A Multilevel Walking Intervention for Sedentary Assisted-Living Seniors

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DESCRIPTION (provided by applicant): Among older Americans regular physical activity (PA) can decrease the risk of developing, and improve outcomes of existing, chronic disease. Yet, levels of PA decline substantially with advancing years making older adults largely inactive. Interventions to promote PA among older adults often focus on structured group exercise programs even though such programs are sometimes difficult to sustain and older adults may prefer doing activity independently. Walking is an activity often promoted for older individuals as it is easy, inexpensive, and can be performed almost anywhere on one's own. Theory grounded in individual and/or social perspectives has guided recent approaches to promoting walking in older adults and lacked environmental dimensions. It is increasingly important to address limitations of the physical environment faced by older adults including uneven sidewalks, unsafe streets, and lack of access to useful destinations. Individuals in assisted living facilities (ALFs) have rarely been the focus of physical activity research yet ALFs are home to increasing numbers of older adults who may be particularly prone to the constraints of their environments. Specialized approaches to increasing walking levels in residents of ALFs hold promise for improving physical functioning and health. The goal of the proposed study is to test a multilevel walking intervention focusing on individual, interpersonal, and environmental levels in assisted-living older adults. The study will be a randomized controlled field trial where residents living in 2-4 ALFs will partake in an intervention or comparison condition. Intervention components will include: pedometers for self-monitoring, feedback and motivation; individualized health counseling focusing on step goal setting; group meetings to encourage social support and problem solve barriers to walking; and tailored walking route maps designed to change participant perceptions of their site and neighborhood environments. Comparison group participants will receive weekly healthy aging seminars on topics other than physical activity. It is hypothesized that, compared to those randomized to the comparison condition, participants in the intervention group will have improved weekly step counts, physical functioning, and reports of depression and quality of life. Relevance: Adults over age 65 constitute a growing segment of the population and increasing numbers are moving to ALFs. Promoting walking in this population can contribute to health and quality of life outcomes yet little is known about how to accomplish this. This project will evaluate an innovative and sustainable intervention that is designed to enable seniors to overcome barriers to PA in their own neighborhood; if successful it may be generalizable to other ALFs.