Neighborhood walkability, fear and risk of falling and response to walking promotion: The Easy Steps to Health 12-month randomized controlled trial
In older adults the relationships between health, fall-related risk factors, perceived neighborhood walkability, walking behavior and intervention impacts are poorly understood. To determine whether: i) health and fall-related risk factors were associated with perceptions of neighborhood walkability...
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| Format: | Article |
| Language: | English |
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Elsevier
2015-01-01
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| Series: | Preventive Medicine Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211335515001138 |
| _version_ | 1819275070238883840 |
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| author | D. Merom K. Gebel P. Fahey T. Astell-Burt A. Voukelatos C. Rissel C. Sherrington |
| author_facet | D. Merom K. Gebel P. Fahey T. Astell-Burt A. Voukelatos C. Rissel C. Sherrington |
| author_sort | D. Merom |
| collection | DOAJ |
| description | In older adults the relationships between health, fall-related risk factors, perceived neighborhood walkability, walking behavior and intervention impacts are poorly understood.
To determine whether: i) health and fall-related risk factors were associated with perceptions of neighborhood walkability; ii) perceived environmental attributes, and fall-related risk factors predicted change in walking behavior at 12 months; and iii) perceived environmental attributes and fall-related risk factors moderated the effect of a self-paced walking program on walking behavior.
Randomized trial on walking and falls conducted between 2009 and 2012 involving 315 community-dwelling inactive adults ≥65 years living in Sydney, Australia. Measures were: mobility status, fall history, injurious fall and fear of falling (i.e., fall-related risk factors), health status, walking self-efficacy and 11 items from the neighborhood walkability scale and planned walking ≥150 min/week at 12 months.
Participants with poorer mobility, fear of falling, and poor health perceived their surroundings as less walkable. Walking at 12 months was significantly greater in “less greenery” (AOR = 3.3, 95% CI: 1.11–9.98) and “high traffic” (AOR = 1.98, 95% CI: 1.00–3.91) neighborhoods. The intervention had greater effects in neighborhoods perceived to have poorer pedestrian infrastructure (p for interaction = 0.036).
Low perceived walkability was shaped by health status and did not appear to be a barrier to walking behavior. There appears to be a greater impact of, and thus, need for, interventions to encourage walking in environments perceived not to have supportive walking infrastructure. Future studies on built environments and walking should gather information on fall-related risk factors to better understand how these characteristics interact. |
| first_indexed | 2024-12-23T23:18:28Z |
| format | Article |
| id | doaj.art-9addae0e27e44fa198ccde4ecd02678a |
| institution | Directory Open Access Journal |
| issn | 2211-3355 |
| language | English |
| last_indexed | 2024-12-23T23:18:28Z |
| publishDate | 2015-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Preventive Medicine Reports |
| spelling | doaj.art-9addae0e27e44fa198ccde4ecd02678a2022-12-21T17:26:24ZengElsevierPreventive Medicine Reports2211-33552015-01-012C70471010.1016/j.pmedr.2015.08.011Neighborhood walkability, fear and risk of falling and response to walking promotion: The Easy Steps to Health 12-month randomized controlled trialD. Merom0K. Gebel1P. Fahey2T. Astell-Burt3A. Voukelatos4C. Rissel5C. Sherrington6School of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith NSW 2751, AustraliaCentre for Chronic Disease Prevention, College of Public Health, Medical & Veterinary Sciences, James Cook University, PO Box 6811, Cairns, QLD 4870, AustraliaSchool of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith NSW 2751, AustraliaSchool of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith NSW 2751, AustraliaHealth Promotion Service, Sydney and South West Sydney Local Health District, Sydney, Camperdown, NSW 2050, AustraliaSchool of Public Health, Level 6, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, AustraliaThe George Institute for Global Health, Sydney Medical School, University of Sydney, Level 13, 321, Kent St Sydney, NSW 2000, AustraliaIn older adults the relationships between health, fall-related risk factors, perceived neighborhood walkability, walking behavior and intervention impacts are poorly understood. To determine whether: i) health and fall-related risk factors were associated with perceptions of neighborhood walkability; ii) perceived environmental attributes, and fall-related risk factors predicted change in walking behavior at 12 months; and iii) perceived environmental attributes and fall-related risk factors moderated the effect of a self-paced walking program on walking behavior. Randomized trial on walking and falls conducted between 2009 and 2012 involving 315 community-dwelling inactive adults ≥65 years living in Sydney, Australia. Measures were: mobility status, fall history, injurious fall and fear of falling (i.e., fall-related risk factors), health status, walking self-efficacy and 11 items from the neighborhood walkability scale and planned walking ≥150 min/week at 12 months. Participants with poorer mobility, fear of falling, and poor health perceived their surroundings as less walkable. Walking at 12 months was significantly greater in “less greenery” (AOR = 3.3, 95% CI: 1.11–9.98) and “high traffic” (AOR = 1.98, 95% CI: 1.00–3.91) neighborhoods. The intervention had greater effects in neighborhoods perceived to have poorer pedestrian infrastructure (p for interaction = 0.036). Low perceived walkability was shaped by health status and did not appear to be a barrier to walking behavior. There appears to be a greater impact of, and thus, need for, interventions to encourage walking in environments perceived not to have supportive walking infrastructure. Future studies on built environments and walking should gather information on fall-related risk factors to better understand how these characteristics interact.http://www.sciencedirect.com/science/article/pii/S2211335515001138WalkingFallNeighborhoodWalkabilityOlder adultsRandomized controlled trial |
| spellingShingle | D. Merom K. Gebel P. Fahey T. Astell-Burt A. Voukelatos C. Rissel C. Sherrington Neighborhood walkability, fear and risk of falling and response to walking promotion: The Easy Steps to Health 12-month randomized controlled trial Preventive Medicine Reports Walking Fall Neighborhood Walkability Older adults Randomized controlled trial |
| title | Neighborhood walkability, fear and risk of falling and response to walking promotion: The Easy Steps to Health 12-month randomized controlled trial |
| title_full | Neighborhood walkability, fear and risk of falling and response to walking promotion: The Easy Steps to Health 12-month randomized controlled trial |
| title_fullStr | Neighborhood walkability, fear and risk of falling and response to walking promotion: The Easy Steps to Health 12-month randomized controlled trial |
| title_full_unstemmed | Neighborhood walkability, fear and risk of falling and response to walking promotion: The Easy Steps to Health 12-month randomized controlled trial |
| title_short | Neighborhood walkability, fear and risk of falling and response to walking promotion: The Easy Steps to Health 12-month randomized controlled trial |
| title_sort | neighborhood walkability fear and risk of falling and response to walking promotion the easy steps to health 12 month randomized controlled trial |
| topic | Walking Fall Neighborhood Walkability Older adults Randomized controlled trial |
| url | http://www.sciencedirect.com/science/article/pii/S2211335515001138 |
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