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Relationship between neighborhood walkability and older adults' physical activity : results from the Belgian Environmental Physical Activity Study in Seniors (BEPAS Seniors)

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Abstract
Background: Adequate knowledge on environmental correlates of physical activity (PA) in older adults is needed to develop effective health promotion initiatives. However, research in this age group is scarce and most existing studies were conducted in North America. The present study aimed to examine relationships between GIS-based neighborhood walkability and objective and self-reported PA in community-dwelling Belgian older adults. Furthermore, moderating effects of neighborhood income levels were investigated. Methods: The Belgian Environmental Physical Activity Study (BEPAS) for Seniors is a cross-sectional study in older adults (>= 65 yrs) and was conducted between October 2010 and September 2012. Data from 438 older adults living in 20 neighborhoods across Ghent (Belgium) were analyzed. Stratification of selected neighborhoods was based upon objective walkability and neighborhood income. Participants wore an accelerometer during seven consecutive days to obtain objective levels of moderate-to-vigorous physical activity (MVPA). Self-reported levels of transportation walking/cycling and recreational walking/cycling were assessed using the International Physical Activity Questionnaire (long, last 7 days version) adapted for the elderly. Multi-level regression analyses were conducted. Results: Findings showed a positive relationship between neighborhood walkability and weekly minutes of older adults' self-reported walking for transportation (B = 4.63 +/- 1.05; p < 0.001) and a negative relationship between walkability and accelerometer-derived low-light PA (B = -1.38 +/- 0.62; p = 0.025). Walkability was not related to any measure of recreational PA. A walkability x income interaction was found for accelerometer-derived MVPA (B = -1.826 +/- 1.03; p = 0.075), showing only a positive association between walkability and MVPA in low-income neighborhood residents. Conclusions: This was the first European study to examine walkability-PA relationships in older adults. These Belgian findings suggest that a high neighborhood walkability relates to higher levels of older adults' transport-related walking. As transport-related walking is an accessible activity for older adults and easy to integrate in their daily routine, policy makers and health promoters are advised to provide sufficient destinations and pedestrian-friendly facilities in the close vicinity of older adults' residences, so short trips can be made by foot. Neighborhood income moderated the relationship between walkability and objectively-measured MVPA. Increasing total MVPA levels in older adults should be a key topic in development of promotion initiatives and special attention should be paid to low-income neighborhood residents.
Keywords
TRANSPORTATION, ASSOCIATIONS, OBESITY, ACCELEROMETER, WALKING, HEALTH, COMPUTER-SCIENCE, BUILT ENVIRONMENT, QUALITY-OF-LIFE, CHINESE URBAN ELDERS, Belgium, Transport-related walking, Socio-economic status, Built environment, Elderly

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MLA
Van Holle, Veerle, et al. “Relationship between Neighborhood Walkability and Older Adults’ Physical Activity : Results from the Belgian Environmental Physical Activity Study in Seniors (BEPAS Seniors).” INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY, vol. 11, 2014, doi:10.1186/s12966-014-0110-3.
APA
Van Holle, V., Van Cauwenberg, J., Van Dyck, D., Deforche, B., Van de Weghe, N., & De Bourdeaudhuij, I. (2014). Relationship between neighborhood walkability and older adults’ physical activity : results from the Belgian Environmental Physical Activity Study in Seniors (BEPAS Seniors). INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY, 11. https://doi.org/10.1186/s12966-014-0110-3
Chicago author-date
Van Holle, Veerle, Jelle Van Cauwenberg, Delfien Van Dyck, Benedicte Deforche, Nico Van de Weghe, and Ilse De Bourdeaudhuij. 2014. “Relationship between Neighborhood Walkability and Older Adults’ Physical Activity : Results from the Belgian Environmental Physical Activity Study in Seniors (BEPAS Seniors).” INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY 11. https://doi.org/10.1186/s12966-014-0110-3.
Chicago author-date (all authors)
Van Holle, Veerle, Jelle Van Cauwenberg, Delfien Van Dyck, Benedicte Deforche, Nico Van de Weghe, and Ilse De Bourdeaudhuij. 2014. “Relationship between Neighborhood Walkability and Older Adults’ Physical Activity : Results from the Belgian Environmental Physical Activity Study in Seniors (BEPAS Seniors).” INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY 11. doi:10.1186/s12966-014-0110-3.
Vancouver
1.
Van Holle V, Van Cauwenberg J, Van Dyck D, Deforche B, Van de Weghe N, De Bourdeaudhuij I. Relationship between neighborhood walkability and older adults’ physical activity : results from the Belgian Environmental Physical Activity Study in Seniors (BEPAS Seniors). INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY. 2014;11.
IEEE
[1]
V. Van Holle, J. Van Cauwenberg, D. Van Dyck, B. Deforche, N. Van de Weghe, and I. De Bourdeaudhuij, “Relationship between neighborhood walkability and older adults’ physical activity : results from the Belgian Environmental Physical Activity Study in Seniors (BEPAS Seniors),” INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY, vol. 11, 2014.
@article{5798482,
  abstract     = {{Background: Adequate knowledge on environmental correlates of physical activity (PA) in older adults is needed to develop effective health promotion initiatives. However, research in this age group is scarce and most existing studies were conducted in North America. The present study aimed to examine relationships between GIS-based neighborhood walkability and objective and self-reported PA in community-dwelling Belgian older adults. Furthermore, moderating effects of neighborhood income levels were investigated. 
Methods: The Belgian Environmental Physical Activity Study (BEPAS) for Seniors is a cross-sectional study in older adults (>= 65 yrs) and was conducted between October 2010 and September 2012. Data from 438 older adults living in 20 neighborhoods across Ghent (Belgium) were analyzed. Stratification of selected neighborhoods was based upon objective walkability and neighborhood income. Participants wore an accelerometer during seven consecutive days to obtain objective levels of moderate-to-vigorous physical activity (MVPA). Self-reported levels of transportation walking/cycling and recreational walking/cycling were assessed using the International Physical Activity Questionnaire (long, last 7 days version) adapted for the elderly. Multi-level regression analyses were conducted. 
Results: Findings showed a positive relationship between neighborhood walkability and weekly minutes of older adults' self-reported walking for transportation (B = 4.63 +/- 1.05; p < 0.001) and a negative relationship between walkability and accelerometer-derived low-light PA (B = -1.38 +/- 0.62; p = 0.025). Walkability was not related to any measure of recreational PA. A walkability x income interaction was found for accelerometer-derived MVPA (B = -1.826 +/- 1.03; p = 0.075), showing only a positive association between walkability and MVPA in low-income neighborhood residents. 
Conclusions: This was the first European study to examine walkability-PA relationships in older adults. These Belgian findings suggest that a high neighborhood walkability relates to higher levels of older adults' transport-related walking. As transport-related walking is an accessible activity for older adults and easy to integrate in their daily routine, policy makers and health promoters are advised to provide sufficient destinations and pedestrian-friendly facilities in the close vicinity of older adults' residences, so short trips can be made by foot. Neighborhood income moderated the relationship between walkability and objectively-measured MVPA. Increasing total MVPA levels in older adults should be a key topic in development of promotion initiatives and special attention should be paid to low-income neighborhood residents.}},
  articleno    = {{110}},
  author       = {{Van Holle, Veerle and Van Cauwenberg, Jelle and Van Dyck, Delfien and Deforche, Benedicte and Van de Weghe, Nico and De Bourdeaudhuij, Ilse}},
  issn         = {{1479-5868}},
  journal      = {{INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY}},
  keywords     = {{TRANSPORTATION,ASSOCIATIONS,OBESITY,ACCELEROMETER,WALKING,HEALTH,COMPUTER-SCIENCE,BUILT ENVIRONMENT,QUALITY-OF-LIFE,CHINESE URBAN ELDERS,Belgium,Transport-related walking,Socio-economic status,Built environment,Elderly}},
  language     = {{eng}},
  pages        = {{9}},
  title        = {{Relationship between neighborhood walkability and older adults' physical activity : results from the Belgian Environmental Physical Activity Study in Seniors (BEPAS Seniors)}},
  url          = {{http://doi.org/10.1186/s12966-014-0110-3}},
  volume       = {{11}},
  year         = {{2014}},
}

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