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      Engaging older adults as advocates for age-friendly, walkable communities: The Senior Change Makers Pilot Study

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          Abstract

          As the U.S. population ages, communities must adapt to help older adults thrive. Built environment features, like safe sidewalks and crosswalks, provide the foundation for age- and physical activity-friendly communities. Controlled studies are needed to evaluate advocacy training programs that instruct and support seniors to advocate for more walkable neighborhoods. The Senior Change Makers Pilot Study evaluated an advocacy program that taught seniors to evaluate pedestrian environments using the validated MAPS-Mini audit tool, identify barriers, and advocate for improvements. Participants ( n = 50) were recruited from four low-income senior housing sites in San Diego, CA, which were randomly assigned to an 8-week advocacy program or physical activity (PA) comparison intervention. Evaluation included surveys, accelerometers to assess PA, and direct observation. Primary outcomes were seniors’ advocacy confidence and skills. Main analyses used repeated measures ANOVAs. Seniors in the advocacy condition ( n = 17) increased their advocacy outcome efficacy ( p = .03) and knowledge of resources ( p = .04) more than seniors in the PA condition ( n = 33). Most seniors in the advocacy condition completed a street audit (84%), submitted an advocacy request (79%), or made an advocacy presentation to city staff (58%). Environmental changes included repairs to sidewalks and crosswalks. City staff approved requests for lighting, curb cuts, and crosswalk markings. Seniors’ accelerometer-measured PA did not significantly increase, but self-reported transportation activity increased in the PA condition ( p = .04). This study showed the potential of advocacy training to empower seniors to make communities more age- and activity-friendly.

          Abstract

          Engaging older adults as advocates is a promising strategy for making age-friendly community improvements; more research is needed to evaluate and disseminate advocacy training programs

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          Physical activity in the United States measured by accelerometer.

          To describe physical activity levels of children (6-11 yr), adolescents (12-19 yr), and adults (20+ yr), using objective data obtained with accelerometers from a representative sample of the U.S. population. These results were obtained from the 2003-2004 National Health and Nutritional Examination Survey (NHANES), a cross-sectional study of a complex, multistage probability sample of the civilian, noninstitutionalized U.S. population in the United States. Data are described from 6329 participants who provided at least 1 d of accelerometer data and from 4867 participants who provided four or more days of accelerometer data. Males are more physically active than females. Physical activity declines dramatically across age groups between childhood and adolescence and continues to decline with age. For example, 42% of children ages 6-11 yr obtain the recommended 60 min x d(-1) of physical activity, whereas only 8% of adolescents achieve this goal. Among adults, adherence to the recommendation to obtain 30 min x d(-1) of physical activity is less than 5%. Objective and subjective measures of physical activity give qualitatively similar results regarding gender and age patterns of activity. However, adherence to physical activity recommendations according to accelerometer-measured activity is substantially lower than according to self-report. Great care must be taken when interpreting self-reported physical activity in clinical practice, public health program design and evaluation, and epidemiological research.
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            Calibration of the Computer Science and Applications, Inc. accelerometer.

            We established accelerometer count ranges for the Computer Science and Applications, Inc. (CSA) activity monitor corresponding to commonly employed MET categories. Data were obtained from 50 adults (25 males, 25 females) during treadmill exercise at three different speeds (4.8, 6.4, and 9.7 km x h(-1)). Activity counts and steady-state oxygen consumption were highly correlated (r = 0.88), and count ranges corresponding to light, moderate, hard, and very hard intensity levels were or = 9499 cnts x min(-1), respectively. A model to predict energy expenditure from activity counts and body mass was developed using data from a random sample of 35 subjects (r2 = 0.82, SEE = 1.40 kcal x min(-1)). Cross validation with data from the remaining 15 subjects revealed no significant differences between actual and predicted energy expenditure at any treadmill speed (SEE = 0.50-1.40 kcal x min(-1)). These data provide a template on which patterns of activity can be classified into intensity levels using the CSA accelerometer.
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              Built environmental correlates of older adults’ total physical activity and walking: a systematic review and meta-analysis

              Background Identifying attributes of the built environment associated with health-enhancing levels of physical activity (PA) in older adults (≥65 years old) has the potential to inform interventions supporting healthy and active ageing. The aim of this study was to first systematically review and quantify findings on built environmental correlates of older adults’ PA, and second, investigate differences by type of PA and environmental attribute measurement. Methods One hundred articles from peer-reviewed and grey literature examining built environmental attributes related to total PA met inclusion criteria and relevant information was extracted. Findings were meta-analysed and weighted by article quality and sample size and then stratified by PA and environmental measurement method. Associations (p < .05) were found in relation to 26 individual built environmental attributes across six categories (walkability, residential density/urbanisation, street connectivity, access to/availability of destinations and services, infrastructure and streetscape, and safety) and total PA and walking specifically. Reported individual- and environmental-level moderators were also examined. Results Positive environmental correlates of PA, ranked by strength of evidence, were: walkability (p < .001), safety from crime (p < .001), overall access to destinations and services (p < .001), recreational facilities (p < .001), parks/public open space (p = .002) and shops/commercial destinations (p = .006), greenery and aesthetically pleasing scenery (p = .004), walk-friendly infrastructure (p = .009), and access to public transport (p = .016). There were 26 individual differences in the number of significant associations when the type of PA and environmental measurement method was considered. No consistent moderating effects on the association between built environmental attributes and PA were found. Conclusions Safe, walkable, and aesthetically pleasing neighbourhoods, with access to overall and specific destinations and services positively influenced older adults’ PA participation. However, when considering the environmental attributes that were sufficiently studied (i.e., in ≥5 separate findings), the strength of evidence of associations of specific categories of environment attributes with PA differed across PA and environmental measurement types. Future research should be mindful of these differences in findings and identify the underlying mechanisms. Higher quality research is also needed. Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0558-z) contains supplementary material, which is available to authorized users.
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                Author and article information

                Journal
                Transl Behav Med
                Transl Behav Med
                tbm
                Translational Behavioral Medicine
                Oxford University Press (US )
                1869-6716
                1613-9860
                September 2021
                22 July 2021
                22 July 2021
                : 11
                : 9
                : 1751-1763
                Affiliations
                [1 ]University of California , San Diego, CA, USA
                [2 ]San Diego State University , San Diego, CA, USA
                [3 ]Seattle Pacific University , Seattle, WA, USA
                [4 ]Massachusetts General Hospital and Harvard Medical School , Boston, MA, USA
                [5 ]Australian Catholic University , Melbourne, VIC, Australia
                Author notes
                Correspondence to: C. Patch, cmt@ 123456ucsd.edu
                Author information
                https://orcid.org/0000-0003-0947-7115
                https://orcid.org/0000-0002-1161-7351
                Article
                ibab098
                10.1093/tbm/ibab098
                8442566
                34293156
                6f3f7493-0d7d-4655-820a-7f4ce510db1e
                © The Author(s) 2021. Published by Oxford University Press on behalf of the Society of Behavioral Medicine.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                Page count
                Pages: 13
                Funding
                Funded by: UC San Diego Foundation, DOI 10.13039/100017800;
                Categories
                Physical Activity
                AcademicSubjects/MED00860
                AcademicSubjects/SCI02170

                Neurology
                exercise,built environment,policy,older adult,walkability,walking,age-friendly
                Neurology
                exercise, built environment, policy, older adult, walkability, walking, age-friendly

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