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Scholarly Works (3 results)

  • Thesis
  • Peer Reviewed
UC Berkeley Electronic Theses and Dissertations (2011)

Background

Mobility, "the ability to move oneself [e.g., by walking, by using assistive devices, or by using transportation) within community environments that expand from one's home, to the neighborhood, and to regions beyond" (Webber, Porter et al. 2010) ], is important to healthy aging. Walking, both for recreation and for transportation, has been suggested to be a particularly accessible, affordable, and safe way to be physically active. It is important to understand the barriers to and supports for walking in one's neighborhood for older adults. Neighborhood socioeconomic status and other neighborhood characteristics, such as perceived safety from crime, are associated with walking and physical activity. Health symptoms may also be important determinants of walking and physical activity for older adults.

Objectives

1. Determine to what extent objective and perceived neighborhood characteristics of older adults vary by the socioeconomic status of the neighborhood. Determine what objective neighborhood and personal characteristics are associated with perceived neighborhood safety in older adults.

2. Determine the leading health symptoms reported by older people as causing difficulty when walking outdoors.

3. Determine the different physical activities engaged in by older men and women. Determine the association between both neighborhood socioeconomic status and perceived safety from crime and physical activity.

Methods

The study titled "Environmental Correlates of Physical Activity among Older Adults: A Healthy Aging Research Network (HAN) Collaboration" (referred to in this dissertation as the "HAN Walking Study") was designed to examine how the neighborhood environment may influence physical activity and walking behavior in older adults, and how this relationship may be modified by the functional capacity of older adults. Data were collected from 884 older adults at four sites across the country, from a diversity of physical environments. Data collection included in person interviews, lower-body functional capacity testing, accelerometers, walking diaries, and secondary GIS data.

Results

1. Participants living in neighborhoods of low socioeconomic status (low SES) have objectively shorter block lengths, higher housing density, and more businesses. Participants living in low SES neighborhoods perceive that they are less safe from crime and traffic. They also perceive that their neighborhood is more densely populated with greater percentages of apartments and condominiums. Perceived crime safety is associated with both neighborhood characteristics as well as the characteristics of the people who live there.

2. Most participants report multiple barriers to walking outside. Overall, 95.5% report at least one health symptom or other barrier to walking, with a range of 0-37 and a mean of 7.9 barriers.

3. The most frequent types of activity reported by both women and men are light housework (93.0%) and shopping or running errands (93.0%), followed by walking at a normal or leisurely pace (77.7%). In a combined model, crime safety, but not neighborhood poverty or primary type of neighborhood housing, is associated with physical activity.

Conclusions

Walking is engaged in by the majority of both older men and women in this study. However, they perceive multiple barriers to walking. Neighborhood determinants of walking may be one pathway through which neighborhood socioeconomic status influences health outcomes. Perceived safety from crime is possibly an important neighborhood determinant of walking and physical activity. Further research is needed to determine how changes in neighborhoods as well as other interventions may reduce barriers and lead to increased walking behavior in older adults.

    Cover page: Physical Activity, Socioeconomic Status, and Perceptions of Neighborhood Safety in Older Adults
    • Article
    • Peer Reviewed
    UC Berkeley Previously Published Works (2016)
    PURPOSE: Mobility disability is associated with poor lower body function among older adults. This study examines whether specific types of neighborhood characteristics moderate that association. DESIGN AND METHODS: This study is based on a cross-sectional sample of 884 people aged ≥ 65 years identified through service organizations in Alameda County, CA; Cook County, IL; Allegheny County, PA; and Wake and Durham counties, NC. In-person interviews focus on neighborhood characteristics, physical and cognitive function, depression, and walking. Functional capacity is tested using objective measures of lower body strength, balance, and walking speed. Mobility disability, the main study outcome, is measured as self-reported level of difficulty in walking 2-3 neighborhood blocks. Estimates of main and interactive effects are derived from logistic regression models. RESULTS: Among older adults with poor lower body function, those who report less proximity to goods and services and barriers to walking report more mobility disability than other older adults. In contrast, among older adults with good lower body function, there is a low prevalence of mobility disability and little association between perceptions of the neighborhood and mobility disability. IMPLICATIONS: In addition to more refined longitudinal studies, this research provides a foundation for innovative place-based rehabilitation and hospital discharge programs for older adults newly diagnosed and treated for chronic health conditions.
      Cover page: Mobility Disability in Older Adults: At the Intersection of People and Places.
      • Article
      • Peer Reviewed
      Berkeley Research Impact Initiative (BRII) (2013)
      A major public health challenge is to communicate effectively with vulnerable populations about preparing for disasters and other health emergencies. People who are Deaf or Hard of Hearing (Deaf/HH) and older adults are particularly vulnerable during health emergencies and require communications that are accessible and understandable. Although health literacy studies indicate that the readability of health communication materials often exceeds people’s literacy levels, we could find no research about the readability of emergency preparedness materials (EPM) intended for Deaf/HH and older adult populations. The objective of this study was to explore issues related to EPM for Deaf/HH and older adult populations, to assess the availability and readability of materials for these populations, and to recommend improvements. In two California counties, we interviewed staff at 14 community-based organizations (CBOs) serving Deaf/HH clients and 20 CBOs serving older adults selected from a stratified, random sample of 227 CBOs. We collected 40 EPM from 10 CBOs and 2 public health departments and 40 EPM from 14 local and national websites with EPM for the public. We used computerized assessments to test the U.S. grade reading levels of the 16 eligible CBO and health department EPM, and the 18 eligible website materials. Results showed that less than half of CBOs had EPM for their clients. All EPM intended for clients of Deaf/HH-serving CBOs tested above the recommended 4th grade reading level, and 91% of the materials intended for clients of older adult-serving CBOs scored above the recommended 6th grade level. EPM for these populations should be widely available through CBOs and public health departments, adhere to health literacy principles, and be accessible in alternative formats including American Sign Language. Developers should engage the intended users of EPM as co-designers and testers. This study adds to the limited literature about EPM for these populations.
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