The effects of small-scale physical and social environmental interventions on walking behaviour among Dutch older adults living in deprived neighbourhoods: results from the quasi-experimental NEW.ROADS study

R G Prins,F J Van Lenthe,C B M Kamphuis

doi:10.1186/s12966-019-0863-9

R G Prins, F J Van Lenthe + Show 1 more

Open Access

https://doi.org/10.1186/s12966-019-0863-9

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Abstract

PurposeImproving the physical and social conditions of residential neighbourhoods may increase walking, especially among older people. Evidence on the effects of physical and social environmental interventions, and particularly the combination of both, on walking behaviour is scarce. We evaluated the effects of a small-scale physical environmental intervention (designated walking route), a social environmental intervention (neighbourhood walking group) and the combination of both on walking behaviour of older adults living in deprived neighbourhoods.MethodsSurvey data of 644 older adults residing in four deprived neighbourhoods of Rotterdam, the Netherlands, were used to compare changes in walking behaviour over time (weekly minutes spent recreational walking, utilitarian walking and total walking) of those exposed to 1) a designated walking route (physical condition), 2) walking groups (social condition), 3) walking routes and walking groups (combined condition), and 4) no intervention (control condition). Measurements took place at baseline (T0), and 3 months (T1) and 9 months (T2) after the intervention. Data were analysed on a multiple imputed dataset, using multi-level negative binomial regression models, adjusting for clustering of observations within individuals. All models were adjusted for demographic covariates.ResultsTotal time spent walking per week increased between T0 and T1 for all conditions. The Incidence Rate Ratio (IRR) for the physical condition was 1.46 (95% CI:1.06;2.05) and for the social intervention 1.52 (95%CI:1.07;2.16). At T2, these differences remained significant for the physical condition, but not for the social condition and the combined condition. These findings were mirrored for utilitarian walking. No evidence was found for an effect on recreational walking.ConclusionImplementing small scale, feasible, interventions in a residential neighbourhood may increase total and utilitarian walking behaviour among older adults.

Highlights

A large body of epidemiological studies show that physical activity is beneficial for healthy ageing [6, 8, 12, 40, 47]
Baseline participants in the combined condition spent less time in total walking at baseline than participants in the physical condition and control condition
We found that participants living in neighbourhoods in which new walking routes, walking groups, were more likely to increase total walking and utilitarian walking compared to a neighbourhood where no interventions were implemented

Summary

Introduction

A large body of epidemiological studies show that physical activity is beneficial for healthy ageing [6, 8, 12, 40, 47]. Objective measures of physical activity even show that on average Dutch older adults only spent 10 min per week in moderate-to-vigorous physical activities [22]. Physical activity is low in those in lower socioeconomic groups [10, 17] and older adults living in deprived neighbourhoods [14, 45]. There is a need to promote physical activity among older adults; among the socioeconomically disadvantaged. We lack a full understanding, some evidence suggests that neighbourhood factors, such as aesthetics [23, 50], road safety [33], neighbourhood safety [50] and access to green spaces and recreational facilities [49] may contribute to the explanation of socioeconomic differences in recreational walking among older adults

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