The Influence of Neighborhood Environment, Mobility Limitations, and Psychosocial Factors on Neighborhood Walking in Older Adults

Abstract

Regular physical activity (PA) provides health benefits for healthy aging. Walking, commonly chosen by older adults, often occurs in neighborhoods. Musculoskeletal deficits may limit older adults in negotiating their neighborhood environment. Social Cognitive Theory (SCT) has been used to study the influence of self-efficacy and outcome expectations on PA and walking in older adults. The purpose of this study was to examine the influence of self-efficacy, outcome expectations, mobility limitations and neighborhood environment on neighborhood walking in older adults living in urban settings. A cross-sectional study was conducted using SCT as the framework. Surveys were mailed to 400 older adults with 326 participating (age 60-99 years, M =76.1, sd= 8.34). The Neighborhood PA Questionnaire, Multidimensional Outcome Expectations for Exercise Scale, Pepper Assessment Tool for Disability, Neighborhood Environment Walkability Scale and self-efficacy scales were used to measure model variables. Hierarchical regression indicated that demographic characteristics explained 3.8% of the variance (p = < .05) in neighborhood walking. Adding mobility limitations (R2 = .125, p < .01), outcome expectations and total self-efficacy (R2 = .213, p < .01), and neighborhood environment (R2 = .273, p < .01) increased the explained variance. All of the SCT variables explained 27.3% of variance in neighborhood walking. Self-efficacy exerted the strongest influence (β = .466, p < .01) followed by number of destinations within walking distance (β = .188, p < .01), and female gender (β = .154, p < .01). In the final model, mobility limitations, outcome expectations and neighborhood density and design had no direct effect on neighborhood walking. Further analyses revealed that self-efficacy for walking duration (β = .186, p < .05) and PA barriers (β = .308, p < .01) were associated with neighborhood walking while self-efficacy for gait, balance and neighborhood barriers were not. Of the neighborhood characteristics, only neighborhood destinations (β = .272, p < .01) were associated with neighborhood walking. Future research should further examine the relationships between the individual variables and neighborhood walking and between mobility limitations and self-efficacy in a diverse population of older adults living in various urban settings with a wide-range of mobility limitations.