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Volume 2: No. 2, April 2005
SPECIAL TOPICS
ORIGINAL RESEARCH: FEATURED
ABSTRACT FROM THE 19TH NATIONAL CONFERENCE ON CHRONIC DISEASE
PREVENTION AND CONTROL
Engaging Older Adults to Be More Active Where They Live: Audit
Tool Development
Melissa Kealey, Judy Kruger, Rebecca Hunter, Susan Ivey, William Satariano, Constance Bayles, Laura
Brennan Ramirez, Lucinda Bryant, Courtney Johnson, Chanam Lee, David Levinger, Kathleen McTigue, Gwen Moni, Anne Vernez Moudon, Delores Pluto, Thomas Prohaska, Christen Sible, Sabrina Tindal, Sara Wilcox, Kendra Winters, Kathy Williams
Suggested citation for this article: Kealey
M, Kruger J, Hunter R, Ivey S, Satariano W, Bayles C, et al. Engaging older
adults to be more active where they live: audit tool development
[abstract]. Prev Chronic Dis [serial online] 2005 Apr
[date cited]. Available from: URL: http://www.cdc.gov/pcd/issues/2005/
apr/04_0142q.htm.
PEER REVIEWED
Track: Social Determinants of Health Inequities
Because of an increase in the prevalence of chronic diseases
and an aging population, older adults are at highest risk for
poor health. Health disparities by age and socioeconomic status
have been shown to exist for many physical activity outcomes and
may be explained in part by differences in the built environment
in which older adults live, work, and play. Partners of the
Environmental Workgroup of the Centers for Disease Control and
Prevention Healthy Aging Research Network (HAN) have designed and
piloted an instrument that focuses on the relationship between
the built environment and physical activity in older adults.
Neighborhoods in seven diverse U.S. communities served by HAN
were studied: Alamosa, Colo; Columbia, SC;
Hendersonville, NC; Seattle, Wash; McKeesport,
Pa; Chicago, Ill; and Berkeley, Calif. An
environmental audit instrument, developed to be sensitive to
issues of importance to older adults, was designed to assess
street-scale factors associated with physical activity across
multiple settings. Audit items included land use, destinations,
sidewalk and intersection conditions, amenities such as benches,
social disorder such as litter, and the types of human activity observed. In the pilot study, 15–30 street
segments were audited by two or more trained researchers at each
of the seven HAN sites. In addition to the audit, qualitative
semi-structured interviews were conducted to identify additional
items of importance to adults aged 65 years or older.
Inter-rater reliability among the trained researchers was
examined. Researchers across the seven HAN sites examined
differences in neighborhood segments audited to determine the
distribution of study variables, such as presence of sidewalks
and crosswalks. Qualitative interviews of older adults about environmental
influences on walking behavior revealed that having destinations to walk to
appeared to be an important motivator for walking, although many people reported
both walking to reach destinations as well as taking walks just for pleasure.
Destinations such as grocery stores, banks, pharmacies, restaurants, and beauty
parlors were mentioned, as were churches, libraries, parks, and the homes of
family, friends, and neighbors. Personal safety was another frequently mentioned
topic, with many residents feeling safe walking during the daytime but not at
night. Interviewees indicated that their choice of walking routes was influenced by
the length of the route, sidewalk quality, people along the route, amount of
traffic, crosswalks and signals for crossing the street, perceived safety from
crime, scenery, aesthetics, and presence of interesting things to look at.
Future directions include using the environmental audit instrument in a study to
see which environmental audit items are correlated with actual walking behavior
in an older population.
Corresponding Author: Judy Kruger, PhD, Epidemiologist,
Centers for Disease Control and Prevention, National Center for
Chronic Disease Prevention and Health Promotion, 4770 Buford
Hwy NE, Mail Stop K-46, Atlanta, GA 30341. Telephone: 770-488-5922.
Email: Jkruger@cdc.gov.
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