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Nigg C, Alothman SA, Alghannam AF, Schipperijn J, AlAhmed R, Alsukait RF, Rakic S, Cetinkaya V, Al-Hazzaa HM, Alqahtani SA. A systematic review on the associations between the built environment and adult's physical activity in global tropical and subtropical climate regions. Int J Behav Nutr Phys Act 2024; 21:59. [PMID: 38773559 PMCID: PMC11107026 DOI: 10.1186/s12966-024-01582-x] [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: 10/08/2023] [Accepted: 03/08/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Physical inactivity is a major public health concern, exacerbated in countries with a (sub)tropical climate. The built environment can facilitate physical activity; however, current evidence is mainly from North American and European countries with activity-friendly climate conditions. This study explored associations between built environment features and physical activity in global tropical or subtropical dry or desert climate regions. METHODS A systematic review of four major databases (Web of Science, Scopus, PubMed, and SportDISCUS) was performed. To be included, studies had to investigate associations between perceived or objective built environment characteristics and adult's physical activity and had to be conducted in a location with (sub)tropical climate. Each investigated association was reported as one case and results were synthesized based upon perceived and objectively assessed environment characteristics as well as Western and non-Western countries. Study quality was evaluated using a tool designed for assessing studies on built environment and physical activity. RESULTS Eighty-four articles from 50 studies in 13 countries with a total of 2546 built environment-physical activity associations were included. Design (connectivity, walking/cycling infrastructure), desirability (aesthetics, safety), and destination accessibility were the built environment characteristics most frequently associated with physical activity across the domains active transport, recreational physical activity, total walking and cycling, and moderate-to-vigorous physical activity, particularly if multiple attributes were present at the same time. Very few studies assessed built environment attributes specifically relevant to physical activity in (sub)tropical climates. Most studies were conducted in Western countries, with results being largely comparable with non-Western countries. Findings were largely generalizable across gender and age groups. Results from natural experiments indicated that relocating to an activity-friendly neighborhood impacted sub-groups differently. CONCLUSIONS Built environment attributes, including destination accessibility, connectivity, walking and cycling infrastructure, safety, and aesthetics, are positively associated with physical activity in locations with (sub)tropical climate. However, few studies focus on built environment attributes specifically relevant in a hot climate, such as shade or indoor recreation options. Further, there is limited evidence from non-Western countries, where most of the urban population lives in (sub)tropical climates. Policy makers should focus on implementing activity-friendly environment attributes to create sustainable and climate-resilient cities.
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Affiliation(s)
- Carina Nigg
- Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, Bern, 3012, Switzerland.
| | - Shaima A Alothman
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah bint Abdulrahman University, PO Box 47330, Riyadh, 11552, Saudi Arabia
| | - Abdullah F Alghannam
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah bint Abdulrahman University, PO Box 47330, Riyadh, 11552, Saudi Arabia
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 39, Odense, 5230, Denmark
| | - Reem AlAhmed
- Biostatistics, Epidemiology and Scientific Computing Department (BESC), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Reem F Alsukait
- Community Health Sciences, King Saud University, PO Box 145111, Riyadh, 11362, Saudi Arabia
| | - Severin Rakic
- The World Bank, 1818 H Street N.W, Washington, DC, 20433, USA
| | | | - Hazzaa M Al-Hazzaa
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah bint Abdulrahman University, PO Box 47330, Riyadh, 11552, Saudi Arabia
- School of Sport Sciences, University of Jordan, King Abdullah II St, Amman, Jordan
| | - Saleh A Alqahtani
- Liver Transplant Center, King Faisal Specialist Hospital & Research Center, Riyadh, 11564, Saudi Arabia
- Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, 21287, USA
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2
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Suri A, VanSwearingen J, Dunlap P, Redfern MS, Rosso AL, Sejdić E. Facilitators and barriers to real-life mobility in community-dwelling older adults: a narrative review of accelerometry- and global positioning system-based studies. Aging Clin Exp Res 2022; 34:1733-1746. [PMID: 35275373 PMCID: PMC8913857 DOI: 10.1007/s40520-022-02096-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/14/2022] [Indexed: 11/01/2022]
Abstract
Real-life mobility, also called "enacted" mobility, characterizes an individual's activity and participation in the community. Real-life mobility may be facilitated or hindered by a variety of factors, such as physical abilities, cognitive function, psychosocial aspects, and external environment characteristics. Advances in technology have allowed for objective quantification of real-life mobility using wearable sensors, specifically, accelerometry and global positioning systems (GPSs). In this review article, first, we summarize the common mobility measures extracted from accelerometry and GPS. Second, we summarize studies assessing the associations of facilitators and barriers influencing mobility of community-dwelling older adults with mobility measures from sensor technology. We found the most used accelerometry measures focus on the duration and intensity of activity in daily life. Gait quality measures, e.g., cadence, variability, and symmetry, are not usually included. GPS has been used to investigate mobility behavior, such as spatial and temporal measures of path traveled, location nodes traversed, and mode of transportation. Factors of note that facilitate/hinder community mobility were cognition and psychosocial influences. Fewer studies have included the influence of external environments, such as sidewalk quality, and socio-economic status in defining enacted mobility. Increasing our understanding of the facilitators and barriers to enacted mobility can inform wearable technology-enabled interventions targeted at delaying mobility-related disability and improving participation of older adults in the community.
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Affiliation(s)
- Anisha Suri
- Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jessie VanSwearingen
- Department of Physical Therapy, School of Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Pamela Dunlap
- Department of Physical Therapy, School of Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mark S Redfern
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Andrea L Rosso
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ervin Sejdić
- Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
- The Edward S. Rogers Department of Electrical and Computer Engineering, University of Toronto, Toronto, ON, Canada.
- North York General Hospital, Toronto, ON, Canada.
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3
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Indoor Built Environment and Older Adults' Activity: A Systematic Review. Can J Aging 2022; 42:241-258. [PMID: 35848156 DOI: 10.1017/s0714980822000241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Although the physical environment can influence people's activity, there are few knowledge syntheses for indoor environments and older adults' daily life routines. Therefore, we conducted a systematic review of peer-reviewed evidence to inform future research and practice. Inclusion criteria were studies with any research designs, across all years and languages focused on older adults 60 years of age or more, on physical activity/sedentary behaviour and the indoor environment. After searching five databases, two authors completed title/abstract and full-text screening. The last search was on December 19, 2020. We screened 1,367 citations, and included 23 studies situated in private or collective dwellings (e.g., assisted living). We identified physical activity-supportive indoor features across three domains: campus (e.g., amenities, pathways), building (e.g., area, floor level), and fixtures (e.g., elevators, hallways). Knowledge of indoor environmental factors for older adults' engagement in daily activities can guide future research and policy on housing design.
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4
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Brüchert T, Hasselder P, Quentin P, Bolte G. Walking for Transport among Older Adults: A Cross-Sectional Study on the Role of the Built Environment in Less Densely Populated Areas in Northern Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249479. [PMID: 33348881 PMCID: PMC7766241 DOI: 10.3390/ijerph17249479] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/10/2020] [Accepted: 12/15/2020] [Indexed: 12/22/2022]
Abstract
In the last decades, there has been rising interest in public health research in the importance of the built environment for a healthy and active life in old age, but little attention has been paid to less densely populated areas. This study aimed to explore the impact of the built environment on walking for transport in the context of an older population living in communities of <100,000 inhabitants. Within the project AFOOT–Securing urban mobility of an aging population, a cross-sectional postal survey was carried out from May to September 2019 in older adults (≥65 years) in the Metropolitan Region Northwest, Germany. Self-reported data from 2189 study participants were analyzed. Logistic and linear regression models were used to examine the associations between the built environment and walking for transport. Any walking and frequent walking were positively associated with nearly all built environment attributes, even after adjustment for demographic and health covariates. The amount of walking in minutes per week was associated only with residential density. Moderating effects of gender, age, and use of walking aids were identified. Improving the built environment appears to be a promising opportunity to motivate and enable older adults to walk for transport.
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Affiliation(s)
- Tanja Brüchert
- Institute of Public Health and Nursing Research, Department of Social Epidemiology, University of Bremen, Grazer Str. 4, 28359 Bremen, Germany; (T.B.); (P.H.)
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany
| | - Pia Hasselder
- Institute of Public Health and Nursing Research, Department of Social Epidemiology, University of Bremen, Grazer Str. 4, 28359 Bremen, Germany; (T.B.); (P.H.)
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany
| | - Paula Quentin
- Department of European Planning Cultures, Faculty of Spatial Planning, TU Dortmund University, August-Schmidt-Straße 10, 44227 Dortmund, Germany;
| | - Gabriele Bolte
- Institute of Public Health and Nursing Research, Department of Social Epidemiology, University of Bremen, Grazer Str. 4, 28359 Bremen, Germany; (T.B.); (P.H.)
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany
- Correspondence: ; Tel.: +49-421-2186-8820
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Chum K, Fitzhenry G, Robinson K, Murphy M, Phan D, Alvarez J, Hand C, Laliberte Rudman D, McGrath C. Examining Community-Based Housing Models to Support Aging in Place: A Scoping Review. THE GERONTOLOGIST 2020; 62:e178-e192. [PMID: 32971538 DOI: 10.1093/geront/gnaa142] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES With the global population aging, there is demand for older adults to age in place, that is, to live and age well in their home and community with some level of independence. Community-based housing models exist and may support this process. This scoping review aimed to describe and synthesize the ways in which community-based housing models relate to older adults' aging in place and identify strengths and gaps in the literature. RESEARCH DESIGN AND METHODS The housing models explored were: villages; naturally occurring retirement communities; congregate housing and co-housing; sheltered housing; and continuing care retirement communities. This exploratory scoping review examined international peer-reviewed literature published from 2004-2019. Six databases were searched using terms related to housing models and older adults. Forty-six articles met the inclusion criteria. Descriptive numerical summary and thematic analysis were used to synthesize study characteristics and findings. RESULTS Our analysis revealed four themes relating to aging in place in the housing models: Social Relations, Health and Well-being, Sense of Self and Autonomy, and Activity Participation. Further analysis identified housing-specific characteristics that appeared to pose barriers to, or enable, aging in place. DISCUSSION AND IMPLICATIONS To best support aging in place, the findings of the review suggest multiple characteristics worth considering when developing or relocating to a community-based housing model. Further research is required to understand how facilitating characteristics can promote aging in place for community-dwelling older adults.
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Affiliation(s)
- Karen Chum
- School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Griffin Fitzhenry
- School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Kali Robinson
- School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Michelle Murphy
- School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Delyth Phan
- School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Jacob Alvarez
- School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Carri Hand
- School of Occupational Therapy, Western University, London, Ontario, Canada
| | | | - Colleen McGrath
- School of Occupational Therapy, Western University, London, Ontario, Canada
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6
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Sims J, Cornell V. Is an Australian's home their castle? The challenges of ageing in place. Australas J Ageing 2020; 39:5-8. [PMID: 32153109 DOI: 10.1111/ajag.12786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 02/09/2020] [Accepted: 02/10/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Jane Sims
- Department of General Practice, School of Primary and Allied Health Care, Monash University, Melbourne, Vic., Australia.,General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Vic., Australia
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Thøgersen-Ntoumani C, Quested E, Biddle SJH, Kritz M, Olson J, Burton E, Cerin E, Hill KD, McVeigh J, Ntoumanis N. Trial feasibility and process evaluation of a motivationally-embellished group peer led walking intervention in retirement villages using the RE-AIM framework: the residents in action trial (RiAT). Health Psychol Behav Med 2019; 7:202-233. [PMID: 34040848 PMCID: PMC8114369 DOI: 10.1080/21642850.2019.1629934] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective: The Residents in Action Trial (RiAT; ACTRN12616001177448) was a 16-week motivationally-embellished peer-led walking intervention designed to increase walking, reduce sitting, and improve mental health and well-being in insufficiently active residents in retirement villages. In this paper we report on 1) trial feasibility and acceptability, and 2) evaluate the processes involved in the implementation of the intervention using the RE-AIM framework. Method: A mixed methods design was employed, consisting of data from accelerometers, surveys, (individual, pair-based and focus group) interviews, and participant logbooks. Participants included 116 walkers (M(SD) age = 78.37(8.30); 92% female), 8 peer leaders (i.e. ambassadors) and 3 retirement village managers from 14 retirement villages. Descriptives and linear mixed modelling were used to analyse the quantitative data and inductive thematic analyses were employed to analyse the interview data. Results: The intended cluster randomised controlled design became quasi-experimental due to insufficient numbers of recruited ambassadors. The perceived burden of the number and frequency of research assessments was a frequently mentioned reason for a poor recruitment. Facilitators to walking maintenance were the use of self-monitoring, goal setting, social support, and having a routine. Reach was modest (about 14% of eligible participants were recruited from each village), but retention was excellent (92%). The motivational strategies taught appeared to have been implemented, at least in part, by the ambassadors. The walkers in the main experimental condition increased marginally their step counts, but there were no group differences on mental health and well-being outcomes, partly because of low statistical power. Conclusions: Walkers and ambassadors who did take part in the study suggested that they enjoyed the programme and found it useful in terms of becoming more active and making social connections. However, the group format was not appealing to some participants, hence, other delivery options should be explored in the future.
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Affiliation(s)
| | - Eleanor Quested
- Physical Activity and Well-Being Lab, School of Psychology, Curtin University, Perth, Australia
| | - Stuart J H Biddle
- Physically Active Lifestyles Research Group, University of Southern Queensland, Springfield, Australia
| | - Marlene Kritz
- Physical Activity and Well-Being Lab, School of Psychology, Curtin University, Perth, Australia
| | - Jenny Olson
- Physical Activity and Well-Being Lab, School of Psychology, Curtin University, Perth, Australia.,Physically Active Lifestyles Research Group, University of Southern Queensland, Springfield, Australia
| | - Elissa Burton
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.,School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - Keith D Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Joanne McVeigh
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia.,Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, Witwatersrand, South Africa
| | - Nikos Ntoumanis
- Physical Activity and Well-Being Lab, School of Psychology, Curtin University, Perth, Australia
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8
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Van Cauwenberg J, Nathan A, Barnett A, Barnett DW, Cerin E. Relationships Between Neighbourhood Physical Environmental Attributes and Older Adults' Leisure-Time Physical Activity: A Systematic Review and Meta-Analysis. Sports Med 2019; 48:1635-1660. [PMID: 29721838 DOI: 10.1007/s40279-018-0917-1] [Citation(s) in RCA: 132] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Activity-friendly neighbourhood physical environments with access to recreational facilities are hypothesised to facilitate leisure-time physical activity (LTPA) among older adults (≥ 65 years old). The aim of the current study was to systematically review and quantitatively summarise study findings on the relationships between physical environmental attributes and LTPA among older adults. METHODS An extensive search of literature, including grey literature, yielded 72 articles eligible for inclusion. The reported associations between seven categories of environmental attributes and six LTPA outcomes were extracted, weighted by sample size and study quality, and quantitatively summarised. Reported moderating effects of individual and environmental characteristics and neighbourhood definition were also examined. RESULTS We observed positive associations for walkability (p = 0.01), land-use mix-access (p = 0.02) and aesthetically pleasing scenery (p < 0.001) with leisure-time walking. For leisure-time walking within the neighbourhood, evidence was found for positive associations with land-use mix-access (p = 0.03) and access to public transit (p = 0.05), and a negative association with barriers to walking/cycling (p = 0.03). Evidence for positive relationships between overall LTPA and access to recreational facilities (p = 0.01) and parks/open space (p = 0.04) was found. Several environmental attribute-LTPA outcome combinations were insufficiently studied to draw conclusions. No consistent moderating effects were observed for individual and environmental characteristics and neighbourhood definition. CONCLUSIONS The observed significant relationships can be used to inform policy makers and planners on how to (re-)design neighbourhoods that promote LTPA among older adults. Many environmental attribute-LTPA outcome relationships have been studied insufficiently and several methodological issues remain to be addressed. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO 2016:CRD42016051180.
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Affiliation(s)
- Jelle Van Cauwenberg
- Department of Public Health, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium. .,Research Foundation Flanders, Egmontstraat 5, 1000, Brussels, Belgium.
| | - Andrea Nathan
- Mary MacKillop Institute for Health Research, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, VIC, 3000, Australia
| | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, VIC, 3000, Australia
| | - David W Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, VIC, 3000, Australia
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, VIC, 3000, Australia.,School of Public Health, The University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong, China.,Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
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9
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Barnett DW, Barnett A, Nathan A, Van Cauwenberg J, Cerin E. Built environmental correlates of older adults' total physical activity and walking: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2017; 14:103. [PMID: 28784183 PMCID: PMC5547528 DOI: 10.1186/s12966-017-0558-z] [Citation(s) in RCA: 359] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 07/31/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Identifying attributes of the built environment associated with health-enhancing levels of physical activity (PA) in older adults (≥65 years old) has the potential to inform interventions supporting healthy and active ageing. The aim of this study was to first systematically review and quantify findings on built environmental correlates of older adults' PA, and second, investigate differences by type of PA and environmental attribute measurement. METHODS One hundred articles from peer-reviewed and grey literature examining built environmental attributes related to total PA met inclusion criteria and relevant information was extracted. Findings were meta-analysed and weighted by article quality and sample size and then stratified by PA and environmental measurement method. Associations (p < .05) were found in relation to 26 individual built environmental attributes across six categories (walkability, residential density/urbanisation, street connectivity, access to/availability of destinations and services, infrastructure and streetscape, and safety) and total PA and walking specifically. Reported individual- and environmental-level moderators were also examined. RESULTS Positive environmental correlates of PA, ranked by strength of evidence, were: walkability (p < .001), safety from crime (p < .001), overall access to destinations and services (p < .001), recreational facilities (p < .001), parks/public open space (p = .002) and shops/commercial destinations (p = .006), greenery and aesthetically pleasing scenery (p = .004), walk-friendly infrastructure (p = .009), and access to public transport (p = .016). There were 26 individual differences in the number of significant associations when the type of PA and environmental measurement method was considered. No consistent moderating effects on the association between built environmental attributes and PA were found. CONCLUSIONS Safe, walkable, and aesthetically pleasing neighbourhoods, with access to overall and specific destinations and services positively influenced older adults' PA participation. However, when considering the environmental attributes that were sufficiently studied (i.e., in ≥5 separate findings), the strength of evidence of associations of specific categories of environment attributes with PA differed across PA and environmental measurement types. Future research should be mindful of these differences in findings and identify the underlying mechanisms. Higher quality research is also needed.
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Affiliation(s)
- David W. Barnett
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
| | - Anthony Barnett
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
| | - Andrea Nathan
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
| | - Jelle Van Cauwenberg
- Department of Public Health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
- Research Foundation Flanders, Egmontstraat 5, 1000 Brussels, Belgium
| | - Ester Cerin
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
- School of Public Health, The University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong, Special Administrative Region China
- Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004 Australia
| | - on behalf of the Council on Environment and Physical Activity (CEPA) – Older Adults working group
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
- Department of Public Health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
- Research Foundation Flanders, Egmontstraat 5, 1000 Brussels, Belgium
- School of Public Health, The University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong, Special Administrative Region China
- Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004 Australia
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10
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Barnett DW, Barnett A, Nathan A, Van Cauwenberg J, Cerin E. Built environmental correlates of older adults' total physical activity and walking: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2017. [PMID: 28784183 DOI: 10.1186/sl2966-017-0558-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Identifying attributes of the built environment associated with health-enhancing levels of physical activity (PA) in older adults (≥65 years old) has the potential to inform interventions supporting healthy and active ageing. The aim of this study was to first systematically review and quantify findings on built environmental correlates of older adults' PA, and second, investigate differences by type of PA and environmental attribute measurement. METHODS One hundred articles from peer-reviewed and grey literature examining built environmental attributes related to total PA met inclusion criteria and relevant information was extracted. Findings were meta-analysed and weighted by article quality and sample size and then stratified by PA and environmental measurement method. Associations (p < .05) were found in relation to 26 individual built environmental attributes across six categories (walkability, residential density/urbanisation, street connectivity, access to/availability of destinations and services, infrastructure and streetscape, and safety) and total PA and walking specifically. Reported individual- and environmental-level moderators were also examined. RESULTS Positive environmental correlates of PA, ranked by strength of evidence, were: walkability (p < .001), safety from crime (p < .001), overall access to destinations and services (p < .001), recreational facilities (p < .001), parks/public open space (p = .002) and shops/commercial destinations (p = .006), greenery and aesthetically pleasing scenery (p = .004), walk-friendly infrastructure (p = .009), and access to public transport (p = .016). There were 26 individual differences in the number of significant associations when the type of PA and environmental measurement method was considered. No consistent moderating effects on the association between built environmental attributes and PA were found. CONCLUSIONS Safe, walkable, and aesthetically pleasing neighbourhoods, with access to overall and specific destinations and services positively influenced older adults' PA participation. However, when considering the environmental attributes that were sufficiently studied (i.e., in ≥5 separate findings), the strength of evidence of associations of specific categories of environment attributes with PA differed across PA and environmental measurement types. Future research should be mindful of these differences in findings and identify the underlying mechanisms. Higher quality research is also needed.
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Affiliation(s)
- David W Barnett
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC, 3000, Australia
| | - Anthony Barnett
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC, 3000, Australia
| | - Andrea Nathan
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC, 3000, Australia
| | - Jelle Van Cauwenberg
- Department of Public Health, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
- Research Foundation Flanders, Egmontstraat 5, 1000, Brussels, Belgium
| | - Ester Cerin
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC, 3000, Australia.
- School of Public Health, The University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong, Special Administrative Region, China.
- Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia.
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11
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Jancey J, Holt AM, Lee A, Kerr D, Robinson S, Tang L, Anderson AS, Hills AP, Howat P. Effects of a physical activity and nutrition program in retirement villages: a cluster randomised controlled trial. Int J Behav Nutr Phys Act 2017; 14:92. [PMID: 28697803 PMCID: PMC5504569 DOI: 10.1186/s12966-017-0543-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 06/29/2017] [Indexed: 02/05/2023] Open
Abstract
Background This cluster randomised controlled trial aimed to determine if a 6- month home-based intervention could improve the physical activity and dietary behaviours of adults aged 60 to 80 years living in retirement villages located in Perth, Western Australia. Methods Participants (n = 363) from 38 retirement villages were recruited into the trial and allocated to the intervention (n = 197: 17 sites) or control (n = 166: 21 sites) group and were blinded. Previously validated instruments-Fat and Fibre Barometer and International Physical Activity Questionnaire, along with anthropometric measures (weight, height, waist and hip circumferences) and blood pressure were collected at baseline and 6 -month time period. Comparisons between intervention and control groups were undertaken pre- and post- intervention using univariate chi-square and t-tests. Multi-level mixed regression analyses were then conducted to ascertain the effects of the intervention on changes in the outcome variables over time and between groups. Results A total of 139 (70.5%) intervention and 141 (84.9%) control group participants completed the program and post-test assessments. The intervention group demonstrated significant increases in time (80 min more per week on average) devoted to moderate-intensity physical activity, engagement in strength exercises (from 23.7% to 48.2%), frequency of fruit consumed as well as fat avoidance and fibre intake scores, in addition to a 0.5 kg mean reduction in weight post program, whereas no apparent changes were observed in the control group. Mixed regression results further confirmed statistically significant improvements in weight loss (p < 0.05), engagement in strength exercises (p < 0.001) and fruit intake (p = 0.012) by the intervention participants at post-test relative to their controls. Conclusions Retirement offers a time to reassess lifestyle, and adopt positive health enhancing physical activity and dietary behaviours. This intervention was successful in improving weight, engagement in strength exercises, increasing levels of moderate-intensity physical activity and consumption of fruit among retirement village residents. Further investigation is needed on how to better engage retirement village managers in such programs. Trial registration Australia and New Zealand Clinical Trial Registry (ACTRN12612001168842) registered November 2, 2012. Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0543-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Heath, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
| | - Anne-Marie Holt
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Heath, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Andy Lee
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Heath, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Deborah Kerr
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Heath, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Suzanne Robinson
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Li Tang
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.,Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, Sichuan Province, 610041, China
| | - A S Anderson
- Centre for Public Health Nutrition Research, Division of Cancer Research, Ninewells Medical School, Dundee University, Level 7, Mailbox 7, Dundee, DD1 9SY, UK
| | - Andrew P Hills
- University of Tasmania, 41 Charles St, Launceston TAS, Launceston, TAS, 7250, Australia
| | - Peter Howat
- School of Public Health, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
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12
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Thøgersen-Ntoumani C, Wright A, Quested E, Burton E, Hill KD, Cerin E, Biddle SJH, Ntoumanis N. Protocol for the residents in action pilot cluster randomised controlled trial (RiAT): evaluating a behaviour change intervention to promote walking, reduce sitting and improve mental health in physically inactive older adults in retirement villages. BMJ Open 2017; 7:e015543. [PMID: 28645969 PMCID: PMC5734553 DOI: 10.1136/bmjopen-2016-015543] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Ageing is accompanied by increased risks of chronic disease, declined functioning and increased dependency. Physical activity is critical to retaining health and independence, but the majority of older people are insufficiently physically active to achieve these benefits and have high levels of sedentary (sitting) time. Activity programmes are often offered in retirement villages; however, their uptake is limited. Furthermore, although the physical environment in and around these villages can play an important role in decisions to be physically active, its role is often overlooked by research in these settings. We aim to develop, implement and evaluate a proof-of-concept motivationally embellished intervention designed to increase walking, reduce sitting and improve mental health in residents in retirement villages. METHODS AND ANALYSIS This will be a 16-week pilot intervention using a cluster randomised design with retirement villages as the unit of randomisation and residents as the unit of assessment. Fourteen retirement villages around Perth, Western Australia, will be recruited for the intervention. Objective audits of neighbourhood environments around each village will be completed using the Pathway Environmental Audit Tool. Seven villages will be randomised to the experimental arm and seven to the control arm. Only participants in the experimental arm will receive motivational training. All outcomes will be assessed at baseline, end of intervention and 6-month follow-up. Changes in physical activity levels, sitting time and mental health will be examined. Multilevel modelling will be used to analyse the data. A mixed methods process evaluation will also be conducted. ETHICS AND DISSEMINATION Ethics approval was granted by Curtin University's Human Research Ethics Committee (HREC2016-0187). The results of the study will be disseminated via peer-reviewed publications, conference presentations and reports to, and seminars with, stakeholders. TRIAL REGISTRATION The trial is registered with the Australian New Zealand Clinical Trials Registry: ACTRN12616001177448.
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Affiliation(s)
- Cecilie Thøgersen-Ntoumani
- Health Psychology & Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Ashlene Wright
- Health Psychology & Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Eleanor Quested
- Health Psychology & Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Elissa Burton
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Keith D Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Ester Cerin
- Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Stuart J H Biddle
- Institute of Sport, Exercise & Active Living, Victoria University, Melbourne, Victoria, Australia
- Institute for Resilient Regions, University of Southern Queensland, Springfield, Queensland, Australia
| | - Nikos Ntoumanis
- Health Psychology & Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
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13
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Cerin E, Nathan A, van Cauwenberg J, Barnett DW, Barnett A. The neighbourhood physical environment and active travel in older adults: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2017; 14:15. [PMID: 28166790 PMCID: PMC5294838 DOI: 10.1186/s12966-017-0471-5] [Citation(s) in RCA: 249] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 01/31/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Perceived and objectively-assessed aspects of the neighbourhood physical environment have been postulated to be key contributors to regular engagement in active travel (AT) in older adults. We systematically reviewed the literature on neighbourhood physical environmental correlates of AT in older adults and applied a novel meta-analytic approach to statistically quantify the strength of evidence for environment-AT associations. METHODS Forty two quantitative studies that estimated associations of aspects of the neighbourhood built environment with AT in older adults (aged ≥ 65 years) and met selection criteria were reviewed and meta-analysed. Findings were analysed according to five AT outcomes (total walking for transport, within-neighbourhood walking for transport, combined walking and cycling for transport, cycling for transport, and all AT outcomes combined) and seven categories of the neighbourhood physical environment (residential density/urbanisation, walkability, street connectivity, access to/availability of services/destinations, pedestrian and cycling infrastructure, aesthetics and cleanliness/order, and safety and traffic). RESULTS Most studies examined correlates of total walking for transport. A sufficient amount of evidence of positive associations with total walking for transport was found for residential density/urbanisation, walkability, street connectivity, overall access to destinations/services, land use mix, pedestrian-friendly features and access to several types of destinations. Littering/vandalism/decay was negatively related to total walking for transport. Limited evidence was available on correlates of cycling and combined walking and cycling for transport, while sufficient evidence emerged for a positive association of within-neighbourhood walking with pedestrian-friendly features and availability of benches/sitting facilities. Correlates of all AT combined mirrored those of walking for transport. Positive associations were also observed with food outlets, business/institutional/industrial destinations, availability of street lights, easy access to building entrance and human and motorised traffic volume. Several but inconsistent individual- and environmental-level moderators of associations were identified. CONCLUSIONS Results support strong links between the neighbourhood physical environment and older adults' AT. Future research should focus on the identification of types and mixes of destinations that support AT in older adults and how these interact with individual characteristics and other environmental factors. Future research should also aim to clarify dose-response relationships through multi-country investigations and data-pooling from diverse geographical regions.
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Affiliation(s)
- Ester Cerin
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
- School of Public Health, The University of Hong Kong, Hong Kong, China
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - Andrea Nathan
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
| | | | - David W. Barnett
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
| | - Anthony Barnett
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
| | - on behalf of the Council on Environment and Physical Activity (CEPA) – Older Adults working group
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
- School of Public Health, The University of Hong Kong, Hong Kong, China
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- Department of Public Health, Ghent University, Ghent, Belgium
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14
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Cerin E, Nathan A, van Cauwenberg J, Barnett DW, Barnett A. The neighbourhood physical environment and active travel in older adults: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2017. [PMID: 28166790 DOI: 10.1186/sl2966-017-0471-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Perceived and objectively-assessed aspects of the neighbourhood physical environment have been postulated to be key contributors to regular engagement in active travel (AT) in older adults. We systematically reviewed the literature on neighbourhood physical environmental correlates of AT in older adults and applied a novel meta-analytic approach to statistically quantify the strength of evidence for environment-AT associations. METHODS Forty two quantitative studies that estimated associations of aspects of the neighbourhood built environment with AT in older adults (aged ≥ 65 years) and met selection criteria were reviewed and meta-analysed. Findings were analysed according to five AT outcomes (total walking for transport, within-neighbourhood walking for transport, combined walking and cycling for transport, cycling for transport, and all AT outcomes combined) and seven categories of the neighbourhood physical environment (residential density/urbanisation, walkability, street connectivity, access to/availability of services/destinations, pedestrian and cycling infrastructure, aesthetics and cleanliness/order, and safety and traffic). RESULTS Most studies examined correlates of total walking for transport. A sufficient amount of evidence of positive associations with total walking for transport was found for residential density/urbanisation, walkability, street connectivity, overall access to destinations/services, land use mix, pedestrian-friendly features and access to several types of destinations. Littering/vandalism/decay was negatively related to total walking for transport. Limited evidence was available on correlates of cycling and combined walking and cycling for transport, while sufficient evidence emerged for a positive association of within-neighbourhood walking with pedestrian-friendly features and availability of benches/sitting facilities. Correlates of all AT combined mirrored those of walking for transport. Positive associations were also observed with food outlets, business/institutional/industrial destinations, availability of street lights, easy access to building entrance and human and motorised traffic volume. Several but inconsistent individual- and environmental-level moderators of associations were identified. CONCLUSIONS Results support strong links between the neighbourhood physical environment and older adults' AT. Future research should focus on the identification of types and mixes of destinations that support AT in older adults and how these interact with individual characteristics and other environmental factors. Future research should also aim to clarify dose-response relationships through multi-country investigations and data-pooling from diverse geographical regions.
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Affiliation(s)
- Ester Cerin
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC, 3000, Australia.
- School of Public Health, The University of Hong Kong, Hong Kong, China.
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
| | - Andrea Nathan
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC, 3000, Australia
| | | | - David W Barnett
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC, 3000, Australia
| | - Anthony Barnett
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC, 3000, Australia
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15
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Nyman SR, Goodwin K, Kwasnicka D, Callaway A. Increasing walking among older people: A test of behaviour change techniques using factorial randomised N-of-1 trials. Psychol Health 2015; 31:313-30. [PMID: 26387689 PMCID: PMC4784513 DOI: 10.1080/08870446.2015.1088014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective: Evaluations of techniques to promote physical activity usually adopt a randomised controlled trial (RCT). Such designs inform how a technique performs on average but cannot be used for treatment of individuals. Our objective was to conduct the first N-of-1 RCTs of behaviour change techniques with older people and test the effectiveness of the techniques for increasing walking within individuals. Design: Eight adults aged 60–87 were randomised to a 2 (goal-setting vs. active control) × 2 (self-monitoring vs. active control) factorial RCT over 62 days. The time series data were analysed for each single case using linear regressions. Main outcome measures: Walking was objectively measured using pedometers. Results: Compared to control days, goal-setting increased walking in 4 out of 8 individuals and self-monitoring increased walking in 7 out of 8 individuals. While the probability for self-monitoring to be effective in 7 out of 8 participants was beyond chance (p = .03), no intervention effect was significant for individual participants. Two participants had a significant but small linear decrease in walking over time. Conclusion: We demonstrate the utility of N-of-1 trials for advancing scientific enquiry of behaviour change and in practice for increasing older people’s physical activity.
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Affiliation(s)
- Samuel R Nyman
- a Faculty of Science and Technology, Department of Psychology , Bournemouth University , Dorset , UK.,b Bournemouth University Dementia Institute, Bournemouth University , Dorset , UK
| | - Kelly Goodwin
- c Faculty of Management, Department of Sport and Physical Activity , Bournemouth University , Dorset , UK
| | - Dominika Kwasnicka
- d Faculty of Medical Sciences , Institute of Health and Society, Newcastle University, Fuse - UKCRC Centre for Translational Research in Public Health , Newcastle Upon Tyne , UK
| | - Andrew Callaway
- c Faculty of Management, Department of Sport and Physical Activity , Bournemouth University , Dorset , UK
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