- Research Unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
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Jahangir S, Bailey A, Hasan MU, Hossain S, Helbich M, Hyde M. "When I need to travel, I feel feverish": Everyday experiences of transport inequalities among older adults in Dhaka, Bangladesh. THE GERONTOLOGIST 2021; 62:493-503. [PMID: 34282443 PMCID: PMC9019655 DOI: 10.1093/geront/gnab103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives Buses are the most common form of public transport for older adults in developing countries. With over 37% of total trips, buses are the principal mode of transport in Dhaka. The majority of older adults are dependent on buses because of their affordability relative to other modes such as auto-rickshaws, rideshares, and taxis. This study aims to investigate key barriers in accessing buses in Dhaka and the consequences of these barriers to the everyday mobility of older adults. Research Design and Methods Thirty participants aged 60 and older were recruited from 2 socioeconomically different neighborhoods in Dhaka. We employed a thematic analysis of visual surveys and in-depth interviews to understand older adults’ spatial and cultural context and their experiences using buses in their everyday lives. Results Boarding and deboarding buses were common barriers for older adults due to overcrowding and traffic congestion. In addition, older adults faced challenges such as ageism, gender discrimination, and undesirable behavior by transport personnel and co-passengers. These barriers affected their independent mobility and influenced their access to work and social life, contributing to their social exclusion. Discussion and Implications This study illustrates the challenges faced by older adults when accessing public transport and the need to improve access to work, health care, and social life. Inclusive transport policies are essential in low- and middle-income countries to improve the well-being of older adults.
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Affiliation(s)
- Selim Jahangir
- Transdisciplinary Centre for Qualitative Methods, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ajay Bailey
- Transdisciplinary Centre for Qualitative Methods, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India.,Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, The Netherlands
| | - Musleh Uddin Hasan
- Department of Urban and Regional Planning, Bangladesh University of Engineering & Technology, Dhaka, Bangladesh
| | | | - Marco Helbich
- Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, The Netherlands
| | - Martin Hyde
- Centre for Innovative Ageing, College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, Wales, UK
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The importance of meaningful participation: health benefits of volunteerism for older adults with mobility-limiting disabilities. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21000842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Volunteerism has been increasingly recognised as a health promotion activity for older adults. However, volunteerism has largely been the domain of those who are in good health with few to no physical limitations, and there is limited information about the experiences of older adults with disabilities. This study explores why older adults with mobility-limiting disabilities engage in volunteer work and their perceptions of the personal benefits of volunteering. Twenty older adults, from three Midwest towns in the United States of America, participated in semi-structured, in-depth, face-to-face interviews. Participants in this study identified as having serious difficulty walking or climbing stairs due to a health condition and had volunteered in the last year. Participants were selected purposively for maximum variation in terms of type of disability/impairment, race, gender and age. The constant comparative method of analysis was used to identify themes from their discussions. When asked about why they volunteer and the personal benefits of volunteering, participants discussed seeking out activities that were meaningful to them for both altruistic and more self-directed reasons. They identified a number of physical and emotional health benefits that they saw as directly and indirectly related to being able to participate in these meaningful activities. Findings from this study suggest that, for older adults with disabilities who are interested in volunteer activities, volunteerism can be a beneficial health promotion activity and a potential mechanism for increasing opportunities for meaningful inclusion and participation in their communities.
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Assessment of Outdoor Lighting: Methods for Capturing the Pedestrian Experience in the Field. ENERGIES 2021. [DOI: 10.3390/en14134005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This study assessed whether methods for capturing the pedestrian experience of outdoor lighting, previously evaluated in a full-scale laboratory, were applicable in a real-world setting. It applied an approach capturing the human response to outdoor lighting in a systematic way, by assessing perception, evaluation and behaviour in the lit environment. The study involved 81 participants from two age groups (Young—n: 48, mean age: 26, 63% women; Elderly—n: 33, mean age: 69, 67% women) and was carried out on a pedestrian path in a park in the centre of Malmö, Sweden, in the evenings during wintertime. Two LED lighting applications, differing in light distribution, uniformity and horizontal illuminance, were presented, and the pedestrians’ perception (facial expression recognition and sign reading), evaluation (arousal, valence and perceived outdoor lighting quality) and behaviour (pedestrian flow) were assessed. The results from the perceptual tasks differed significantly between the lighting applications, in favour of the lighting application with greatest uniformity and horizontal illuminance. There was a significant difference in sign reading distance between the two age groups. The methods applied in this study are feasible to administer and could be used to assess lighting solutions in order to capture the needs of vulnerable groups.
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Li Y, Wang Y, Morrow-Howell N. Neighborhood Effects on the Health of Chinese Older Adults: Beyond the Rural and Urban Dichotomy. THE GERONTOLOGIST 2021; 61:403-412. [PMID: 32598467 DOI: 10.1093/geront/gnaa081] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The associations between physical frailty and depressive symptoms among older individuals were established in the existing literature. Taking the person-environment perspective, we argue that neighborhood environment could either buffer the stress derived from being physically vulnerable or worsen it by adding another layer of stressors in the environmental context when physical health declined. The objectives of this study were to explore to what extent the neighborhood-level characteristics moderate the relationship between physical frailty and depressive symptoms. RESEARCH DESIGN AND METHODS Using the China Health and Retirement Longitudinal Study 2011 wave, 6,245 individuals aged 60 years and older were included for analyses. Multilevel mixed-effects models were fitted to examine the moderating effects of urbanicity and neighborhood-level socioeconomic status (SES) on the relationship between frailty and depressive symptoms among older adults, controlling for individual-level characteristics. RESULTS Results showed a stronger relationship between deterioration in physical health and depressive symptoms in rural neighborhoods and neighborhoods with lower SES, after controlling for individual-level SES. Also, the moderating effects of the neighborhood-level socioeconomic factors remained after controlling for urbanicity, indicating that neighborhood SES works beyond the rural-urban contexts. DISCUSSION AND IMPLICATIONS Findings from this study demonstrate the important roles of neighborhood socioeconomic characteristics in reshaping, and the need to redefine, China's rural-urban dichotomy. The findings also identified neighborhoods with low SES as potential targets for policy and practice to reduce the stress associated with health decline.
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Affiliation(s)
- Yuekang Li
- Brown School, Washington University in St. Louis, Missouri.,Social Survey and Opinion Research Center, Central South University, Changsha, China
| | - Yi Wang
- School of Social Work, University of Iowa
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Hu D, Zhou S, Crowley-McHattan ZJ, Liu Z. Factors That Influence Participation in Physical Activity in School-Aged Children and Adolescents: A Systematic Review from the Social Ecological Model Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3147. [PMID: 33803733 PMCID: PMC8003258 DOI: 10.3390/ijerph18063147] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 12/23/2022]
Abstract
High prevalence of physical inactivity and obesity in children and adolescents has become a global problem. This systematic review aimed to examine the existing literature regarding the factors that influence participation in physical activity (PA) in children and adolescents with reference to the social ecological model (SEM) proposed by McLeroy et al. (1988). The SEM provides a framework under which the influencing factors are categorized into five levels: intrapersonal, interpersonal, organizational, community, and public policy. A systematic search of relevant literature published before July 2020 was conducted through Ebsco, ProQuest, PubMed Central, Scopus, and Web of Science. A total of fourteen studies met the inclusion criteria. The selected articles were all of high quality as assessed using the Mixed Methods Appraisal Tool (2018). The results indicated that gender, age, ethnicity, and self-concept were the most common influencing factors at the intrapersonal level. At the interpersonal and organization levels, supports from friends, parents, and teachers were positive predictors of students' PA participation. Accessibility of facilities and safe neighborhoods was a crucial factor that influenced children and adolescents' participation in PA at the community level. Future studies on the effective types of policies or practices that could successfully promote facilities' accessibility and improve neighborhood safety are required. The outcomes of this systematic review are expected to inform practice and support the development and implementation of sound policies for the promotion of PA participation in children or adolescents from a comprehensive social ecological viewpoint.
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Affiliation(s)
- Donglin Hu
- Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia; (S.Z.); (Z.J.C.-M.)
- School of Physical Education and Educational Science, Tianjin University of Sport, Tianjin 301617, China
- Department of Physical Education, Nanjing Agricultural University, Nanjing 210095, China
| | - Shi Zhou
- Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia; (S.Z.); (Z.J.C.-M.)
| | | | - Zhiyun Liu
- School of Physical Education and Educational Science, Tianjin University of Sport, Tianjin 301617, China
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Neighborhood Urban Design and Outdoor Later Life: An Objective Assessment of Out-of-Home Time and Physical Activity Among Older Adults in Barcelona. J Aging Phys Act 2021; 29:781-792. [PMID: 33652416 DOI: 10.1123/japa.2020-0254] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/16/2020] [Accepted: 11/11/2020] [Indexed: 01/10/2023]
Abstract
This study explores how older adults' time out-of-home and physical activity (PA) are associated with the provision of urban open spaces (green spaces, plazas, and boulevards) and microelements (street trees and benches) in their neighborhoods. The authors used data from 103 residents in Barcelona and matched it to official geospatial data. The authors adjusted a set of mixed-effects linear regressions, both for the entire sample and also stratified by age and gender. For the entire sample, the percentage of green spaces showed a positive association with neighborhood time out-of-home and PA, while participants' PA also showed a positive association with the presence of benches. Outdoor time among older women was not associated with any of the measured exposures. For men, the provision of green spaces and benches was positively associated with time out-of-home and PA. These results could inform the design of urban spaces that aim to encourage outdoor activity among older adults.
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Joshi R, Joseph A, Mihandoust S, Hoskins L, O'Hara S, Dye CJ, Chalil Madathil K. Understanding key home and community environment challenges encountered by older adults undergoing total knee or hip arthroplasty. THE GERONTOLOGIST 2021; 61:1071-1084. [PMID: 33605410 DOI: 10.1093/geront/gnab025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Older adults undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) experience significant challenges while navigating their homes post-surgery and are at higher risk for falls and injuries. This study explored specific home and community physical environment challenges faced by community-dwelling older adults while performing daily activities and actions taken to modify their homes before surgery. RESEARCH DESIGN AND METHODS Using a qualitative descriptive methodology, semi-structured interviews were conducted with 22 older adult-care partner dyads pre- and post-surgery to identify key built environment barriers and facilitators in addition to home modifications made pre-and post-surgery. RESULTS Challenges anticipated by participants to perform daily activities pre-surgery varied from those experienced post-surgery. Lack of support along stairs or in bathrooms, flooring material, and transitions were significant concerns raised by participants pre-surgery. Size and layout of home and ergonomics of resting furniture were recognized as issues post-surgery. Modifications ranged from easy fixes like rearranging furniture, removing clutter, installing grab bars to high-cost structural changes like remodeling critical spaces like bathrooms. Although participants agreed on the importance of conducting proactive home assessments and modifications before surgery, perceived costs, and lack of knowledge or services limit older adults from implementing some changes. DISCUSSION AND IMPLICATIONS Home modifications must be considered proactively before an event such as a THA or TKA. These should be done within the context of the specific needs, abilities, financial capabilities, and social and physical home environments of the individual and the residential caregivers.
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Affiliation(s)
- Rutali Joshi
- Center for Health Facility Design and Testing, Clemson University, Clemson, SC, USA
| | - Anjali Joseph
- Center for Health Facility Design and Testing, Clemson University, Clemson, SC, USA
| | - Sahar Mihandoust
- Center for Health Facility Design and Testing, Clemson University, Clemson, SC, USA
| | - Lisa Hoskins
- Center for Health Facility Design and Testing, Clemson University, Clemson, SC, USA
| | - Susan O'Hara
- School of Nursing, Architecture; College of Behavioral, Social and Health Sciences, CUSHR, Clemson University, Clemson, SC, USA
| | - Cheryl J Dye
- CU Institute for Engaged Aging, Department of Public Health Sciences, Clemson University, Clemson, SC, USA
| | - Kapil Chalil Madathil
- Departments of Industrial and Civil Engineering, Clemson University, Clemson, SC, USA
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Eisenberg Y, Vanderbom KA, Harris K, Herman C, Hefelfinger J, Rauworth A. Evaluation of the Reaching People with Disabilities through Healthy Communities Project. Disabil Health J 2021; 14:101061. [PMID: 33516725 DOI: 10.1016/j.dhjo.2021.101061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 01/07/2021] [Accepted: 01/10/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND People with disabilities experience disparities in chronic diseases, such as obesity, heart disease, and diabetes, in disproportionate numbers. Research suggests that healthy communities initiatives that work to implement policy, systems and environmental (PSE) changes can help reduce these disparities by improving access to healthy choices for community residents with disabilities. However, healthy communities efforts to implement PSE changes are often not inclusive of people with disabilities. OBJECTIVE The purpose of this paper is to evaluate the implementation of an Inclusive Healthy Communities Model that was designed to reach people with disabilities through inclusive PSE changes. METHODS Professionals from local public health agencies and disability organizations in 10 diverse communities worked to infuse disability inclusion into PSE changes promoting healthy living. Data on PSE implementation was collected and coded into categories to describe the nature of the inclusive PSEs. RESULTS Communities implemented 507 inclusive PSEs, 466 of which were environmental changes, 25 systems changes, and 16 policy changes. A large majority of PSEs were related to improving the built environment to facilitate access to public spaces, such as parks, playgrounds, and community gardens. Many communities also implemented policy and systems changes related to the addition of inclusion into existing policies, community plans, and ongoing training of staff. CONCLUSION Integrating disability inclusion into traditional healthy communities efforts can facilitate improved access and opportunity for healthy living among people with disabilities. This pilot project has implications for public health workforce training, current practices, and PSE development with interdisciplinary teams and multisectoral coalitions.
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Affiliation(s)
- Yochai Eisenberg
- Department of Disability and Human Development, University of Illinois at Chicago, 1640 W. Roosevelt Rd. M/C 626, Chicago, IL 60608, USA.
| | - Kerri A Vanderbom
- University of Alabama at Birmingham/Lakeshore Research Collaborative, 4000 Ridgeway Dr., Birmingham, AL 35209, USA.
| | - Karma Harris
- National Association of Chronic Disease Directors, 325 Swanton Way, Atlanta, GA 30030 USA.
| | - Casey Herman
- National Center on Health Physical Activity and Disability/Lakeshore Foundation, 4000 Ridgeway Dr., Birmingham, AL 35209, USA
| | - Jennie Hefelfinger
- National Association of Chronic Disease Directors, 325 Swanton Way, Atlanta, GA 30030 USA.
| | - Amy Rauworth
- National Center on Health Physical Activity and Disability/Lakeshore Foundation, 4000 Ridgeway Dr., Birmingham, AL 35209, USA.
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Liu P, Powers M, Dye C, Vincent E, Padua M. Walking in Your Culture: A Study of Culturally Sensitive Outdoor Walking Space for Chinese Elderly Immigrants. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 14:247-257. [PMID: 33438445 DOI: 10.1177/1937586720985885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES This was a study conducted in Atlanta, GA, in the United States with Chinese elderly immigrants, examining the relationship between visual preference and motivation to walk in a particular outdoor space. BACKGROUNDS Outdoor walking promotes the well-being of older adults. However, their declined body functions impact their motivation to walk outside. For elderly immigrants living in a country with different cultural backgrounds from their homelands, it is important to find the ways to enhance their motivation of outdoor walking. METHOD Visual preference survey was conducted to assess preferences of first-generation Chinese elderly immigrants attending a care facility setting. Preferences included Chinese classical walking spaces or American modern walking spaces. The data were interpreted using descriptive statistics and factorial experiment analysis. RESULTS A total of 95 Chinese elderly immigrants gave valid responses to the visual preference survey. Survey results revealed that respondents had a high preference for Chinese classical walking spaces even though they had an average time of 26 years as a U.S. resident. Although the functions and purposes of the walking spaces caused safety and comfort concerns, the interaction effects of design style, design function, and design purpose illustrated that Chinese classical style had high effectiveness to promote outdoor walking of Chinese elderly immigrants. CONCLUSIONS These results support the significance of culturally sensitive care environments in promoting outdoor walking for elderly Chinese immigrants. It also indicates that spaces designed with an assigned cultural style had higher attractiveness to older adults from the same assigned cultural background.
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Affiliation(s)
- Pai Liu
- 2545Dalian University of Technology, Liaoning, China
| | | | - Cheryl Dye
- 2545Clemson University, Clemson, SC, USA
| | | | - Mary Padua
- 2545Clemson University, Clemson, SC, USA
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Kamyuka D, Carlin L, McPherson G, Misener L. Access to Physical Activity and Sport and the Effects of Isolation and Cordon Sanitaire During COVID-19 for People With Disabilities in Scotland and Canada. Front Sports Act Living 2021; 2:594501. [PMID: 33426519 PMCID: PMC7786384 DOI: 10.3389/fspor.2020.594501] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/27/2020] [Indexed: 11/13/2022] Open
Abstract
People with a disability are more at risk of experiencing inequalities in relation to sporting and physical activity opportunities, COVID-19 and the resulting restrictions stand to exacerbate these inequalities. This research directly contributes toward the World Health Organization, global research roadmap priority to explore “the impact of restrictive public health measures (e.g., quarantine, isolation, cordon sanitaire).” Social loneliness and social isolation have a significant impact on the health and wellbeing of individuals, therefore, it is imperative to gain an understanding of the effects of self-isolation and shielding during Covid-19 for people with disabilities to help those in policy and agency positions address these issues. This research utilized a qualitative approach, to speak with people with a disability, athletes and non-athletes and those in a position of management and policy making. Six online focus groups, with people participating in sport and physical activity, using live captioning, chat functions, and an online written discussion forum; through Project Echo website as part of a wider study on sport and accessibility were utilized. The study also drew on interviews and one of the focus groups was with senior policy makers and regional managers responsible for disability sport in Scotland.
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Affiliation(s)
- Denise Kamyuka
- School of Kinesiology, Western University, London, ON, Canada
| | - Liz Carlin
- School of Health and Life Sciences, University of West Scotland, Paisley, United Kingdom
| | - Gayle McPherson
- School of Business and Creative Industries, University of West Scotland, Paisley, United Kingdom
| | - Laura Misener
- School of Kinesiology, Western University, London, ON, Canada
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Bowden JL, Hunter DJ, Feng Y. How can neighborhood environments facilitate management of osteoarthritis: A scoping review. Semin Arthritis Rheum 2020; 51:253-265. [PMID: 33387921 DOI: 10.1016/j.semarthrit.2020.09.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/09/2020] [Accepted: 09/11/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The association between neighborhood environments and health outcomes has long been recognized, but the importance of environmental factors is less well examined in osteoarthritis (OA). We aimed to give an overview of the literature examining the role of neighborhood built environments in the context of OA self-management. MATERIAL AND METHODS A literature search between 2000 and 2019 was performed using a scoping methodology. Literature examining the influence of neighborhood built environments on health and other outcomes in people with OA, mixed or unspecified arthritis were screened by two independent reviewers. Seven domains were pre-determined based on the World Health Organization European Healthy Cities Framework. Sub-domains and themes were synthesized from the literature. RESULTS We included 27 studies across seven pre-determined domains, 23 sub-domains. We identified 6 key outcomes of physical activity, quality of life, community participation, resource use, psychological health, and other physical health. The majority of studies emphasized the importance of neighborhood built environment on supporting OA self-management, particularly for facilitating physical activity. The impacts on other outcomes were also considered important but were less well studied, especially access to healthy food. CONCLUSIONS This review highlights the potential of better using the built environment to support OA management to address many different outcomes. Understanding the impacts of different environments is the first step, and designing new and novel ways to utilize neighborhoods is needed. Implementing strategies and public policies at a neighborhood level may be a more viable way to curb further increases in the OA epidemic than addressing individual factors alone.
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Affiliation(s)
- Jocelyn L Bowden
- Institute of Bone and Joint Research, the Kolling Institute, The University of Sydney, and Rheumatology Department, Royal North Shore Hospital, Sydney, Australia.
| | - David J Hunter
- Institute of Bone and Joint Research, the Kolling Institute, The University of Sydney, and Rheumatology Department, Royal North Shore Hospital, Sydney, Australia
| | - Yingyu Feng
- Institute of Bone and Joint Research, The Kolling Institute, The University of Sydney, Australia
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Fortune N, Singh A, Badland H, Stancliffe RJ, Llewellyn G. Area-Level Associations between Built Environment Characteristics and Disability Prevalence in Australia: An Ecological Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7844. [PMID: 33114716 PMCID: PMC7662552 DOI: 10.3390/ijerph17217844] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/15/2020] [Accepted: 10/21/2020] [Indexed: 12/05/2022]
Abstract
The importance of health-promoting neighborhoods has long been recognized, and characteristics of local built environments are among the social determinants of health. People with disability are more likely than other population groups to experience geographic mobility and cost restrictions, and to be reliant on 'opportunity structures' available locally. We conducted an ecological analysis to explore associations between area-level disability prevalence for people aged 15-64 years and area-level built environment characteristics in Australia's 21 largest cities. Overall, disability was more prevalent in areas with lower walkability and lower local availability of various neighborhood amenities such as public transport, healthier food options, public open space, physical activity and recreation destinations and health and mental health services. These patterns of lower liveability in areas of higher disability prevalence were observed in major cities but not in regional cities. Our findings suggest that geographically targeted interventions to improve access to health-enhancing neighborhood infrastructure could reduce disability-related inequalities in the social determinants of health.
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Affiliation(s)
- Nicola Fortune
- Centre of Research Excellence in Disability and Health, University of Melbourne, Parkville, VIC 3010, Australia; (A.S.); (H.B.); (R.J.S.); (G.L.)
- Centre for Disability Research and Policy, University of Sydney, Lidcombe, NSW 2141, Australia
| | - Ankur Singh
- Centre of Research Excellence in Disability and Health, University of Melbourne, Parkville, VIC 3010, Australia; (A.S.); (H.B.); (R.J.S.); (G.L.)
- Centre for Health Equity & Centre for Epidemiology & Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC 3053, Australia
| | - Hannah Badland
- Centre of Research Excellence in Disability and Health, University of Melbourne, Parkville, VIC 3010, Australia; (A.S.); (H.B.); (R.J.S.); (G.L.)
- Centre for Urban Research, RMIT University, Melbourne, VIC 3000, Australia
| | - Roger J. Stancliffe
- Centre of Research Excellence in Disability and Health, University of Melbourne, Parkville, VIC 3010, Australia; (A.S.); (H.B.); (R.J.S.); (G.L.)
- Centre for Disability Research and Policy, University of Sydney, Lidcombe, NSW 2141, Australia
| | - Gwynnyth Llewellyn
- Centre of Research Excellence in Disability and Health, University of Melbourne, Parkville, VIC 3010, Australia; (A.S.); (H.B.); (R.J.S.); (G.L.)
- Centre for Disability Research and Policy, University of Sydney, Lidcombe, NSW 2141, Australia
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Physical Activity Barriers in Danish Manual Wheelchair Users: A Cross-sectional Study. Arch Phys Med Rehabil 2020; 102:687-693. [PMID: 33091383 DOI: 10.1016/j.apmr.2020.09.384] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 09/10/2020] [Accepted: 09/20/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To identify physical activity barrier prevalence and severity among manual wheelchair users (MWCUs) and test whether barrier impact is associated with self-reported physical activity level (PAL). DESIGN Cross-sectional survey. The Barriers to Physical Activity Questionnaire for People with Mobility Impairments (BPAQ-MI) was translated from English to Danish and administered online. The BPAQ-MI includes barriers within 4 domains and 8 subdomains and queries if an item hindered physical activity participation in the last 3 months (yes/no). If "yes," participants graded barrier severity from very small (1) to very big (5). Barrier impact scores were summed within and across domains. SETTING General community. PARTICIPANTS Danish MWCUs (N=181; 52.5% female, mean age, 48±14y.). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES PAL was rated from not active (1) to extremely active (10). Individual barrier prevalence (frequency, %) and severity (median [interquartile range]) was computed. Unadjusted (Spearman rank correlations, domains, subdomains) and adjusted (multivariate linear regression, subdomains) associations between PAL and barrier impact were computed. RESULTS The 5 most prevalent barriers were reported by ≥49.6% of participants (2 intrapersonal and 3 community). The 5 most severe barriers all had a median of 5 (1 organizational and 4 community). Unadjusted analysis showed that PAL was inversely associated with total intrapersonal (r=-0.487, P<.01) and overall (r=-0.241, P<.01) impact and the intrapersonal "health" (r=-0.477, P<.01) and "beliefs/attitudes"(r=-0.307, P<.01) subdomains. Adjustment for shared variance revealed only the "health" subdomain impact score was independently associated with PAL (P<.001). CONCLUSIONS Intrapersonal barriers were highly prevalent. Health-related barriers were inversely related to PAL. When organizational and community barriers were present, they were rated as particularly severe. These results provide novel information that can guide the design of future interventions aiming to increase MWCUs PALs.
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Black K, Jester DJ. Examining Older Adults' Perspectives on the Built Environment and Correlates of Healthy Aging in an American Age-Friendly Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197056. [PMID: 32992480 PMCID: PMC7578930 DOI: 10.3390/ijerph17197056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 11/16/2022]
Abstract
Population aging has led to an increased focus on the environmental context in which we age. While researchers have identified significant health benefits associated with built community features such as housing, transportation and outdoor spaces and buildings, less attention has focused on the correlates of healthy aging and other characteristics via the perspective of community-dwelling older adults. This study utilized cluster analysis to examine health-related subgroups of older adults (n = 598) in an age-friendly community located in the United States, of which nearly half of its residents are age 60 and older. Linear regression was used to associate the health clusters with perceptions of built environmental features and socio-demographics. Four distinct profiles were identified, with the greatest preference for housing and transportation found among those reporting poorer health compared to those reporting excellent health across multi-dimensional healthy aging measures. Perceptions on the importance of built environmental features were also found to vary by age, income and home accessibility status. Findings suggest that older adults’ perceptions about built environmental features differ across health and home status as well as age and income, underscoring opportunities for public health action to better reach and engage older adults by life-course trajectories in age-friendly communities.
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Affiliation(s)
- Kathy Black
- School of Aging Studies, College of Behavioral and Community Sciences, Sarasota-Manatee Campus, University of South Florida, Sarasota, FL 34243, USA
- Correspondence:
| | - Dylan J. Jester
- School of Aging Studies, University of South Florida, Tampa, FL 33620, USA;
- College of Public Health, University of South Florida, Tampa, FL 33620, USA
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Moraes SAD, Furlanetto EC, Ricci NA, Perracini MR. Sedentary behavior: barriers and facilitators among older adults after hip fracture surgery. A qualitative study. Braz J Phys Ther 2020; 24:407-414. [PMID: 31345662 PMCID: PMC7563798 DOI: 10.1016/j.bjpt.2019.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 05/23/2019] [Accepted: 07/02/2019] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Understand the experience of older adults after hip fracture surgery considering barriers and facilitators related to sedentary behavior. METHODS A qualitative study using a semi-structured interview with three men and eight women aged 60 years or older after hip fracture surgery. RESULTS Five barriers emerged: physical complaints, lack of accessibility, fear of falling, demotivation and negative social representation of old age, and two facilitators: overcoming dependency and having a caregiver. CONCLUSION Our results highlight that physical complaints commonly addressed by physical therapists on their interventions are not the only impediments to reduce sedentary behavior. Important individual and social barriers should not be neglected when physical therapists conduct interventions to reduce sedentary behavior to maximize functional recovery in older adults after hip fracture surgery. Future clinical trials are required to investigate the effectiveness of more comprehensive interventions to reduce sedentary behavior in this population.
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Affiliation(s)
| | | | - Natalia Aquaroni Ricci
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
| | - Monica Rodrigues Perracini
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil
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Schehl B, Leukel J. Associations between individual factors, environmental factors, and outdoor independence in older adults. Eur J Ageing 2020; 17:291-298. [PMID: 32904714 PMCID: PMC7458989 DOI: 10.1007/s10433-020-00553-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The degree to which individuals can accomplish outdoor activity by themselves or require support is an important facet of successful aging. While prior research focuses on participation in outdoor activity, understanding of older adults' outdoor independence is limited. We adopt an ecological approach to examine the role of individual factors and environmental factors in explaining outdoor independence. Our sample comprised older adults aged 65 + living in a medium-sized city in Germany (N = 1070). The results show that being male, younger, and healthier was positively associated with outdoor independence, while living together was not. Further, outdoor independence decreased with higher levels of perceived environmental barriers. This negative association was moderated such that it was stronger for the less healthy and older participants. Based on our empirical findings, we offer insights for policy makers, urban planners, and community groups to design age-friendly communities and consequently facilitate outdoor independence among older adults.
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Affiliation(s)
- Barbara Schehl
- Institute for Health Care and Public Management, Faculty of Business, Economics and Social Sciences, University of Hohenheim, Schwerzstraße 35, 70599 Stuttgart, Germany
| | - Joerg Leukel
- Institute for Health Care and Public Management, Faculty of Business, Economics and Social Sciences, University of Hohenheim, Schwerzstraße 35, 70599 Stuttgart, Germany
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Eskytė I, Lawson A, Orchard M, Andrews E. Out on the streets - Crisis, opportunity and disabled people in the era of Covid-19: Reflections from the UK. ALTER-EUROPEAN JOURNAL OF DISABILITY RESEARCH 2020; 14:329-336. [PMID: 32837629 PMCID: PMC7434420 DOI: 10.1016/j.alter.2020.07.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 07/14/2020] [Indexed: 12/14/2022]
Abstract
Governments have responded to the Covid-19 crisis through various measures designed to reduce transmission and protect people judged to be at heightened risk. This paper explores the implications of such measures in the UK for disabled people, with a particular focus on measures designed to reduce and reshape the use of streets and public space. We divide UK measures into two broad categories. First, there are measures designed to reduce the use of streets and public spaces – e.g., rules requiring people to stay at home except in tightly prescribed circumstances and measures providing specific support (including food delivery and priority online shopping) for people designated as clinically extremely ‘vulnerable’. Second, there are measures designed to control the behaviour of people using streets and public space – e.g., rules on physical distancing and the use of face coverings. We explore the disability-related concerns associated with these types of measure. We also highlight the opportunities this crisis presents for embedding accessibility and inclusion more firmly into the fabric of our streets and call for renewed resistance to policies and practices shaped by ableist assumptions and attitudes.
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Affiliation(s)
- Ieva Eskytė
- Centre for Disability Studies, School of Law, University of Leeds, LS2 9JP, Leeds, United Kingdom
| | - Anna Lawson
- Centre for Disability Studies, School of Law, University of Leeds, LS2 9JP, Leeds, United Kingdom
| | - Maria Orchard
- Centre for Disability Studies, School of Law, University of Leeds, LS2 9JP, Leeds, United Kingdom
| | - Elizabeth Andrews
- Centre for Disability Studies, School of Law, University of Leeds, LS2 9JP, Leeds, United Kingdom
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Independent living with mobility restrictions: older people's perceptions of their out-of-home mobility. AGEING & SOCIETY 2020. [DOI: 10.1017/s0144686x20000823] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractWe studied older people's perceptions of how they organise their out-of-home mobility and independent living when they face mobility restrictions, based on seven focus groups with older people (N = 28) from a suburb in Finland. This article provides an everyday life view of how the ability to move outside the home evolves through interdependencies between older people and their neighbourhoods, social relations and societal arrangements. Our findings show that supportive socio-material surroundings can provide older people with new ways to move outside their home despite mobility restrictions and new ways to organise their daily life with decreased mobility. In contrast, restrictive socio-material surroundings can lead to situations in which older people forgo certain out-of-home journeys and activities. The findings contribute to an understanding that organising one's daily life and out-of-home mobility is an act of interdependence. Policies promoting independent living in old age should recognise these fundamental interdependencies and support versatile ways of living rather than overemphasise activity and self-reliance. Based on older people's everyday life perspectives, both sides of the coin need to be considered: how to enable the out-of-home mobility of older people facing mobility restrictions and how to support them in managing and enjoying daily life with decreased mobility.
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Prescott M, Miller WC, Routhier F, Mortenson WB. Factors affecting the activity spaces of people who use mobility devices to get around the community. Health Place 2020; 64:102375. [DOI: 10.1016/j.healthplace.2020.102375] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 11/16/2022]
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Hollis ND, Zhang QC, Cyrus AC, Courtney-Long E, Watson K, Carroll DD. Physical activity types among US adults with mobility disability, Behavioral Risk Factor Surveillance System, 2017. Disabil Health J 2020; 13:100888. [PMID: 32061542 DOI: 10.1016/j.dhjo.2020.100888] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 01/10/2020] [Accepted: 01/27/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Physical Activity Guidelines for Americans, second edition, recommend that all adults participate in moderate-intensity equivalent aerobic physical activity at least 150-300 min/week for substantial health benefits and muscle-strengthening activities involving all major muscle groups 2 or more days a week. The prevalence of the general population meeting the Guidelines and the types of physical activity in which they engage have been described elsewhere. Similar descriptions are lacking for individuals with mobility disability whose physical activity profiles may differ from the general population. OBJECTIVE This study examined patterns of aerobic and muscle-strengthening physical activity among US adults with mobility disability. METHODS We used 2017 Behavioral Risk Factor Surveillance System data from 66,635 adults with mobility disability. We estimated the percentage who engaged in any aerobic physical activity, met the aerobic and/or muscle-strengthening guidelines, and who participated in specific activities. RESULTS Less than half (45.2%) of US adults with mobility disability reported engaging in aerobic physical activity, and 39.5% met one or both components of the physical activity guidelines. Walking was the most commonly reported activity type (34.0%). CONCLUSIONS Walking is a common activity type among adults with mobility disability. Efforts to make walking or wheelchair rolling a safe, viable option are important to helping decrease barriers that may limit the ability of those with mobility disability to engage in walking or other physical activity types.
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Affiliation(s)
- NaTasha D Hollis
- Disability and Health Branch, Division of Human Development and Disability, National Center of Birth Defects and Developmental Disabilities, Atlanta, GA, USA; Commissioned Corps, U.S. Public Health Service, Atlanta, GA, USA.
| | - Qing C Zhang
- Disability and Health Branch, Division of Human Development and Disability, National Center of Birth Defects and Developmental Disabilities, Atlanta, GA, USA
| | - Alissa C Cyrus
- Disability and Health Branch, Division of Human Development and Disability, National Center of Birth Defects and Developmental Disabilities, Atlanta, GA, USA
| | - Elizabeth Courtney-Long
- Disability and Health Branch, Division of Human Development and Disability, National Center of Birth Defects and Developmental Disabilities, Atlanta, GA, USA
| | - Kathleen Watson
- Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, National Center of Chronic Disease Prevention and Health Promotion, Atlanta, GA, USA
| | - Dianna D Carroll
- Epidemiology Workforce Branch, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA; Commissioned Corps, U.S. Public Health Service, Atlanta, GA, USA
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Wang Z. Cross-National Comparison of Environmental Factors Important to Facility-Based Senior Living. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2020; 13:186-199. [PMID: 31994919 DOI: 10.1177/1937586720901344] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Focusing on environmental factors important to facility-based senior living, this research intends to identify cross-national similarities and differences in perspective on elderly care between senior-living professionals in the United States and China. BACKGROUND American models of senior-living facility design have been introduced in China. In social and cultural context, environmental factors important to facility-based senior living are expected to be different by nation and need to be clarified. METHOD Questionnaire data were collected from 188 staff members working in senior-living facilities in the United States and China. Seven factors summarized through literature review were investigated. The frequencies of each factor selected by the participants as one of the three most important factors were ranked. The influence of personal and social factors on environmental perception was analyzed using analysis of variance tests. RESULTS Common area and cross-facility home-like decoration were similarly valued by both groups as two of the three most important factors. Residential room was valued more in the United States whereas natural lighting was valued more in China. Chinese participants with more work experience valued building layout more. Amenities were valued less than expected in both countries. CONCLUSION Environmental factors important to facility-based senior living are different between countries. American models of senior-living facility design should be adjusted for use in China. There is much to be gained from investigating the similarities and differences in perspective on elderly care.
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Affiliation(s)
- Zhe Wang
- Department of Architecture, Henan University, Kaifeng, China
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Delclòs-Alió X, Marquet O, Vich G, Schipperijn J, Zhang K, Maciejewska M, Miralles-Guasch C. Temperature and Rain Moderate the Effect of Neighborhood Walkability on Walking Time for Seniors in Barcelona. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:E14. [PMID: 31861363 PMCID: PMC6981853 DOI: 10.3390/ijerph17010014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/14/2019] [Accepted: 12/15/2019] [Indexed: 12/16/2022]
Abstract
Walking is the most accessible form for seniors to engage in daily light or moderate physical activity. Walking activity depends on both individual and environmental factors, the latter including how walkable a given setting is. Recent papers have pointed at the relevance of also considering meteorological conditions in relation to the walking behavior of older adults. This paper explores the combined effect of neighborhood walkability, temperature and rain on daily walking time among seniors residing in Barcelona. Daily walking time was extracted from 7-day GPS (Global Positioning System) devices and accelerometer data of 227 seniors residing in the Barcelona Metropolitan Region (Spain). Temperature and rain data were extracted from official governmental weather stations. Mixed-effects linear regression models were adjusted to test the combined association between weather and walkability on daily walking time. Neighborhood walkability is positively associated with walking time among seniors, while rain generally deters it. Additionally, this study demonstrates that temperature and rain modify the effect of residential walkability on senior walking activity: low temperatures are particularly associated with lower walking activity among those residing in low walkable areas, while the presence of rain presents a negative association with walking time in high walkable environments. The combined effect of walkability and weather should be considered both in design actions that aim at improving walking infrastructure and also in prevention programs aimed at encouraging daily walking among seniors.
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Affiliation(s)
- Xavier Delclòs-Alió
- Research Group on Mobility, Transportation and Territory (GEMOTT), Department of Geography, Autonomous University of Barcelona, 08193 Cerdanyola del Vallès, Spain; (X.D.-A.); (G.V.);
| | - Oriol Marquet
- Barcelona Institute for Global Health (ISGlobal), 08003 Barcelona, Spain;
| | - Guillem Vich
- Research Group on Mobility, Transportation and Territory (GEMOTT), Department of Geography, Autonomous University of Barcelona, 08193 Cerdanyola del Vallès, Spain; (X.D.-A.); (G.V.);
| | - Jasper Schipperijn
- Research Unit for Active Living, Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark;
| | - Kai Zhang
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston, TX 77030, USA;
| | - Monika Maciejewska
- Research Group on Mobility, Transportation and Territory (GEMOTT), Department of Geography, Autonomous University of Barcelona, 08193 Cerdanyola del Vallès, Spain; (X.D.-A.); (G.V.);
| | - Carme Miralles-Guasch
- Research Group on Mobility, Transportation and Territory (GEMOTT), Department of Geography & Institute of Environmental Science and Technology (ICTA), Autonomous University of Barcelona, 08193 Cerdanyola del Vallès, Spain;
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Miller MJ, Jones J, Anderson CB, Christiansen CL. Factors influencing participation in physical activity after dysvascular amputation: a qualitative meta-synthesis. Disabil Rehabil 2019; 41:3141-3150. [PMID: 30261758 PMCID: PMC6437000 DOI: 10.1080/09638288.2018.1492031] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 05/21/2018] [Accepted: 06/19/2018] [Indexed: 10/28/2022]
Abstract
Purpose: Identifying factors associated with physical activity after dysvascular lower limb amputation (LLA) could provide targets for improving rehabilitation outcomes. The purpose of this meta-synthesis was to identify modifiable factors that may influence physical activity after LLA, a condition characterized by amputation in the setting of older age, diabetes mellitus (DM), and/or peripheral artery disease (PAD).Methods: A systematic search of the literature identified qualitative studies exploring the perceptions of physical activity in people with lower limb amputation, older age, DM, or PAD. Qualitative rigor was assessed using the McMaster University's Guidelines for Qualitative Review. Meta-synthesis was undertaken to analyze the findings of included studies.Results: Fourteen studies of variable methodological quality were included for analysis. Three overarching factors that may influence physical activity after LLA emerged: 1) educational experiences and motivation, 2) support and self-efficacy, and 3) special concerns after lower limb amputation (e.g., prosthesis, equipment, and environment).Conclusions: Physical activity after LLA is influenced by relationships among health understanding, motivation, support, and self-efficacy in the presence of disability. Themes from this meta-synthesis can be used to develop and test behavior-based interventions to improve physical activity after LLA.Implications for rehabilitationPhysical activity participation after dysvascular lower limb amputation is complicated by the presence of chronic conditions, severe disability, and unaddressed psychosocial factors.Addressing a patient's self-efficacy, social support, motivation, and understanding during physically focused rehabilitation may improve participation in physical activity after dysvascular lower limb amputation.Rehabilitation professionals can address self-efficacy, motivation, and understanding by using collaborative, empathetic communication strategies known to enhance a patient's sense of support.
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Affiliation(s)
- Matthew J Miller
- Geriatric Research Education and Clinical Center, VA Eastern Colorado Healthcare System, Denver, CO, USA
- Department of Physical Medicine and Rehabilitation, Physical Therapy Program, University of Colorado, Aurora, CO, USA
| | | | - Chelsey B Anderson
- Department of Physical Medicine and Rehabilitation, Physical Therapy Program, University of Colorado, Aurora, CO, USA
| | - Cory L Christiansen
- Geriatric Research Education and Clinical Center, VA Eastern Colorado Healthcare System, Denver, CO, USA
- Department of Physical Medicine and Rehabilitation, Physical Therapy Program, University of Colorado, Aurora, CO, USA
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Candiotti JL, Daveler BJ, Kamaraj DC, Chung CS, Cooper R, Grindle GG, Cooper RA. A Heuristic Approach to Overcome Architectural Barriers Using a Robotic Wheelchair. IEEE Trans Neural Syst Rehabil Eng 2019; 27:1846-1854. [PMID: 31403434 DOI: 10.1109/tnsre.2019.2934387] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The Mobility Enhancement roBotic (MEBot) wheelchair was developed to improve the safety and accessibility of wheelchair users when facing architectural barriers. MEBot uses pneumatic actuators attached to its frame and six wheels to provide curb ascending/descending for heights up to 20.3 cm. To improve MEBot's application, this study used a heuristic approach with power wheelchair users to evaluate and improve the MEBot application at different curb heights. Wheelchair users were trained on MEBot's features to operate its curb ascending/descending application. Three trials were carried out with wheelchair users ascending and descending three curbs of different height. Quantitative variables were analyzed to improve the sequential steps to ascend/descend curbs. Additionally, the application's effectiveness and efficiency were measured by the number of completed tasks, change in seat angle, and task completion time. Results showed that participants completed each trial and applied alternative strategies to traverse different curb heights. Furthermore, results suggested the combination and/or re-arrangement of steps to reduce task completion time. MEBot demonstrated its effectiveness to ascend/descend different curb heights with a heterogeneous participant sample. Future work will incorporate participant's most efficient strategies to improve the ascending/ascending process and the efficiency of the MEBot application.
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Designing a Client and Family Empowerment Model to Promote Constructive Life Recovery Among Persons with Spinal Cord Injury: A Qualitative Study. ARCHIVES OF NEUROSCIENCE 2019. [DOI: 10.5812/ans.87867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Gough C, Weber H, George S, Maeder A, Lewis L. Location monitoring of physical activity and participation in community dwelling older people: a scoping review. Disabil Rehabil 2019; 43:270-283. [PMID: 31131649 DOI: 10.1080/09638288.2019.1618928] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background: Community participation and physical activity are important for the health of older adults. This review aimed to identify studies which have measured physical activity and community participation in older adults using Global positioning systems.Materials and methods: This scoping review searched key databases using predetermined subject headings and keywords. Two independent reviewers selected studies based on a systematic procedure following current guidelines. Inclusion criteria for studies were: participants aged over 50 years living independently in the community that reported on physical activity and/or participation inclusive of physical and social activity, and including a quantitative measure of location. All searches were limited to English. The primary review question was; "What studies have monitored the location of physical activity in an older population?" with secondary enquiries investigating the types of global positioning system devices, barriers and facilitators for activity and community participation.Results: The search returned 3723 articles (following duplicate removal) and 45 met the inclusion criteria. Studies from 12 countries published over a 12-year period were included. Participants were mainly healthy (n = 23) followed by having a cognitive impairment (n = 10). There were 14 different global positioning system devices used, assessing a variety of outcomes (n = 24). Seventeen studies identified facilitators and barriers to participation and physical activity in an older population. The most common facilitators were safety, weather and access to multi-purpose facilities. The most common barriers were weather, safety, low income/high deprivation areas and use of motor vehicles.Conclusion: This scoping review identified a variety of locational monitoring of older people using global positioning devices. Global positioning systems are a valuable tool to obtain accurate activity locations of older people. There is a need for clear guidelines regarding the use of global positioning system devices and specified outcomes in primary research to enable comparison across studies.Implications for rehabilitationPhysical activity and community participation are vital for healthy ageing.The environment can act as a facilitator or barrier to physical activity and community participation for older adults.Interventions need to target facilitators (weather, safety, facility access and social components) to maximize physical activity and community participation in older people.Interventions should be designed to reduce the barriers (weather, safety, low income and motor vehicle dependency) that prevent older adults from actively participating in their community.
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Affiliation(s)
- Claire Gough
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Heather Weber
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Stacey George
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Anthony Maeder
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Lucy Lewis
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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