Determinants of Walking among Middle-Aged and Older Overweight and Obese Adults: Sociodemographic, Health, and Built Environmental Factors

Abstract

Background This study examined the association between selected sociodemographic, health, and built environmental factors and walking behaviors of middle-aged and older overweight/obese adults. Methods Subjective data were obtained from surveys administered to community-dwelling overweight/obese adults aged ≥50 years residing in four Texas cities from October 2013 to June 2014, along with objective data on neighborhood walkability (Walk Score™). Multivariate logistic regression identified factors predicting the odds of walking the recommended ≥150 minutes per week for any purpose. Results Of 253 participants, the majority were non-Hispanic white (81.8%), married (74.5%), and male (53.4%) and reported an annual income of ≥$50,000 (65.5%). Approximately, half were employed (49.6%) or had at least a college degree (51.6%). Walking the recommended ≥150 minutes per week for any purpose (n = 57, 22.5%) was significantly associated with having at least a college degree (OR = 5.55, 95% CI = 1.79–17.25), having no difficulty walking a quarter of a mile (OR = 5.18, 95% CI = 1.30–20.83), and being unemployed (OR = 3.25, 95% CI = 1.18–8.93) as well as perceived presence of sidewalks/protected walkways (OR = 3.56, 95% CI = 1.10–11.50) and perceived absence of distracted drivers in the neighborhood (OR = 4.08, 95% CI = 1.47–11.36). Conclusion Addressing neighborhood conditions related to distracted drivers and pedestrian infrastructure may promote walking among middle-aged and older overweight/obese individuals.

Measuring the association of objective and perceived neighborhood environment with physical activity in older adults: challenges and implications from a systematic review

“…One quarter of the studies (n = 9) tested the mediating role of demographic, psychosocial, functional, behavioral, and/or environmental features on the association between NE and PA [ 125 , 127 , 128 , 130 – 132 , 144 – 146 ]. Other studies tested whether associations between NE and PA were moderated by age, sex or education, driving status, crime and safety or objective walkability [ 82 , 121 , 126 , 147 , 148 ]. The target of one study [ 149 ] was to examine the value of PA as a moderating element for somatic health.…”

“…With regard to PA, sociodemographic factors (i.e., sex and age) were the most frequently examined moderators at the individual level. At the NE level, objectively measured walkability [ 148 ], a Walkscore [ 126 ], buffer sizes [ 137 ] and primary type of buildings in the neighborhood [ 145 ] were assessed. However, the majority of studies (n = 19) examined self-reported features such as mental health status [ 127 , 131 ], perceived PA [ 40 , 125 , 127 ], perception of crime and safety [ 145 – 147 ], perceived NE [ 130 , 131 ], social cohesion/support [ 127 , 132 , 144 , 146 ], health/medical condition or functional limitations [ 132 , 149 ], self-efficacy [ 132 ], perceptions of proximity [ 153 ] and self-reported park visits [ 40 ].…”

“…However, the majority of studies (n = 19) examined self-reported features such as mental health status [ 127 , 131 ], perceived PA [ 40 , 125 , 127 ], perception of crime and safety [ 145 – 147 ], perceived NE [ 130 , 131 ], social cohesion/support [ 127 , 132 , 144 , 146 ], health/medical condition or functional limitations [ 132 , 149 ], self-efficacy [ 132 ], perceptions of proximity [ 153 ] and self-reported park visits [ 40 ]. Potential influencing factors for the perception of the NE, such as driving status [ 82 , 145 ], objective walkability [ 126 , 148 ], individual-level demographics and income [ 121 , 126 , 148 ], dogs in household [ 126 ], as well as body mass index (BMI) [ 126 ] were also included as moderator variables.…”

Translating Urban Walkability Initiatives for Older Adults in Rural and Under-Resourced Communities

“…Microscale, or neighborhood level, infrastructure includes solutions such a maintained footpaths [35], availability of street lights [35], presence of sidewalks/protected walkways [36,37], quality of street crossings [20], street connectivity [39], recreational facilities [28], as well as rest stops and benches [35]. Microscale changes not only increase walkability [41], but have also been shown to have a positive impact on walking for travel in older adults [20,28,34,35,36,37,40,42]. Microscale infrastructure also positively affects neighborhood aesthetics, which has been shown to increase leisure and utilitarian walking [34,40,42].…”

Restricted Social Engagement among Adults Living with Chronic Conditions

“…Environmental interventions focused on the built environment can be a critical component that can both target social interactions and physical activity [ 39 , 40 ]. Identifying sustainable solutions—namely walkable environments that will help increase or maintain adequate levels of physical activity [ 12 , 39 , 40 , 41 , 42 ]—is critical. Potential solutions also transcend environmental solutions into behavioral interventions.…”