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Walkabout, social and built environments, and quality of life in older adults Bigloo, Fay 2012

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WALKABOUT, SOCIAL AND BUILT ENVIRONMENTS AND QUALITY OF LIFE IN OLDER ADULTS by Fay Bigloo  A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS in THE FACULTY OF GRADUATE STUDIES (Physical Education) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver)  November 2012 © Fay Bigloo, 2012  Abstract  The purpose of this multilevel exploratory study was to determine the effects of Walkabout, a community-based physical activity program initiated by Dr. Joy Butler of The University of British Columbia, on the quality of life (QOL) of older adult participants. This multifaceted study also explored the impacts of physical, built and created social environments on the amount of older adult participants’ engagements in physical activities. A total of 23 older adults participated in the study and 21 finished it. The study was primarily focused on two Walkabout teams, ten participants in total. The members of one team lived in the Richmond area of Metro Vancouver and the other team members lived in an independent living centre in Vancouver’s Westside. Both teams consisted of physically and cognitively independent individuals who were capable of performing their own Instrumental Activities of Daily Living (IADL). The majority of the data were collected from the participants through private interviews and some anecdotal journals. A literature review was conducted. A separate examination of the two neighbourhoods under study was also performed using the Senior Walking Environmental Audit Tool-Revised (SWEAT-R) (Chaudhury, Sarte, Michael, Mahmood, Keast, Dogaru, & Wister, 2011). The findings through a qualitative method demonstrated the benefits of the Walkabout Program for health and life satisfaction, which the older adult participants identified as the most important contributing factors to their QOL. The social environment created through Walkabout was what the majority of the participants enjoyed the most. The older participants considered social networking and social ii  capital as two important factors that contributed to their quality of life. In addition, the study also identified such factors as aesthetics, safety, convenience, distance, and diversity of physical and built environments as environmental attributes that impacted the level of older adult participants’ engagements in physical activity.  iii  Preface  Approval for the research was granted by The University of British Columbia on December 16, 2011, for a period of one year. The certificate number is H11-02622. The Principal Investigator for the study is Dr. Joy Butler.  iv  Table of Contents  Abstract...................................................................................................................... ii Preface ...................................................................................................................... iv Table of Contents ...................................................................................................... v List of Tables .......................................................................................................... viii List of Figures .......................................................................................................... ix Acknowledgements .................................................................................................. x Dedication ................................................................................................................ xii 1  Chapter: Introduction and Literature Review ................................................... 1 1.1  Terminology.............................................................................................................. 2  1.1.1  Quality Of Life, QOL ............................................................................................ 2  1.1.2  Healthy Aging ...................................................................................................... 3  1.1.3  Physical Activity .................................................................................................. 3  1.1.4  Social Capital ...................................................................................................... 4  1.2  Physical Activity and Its Benefits in Later Years in Life ...................................... 4  1.2.1  Physiological Benefits of Physical Activity .......................................................... 5  1.2.2  Emotional Health Benefits of Physical Activity .................................................... 7  1.2.3  The Role of Physical Activity in Prevention of Diseases and Coping with  Illnesses .......................................................................................................................... 8 1.2.4  Physical and Built Environments and Their Impacts on the Promotion of  Physical Activity in Older Adults .................................................................................... 10  2  Chapter: Research Paradigm and Methodology ............................................ 12 2.1  Research Questions .............................................................................................. 12  2.2  Research Framework ............................................................................................. 14  2.3  Research Methodology, Method, and Paradigm ................................................. 15  2.4  Recruiting Older Adults ......................................................................................... 17  2.5  Procedure ............................................................................................................... 17  2.6  Data Collection ....................................................................................................... 20  v  3  4  Chapter: Walkabout and the Older Adults ...................................................... 26 3.1  Research Questions and the Walkabout ............................................................. 26  3.2  Walkabout Program ............................................................................................... 26  3.2.1  Walkabout, Health, and Quality of Life in Older Adult Participants ................... 31  3.2.2  Walkabout, Physical Activity and Older Adult Participants................................ 34  3.2.3  Walkabout, Teamwork, Social Capital, and Older Adult ................................... 39  3.2.4  Walkabout and Physical Literacy ...................................................................... 47  Chapter: Physical, Built, and Created Social Environments and the Older  Adults ....................................................................................................................... 53 4.1  Physical and Built Environments and Research Questions .............................. 54  4.1.1  The Impacts of Physical and Built Environments on the Engagement of Older  Adult Participants in Walking......................................................................................... 55 4.1.2  The Impacts of Social Environment Created Through Built Environment on the  QOL in Older Adult Participants .................................................................................... 62 4.2  Viewing Physical & Built Environments through the Lens of SWEAT-R .......... 67  4.2.1  4.2.1.1  Northwest Corner of Wesbrook Mall ....................................................................... 69  4.2.1.2  Mid-Block Crossing Area......................................................................................... 70  4.2.1.3  Southeast Corner .................................................................................................... 72  4.2.1.4  Buffer Area .............................................................................................................. 73  4.2.1.5  Land Use ................................................................................................................. 74  4.2.1.6  Summary ................................................................................................................. 76  4.2.2  5  Assessment of Wesbrook Mall Village .............................................................. 68  Assessment of Steveston Village in Richmond ................................................. 78  4.2.2.1  Northwest Corner of Bayview Street in Steveston .................................................. 79  4.2.2.2  Mid-Block Crossing Area......................................................................................... 80  4.2.2.3  Southeast Corner in Steveston ............................................................................... 80  4.2.2.4  Buffer Area .............................................................................................................. 81  4.2.2.5  Land Use ................................................................................................................. 82  4.2.2.6  Summary ................................................................................................................. 84  Chapter: Conclusions & Implications ............................................................. 86 5.1  Health, QOL, and Walkabout ................................................................................. 91  5.2  Created Social Environment ................................................................................. 94  5.3  Walkabout and Physical Literacy ......................................................................... 97  5.4  Physical and Built Environments, Physical Activity, and Older Adults ........... 99  vi  5.5  Physical and Built Environments, Social Capital, and the Older Adults ........ 100  5.6  Implications for Health, Physical & Social Activity, and the Walkabout......... 102  5.7  Implications for the Environmental Factors ...................................................... 104  5.8  Implications for Research ................................................................................... 106  References ............................................................................................................. 109 Appendices ............................................................................................................ 119 Appendix A UBC Ethics Certificate of Approval ........................................................ 119 Appendix B List of Questions for the Private interviews .......................................... 120 Appendix C Senior Walking Environmental Tool Audit-Revised (SWEAT-R) ......... 121 C.1  SWEAT-R Data for Wesbrook Mall Village ........................................................ 121  C.2  SWEAT-R Data for Steveston Village ............................................................... 130  Appendix D Transcript of Interview With Beverly ...................................................... 139  vii  List of Tables  Table 2.1  Summarized Description of the Study's Participants ........................... 19  Table 5.1  Summary of the Study’s Findings ...................................................... 102  viii  List of Figures  Figure 4.1  Northwest Corner Crossing, Wesbrook Mall ....................................... 70  Figure 4.2  Mid-Block Crossing, Wesbrook Mall .................................................... 71  Figure 4.3  Invisible Pedestrian Sign, Wesbrook Mall ........................................... 71  Figure 4.4  Southeast Corner, Wesbrook Mall. ..................................................... 72  Figure 4.5  Buffer Area at Wesbrook Mall ............................................................. 73  Figure 4.6  Courtyard at Wesbrook Mall ................................................................ 75  Figure 4.7  Roundabout Near Wesbrook Mall ....................................................... 77  Figure 4.8  Northwest Corner Crossing, Bayview Street, Steveston ..................... 79  Figure 4.9  Mid-Block Crossing, Steveston ........................................................... 80  Figure 4.10 Southeast Corner Crossing, Steveston ............................................... 81 Figure 4.11 Buffer Area, Steveston ........................................................................ 82 Figure 4.12 Public Seating at Fisherman’s Wharf, Steveston ................................ 83  ix  Acknowledgements  There are a number of people who have generously made their knowledge, wisdom, and assistance available to me throughout the course of my advanced education. First and foremost, I would like to acknowledge the enormous amount of generosity and dedication that I have received from my best friend and husband who with a power of insight and endless kindness encouraged me to pursue my dreams regardless. In parallel, I would like to express my most sincere appreciation for the immense and extensive openness, magnanimity and guidance that I have received from my supervisor, Dr. Joy Butler, who allowed me to use the Walkabout program for the benefits of the research. I would like to extend my gratitude to Dr. Atiya Mahmood and Dr. Habib Chaudhury (Gerontology professors at Simon Fraser University) who introduced me to gerontology. I also would like to express my deepest respect for Dr. Sandra Scott for her extraordinary style of teaching and her warm and respectful reception of her students. I will never forget her innovative teaching style, but mostly the depth of her understanding and care for the others. I would like to thank Dr. Christine Loock and Ron Friesen endlessly. They are wonderful friends who have always made me stand taller and feel prouder. In addition, I would like to thank Cordoniers whose presence and willingness to help enabled me in many ways. I also am grateful for having Benettes as inspiring friends. I would like to extend my countless thanks to the older adult participants, in particular those in the Tapestry and Richmond teams, for their contributions to the study. The results were achieved because of the knowledge, wisdom, truthfulness, x  dedication, hard work, and kindness with which they generously accompanied me in this journey. I would like to extend my special appreciation to the Tapestry independent living centre and its staff, in particular Michiko Mazloum and John Fleming, who welcomed me with immeasurable assistance and warm reception. I would like to thank the Walkabout Committee. It was because of the endless support of this group that Walkabout was possible, and also that the study was successfully operational. The Walkabout Committee members not only generously offered me their knowledge and talents, but they also accepted my weaknesses gracefully and helped me to learn and to grow. Finally, I would like to express my sincere gratitude to Cameron who helped me with his expertise in proofreading my writing.  xi  Dedication This thesis is dedicated to my daughter who is the love of my life. It has been through her existence that I have been able to experience, to grow, and to become a better person.  xii  1  Chapter: Introduction and Literature Review  The world’s population is rapidly changing, and the global population of adults 60 years of age and older is expected to reach two billion by the year 2050 (Beard & Petitot, 2010). Bearing in mind that 80 percent of this segment of the population will live in what are known as middle-income countries makes aging rather a global concern which requires immediate attention (Beard & Petitot, 2010). The demographic picture of Canada’s population is also changing and by the year 2025 one in five Canadians will be 65 or older (Statistics Canada, 2010). As the older adult category forms a large proportion of Canadian society we, as a nation, will face many challenges in an effort to provide health care for our elderly population. In addition to having psychological, mental, and physical disabilities, which increase economic and social expenses, the frail members of the elderly population are also vulnerable, lack social support, and are unable to successfully integrate and access health care (Campose-Outcalt et al., 2007). Despite this gloomy picture, researchers suggest that with increased physical activity and preventative care, many older people will be able to improve their overall quality of life (QOL) and lessen their dependence on reactive medicine. Health and illnesses occur in social contexts, yet physical activity intervention has almost always examined the individual-level outcomes and very little has been studied in terms of the effects of the environments, social or built, on the level of activity that older adults may engage in (Fisher & Li, 2004). This multifaceted research study has explored the effects of a community-based physical activity program, Walkabout, which encourages participants to walk a 1  recommended minimum of 10,000 daily steps, on the QOL in older adult participants. In recognition of the importance of place in older adults’ lives, attention was paid to multifaceted and multilevel ecological influences, in particular simultaneous consideration of the relative influences of individual and contextual factors (i.e., neighbourhood social and physical environments) on physical activity.  1.1  Terminology Before any further explanation of the study, and in order to familiarize readers with  some of the terminology used in this paper, the following definitions are provided. This may help to better familiarize readers with some of the issues and concerns that may arise in the later years in life.  1.1.1 Quality Of Life, QOL One of the terms frequently used in relation to older adults is “quality of life” or QOL. The term “quality of life” directly corresponds with the World Health Organization’s (WHO) definition of health, which includes optimal physical, mental, and social functioning (World Health Organization, 2011). QOL is dynamic, multidimensional, and comprised of physical functioning, psychological well-being, social functioning, and health perceptions, all within a given individual’s perceived environment. Like the WHO definition of “health,” the concept of “quality of life” is more than simply an absence of disease. Reaching dynamic quality of life is the ability to adapt and respond within the domains of physical health, psychological functioning, social relationships, and the environment as a whole. Given the social and organizational changes in our society, older people may lack the  2  financial resources and social support networks they need to ensure that their level of health and quality of life is maintained. There are many studies suggesting that simple changes to an older adult’s lifestyle can in fact result in long-term positive change even if lifestyle shifts are adopted very late in life. Maintaining a better quality of life is becoming a critical social issue for older adults as life expectancy increases (Sugiyama, Ward Thompson, & Alves, 2009). As mentioned above, quality of life is a multiple construct; however, Kahn and Juster (2002) argue that quality of life has two major components: health and life satisfaction.  1.1.2 Healthy Aging A common response when one is asked to define “health” is “the absence of disease.” However, the concept of health is much more complicated and abstract than this, encompassing mental, social, and psychological well-being in addition to physical well-being.  1.1.3 Physical Activity Physical activity is defined by the U.S. Department of Health and Human Services (USDHHS) as “bodily movement produced by the contraction of skeletal muscle that increases energy expenditure above the basal level” (1996, p. 20). Physical activity has been recognized as a health behaviour that is linked to optimal healthy aging (USDHHS, 2000).  3  1.1.4 Social Capital Social capital has been defined as the features of communities that involve levels of interpersonal relationships which create trust, reciprocity, and social bonding that facilitates cooperation for mutual benefits (Kawachi & Berkman, 2000; Putnam, 1995). Social capital has great importance from the population health perspective (Li et al., 2005). Some studies that have linked social capital to health have examined several indicators such as mortality (Kawachi, Kennedy, Lochner, & Porthrow-Stith, 1997; Lochner, Kawachi, Bernnan, & Buka, 2003) and self-related health status (Kawachi, Kennedy, & Glass, 1999; Veenstra, 2000). In the following sections a literature review is presented in order to create a picture of later years in life and some of the issues that may arise as people age. The literature review provides an overview of the existing research about physical activity and its physiological and emotional benefits for older adults. Furthermore, to gain more insight into physical activity, the review will discuss the benefits of physical activity in coping with diseases and in prevention of illnesses. Lastly, since physical activity occurs in physical, built, and social environments, the inclusion of these environmental factors and their impacts on the promotion of physical activity will also be featured.  1.2  Physical Activity and Its Benefits in Later Years in Life To date, the majority of research concerning older adults’ experiences of physical  activity has been limited to the physiological benefits of exercise, equating aging with functional decline and providing arguments for the benefits of exercise in improving bone density and cognition, increasing immune response and life expectancy, and rejuvenating  4  muscle tissue, to cite just a few examples. Although additional benefits such as emotional ones have been mentioned in literature, the predominant focus has been on the physiological effects of the physical activity. Moreover, many studies have focused on the individual’s outcomes, failing to consider the importance of other factors such as social and built environments and their impacts on mobility and QOL in older adults.  1.2.1 Physiological Benefits of Physical Activity Many people are aware of the physiological benefits of physical activity generally. A review of recent findings will reaffirm the positive impacts of physical activity in later life. As mentioned in the literature, only a portion of functional decline in older patients is the result of disease and the rest actually is the result of inactivity, or disuse (Wykle, Whitehouse, & Morris, 2005). In other words, there is a general assumption that getting old requires the body to slow down, whereas research has demonstrated that there is a benefit in continuing to make choices that allow the body to continue to function as it has in the past. Another way to look at this is to determine whether declines in functions due to physiological changes can be caused by lifestyle choices, or if they are simply related to a person’s intrinsic ability. It is not rare to find individuals in their late 60s who are physically active, fit, and as strong as most people in their youth. The understanding is that by addressing changes in physical activity, there is a possibility that one may be able to make an impact on physical health. One of the biggest impacts that physical activity can have is on a person’s bone mineral density. A study by Daly et al. (2008) measured the effects of exercise in later years on a longitudinal basis and proved that there was a measurable improvement in  5  QOL in active older adults. Some of the factors that contributed to this improvement included a reduced level of fatigue, improved mobility and balance, reduced incontinence and reduced depression. Rietberg, Brooks, Uitdehaag, and Kwakkel (2006) noted similar results with the introduction of exercise for older adults with multiple sclerosis (MS). Higher bone density and improved muscle mass were observed which was a finding also reflected in the broader study developed by Daly et al. (2008). While the primary goal of the Rietberg et al. (2006) research was an overarching improvement in health factors related to MS, the results indicated that the patients were experiencing an increase in the perception of muscle power function as well. This perception may have been the underlying reason why the participants in the study were not only feeling better physically, but also had a more positive outlook on their future health. Because MS can lead to muscle power decline, participants in the study felt that the disease was better under their own control due to the fact that they were able to contribute to their own muscle strength. To this end, Rietberg et al. (2006) suggested that exercise therapy can be beneficial for older adults in terms of “isometric strength, physical fitness, and mobility related Activities of Daily Living, ADLs, such as time needed for transfer, walking cadence, and balance time” (p. 11). Rietberg et al. (2006) also mentioned that positive outcomes of related mood, such as a decrease in anxiety and depression, are common at the instigation of exercise systems. They suggested that their findings could be extrapolated to other older adults with chronic diseases.  6  1.2.2 Emotional Health Benefits of Physical Activity The emotional health benefits of physical activity may well outweigh the physiological benefits. Social determinants of health can exacerbate existing health conditions and make care more difficult. For example, mobility issues play an important role in the emotional well-being of an older person. According to Kubzansky et al. (2005, p. 254), “elderly mental health may be particularly sensitive…because, as a group, elderly persons tend to be less mobile and more reliant on locally provided services and amenities, as well as sources of social support and contact.” Thus, the elderly may be more likely to be subject to differential risks such as a lack of will to access care, which increases with poverty and connected lack of mobility. Emotional well-being in the elderly is positively affected by physical activity. Wellness is a continuum of positive health indicators, including the physical, psychological, social, and environmental, upon which individuals strive to advance. It is important to note that these positive health indicators are not static, but rather are part of a dynamic, ever-changing process of trying to achieve one’s individual potential and thereby increase one’s QOL (Saxon, Etten, & Perkins, 2009). According to Garatachea et al. (2009), there are clear connections between seniors’ body strength, dynamic balance, aerobic endurance, self-reported weekly energy expenditure, total time spent on physical activity, and a sense of both material and subjective well-being. This means that there is an increased level of self-confidence among active older adults that enables them to move towards more positive choices in their lives. The Garatachea et al. (2009) study found that the same results were shown  7  irrespective of demographic factors, meaning that there is a strong link between positive outlooks, positive life outcomes and physical activity. As noted by Siahpush, Spittal, & Singh (2008), happiness, life satisfaction, and confidence in older adults were also proven to have a link with physical activity among participants in their study. This longitudinal study measured the level of activity and its relation to attitude among almost 10,000 respondents over a two-year period. There were shown to be correlating variables between happiness and physical activity that went in both directions; in other words, the more active an individual was, the more likely she/he was to be happy and vice versa. The reason this happens is that through activity, in response to pain, the brain triggers the release of endorphins—the body’s natural tranquilizer—a kind of chemical messenger that is involved in transmitting messages within the body (Saxon et al. 2009). Endorphins act by connecting with receptors in the nervous system for chemicals that transmit pain messages to the brain. Once the endorphin connects, the pain-causing chemicals are prevented from transmitting their messages. As noted by Siahpush et al. (2008), the same chemical reaction happens in the body during exercise. The more exercise that a person takes on the more of this chemical is released, making the individual more satisfied with life.  1.2.3 The Role of Physical Activity in Prevention of Diseases and Coping with Illnesses Coping with health changes and aging is linked to what Marmot (2005) described as the health belief model and the theory of reasoned action with respect to health care access. In these social determinants frameworks, care is taken to examine attitudes, intentions, and perceptions regarding health care, and thereby understand compliance  8  with health care processes and health seeking behaviors (Marmot, 2005). In other words, there are links between personal and social factors and the ability of a person to react in a healthy way to health changes and aging. The existing literature has demonstrated that specific diseases associated with aging can be prevented with physical activity. There is a long list of diseases that can be prevented or coped with if one adopts a physically active lifestyle. Two of these diseases are more frequently mentioned in literature in relation to physical activity and prevention of disease. The first of these preventable diseases is diabetes. Not only do extensive health problems present themselves with the onset of old age combined with diabetes, but also there are complicating factors such as blindness, foot problems, and other issues that limit activity after the onset of diabetes (Marmot, 2005). It is extremely important to have regular physical activity in prevention and control of diabetes. Not only does exercise help to achieve and maintain a healthy body weight, but it also helps the tissue to be more responsive to the insulin (Sizer, 2006). With an increase in physical activity, even modest weight loss in overweight people seems to delay the onset of diabetes. Inactivity and depressed mood are both associated with a higher likelihood of diabetes related complications (Lysy, Da Costa, & Dasugupta, 2008). This means that an older person who has diabetes and does not exercise will be more likely to be depressed and experiencing the serious side effects of the disease. Another disease for which an increase in physical activity among older adults can aid in prevention is cardiovascular disease. The useful capacities of the heart and skeletal muscles decline with age, but there is a way to prevent this through an individual’s ability to remain active (Goldspink, 2005). What happens when older adults  9  use these muscles, Goldspink (2005) explained, is that they will be better equipped to deal with physical and mental stresses and illnesses. Although many studies mention the benefits of physical activity in prevention of or coping with cardiovascular diseases, there is a lack of clarity as to what kind of physical activity is warranted for an increase in overall cardiovascular health among older adults (Houde & Melillo, 2002).  1.2.4 Physical and Built Environments and Their Impacts on the Promotion of Physical Activity in Older Adults Importance should be placed on the factor of environment when addressing physical activity and quality of life in older adults. Dr. Habib Chaudhury, Gerontology professor at Simon Fraser University, in an article on quality of life and place therapy (Chaudhury, 2003), mentioned Powell Lawton, a pioneer in investigating psychological and social aspects of aging, who emphasized the centrality of place in people’s lives, particularly in later years. Despite of the importance of place in individuals’ lives, not many scholars to date have studied physical activity in the context of physical and social environments. Even in the studies that involved community-based intervention, the focus of the outcomes was predominantly on the individuals (Lamb, Bartlett, Ashley, & Bird, 2002). The importance of the social environment and the way it is influenced by the built environment, particularly in the life of older adults, deserves more attention. As people age, there is an increasing awareness of the need to maintain quality of life (Fisher & Li, 2004). Those aspects of the individual’s living situation that cause the individual feel and function better and live independently on daily basis are directly related to the individual’s quality of life (Spirduso & Cronin, 2001). There is an  10  emerging trend calling for ecological approaches to incorporate inter- and intrapersonal and environmental factors in physical activity research (Bauman, Sallis, & Owen, 2002; Sallis & Owen, 2002). It is suggested that multilevel approaches that distinguish the variability in physical activity behaviour at both the individual and neighbourhood levels provide more comprehensive results (Fisher, Li, & Cleveland, 2004). In addition, Michael, Beard, Choi, Farquhar, and Carlson (2006) suggested that both actual environmental features and perceptions of these aspects affect walking behaviour. A multilevel approach also allows for the precise delineation of level-specific predictors and changes in physical activity related outcomes (Fisher & Li, 2004).  11  2  Chapter: Research Paradigm and Methodology  The study approached physical activity through the lens of a community-based physical activity program, Walkabout. The research explored the effects of the program on the quality of life (QOL) in older adult participants. A comprehensive description of the Walkabout Program will be provided later in this thesis, but it should be mentioned here that Dr. Joy Butler of The University of British Columbia (UBC) created the program in 2006. The fundamental goal of the program is to encourage students, staff, faculty members, and UBC community members to become more physically and socially active in order to have a better quality of life. In this chapter, the study and research questions are presented first. Then, the framework in which the study is implemented is provided. Method, methodology, and paradigm are then identified and discussed. Later, recruiting and the study’s procedure will be explained. Finally, the data collection strategies will be clarified.  2.1  Research Questions This study explored the effects of Walkabout on QOL in older adult participants.  Understanding the importance of the social environment created through the Walkabout program, the study was also intended to explore the effects of social environment on QOL in older participants. The research approach has also recognized the importance of place in the later years in life, and it has tried to explore the impacts of physical and built environments and their created social environment on the level of older adult participants’ engagements in physical activity. Thus, this multifaceted research consists of four aspects. 12  At first, the study focused on the Walkabout Program, which mainly encourages participants to meet the recommended daily walking of 10,000 steps and try gradually to increase the amount of their physical activities. This focus led to the first question of the study: 1. What are the effects of a community-based physical activity program such as Walkabout on the quality of life for the older adult participants? Second, the study explored the effects of the social environment created through Walkabout on QOL in later years and that formed the second research question: 2. What are the effects of the Walkabout Program’s created social environment on the quality of life for the older adult participants? Then, particular attention was paid to the physical and built environments of the participants and the study explored the impacts of the environmental factors on the level of older adult participants’ engagements in physical activity. The question here was: 3. What are the impacts of physical and built environments on the level of older adult participants’ engagements in physical activity, in particular walking? Fourth and finally, the study focused on the social environment created through the physical and built environments and asked the following: 4. What are the impacts of the created social environment through built and physical environments on the quality of life in older adult participants? Clearly the study, with its multi-level structure and holistic approach, was constructed with the purpose of gaining a better understanding of the contributing factors to QOL in later years. In exploration and comprehension of these factors, the study involved a qualitative method, which will be discussed in detail later in this thesis. The  13  purpose of this method is to understand and to value the issues from the older adult participants’ perspectives.  2.2  Research Framework In a healthy community, people assist each other to meet both basic needs such  as shelter, and higher ranking needs such as sense of belonging. The physical, social, and economic dimensions of health are inseparable, interdependent and entwined. The study’s framework, aligned with “place-based” education, is focused on the connection of individuals to their environments and surroundings. This is a way to remember the individuals who are dismembered from the physical context of the immediate environments and to relate to an “I–Thou” way to feel a more intimate environmental relationship that helps individuals to feel part of the greater whole (Knapp, 2005). The aim of the study is to understand the ties between physical activity, quality of life, and social and built environments through a holistic approach of recognizing participants’ perspectives as the most important source of knowledge. The study, which contains all five thematic patterns that form a conceptual umbrella known as experiential learning embedded in the context of community life, and involves active engagement (Knapp, 2005), is a community-based experiential learning study. The five thematic patterns of experiential learning are: (1) using cultural or historical phenomena; (2) paying attention to the natural environment; (3) focusing on real world problems by identifying community issues and problems, studying them, and proposing possible solutions; (4) getting more involved in community life; and (5) complete immersion into community life existing in current educational settings.  14  The research has tried to include Aldo Leopold’s vision by learning about the environment through concrete experiences and by applying interdisciplinary content (Knapp, 2005). The reason for considering this ecological paradigm is to go beyond the conventional linear approach and consider multifaceted and multilevel ecological influences on older adult populations’ physical activity. This “Landfull Framework” recognizes that people come to know a place in different ways (Baker, 2005). According to Baker (2005) this framework makes people become deeply aware of their environment through asking questions about their whereabouts and their surroundings. The framework also provides a sense of place in the present through a search for the uniqueness of the place, what the place means to individuals, and who lives or passes through the place and what their relationship is to the land (Baker, 2005).  2.3  Research Methodology, Method, and Paradigm Phenomenology is the methodology used in this research. This approach  identifies the essence of human experiences of a phenomenon from the participants’ points of view (Creswell, 2009). It is through a systematic reflection that the essential properties and structures of the lived experiences are determined. The approach involves focus on a small number of participants for an in-depth understanding (Creswell, 2009). The method used in this study is qualitative, which results in a more in-depth understanding of the issues due to its inclusive nature. The paradigms that supported the study were the naturalist paradigm, post-modernism and post-pragmatism. The study benefited from a naturalistic paradigm, which advocates the existence of multiple realities  15  and explains that different parts of reality, which are interrelated and consequently influenced by each other, become known through different sources (Guba, 1981). It was through this paradigm that I tried to pay attention to differences as much as I focused on similarities. In choosing this paradigm, my hope was also to explore and build upon experience and to expand on tacit knowledge (Guba, 1981). The post-modernist point of view led the researcher to look for the complexity of views instead of narrowing the understanding into a few categories (Denzin & Lincoln, 2008). In this worldview, research looks for multiple meanings of a certain object, thing, or issue, thus making the participants’ views of the situation the centre of focus (Denzin & Lincoln, 2008). According to Creswell (2009), post-pragmatism suggests a pluralistic approach to understanding the problem. This pluralistic approach also provides a philosophical base for the research. The research tries to understand not only the effects of walking on QOL, but also the impacts of factors such as social and built environments, which are mostly beyond the individual’s control. The research was also supported by a post-colonial paradigm since it advocated and implemented the visions of dignity, care, and democracy through equality between the researcher and the participants (Denzin & Lincoln, 2008). The participants were informed from the beginning that they had the right to withdraw from the program at any point in the research. The participants also had the opportunity to change the content of their views expressed in the private interviews through editing their transcriptions in any form and to any extent they desired.  16  2.4  Recruiting Older Adults The older adult participants were recruited through different avenues. For  example, the researcher made direct contact with Tapestry independent living centre located at Wesbrook Mall Village to discuss the possibility of a co-operation between the centre and the study. The warm reception of the administration and staff at Tapestry encouraged the researcher to proceed further, and the study gained eight participants from Tapestry. Fifteen other people were recruited through word of mouth; five of these individuals were recruited with the help of the Principal Investigator, Dr. Joy Butler. All of the participants, a total of 23 individuals, were adults 60 years of age or older. There were 3 men and 20 women, and all were Caucasian. The participants were registered in Walkabout after participating in the initial information sessions and completion of all the necessary forms. The program’s registration fee, which included the cost of a pedometer, was waived for the participants in the study. At the beginning of the Walkabout Program one participant announced his resignation due to health concerns but still helped his team with the administration duties. Another participant was also forced to drop from the program due to illness, and the rest of the participants, a total of 21 individuals, finished the course of the program.  2.5  Procedure In the process of recruiting, information sessions were set up with the interested  parties. One general information session was arranged for Tapestry independent living centre residents to provide them with the initial information on the study and the Walkabout Program. All the necessary documents and forms for the prospective  17  participants were distributed in this session. The Principal Investigator, Dr. Joy Butler, was present in this session as well. Other information sessions were set up with other prospective participants, mostly in individual meeting forms to accommodate the individuals’ schedules. As was mentioned previously, 23 older adult participants agreed to take part in the study. After the initial information session, another session was scheduled with the Tapestry participants to collect the interested participants’ documents and to respond to any further questions or concerns. It was in this session that detailed information about the Walkabout Program and its rules and regulations was provided to the participants. Similar procedures were applied to the other participants as well. The recruiting process for the participating team from the municipality of Richmond in Metro Vancouver was a little different. This team had been participating in Walkabout for the previous five years, so they were very familiar with the program. Consequently, only one information session was offered to the participants of this team. Four teams were formed, each consisting of five older adults. There was another person who participated as an individual and was placed in a team later on. I closely monitored all of the older adult participants; however, for the purpose of time and data management, I became particularly interested in two teams. Team One, whose participants lived in the community of Richmond in Metro Vancouver, had been participating in the Walkabout Program for the previous five years. Team Two, whose participants lived at Tapestry independent living centre located in Wesbrook Mall in Vancouver, was participating in the Walkabout Program for the first time. Table 2.1 highlights the characteristics of the two teams.  18  Table 2.1  Teams  Richmond  Tapestry  Summarized Description of the Study’s Participants  Gender  5 Female  4 Female & 1 Male  Average Age  67.2  76  Working  Physical  Status  Abilities  1 member  Capable of  works part-  performing  time  ADLs & IADLs  1 member  Capable of  works part-  performing  time  ADLs & IADLs  The following reasons contributed to the selection of these two teams for the study. 1. All the members of Team One lived in Richmond, while all the members of Team Two lived in Wesbrook Mall Village near UBC. This provided an opportunity to compare two different areas when the physical, built, and created social environments were in focus. In other words, by including these two teams, the study could explore the impacts of physical, built, and social environments on the level of older adult participants’ engagements in physical activity in two neighbourhoods. This increased the validity of the data. 2. The members of Team One lived in the community, while the members of Team Two lived at Tapestry independent living centre. The inclusion of these two groups provided the study with diverse and rich representations and perspectives on the issues of accessibility to services, social environment, and quality of life. 3. Some members in both teams were still working when the study was completed while others were fully retired. This represented the compatibility of the two teams,  19  meaning that although one group lived in an independent living centre, its members had similar conditions and challenges as the other team with respect to work or other commitments. 4. All individuals in both teams were independent and they were capable of performing the Activities of Daily Living, ADLs, such as eating and bathing, and the Instrumental Activities of Daily Living, IADLs, such as shopping, going to doctor appointments, etc. without assistance. This again represented the compatibility of the two teams. 5. These two teams also were chosen in order to have a broader perspective on the possible long- and short-term effects of the Walkabout Program on the participants’ lifestyle since one team was participating in Walkabout for the sixth time while the other one was participating for the first time. It is essential to remind the reader that no effort has been made to compare the two neighbourhoods.  2.6  Data Collection Since QOL is multidimensional, a holistic approach seemed more appropriate to  understand this phenomenon at a deeper level. Structured and unstructured approaches were combined at different stages of the study to gain a clear understanding of the issues and concerns (Palys & Atchison, 2008). Therefore, the researcher began and continued the study through asking questions of knowledgeable people in the field, reviewing the literature, and consulting older people for their opinions, as they were most likely to be affected by the research.  20  In addition to collecting the data through Excel sheets, which only indicated how many steps each person had taken every day, the members of the two groups this study focused on were asked to provide a daily journal for a week or two during the operation of the Walkabout. This was to satisfy the following obligations: 1. By documenting some of the activities and the importance of them to the participants, and by writing the feelings the participants had when performing these activities, important traces could be made. These traces then could provide information about the kinds of activities the participants performed or preferred, the level of their engagement in the activities, the reasons for performing such activity, or the factors contributing to the performance of such activities. The hope was that this multilevel approach to data collection might provide the study with a broader window on perspectives and richer results. The intention was to eliminate a linear approach in which data emerge from one source or are analyzed through one channel only. 2. This approach also added to the validity of the data in the study since it provided an opportunity of comparison of the same data from different sources. During the Walkabout Program period, interventions were provided for the participants in the form of social walking sessions to encourage them to become more physically and socially active. The social walking sessions were provided for both the residents at Tapestry and the Richmond location team by the researcher to ensure of consistency of the intervention among the participants. Private interviews with some open-ended questions were conducted at the end of the Walkabout Program. Private interviews benefited from a casual atmosphere and  21  semi-structured nature. The structure was selected to ensure that contributors had a true voice in the research and to explore what QOL meant from the participants’ vantage points. As noted by Koch (1993), the opportunity for participants to have a voice in research increases the credibility of the research. This structure was also adopted to explore from their perspective how created social environment through Walkabout impacted their quality of life. By encouraging the participants to take charge of the interviews’ directions, the semi-structured nature of the interviews also helped participants to understand how the built environment they lived in and its created social environment might have increased their engagement in physical activity. Audiotapes were used to record the content of the private interviews. These audiotapes were then transcribed, and the contributors were provided with the opportunity to read their transcriptions for accuracy and had the opportunity to edit the details of their provided information. The intention was to advocate democracy and reciprocity which encouraged the participants to speak of the feelings and related issues that were important to them rather than focusing on those of the researcher (Palys & Atchison, 2008). This approach was taken to further boost the credibility of the research. The interview sessions were approximately 45 to 90 minutes in length. However, all the participants were in good physical shape and wonderful spirit, and all the interviews were finished in one session for each participant. In these interview sessions, in addition to the questions of the researcher (see Appendix B), each participant or contributor was also encouraged to bring her/his own related questions or concerns that were considered to be important. They were also encouraged to make suggestions or offer possible solutions. The intention of this  22  approach was to provide the contributors with a voice, which was very important to the validity of the study (Denzin & Lincoln, 2008). The intention was also to increase the validity of the data by adding the process of member check to the study. When reflecting on the contents of the private interviews, pseudonyms were adopted to protect the anonymity of the participants. To assess the quality of built environments at the UBC and Richmond locations in regards to four SWEAT-R domains of the built environment (1: Safety, such as crosswalk, pedestrians signal, street lights; 2: Function, such as building use, sidewalks, street life; 3: Destinations, such as restaurant, grocery, and services; and 4: Aesthetics, such as trees, maintenance (Pikora, Giles-Corti, Bull, Jamrozik, & Donovan, 2003), physical examinations were conducted of the area surrounding the Tapestry residence and the area where the Richmond team held their walking sessions. The researcher modified the use of SWEAT-R, the Senior Walking Environmental Audit Tool-Revised (Chaudhury et al., 2011), to showcase her own interpretation of the environmental factors in the two neighbourhoods. Please refer to Appendix C for SWEAT-R forms. The data collected through private interviews, and the researcher’s interpretation of the built environment with the help of SWEAT-R combined with visual images, have provided the study with a comprehensive overview and understanding of the factors contributing to the engagement of the older adult participants in walking and to an increase in their quality of life. Some parts of the data were analyzed and other parts were simply conveyed in this paper so as to provide readers with the opportunity of active engagement in making conclusions. In other instances, there were simply many different  23  ways of analyzing one set of data; the interpretation provided in this paper is only one of many ways to benefit from the data. During the data analysis, efforts were made to ensure that the codes fit the data instead of forcing the data into the codes (Charmaz, 1983). The intention was to develop categories that are analytic—“sufficiently generalized to designate characteristics of concrete entities, not the entities themselves”—and to combine data into a coherent whole to “yield a meaningful picture abetted by apt illustrations that enable one to grasp the reference in terms of one’s own experience” (Glaser & Strauss, 1967, pp. 38–39). This involved reading and re-reading the transcripts of the interviews, scrutinizing the data to discover the repeated responses, clustering and sorting, and accepting dis-agreeable situations (Zerubavel, 1996). In the process of decoding, open coding was performed first. The aim was to read the transcripts and look for distinct concepts and categories, thus the headings and subheadings emerged from the broken data. Later on, axial coding was performed using the concepts and categories while re-reading the text. Two purposes were behind this stage of data analysis: first, to confirm that the categories and concepts that emerged were accurately representing the interviews’ responses, and second to discover the possible relations between the categories and concepts. Transparency was chosen throughout the research because dependability and consequently trustworthiness (rigour) are established if the readers are able to recognize and audit the events, actions, and influences of the researcher (Guba & Lincoln, 1985). The study also benefited from transferability (external validity) because its relevance was rooted, sensed, and repeated in the real life of its participants (Guba, 1981).  24  Finally, obviously and inevitably, although not consciously, the objective opinions of the researcher as a mature adult of 53 years of age shaped the data analysis throughout the study.  25  3  Chapter: Walkabout and the Older Adults  In this chapter the intention is to explore the first two research questions, which are presented again at the beginning of the chapter. Second, a comprehensive coverage of the Walkabout Program is included, so that readers will have some understanding of the nature and operation of the program. Then, data are presented which reflects the older adult participants’ perspectives about the Walkabout Program and its possible effects on the life of older participants. The data presented in this chapter were mostly collected through the transcriptions of the recorded private interviews.  3.1  Research Questions and the Walkabout 1. What are the effects of a community-based physical activity program such as Walkabout on the quality of life for the older adult participants? 2. What are the effects of the Walkabout Program’s created social environment on the quality of life for the older adult participants?  3.2  Walkabout Program Walkabout is a multi-dimensional physical activity community-based program  created by Dr. Joy Butler that has tried to approach physical activity from a holistic point of view. This program was born from a constructivist mindset placing the participants’ needs at the heart of the program. Recognizing the diversity that each individual represents, Dr. Butler has developed a multidimensional program that addresses the complex nature of individuals and the intricacy of the issues of physical activity and quality of life. She has tried to get the participants involved in all aspects of the 26  Walkabout, believing that their participation results in understanding the program’s concepts and goals. Because she supports “Pedagogy for Delight” and believes that in Physical Education too much focus has been put on objective measures while subjective measures have been underplayed, Dr. Butler has also tried to create a balance between health and meaning, as mentioned by Scott Kretchmar in Griffin and Butler (2005). Walkabout starts at the end of January each year and continues for the duration of 9 weeks. Participants in the program are encouraged to form teams and become as physically active as possible during these nine weeks. The focus of the program is on walking as an activity, recognizing that walking is the most sustainable form of activity as far as performance, maintenance, and facility are concerned. In other words, walking is an activity that can be performed by most people, can be maintained throughout life, and can be performed in almost any place. At the beginning of the program, each participant is provided with a pedometer so they can keep a record of their walking steps. The goal throughout these nine weeks is to gradually increase the number of steps taken. Although the participants in the Walkabout Program are provided with healthy and fun opportunities for competition, the program is not about competing. In general, the participants are encouraged to walk a recommended daily amount of 10,000 steps; however, some participants have already passed this recommended amount at the beginning of the program while others’ activity level is far below that. Therefore, the focus is on the individual’s improvement, which provides the participants with a sense of selfworth, confidence, achievement and accomplishment rather than causing them additional stress due to competing with each other.  27  The program follows a specific theme every year; for example, while in 2010 the theme of the program was the BC Olympics Torch Relay Route, in 2011 the program focused on a more serious global issue by adopting earthquakes in Haiti as a theme. The 2012 program theme was visiting parks in British Columbia. A number of parks were carefully mapped and the distance between them was accurately measured. The purposes were to include as many parks as possible in BC for the virtual tour, and to provide the participants with measurable distances. The participants were encouraged to take advantage of every opportunity to be active, either on their own or with their teammates, to gather as many steps as possible, which were counted towards their virtual tours to different parks in BC. As has been mentioned, the participants are encouraged to participate in the Walkabout Program in teams. Each team has five members including a leader who is responsible for receiving Excel Scoring Sheets from the program operators and distributing them to the other team members to be filled with their weekly scores. The leaders are also responsible for receiving the members’ scores and posting their team’s totals on the website every Monday morning. The team leaders are provided with an access code so they can post their team’s results on the program website. It is essential to mention that the Walkabout Program is mainly run by a group of volunteers from different sections of the UBC Education Department. This group is a diverse population and includes staff, faculty members, students, and community members (people living in the area). These members meet on a regular basis at their lunch breaks to make sure of the smooth operation of the program for the benefit of the participants. During the program and at the end of each week, the program operators  28  post and update the teams’ results on the website as an observational and motivational tool. Unfortunately this element was not available online this year due to technical difficulties. However, the team results were available in manual form posted in the foyer of the Faculty of Education building. The goal for the teams this year was to become more physically active and to visit as many parks as possible. Although the participants were encouraged and rewarded with 10,000 steps for every physical visit of their team to a mapped park in British Columbia, visiting the parks was mostly performed virtually through the conversion of their daily steps to the distances between the parks. Understanding the diversity of the participants and the variety of their interests, the Walkabout Program values all forms of physical activity. Therefore, an equivalency chart is designed to the participants’ interests and is available through the website. It is by using this chart that the participants are able to convert many forms of their physical activities to walking steps. The participants are encouraged to form teams consisting of a diverse group of people. A reward of 10,000 steps is awarded to the teams that have members from staff, faculty, students, and the community. The intention is to provide people with networking opportunities, which ultimately lead to the generating of social capital. While this type of team formation may provide the ultimate opportunity for networking in the university environment, participants may choose a different formation. For example, the older adult participant team members mostly consisted of their partners, friends, neighbours, or acquaintances. During the nine weeks of the program motivational tools are used to encourage the teams to maintain and to increase their activity level. For instance, a number of social  29  walking sessions are scheduled, usually at lunch breaks, and announced in advance. Points are awarded and prizes are given to the teams that participate in these social walking sessions. Information sessions are also arranged to provide participants with the latest knowledge in physical activity and health related issues. This year an additional motivational tool called “Bonus Park” was introduced to motivate the team members in socializing and staying active. Each team that sent a picture of all its members visiting a park in British Columbia was rewarded with 10,000 steps. The bonus park was included in order to put more emphasis on social gathering and networking, to encourage the participants to get out and reconnect with their natural environment, and to reward the extra efforts that teams may make in discovering or revisiting parks. The program has never implemented an age restriction, but this year the program has paid particular attention to the older adult participants through the implementation of this study and its focus on exploring physical activity and environmental factors affecting QOL in later years. As was mentioned at the beginning of this section, the Walkabout Program has been trying to establish a healthy habit in the life of its participants through meaningful participation in the program. This intention is implemented through a process that is encouraging, relaxed, and rewarding. Besides serving the interests of the collective through team formations, networking, and creation of healthy habits, the program also values the individual’s progress. For instance, individuals who achieve a million steps during the program are presented with a pin to mark the importance of this milestone. The intention is to provide the participants with positive experiences through inclusive and  30  relaxing physical activity opportunities, so there is a higher probability that the participants will stay active after the program ends.  3.2.1 Walkabout, Health, and Quality of Life in Older Adult Participants Although the inclusive nature of the Walkabout Program invites people of all ages to get involved, become active, and have fun, the issue of QOL in later years and the effects of a community-based physical activity program on quality of life created a new focus and dimension for the program. This section of the study explores the older adults’ perspectives on the impacts of a physical activity program such as Walkabout on health and QOL in older adults. As was mentioned earlier, Walkabout is a physical activity program with a holistic approach on producing quality of life for its participants. The importance of the two factors of physiological and emotional health and their influences on quality of life are recognized and considered in the programming and operation of the Walkabout Program. These two factors contributing to QOL also surfaced as themes in the private interviews. The majority of the older participants in this study perceived good health and life satisfaction as two major factors contributing to their quality of life, something also found in a study by Kahn and Juster (2002). For example, when the older participants were asked to describe their quality of life and to provide reasons for their descriptions, most of the participants made a strong link between their quality of life, their health, and their satisfaction from life.  31  Jo-Anne, a 72-year-old participant, mentioned that her quality of life was good, and her reply to a question about why it was good was: I think for me is very important that I am healthy at my age and that I can still do a lot of things. Because if you don’t have a good health you lose some happiness and you can’t enjoy life as much. When another participant, Kathy, an 88-year-old female, was asked the same question she answered that her quality of life was excellent and other than having a cold, she was in good health. Kathy also made a link between her quality of life and life satisfaction when she continued: “I don’t have to worry about anything and there is lots and lots to do and that is what I like.” Mariam, who is 71, in answering this question mentioned that her quality of life was fantastic and she provided the following explanation: “I have my life, my health, my lovely family, my friends, my garden. For my age you know. I am able to do so much and I have a lot of energy and I am always busy.” Susan, who is 78 years old, responded that her quality of life on the scale of one to ten was ten. When she was asked why she rated her quality of life at ten, she explained, “So for one thing, I am healthy and my husband is fine and we are able to walk which is really important.” Cindy, whose age is 70, perceived the quality of her life in combination with many things that contributed to her satisfaction in life, but she made a special reference to the importance of mental health as a contributing factor to her quality of life when she responded to the question by saying: “I think my brain still works.” Christine, with a unique care giving situation, describes the quality of her life as very good. She made a direct link between her quality of life, physical activity,  32  and emotional well-being when she added to her answer by saying: “There are limitations due to our own situation that um…cause me stress, but that’s where walking plays such an important role in my life.” George, a very healthy active male participant, considered himself to have a very good quality of life. He mentioned “I would have liked to, to do more after my retirement you know because I’m healthy and, but unfortunately not everything could be done.” Beverly, another participant in the study who is facing health challenges, also made a strong link between her quality of life and her health. She believed that if she could have taken her health problem out of the equation, she loves her life in general and is very satisfied with it. Heather also considered herself as having a good quality of life because of her health. She also viewed her quality of life in relation to being satisfied with her life outcomes. In general, the participants were unanimous in perceiving health as an important factor contributing to their quality of life. Many of the participants articulately linked their health to their level of satisfaction from life, which led to the increase in their quality of life. Others took the domain of health for granted and linked being active to QOL. As noted in the first chapter of this thesis, the physiological and emotional health benefits of physical activity are well documented and noted in the literature. In recent years, there have been clinical statements in geriatrics and increasing research evidence that physical activity is a viable public health  33  intervention for increasing or maintaining quality of life among older adults (Buchner, 1997; Rejeski, Brawley, & Shumaker, 1996). In fact, in the epidemiological study of chronic disease traditional medical outcomes such as morbidity and mortality are commonly augmented by measures of patients’ health-related quality of life (Kaplan, Bush, 1982). Equivalent to what was mentioned in the literature review, the importance of physical activity in maintaining health and producing quality of life in later years was emphasized by the older participants in the study. The participants mentioned the ability to stay healthy and its relation to being active in later years. This highlighted the importance of programs such as Walkabout and their positive effects on the health of older adults through activity and mobility. Walkabout as an intervention has enabled the older participants to stay active, which both directly and indirectly has had positive influences on life satisfaction and quality of life for them.  3.2.2 Walkabout, Physical Activity and Older Adult Participants A common societal stereotype of older adults as passive citizens who are supported by working people has portrayed them as a burden to society (Becker & Schroots, 2008; Butrica & Schaner, 2005; Chawla, 1991; Fernández-Ballesteros, 1992, 2006; Fernández-Ballesteros & Díez-Nicolás, 2008). On the contrary, older adults are a group of active citizens who not only have contributed to society as workers and professionals before their retirement, but also have continued to contribute to their families, friends, and society after retirement. For instance, many older adults get involved in volunteer work while others contribute to their families  34  through providing care services by looking after their grandchildren (Chappell, McDonald, & Stone, 2008). Not to mention the monetary contribution of older adults to their families and society that amounts to a considerable sum every year (Chappell et al., 2008). These forms of contributions and activities are not only beneficial to the families, friends, and society, but also satisfy older adults emotionally, which contributes to their quality of life. Being physically active for the purpose of self-health was another factor the older adults in the study mentioned as a contributing factor to their life satisfaction and consequently their quality of life. Whether the activity is social or physical, the benefits are tremendous in the life of older adults because on the one hand it keeps them healthy—mentally, emotionally, and physiologically—and on the other it maintains their connectivity to society, which is of huge importance to them. According to Activity Theory, aging brings problems such as a decrease in life satisfaction, which can be alleviated by engaging in activities (Chappell et al., 2008). This theory is based on the proposition that although older people may face health decline, they continue to have the social and psychological needs of earlier life (Chappell et al., 2008). Thus, the individuals who are capable of meeting these psychological and social needs through maintaining the activities they had in middle life, by taking new roles, activities, and friends, will be the best adjusted and most satisfied with life. Related to Activity Theory is the concept of successful aging, as noted by Chappell et al. (2008). The main message of successful aging is that older adults have remarkable abilities to prevent illness, to minimize losses in physical and mental functions, and to improve their engagement in life by simply staying active.  35  Tobin & Neugarten (1961) noted that activity becomes an increasingly important contributing factor to life satisfaction in later years. Similar to this finding, the participants in this study expressed the importance of staying active socially and physically by engaging in new activities. For example, Jo-Anne said that she had just started a fitness program on a new machine in the gym at Tapestry in order to stay active and connected. She also mentioned that she used to run, but she no longer can. Thus, she stays active by walking. In contrast, Mariam reported that she was able to start running at age 50 since she benefited from healthy joints. She also mentioned that her ability to run greatly contributes to her satisfaction in life. Susan also reported her satisfaction from her new roles and social gatherings through programs such as the walkabout. Therefore, it can be concluded that the activity theory suited and supported the voice of the participants in this study the best. Walking, which is the most commonly reported physical activity behaviour according to Australian Bureau of Statistics and Health (2000) and Siegel, Brackbill, and Heath (1995), has positive influences on QOL in later years. Similar perspectives on the issue of activity, in particular walking, and its link to quality of life were reported in the private interviews by the older adult participants in the study. Jo-Anne mentioned the importance of being active and reported it as a contributing factor to her quality of life. She also said that she likes walking, especially when she has the opportunity to do it in a park-like setting. Mariam attributed her quality of life significantly to being active in addition to having health, her lovely family, friends, and her garden. She believes that is why  36  she has an excellent quality of life. When she was asked that what her favourite physical activities were, she replied: Well, I don’t know whether to say walking or running. I would say probably running because I feel good that I am still able to do that. I am proud that I can do that. I guess there is the sense of accomplishment. Both Jo-Anne and Mariam viewed being busy and being physically active as a very important factor in keeping their bodies, minds, and spirits healthy. The importance of being active and having a healthy balanced lifestyle was also mentioned by Lili. She commented that her life benefited from a good quality because she was retired, but she worked a little and travelled a little, and she walked, lifted weights, and skied. The balance Lili has created through physical activity and through working part time and travelling contributes to her quality of life. Susan linked her quality of life directly to health and mobility when she said, as mentioned earlier, “So for one thing, I am healthy and my husband is fine and we are able to walk which is really important.” The issue of mobility and independence seemed very important to Susan in the maintenance of her quality of life. Beverly announced that her favourite activities are not that physical. However, she reported that she liked gardening since she could see the fruits of her labour. She also said “I like walking more when we are on holidays to see other places.” Beverly’s statement exhibits the importance of purposeful activity as a motivator in performing physical activity for herself as a not-so-physically-active person. Costello et al. (2011) also noted the importance of purposeful physical activity for non-active individuals.  37  George considered his quality of life as very good. He linked his quality of life directly to his activity level and implied that his quality of life was positively affected by the level of his activity. George reported swimming as his favourite activity, but said that he does lots of walking for the purpose of performing his daily chores. In summary, the older participants in the study strove to be active and highlighted physical activity as an important contributing factor in their quality of life. The participants’ views in the study re-emphasized the importance of walking, mobility, being physically active, and independence. The participants identified being physically active and socially busy the two important factors contributing to their quality of life. Thus, a strong and positive link was made between the program, which encouraged the participants to become more physically active in addition to providing them with social responsibilities and engagements, and the participants’ quality of life. Furthermore, although there was common consent among the participants about walking as the most performed form of physical activity, they also had a wide range of interests in regards to physical activity. This variety in participants’ interest in different forms of physical activity has been realized and accommodated in the Walkabout Program. While the focus of the program has been on walking as a form of activity that can be performed almost anywhere and can be maintained throughout life, the program has also recognized and valued many other forms of activity by providing the participants with an equivalency chart. It is through this chart that the participants can convert their preferred form of physical activity to an equivalent number of walking steps for the purpose of recording.  38  3.2.3 Walkabout, Teamwork, Social Capital, and Older Adult Participants Subjective measures of emotional connectedness to others are related to general health and well-being (Chappell, 1992, cited in Chappell et al., 2008). Social network, which refers to the entire web of relationships that individuals are directly or indirectly involved in, has a positive effect on the well-being of older adults (Chappell et al., 2008). As noted before, the Walkabout Program understands the importance of networking in the life of people and values that in different ways. For instance, realizing that social participation is linked with well-being and quality of life (Andonian & MacRae, 2011), Walkabout encourages participants to engage in the program by forming teams. This focus on teams instead of on individuals offers many benefits to both the individual and the collective. The program also places more emphasis on networking through the composition of teams and awards the teams with a diverse member structure. The teams with members from staff, faculty, students, and community are awarded with 10,000 steps for this composition. The reason behind the emphasis on diversity in team membership is rooted in a belief that each of these groups of people has a unique characteristic, which results in a unique type of contribution to the team and its members. This diversity in individuals’ capacities and skills makes teams stronger and it also provides the team members with the opportunity of networking, which results in the generation of social capital. This feature in the Walkabout Program results in one ultimate form of networking, but there are a number of other team settings providing members with similar networking opportunities. For  39  example, both older adult teams focused on in this study chose to form teams consisting of their partners, friends, neighbours, and peers. To explore the impacts of teamwork on the level of older adults’ engagements in physical activity, and the effects of networking on their quality of life, we asked the participants in the study what the determining factors were in the level of their engagements in the walking. We also asked the participants of the two teams about what they enjoyed the most in the Walkabout Program. The most repeated contributing factors were that they felt responsible for the team and that they enjoyed the social part of the program. Thus, the two themes of social responsibility and commitment, and social engagement or networking emerged. The following are some of the statements the participants provided in private interviews. When Kathy, who finds walking a little boring, was asked about the most enjoyable part of the Walkabout Program, she said she most enjoyed completing the program in a team setting. She also said that nice weather and the company of a friend and team member who called her to go for a walk were two factors that contributed to the level of her engagement in walking. Kathy, like many other older participants, also reported that the majority of her steps came from walking. It could be concluded from Kathy’s statements that it was not the form but rather the timing of the activity that was the least desirable to Kathy and a deterrent factor in her engagement in physical activity. It could also be concluded that it was the nature and the social construct of the Walkabout Program that made participants such as Kathy continue walking despite perceiving it as a rather boring activity.  40  Beverly’s response to the question about what she enjoyed the most in the program was “I think the most was just getting together with my friends and walking.” When Beverly was asked about the determining factors in the level of her engagement in walking, she presented the following statement: Yah, but there were a number of times that I chose to walk when normally I wouldn’t have, just to increase my steps because I’m the lowest on my team. They are really good walkers. They are much better walkers than I am, so you know, just maybe not to be so embarrassed by such a having such low numbers I had to do that. Beverly’s feelings about the amount of her contribution to the team could be partially linked to Social Exchange Theory, set forth by George Homans in 1961, which is concerned with person-to-person interaction focusing on negotiation and calculation between individuals as they try to maximize rewards and minimize the costs (Chappell et al., 2008). The rewards can be material, such as property or money, or non-material, such as approval. Costs are the loss of rewards. This theory rests on the proposition that people want to profit in their social interactions and that exchanges are most satisfying when the offered resources are approximately equal (Chappell et al., 2008). The belief is that when one individual offers fewer resources in an exchange, that person is forced to offer compliance to others, or may discontinue the social interaction (Chappell et al., 2008). Even though the first part of Beverly’s feeling supported the part of Social Exchange Theory about the formulation of costs and rewards in social exchanges, her reaction was not to leave or to surrender. Beverly recognized the rewards and losses for the team when she realized that the amount or level of her contribution was the lowest in the team. However, in this case, Beverly made a conscious  41  decision to become more active and to contribute as much as she could to the success of her team instead of surrendering to the situation or discontinuing her social exchange with the team. Beverly’s action is a good example that in an imbalance of a social exchange compliance to the others or discontinuation of the exchange may not be the only solution. For instance, because Beverly enjoyed the company of her friends and their social walking sessions she tried her best to capitalize on her physical activity whenever she found even the smallest possibilities. She reported: Recently I had to go up to drop off something to somebody up at Minoru Seniors Centre and they have a track there, so while I was there, I just got out and I walked around the track a few times. First time I’ve ever been on that track. This understanding about the power of collective and the importance that sense of belonging has in the life of people is well realized by the Walkabout Program. The program places an importance on the team because it is in a team setting that the participants have the opportunity for socializing, becoming active, assessing their contributions, caring for the well-being of the collective, and taking positive actions towards a common goal. In other words, it is the needs of the collective—the team—which made Beverly take the initiative in increasing her level of physical activity. Heather, who is 70, found counting steps to be a motivational factor and what she enjoyed the most about the Walkabout Program. She explained: “I mean I tend to be a little competitive (laughing), so you know the whole idea of getting more steps is just another way of getting you out there.” In regards to the determining factors in the level of her engagement in physical activity, she believed that her  42  commitment to her group and her commitment to staying active were the two main factors. The importance and power of teamwork could also be seen from Heather’s writing in her anecdotal journal dated March 12, 2012: Walked home with the walking group…it was so windy we couldn’t go on the dyke so walked up and down the streets until we had walked for an hour…didn’t pass too many people we were the only fools walking today!!! In a more direct way, Susan pointed out the importance of networking and the satisfaction it provided when she said, “Well, it was fun comparing notes with the other team members to see how many steps they have done.” Susan also mentioned the pedometer as a determining factor in her engagement in walking. However, she regarded camaraderie and her commitment to the team as two important factors that contributed to her level of engagement. Mariam mentioned that she enjoyed the social gathering of the Walkabout Program the most. She said We always look forward to the end because it’s fun to see the other people and the way they show the pictures of us all. It’s kind of fun to hear all the names and all the different people. Mariam’s response emphasizes the importance of networking and social capital in her life. Walkabout has been able to create and fit these social gatherings into the program. It is through these gatherings that the participants have the opportunity to meet other teams’ members and socialize with them. This socializing also helps to generate social capital among the participants. These purposeful gatherings also increase the participants’ self-confidence through the recognition of their accomplishments. Mariam highlighted this feeling when she commented on the closing ceremony, “We haven’t been doing well this year. Other years actually we  43  have got up to the top three or four for our social and other, but not this year.” Although Mariam is making a comparison between her team’s previous accomplishments and this year’s results, one can clearly feel the penetration of her pride in the team’s previous accomplishments. This sense of having meaningful and productive accomplishments suggest that activity may bestow survival benefits through psychological pathways, as mentioned in Glass et al. (1999). When Jo-Anne was asked what she most enjoyed about the Walkabout Program, her answer was that there was nothing, it was just walking and it was already in her system. However, later on Jo-Anne said: Oh maybe because of the Walkabout you want to make more points for your group so even if I did exercise and I was a bit tired, you still want to have a walk, or you still want to do something, just to get your steps in. This comment from Jo-Anne became a familiar theme since she, like other participants, was affected by the sense of belonging to her team and the responsibility she felt towards them. These two factors clearly impacted her level of engagement in physical activity. Lili’s response regarding what she enjoyed the most in the Walkabout was: Well, the Walkabout specifically is that it gets you out more in the winter. Everything else we do all year round, so for the Walkabout it is actually that we do try to get your steps in, and you have to you know you have to go outside most times, unless I do weights or something like that, I have to get outside to get steps. Lili appreciated gathering steps as a motivational factor to get outside at a time of the year when she usually prefers to stay in, since the weather is not conducive to walking. She found the timing of the program a double-edged sword  44  and mentioned that the timing was both her most enjoyable and least favourite part of the program. In answer to the question about the determining factors in the level of her engagement in physical activity, Lili said “When we travel there is nobody to walk with, so that when we travel it’s very hard to walk when you are not with the walking people.” Not having a walking partner was also mentioned in Costello et al. (2011) as a barrier to performing physical activity. Lili also mentioned that her team always walks on the two days that the team has chosen for their social walking, regardless of the weather: “We walk period. It doesn’t matter what the weather is, but I wouldn’t walk in the rain per say if it wasn’t for the Walkabout.” Lili’s statement shows the power of teamwork and demonstrates that participation in the program may also have mitigated the effects of bad weather on exercise. Christine admitted that she enjoyed the camaraderie, mutual trust and friendship among her team members the most. This spirit of familiarity and closeness was very important to Christine. She commented: They have great sense of humour and I love, I’ve been so isolated from people that are in different work fields because a lot of people I know here that are friends are still working, so you don’t get that social aspect, so I really enjoyed that. In another section of the interview Christine further emphasized the importance of walking with her teammates by explaining, “Because I never socially walked with people out there because they work or the hours are different, but that part of it was lovely. That was more important to me than anything else.” George, who thinks socializing is not his strength, makes the following critique of the Walkabout:  45  I know I found that there is lot of emphasis on the social part, and I can’t see the benefit of that you know, but as I said you know I am not a social person, so I don’t see the benefit of that you know, I would like to see more emphasis on the activity part. However, later on the “not so social George” did feel an increase in his physical activities during the Walkabout and when he was asked what the reasons were for this increase, he made the following statement: There were certain days especially the days that did the jogging, in the afternoon I was very tired, but when Jo-Anne said let’s go for a walk or let’s go to the village we have to do few things then I say ok I go with you just to get some more steps you know. When George was asked for whom he did these steps, he answered that he did them for the team and for himself too. The success of the team and the sense of belonging were important to all members of both teams, even the ones who claimed not to be so social. In conclusion, the social networking opportunities that the Walkabout Program provided seemed to have a great impact on QOL in the older adult participants. Whether it was the closing ceremony, the sense of belonging, counting and comparing notes, or the simple act of getting together with friends and walking, these social gatherings were what the majority of the participants enjoyed the most in the Walkabout. These social gatherings were vital factors that contributed to the increase in the participants’ physical activities and in their quality of life. The motivational value that the Walkabout engineered through these gatherings and the responsibility that individuals felt towards the team and its performance were the factors that most contributed to increasing their physical activity and their quality of life.  46  3.2.4 Walkabout and Physical Literacy The study explored the other possible effects of the Walkabout on the participants’ lives. It was because of the semi-structured nature of the interviews that each interview became unique, offering rich data to the study. It was through this informal atmosphere that the participants felt comfortable to speak about their true feelings. Lili, who has been participating in the program for the past six years, enjoyed the timing of the program the best and the least, as was mentioned previously. When she was asked if the Walkabout made any positive changes in her life or created a new habit in her, she responded: “No, no, other than, other than walking in the rain. What I wouldn’t have done if it wasn’t for the Walkabout.” Lili’s answer provided an opportunity for more probing, so she was asked if she would continue walking in the rain after the program. She replied: Only if it’s the day that we are walking. It doesn’t matter what the weather is, but in between, I wouldn’t walk in the rain per se if it wasn’t for the Walkabout. That’s why is so good in winter. Lili explained that Walkabout has created a positive change in her life— walking in the rain in winter—although the change might have been temporary and only during the operation of the program. It was Lili’s answer to the next question that exhibited the real effect of the Walkabout on her life. When Lili was asked if she would stay as active after the program is finished, she replied: “Oh, yah, I mean, I get my ten thousand steps every day, but I am still doing the walk you know.” This special attention to walking a daily amount of ten thousand steps, which is the  47  Walkabout emphasis, demonstrates the program’s effect on Lili’s lifestyle due to the repeated exposure to the information provided by the program. Lili also thought that having programs like Walkabout offered at her local community centre was a good idea. The implications were that programs like Walkabout may provide other people with experiences like Lili’s experiences through the Walkabout. This desire in Lili might be the results of physical literacy: physical, cognitive, social, and affective developments and growth in individuals through physical activity (Mandigo & Francis, 2009). In other words, due to long-term participation in the Walkabout, Lili has exhibited growth by making changes in her level of activities. She also demonstrated physical literacy when she expressed a wishful desire for other members of the community to have the same experiences as herself. Lili also demonstrated physical literacy by having the ability to comprehend different aspects of the program when she recognized the timing of the Walkabout as both the most and the least desirable features of the program, and she exhibited the ultimate level of physical literacy by being responsive, reactive, and adaptable to the timing of the program (Mandigo & Francis, 2009). Cindy, who found the program informative, challenging, enabling, and rewarding all at the same time, replied to the question of whether the program made any positive changes in her life with the following statement: Yah, I think I am more active and I think about it. I pay more attention to doing it. And now that you really know, you can kick yourself about how active you’ve been. Now that you know, I got my husband walking up the stairs. We take the stairs from the garage now. We got our cat walking with us too. We take him up on the last floor for walking, but he is not much of a walker though.  48  Cindy reported the development of a new habit in that she takes stairs more often. She also thought and hoped that she would stay as active after the program was finished, which implied that she attributed her lifestyle change to the program. The physical and cognitive growth that Cindy reported is linked to developing physical literacy due to the exposure to the Walkabout. Susan, who had reported as her favourite feature the social aspects of the Walkabout, such as social walking and comparing notes, thought that the program also encouraged and inspired the participants to become more physically active. She also emphasized the camaraderie in her team as one of the program’s positive results for her social life. Although Susan stated that she did not think that she would participate in the Walkabout again, she said: “Well, I’ve done it once and I know what it is all about and I just keep walking, I keep walking.” What Susan mentioned in the interview not only implied the changing effect of the program in her life, but also re-emphasized the multiple effects of the program on the development and growth of the social and affective domains of her life, in addition to the physical fitness. The knowledge the Walkabout equipped Susan with made her a physically literate person. Well, at the time of doing it, it made a difference because I would make a point of going out to make sure I got the ten thousand every day. If I am not in the program then I might let a day go by. The above statement was Mariam’s reply when she was asked if the Walkabout made any changes in her life. Like Lili, Mariam also exhibited physical literacy through cognitive growth in addition to affective growth by wanting other  49  members of the community to have the similar experiences as hers in regards to physical activity. Heather, who had been participating in the Walkabout for six years, reported that she will definitely participate in the Walkabout again next year. Not having the opportunity this year to trace her team’s progress online, as this feature was not available due to technical difficulties, was what she enjoyed the least in the program. Heather thought of the program as a great motivator to get people going. She indicated that she did not think of making any changes to the program: “I think people who organize it although it was a different group this year mainly, you know, they put lot of effort into it. I appreciate that. Yah, I think they do a really good job.” The understanding Heather demonstrated, in an ethical and proficient way, in relation to the environment, task, and situation means that she is a truly physically literate person according to the parameters outlined by Mandigo and Francis (2009). George, a new participant in the Walkabout, said that he did not think about the Walkabout much and just gave it a try. With a unique personality, what George proposed as a change to the program was more focus on the activity part rather than a lot of emphasis on the social part, which he claimed was not his strength. George also believed that the program did not result in any lifestyle changes for him, as he has always been an avid walker. Later on, George mentioned that his activity level might have increased during the Walkabout since he was motivated to get more steps for the team. The physical and social growth demonstrated by George made him a physically literate person as well.  50  Beverly, another veteran participant, thought of the Walkabout as a good program that creates awareness about physical activity, which the participants benefit from. In addition, Beverly thought that the Walkabout understood the more competitive participants and provided them with opportunities to walk and talk, which focused on the social domain of their life. This emphasis on social growth enhanced QOL in this type of participant as Beverly noted. Beverly also mentioned the positive change that the Walkabout brought her: “If I had to go over to the Seven-Eleven to mail something, I know in the past I got in my car. It’s only couple of blocks away, but now I just walk.” Beverly was critical of the program for focusing a lot on the UBC community and imposing disadvantages to the participants from outside of that community. For example, in her opinion having the teams’ progress posted manually at UBC was a positive motivational factor that only the teams from UBC benefited from. Beverly’s detailed analysis of the physical, social, and cognitive domains of the Walkabout exhibited her growth and her understanding of the program’s structure and operation, which was an indicator of her high level of physical literacy. Jo-Anne, a first-time participant, did not think that the Walkabout made any changes in her life since the walking was already in her system. However, she mentioned the motivational aspect of the program and its application in her life, as she now wanted to do more. Jo-Anne said: “I did exercise and I was a bit tired, you still want to have a walk, or you still want to do something just to get your steps in.” Jo-Anne also reported:  51  I prefer the most just walk for the walking uh, in here in the Pacific Spirits Park, then I can go as far as I want, where I want to go, but I also walk, um, because I have certain things to do. Jo-Anne also highlighted the spiritual benefits of her walking by expressing her love for the forest—its smells, its peacefulness, its greens, its moss and colours—when walking there, and the happiness that it provided her with. Whether it was walking for the purpose of performing daily chores, or a walk for the sole purpose of walking, Jo-Anne exhibited a level of physical literacy that could be described as the ability and motivation to capitalize on her movement potential to make a significant contribution to her quality of life. These are physical literacy characteristics as defined by Whitehead (2007) and cited by Mandigo and Francis (2009).  52  4  Chapter: Physical, Built, and Created Social Environments and  the Older Adults  In this chapter the reader is reminded of the third research question and is presented with a discussion of physical and built environments. Then, an analysis is provided of the data gathered through private interviews regarding the physical and built environments of the older adult participants’ neighbourhoods. This analysis is for the purpose of understanding what elements of the physical and built environments are important to the participants and encourage them to become more active. Subsequently, the fourth research question, on the possible impacts of the created social environment on the level of older adults’ engagements in physical activity, in particular walking, is explored. The influence of social environment in networking, generating social capital, and increasing quality of life for older adults will also be looked at from the participants’ perspectives. This unfolds the final section of the study. At the end of the chapter, a review report discussing the two neighbourhoods, Wesbrook Village and Steveston Village, which were explored using the Senior Walking Environmental Audit Tool Revised, SWEAT-R (Chaudhury et al., 2011), will be presented to include the researcher’s interpretation of the possible impacts of these neighbourhoods’ characteristics on QOL in their older adult residents.  53  4.1  Physical and Built Environments and Research Questions This section explores the impacts of the physical and built environments and  their created social environment on the level of older adult participants’ engagement in physical activity and increase of QOL. This analysis is based on the third and fourth research questions: 3. What are the impacts of physical and built environments on the level of older adult participants’ engagements in physical activity, in particular walking? 4. What are the impacts of the created social environment through built and physical environments on the quality of life in older adult participants? Theoretically, there is a strong case that environmental influences can play an important role in shaping habitual behaviour patterns (Owen, Humpel, Leslie, Bauman, & Sallis, 2004). It is assumed that the choice to be active or inactive is conscious and deliberate and based upon attitudes, intentions, self-efficacy, and other cognitive mediums of behavioural change (Sallis & Owen, 1999; Trost, Owen, Bauman, Sallis, & Brown, 2002). However, social cognitive models have identified environmental influences under some circumstances (Owen et al., 2004). Bandura (1986) has argued that when the behaviour is facilitated or constrained by the environment in which it takes place, the environmental influences would be the predominant class of determinants. As mentioned previously, walking has been recognized by the Australian Bureau of Statistics (2000) and Siegel et al. (1995) as the most commonly reported physical activity behaviour. Walking has also been identified as the physical activity behaviour of adults that should be most susceptible to influence (Australian Bureau  54  of Statistics, 2000; Sallis & Owen, 1999). Thus, there is an urgency to understand the environmental determinants of physical activity and in particular the behaviour of walking. Environmental attributes, especially aesthetics, convenience, and access, have been associated with an increase in physical activity (Humpel, Owen, & Leslie, 2002). Identifying objectively measured environmental attributes such as mixed land use, residential density, and intersection density and their effects on engagement in walking seems essential.  4.1.1 The Impacts of Physical and Built Environments on the Engagement of Older Adult Participants in Walking Researchers have defined built environment as encompassing all the buildings, spaces, and products created and modified by people (Rao, 2007). The built environment affecting the indoor and outdoor physical and social environment has a great influence on health and quality of life, according to Srinivasan, O’Fallon, and Dearry (2003). Noticing this importance, questions regarding the older adult participants’ physical and built environments were included in the list of interview questions. First, the questions aimed to identify whether such environmental impacts on engagement in physical activities existed from the older adult participants’ perspective. Second, the purpose was also to explore these attributes from the lenses of the participants. During the interviews, the participants were asked whether their neighbourhoods were supportive of physical activity, specifically when walking. They provided the following information. George explained:  55  When we lived at the other side of the Wesbrook Mall closer to the Beach, I intended to do walks to Spanish Banks you know and walk there. It’s a nice walk, but here is only the park and for the rest is only the…the…this area here. The campus yah, I find it noisy and all the construction and no too much traffic, no I don’t like the campus, but the other side, it was nice and close to the beach there, and I intended more to say ok I take a walk to the beach you know today. George does not think that his neighbourhood is supportive of walking and presents the following reasons to justify his opinion: First the sidewalks you know, sometimes along the Marine Drive suddenly is gone. You have to walk along the highway and then it continues again and same here, if you walk to the bus stop you, suddenly the sidewalk is gone, and again all these bicycles you know if you walk students riding on the bikes, it’s dangerous. If anything they shouldn’t be, shouldn’t be on the sidewalks, no, not supportive. They say they are supportive. I don’t see it happening. Analyzing George’s statements, positive and negative environmental factors that impact the level of his engagement in walking can be identified. The first factor George pointed out as an encouraging factor for walking was the close proximity to the beach, which is an aesthetic attribute of the environment for his walking habit. He found that where he lived previously encouraged him to walk more compared to where he lives now, because of the previous neighbourhood’s close proximity to the beach. This aesthetic environmental attribute played an important role in the amount of walking that George performed. It impacted George’s decision to walk as well as his satisfaction about his neighbourhood. George also mentioned the noise and construction in the village as a negative environmental factor, which fell into the category of pollution and inconvenience. The traffic, a safety issue, was the third environmental factor George believed made his neighbourhood unsupportive of walking. Another safety issue was the conditions of the sidewalks. The inconsistency in the existence of sidewalks in some areas of  56  the neighbourhood raised safety concerns, which were very important to George. In addition to this absence of sidewalks in some areas, George mentioned that cyclists pose a threat to the pedestrians by riding on the sidewalks. This threat was another safety issue, which was very serious in George’s view. Humpel et al. (2002) noted that both perceived and objectively determined environmental attributes, in particular aesthetics, convenience, and access, have important impacts on the level of older adults’ engagements in physical activities. Beverly also found physical and built environments to be determining factors in the amount of her engagement in walking. The following comments illustrate what Beverly believed were determining factors in her neighbourhood that impacted not only her own level of engagement in physical activity, but also that of other people in the neighbourhood. I think what we have here, we are so lucky. Just to be able to go down the street and to get on the dyke and to have that nice flat wide area which goes for miles and miles and miles with no motorized vehicles on it, I think that is really really helpful and you know on a sunny day you can’t believe the number of people out here. You know on bikes or walking. I think we are very very lucky here to have that. Booth, Owen, Bauman, Clavisi, and Leslie (2000) found that older adults who reported the availability of safe footpaths in their neighbourhoods were more frequently physically active. When Jo-Anne was asked if her neighbourhood was supportive of walking, she offered the following information: For lot of things, yah, yah, but they should keep track of the bicycles too. I know on certain parts they are allowed here near the roundabout, but it’s a wider part and there is a marking on the sidewalk. You are prepared that there could be a bicycle behind you, but they should not be on the normal sidewalk. You don’t look around if there is a bicycle around you, eh?  57  Jo-Anne also had traffic taming concerns about the roundabout, the traffic circle near the Tapestry. She felt that the roundabout was very dangerous for crossing, especially for older adults and people with small children. She mentioned the issue once more and emphasized the bicycles on the sidewalks, explaining: One time, one nearly knocked me over. I can’t hear because I’m deaf in one ear and wanted to step aside and then there were the bicycles on the sidewalk. I have the right to walk on the sidewalk. Kathy found her neighbourhood definitely supportive of walking and said, “Yes, there are lots of places to walk here. Oh, yes we went to the forest. We went down the streets and often places I’ve never seen before. It is nice to be in this environment.” Cindy pointed to the diversity of Wesbrook Mall Village and its effects on walking by saying that there are lots of places to walk and it’s not boring. She explained, “I mean we are steps from Pacific Spirit Park and miles of trails.” However, Cindy expressed some concerns about walking in the park alone. When she was asked if her concerns were safety related, she offered the following clarification. It doesn’t feel not being safe in there. It is just I’ll be walking and not paying attention and I get lost in the forest or something. It is not I think I am going to be mugged or killed. When I am on my own, I need to pay more attention, and I am not one of those people that say ok, that is north and this is south, I have no idea. Cindy thought having a map at the entrance of the park showing the immediate areas, like the maps for Downtown, would be a good idea to have, since once you have the map in your head it is clear where the roads go. Cindy also mentioned that part of what we all want is walkable neighbourhood. She said that  58  she likes walking to Save on Foods, and she explained that “if you want to have services you have to have density and that means you have to have more people and you are going to have more cars.” Cindy also noted: You have chosen an urban environment and I think the physical structure is fine, there is wide sidewalk. I think the traffic circle up here is crazy. I think it’s terrifying when you’re walking across it and I think it’s crazy when you’re driving out. We drive out of there every morning and turn onto 16th and people are walking. It is just too many things to watch. When focusing on the physical environment impacts on the level of engagement of older adult participants in walking, two types of walks came into focus. One was a form of walking that was performed for performance and exercise. The second form of walking mentioned by the participants was walking to and from, or walking with a purpose. It is essential to mention that both forms of walking were important to the participants and were considered by them when participating in the interviews. Therefore, the study also included both forms of walking when interviewing the participants. The other question asked of the participants was “What were the most important factors in the built environment that encouraged you to walk more?” Safety, the dyke, and traffic were three determining factors that came to Lili’s mind when speaking about the physical and built environment in Richmond. She replied: “Well, for here is the dyke that determines our walk, so physical environment is conducive to walking and there are no concerns about the safety or anything else. It’s a safe place.” Lili also explained that the fact that the cars are not allowed in Steveston in summer time and that Steveston is a tourist destination attracting a  59  diverse population visiting the area are two other factors that encourage people to walk more. Kathy reported that most of her walking came from walking with a purpose since walking as a sport doesn’t interest her, so she would walk to shop or walk to her doctor’s appointment and things that needed to be done. Therefore, the implication could be made that in Kathy’s view convenience and access were two factors that contributed to the level of her engagement in walking. Kathy also mentioned that there are lots of places to walk to in the village. For example, she said “We went to the forest. We went down the streets and often places I’ve never seen before.” When Kathy was asked if she enjoyed walking on the street, she replied that the main street in the Wesbrook Mall village is very noisy, so she tries to branch off of it to more secluded areas. This once again pointed to noise as an unpleasant environmental factor, which could negatively influence the level of older adults’ engagement in walking. Jo-Anne stated that she does not like walking around the campus and added that the only time she likes walking here is in the Pacific Spirit Park. She finds campus too noisy and too often the sidewalks are closed and she has to walk on the street. She expressed her dissatisfaction about the situation. However, she mentioned walking around the campus on short walks. Jo-Anne also mentioned that she walks in the village for the purpose of shopping. She added that she preferred to walk in Pacific Spirit Park because of its peacefulness, quiet atmosphere, and nature.  60  Heather, who lives in Richmond, replied to the question of what environmental factors were determining factors in her level of engagement in walking with the following statement: “We have very good environment for walking with regards to our streets. I mean we have sidewalks and I mean it’s a safe environment for walking.” The following was Susan’s reply regarding whether built environment is a determining factor. Oh yes, because I love walking of course you know. With me I like walking in the park rather than being on the busy street with traffic you know. There are so many wonderful trails you know there is no excuse except you have to have a buddy with you when you walk in the forest. You can’t walk alone, so unless you have someone with you. I have a friend who I would call and say let’s go for a walk. We do a good hour in the forest. Susan re-emphasized Cindy’s point about Pacific Spirit Park and not wanting to walk alone in the park. This was another issue that all the participants living in Wesbrook Mall Village were concerned about. Although all the participants expressed gaining spiritual and physical pleasure from walking in the park, almost none wanted to walk there alone. Christine from Richmond shares Susan’s concern about busy roads. She replied by saying that she would go anywhere to walk near the water and would not walk on busy roads. Christine is concerned that fewer and fewer green areas are being built in Richmond. She commented, You see wall-to-wall townhomes going up and there is no area for children to play outside, or there is no area for people to just uh have a picnic outside. Um for seniors to have to sit in the sunshine on a park bench, and well they are lucky here, but if you drive around some of new construction areas in Richmond, there are fewer and fewer green spaces.  61  The factors that determined the participants’ engagements in physical activity included proximity to water as a positive aesthetic factor, proximity to parks and green spaces, safety concerns such as sidewalk conditions and cyclists riding on sidewalks, the availability of flat walking surfaces, diversity of the physical and built environments, diversity of the population, traffic and noise, and convenience and accessibility.  4.1.2 The Impacts of Social Environment Created Through Built Environment on the QOL in Older Adult Participants When Cindy and I were talking about the built environment, she explained that one of the reasons for them to move to the Wesbrook Mall Village was its proximity to UBC, which offers a more vibrant environment. She also mentioned that the area is relatively flat and there are lots of places that one can ride a bike. She re-emphasized the importance of services such as a hospital being nearby. When she was asked why the proximity to UBC was important in her view, she provided the following statement: I think its lots of things. It is the Museum of Anthropology, The Chan Centre. It does bring you the younger environment. It is this kind of nice mix. It is energetic and school brings lots of services and lots of interesting things to the environment that would not be there otherwise. Cindy’s statement provided a substantial amount of information. First, she pointed to the diversity of the built environment by mentioning having the Museum of Anthropology and the Chan Centre nearby. Then she mentioned the social environment that the youth at UBC have created and its impact on her life. She felt that this nice mix has created a vibrant environment. She also mentioned that being close to UBC means having lots of services nearby. Cindy also highlighted the 62  exciting and stimulating environment that UBC has provided as a place for innovations that otherwise would not be there. Jo-Anne was very fond of the Pacific Spirit Park and said: Uh, everything to do here for me is in the park. I love the forests, the smells, the peacefulness, the greens, the colours of the moss and I don’t know, I feel always happy in the forests. Although Jo-Anne did prefer the peacefulness of the park to the hustle and bustle of the mixed-use environment in the village, she did mention that she often goes for short walks for the purpose of shopping. This combination of urban living close to a natural setting has created a social environment in which on the one hand Jo-Anne is energized spiritually by walking in the park and on the other she has the convenience of walking for the purpose of performing her Instrumental Activities of Daily Living, IADLs. The conversation with Kathy led to the following questions: By looking at your area what would you like to see to facilitate walking or to make you more determined to do more walking? Do you like to see more local merchants? Do you like to see less of them? Do you like to see less density? Do you like to see more density? What would you like to see in your neighbourhood? Kathy’s response was: I think I like it now. I don’t like to see more things going up, more building. No, no. Particularly, when you say there is condominiums going up which is going to block out the forest. You know I like to see natural, more natural. I lived in False Creek, so I could see the creek and I could see the mountains and the city and I don’t see that here, so that is one of the things I miss.  63  Clearly the diversity of the physical and built environments has an aesthetic appeal to Kathy. Being able to see the water, the mountains, and the city through the window is what Kathy is missing in her current place. Observation opportunity was very important in Kathy’s life. The following statement made the importance of this factor clearer. Yes, but my view from my suite was very open and as I say creek and the mountains, you see. I saw the walking, the shore, you see and the sea wall, people walking in open grass and children playing. Kathy’s reference for her previous neighbourhood sparked two questions in my mind: 1. Was it a suite with a view that made Kathy more satisfied with her previous neighbourhood? 2. Was it the nature of the view itself that had an impact on Kathy’s feelings and ultimately her engagement in activity? Clearly having a home with a view of nature was something that contributed to Kathy’s quality of life. However, what had the most impact on Kathy’s satisfaction was the kind of view that she desired. It was the diverse view consisting of the natural elements and the built environment that created the vibrant social environment Kathy enjoyed the most. Factors such as having the opportunity to observe the daily activities of the others, created through built environment, caused an increase in Kathy’s quality of life even if she did not go out and did not participate in any of those activities. The diversity of the physical and built environment in Kathy’s previous neighbourhood created a social dynamic that was very exciting and enticing to watch and to be a part of. This diversity created an energetic setting in  64  which QOL would have been increased even with the simple act of observing other people’s activities. During the interview with Beverly, I asked her which she would choose if she had a choice to do her physical activity in the gym or at a park, or to incorporate it into her daily routine instead. She said that she would have chosen incorporating the activities in her daily routine, for two reasons. First, she was a very social person so incorporating her physical activity into her daily routines would have added few social aspects to her walking. Second, for medical reasons she can no longer exercise in the gym, so gym in her life belongs to the past. It is for the purpose of socializing that Beverly has become active. It is more important to Beverly to socialize than to exercise, so she wisely uses the avenue of socializing to her advantage. Mariam, who was asked the same question, stated: No, the park, no, I have done that and I do not like walking in the park and there is nothing to see. It’s boring. It’s just grass, and maybe couple of trees and you do the same route. Because if you are going to a park for walking. Say it takes you ten minutes to go around the park. Well, you have to walk around the park again. So I like to walk where I can see things. I look at the flowers, I look at the houses, I look at people’s balcony, I look at. I like to see all sorts of, that’s why the shell road is a bit boring because you don’t see anybody but trees on each side and you meet the odd person, but. Like Kathy, Mariam pointed to the importance of diversity in the physical and built environments. The implication could be taken from her statement that it was through a diverse physical environment that interesting social environments are born. Mariam went further and implied the existence of the third element, the opportunity to meet other people, as an important factor in her engagement in physical activity and elevating her quality of life.  65  Susan expanded her answer about her quality of life and linked the subject of QOL directly to her current residence and the positive social environment it has created for her and her husband. She said: And you can always feel that you are such a part of the community and you feel that you always have friends and you always have someone to chat. You always have someone to walk with. You know the companionship in our age I think it’s wonderful because our families, I have four children and none of them live really close by. They all are scattered around the country, and so I don’t see my family that often. Only through emails of course, skype, and other things and that is great, but I just know that it is impossible to see them. I asked Susan if there were any more things that she would like to see coming to her neighbourhood. She responded by saying: What I like to see is less. Is less building and I think, UBC has done a terrible job with their planning because they are building and building and spoiling our wonderful view. From the seventh floor you know we saw trees and water and Vancouver Island in the distance. Very soon we won’t be able to see anything except buildings. Having the same thoughts as Kathy, Susan indicated the importance of observation from her apartment and was concerned about losing this opportunity. The aesthetic aspect of the observational opportunity from her apartment’s window seemed significant to Susan’s quality of life. It was a visual connection she had with her physical environment, through the built environment, that created a social environment she was fond of. Although Christine preferred a park-like setting for the purpose of walking, she also mentioned that she walks to and from very often. She said that she walks to do her shopping. Christine continued: “But when I prefer to walk I don’t want to walk up the main road with traffic. I certainly, I don’t want to walk in the mall. That is a definite no.” She also implied that diversity in the structure of the neighbourhood  66  was an important factor in her life when she said “there are areas that you can do your shopping, you can meet a friend, and you can walk to.” The idea of the built environment creating opportunities of networking and generating social capital was a recurring theme among the participants. When I asked Lili what kind of walking she did the most, she replied: Most of the year uh, walking with a purpose as I do all the time. I walk to my appointments, walking to pick up a little bit of grocery, walking to mail the letters, walking, walking, walking, um, I do the, now that I am doing pole walking, I do that on regular basis and I do weights on regular basis, but I think that walking, if I added it all up, the walking with a purpose would likely to be the most times that I do something, maybe not the longest, but the most times. The majority of the older adult participants also referred to walking as a form of transportation since they often walked for the purpose of shopping and performing of other Instrumental Activities of Daily Living. There was variety in where they preferred to walk, but a recurring theme was walking in a stimulating environment where diversity was the key. Participants enjoyed the opportunity to observe social dynamics created through the physical and built environmental factors. Aesthetics and diversity were two important elements contributing to the creation of these social dynamics. The participants also enjoyed walking in places that were aesthetically pleasing and stimulating. What was fondly shared among the majority of the participants was the opportunity of walking, meeting, and greeting other people.  4.2  Viewing Physical & Built Environments through the Lens of SWEAT-R As has been mentioned several times, this study was multifaceted, which  required a multi-level analysis. To continue with this theme and for the purpose of  67  inclusion of different views, the Senior Walking Environment Audit Tool-Revised (SWEAT-R), created by Chaudhury et al. in 2007 (Chaudhury et al., 2011), was employed in the study as well. The purpose was simply to make a report about the two neighbourhoods and their features that may contribute to the increase of walking in older adults. The intention was to draw attention to the built environment’s characteristics, which may deter or encourage walking in older adults. SWEAT-R is a nine-page document (see Appendix C) which assesses accessibility, diversity, safety, security, and many other features of the built environment that have impacts on the mobility of older adults. In addition to written descriptions of the two neighbourhoods, some photographs are included here so that visual cues may assist readers to better comprehend these built environment’s factors.  4.2.1 Assessment of Wesbrook Mall Village Wesbrook Mall Village, situated at the south end of the Wesbrook Mall, is a relatively newly built environment. The segment of the Wesbrook Mall Village where the Tapestry independent living centre is situated has been chosen as the subject of the report. The purpose is to identify the built environmental factors that may contribute to the level of older adults’ engagement in walking. With this intention in mind, the directions of north, south, east, and west were identified in the segment and the assessment then started from the northwest corner of the segment.  68  4.2.1.1  Northwest Corner of Wesbrook Mall  At the corner of this segment there is an intended marked pedestrian crossing (Figure 4.1). The crossing is wide enough to accommodate combinations of different types of pedestrians including people in wheelchairs, or with walkers. The width of the crosswalk well separates the pedestrians from the vehicles and creates a sense of safety and security for them. Although the marking is in a contrasting colour to the road, a higher colour contrast would be more helpful and more visually detectable by the older pedestrians, and older drivers as well since depth perception declines with age. There is no traffic signal at this corner. There is a stop sign; however, no pedestrian crossing sign provides warning for the oncoming traffic at this corner. No pedestrian signals exist, either activated or non-activated. There are two-sided ramps, which connect the sidewalk to the street. These ramps have wide aprons and are covered with colour, texture, and material contrasting with the colour, texture, and material used on the sidewalk. The characteristics of the ramps provide the older adults with a safe transition from the sidewalk to the street. The curb height in this corner is 3.5 inches which provides an easy and smooth transition from the sidewalk to the street, specifically for frail older pedestrians or pedestrians with different abilities (Figure 4.1).  69  Figure 4.1  Northwest Corner Crossing, Wesbrook Mall  Figure 4.1. Photo by Fay Bigloo, 2012.  4.2.1.2  Mid-Block Crossing Area  There is an intended mid-crossing area for pedestrians (Figure 4.2). The crossing is wide and it is with colour contrasting materials. Although the colour contrasting blends in with the rest of the construction well and adds charm and beauty to the built environment, more contrast in the colours between the surface of the street and the crossing area would make a better visual distinction between the two areas for both older pedestrians and older drivers. There is no pedestrian’s signal, activated or non-activated; pedestrian crossing signs are present but almost invisible from the street (Figure 4.3).  70  Figure 4.2  Mid-Block Crossing, Wesbrook Mall  Figure 4.2. Photo by Fay Bigloo, 2012.  Figure 4.3  Invisible Pedestrian Sign, Wesbrook Mall  Figure 4.3. Photo by Fay Bigloo, 2012.  71  There are no ramps, nor is a curb present on this mid-block crossing. A gentle structured slope leads the pedestrians onto the street. This slope has the same colour and material as the street. Minimum warning is created for pedestrians that the sidewalk is leading to the street. Motorists also have the least number of visual clues warning them about people crossing the street.  4.2.1.3  Southeast Corner  An intended southeast crossing area is present at this corner, and the crossing is marked with the same colour and material as the northwest corner. There is a stop sign, but there are no traffic, yield, or pedestrian crossing signs. No pedestrians signal—either activated or non-activated—are present. The segment at this end has a two-sided ramp with broad apron at the curb cuts. There is a material and colour contrast between the surface of the ramp and the ground surface. These characteristics can be seen in Figure 4.4. Figure 4.4  Southeast Corner, Wesbrook Mall  Figure 4.4. Photo by Fay Bigloo, 2012.  72  4.2.1.4  Buffer Area  A buffer area is a space on the sidewalk designated to trees or shrubs, which offers visual and physical protection to the pedestrians from the oncoming traffic. A buffer area with mature trees also protects pedestrians from environmental elements such as rain, sun, and wind. A buffer area can be one- or two-sided depending on the design and width designated to the sidewalk. In a two-sided buffer area, some designated seating arrangements can offer a resting area to passersby. Having a wide landscaped buffer zone with seating area is inviting to a wide range of people. It is the convenience of having rest areas nearby which positively impacts the frail older adults’ engagements in walking. A buffer area of maximum five feet is present on the sidewalks. Seventeen trees exist on the street side of the sidewalks in this segment (Figure 4.5). Figure 4.5  Buffer Area at Wesbrook Mall  Figure 4.5. Photo by Fay Bigloo, 2012.  73  4.2.1.5  Land Use  A combination of low-rise construction and high-rise structure is the dominant form of buildings in the segment. Neither a recreation facility such as a gym or fitness centre nor a movie theatre is present on the site. Although no grocery store exists in this segment, there is a large grocery store in the next block within a very short walking distance, offering grocery shopping beside pharmacy services and a casual eating area. There are other retail stores such as a coffee shop. Services such as offices, a beauty salon, and insurance services are also available. There are no signs of industrial constructions. This mixed-use structure in the buildings contributes to a variety of services attracting a diverse population. This diversity in services and people in return contributes to the vibrancy of the place, as was reported by the older adult participants. At the current time, many of the retail properties are unoccupied; however, once these stores become operational, they will offer more local services to the neighbourhood’s residents. In addition to the convenience these services provide, their proximity invites the residents to become more physically active and to walk more often. This increase in walking may have at the very least two important effects. First, it positively affects the physiological and emotional health of the residents in general and older adults in particular. Since the elderly are more reliant on local services, according to Kubzansky et al. (2005), a complete neighbourhood, in which all services are available within close proximity, enables older adults to walk more often. This was also reported by some of the participants. Second, the act of  74  walking in the neighbourhood affords the older adults the opportunity of networking, which has positive effects on their emotional well-being and quality of life. Predominant building height in this segment is five or more stories. However, in the next segment, the predominant structure is two- to three-storey buildings. There are signs indicating the existence of an independent living centre. A courtyard with water features and sitting places is between two of the buildings in this segment of the street (Figure 4.6). This is a very pleasant and inviting area that encourages people to get outside of their homes. This courtyard, which is close to a coffee shop and MBA House, also provides the older adults with another interesting meeting place. Figure 4.6  Courtyard at Wesbrook Mall  Figure 4.6. Photo by Fay Bigloo, 2012.  75  There are no benches on the sidewalks; however, there are sitting areas available in the courtyard. Both sides of the street contain sidewalks with good condition. No indication of repair was observed at the time of the assessment. The sidewalks have clear tempered glass awnings offering bright shelter to the passersby. The slope in this segment is very gentle, providing an ideal surface for walking for older adults. The street also benefits from the same good condition with two lanes of traffic; however, there are no bike lanes on the street. There are some traffic taming devices such as stop sign, sidewalk extensions, and pedestrians sign. A number of 24 streetlights are present in this segment of the street. General parking is also available on this segment of the street. All the buildings are in an excellent shape with no warning signs such as protecting bars on the windows indicating the existence of a safe friendly environment.  4.2.1.6  Summary  The village in general benefits from the advantages of a new structure with traditional design, which is trying to bring more local services to the area. This is for the purpose of creating a complete neighbourhood in which the residents including the older population can perform their Instrumental Activities of Daily Living by walking. A mixed-use structure is also advocated to create opportunities for networking and generating social capital. The sidewalks are wide and streets are well lit and well connected, encouraging the residents to get out and become active. More pedestrian signage would make the area safer for the walkers. There are no  76  lanes designated to bicycles, but in the wider section of the sidewalk, which is properly marked, bikes are permitted. This might create confusion for cyclists, as they are not permitted to ride their bicycles on other sections of the sidewalks. The traffic circle, the roundabout, which is a very short distance from the observed segment, is also very intimidating and confusing for pedestrians as well as for motorists (Figure 4.7). The number of cars and the options and order of actions to be taken create a situation that makes both drivers and pedestrians reluctant and confused. Figure 4.7  Roundabout Near Wesbrook Mall  Figure 4.7. Photo by Fay Bigloo, 2012.  77  In front of the participants’ residence, a sitting area is designated for observation of the street life. A chain grocery store, a coffee shop, a bank, a graduate school, and few retail stores and services are currently the existing businesses in the area, although the future is promising more services for this area. The existence of the Pacific Spirit Park and miles of trails offers residents a fantastic alternative walking opportunity. However, safety is a concern in relation to walking alone in the park. The proximity to UBC and its services is of tremendous value to the residents since it provides the residents with more services and places for entertainment and shopping, as was mentioned by the participants in this study. This proximity of walking destinations, in addition to living near a natural setting, is independently associated with an increase in walking activity among older adults, according to Nagel, Carlson, Bosworth, and Michael (2008).  4.2.2 Assessment of Steveston Village in Richmond Situated in the city of Richmond, Steveston village is a tourist destination which attracts many people every year. The village is connected to the water from one side and offers its residents many places for walking. The older adults from Richmond who participated in this study live in different parts of the city. However, twice a week they gather together as a team and walk in the Garry Point Park near the village. Part of their walking is in the Steveston Village area. Thus, a segment of the village near the Fisherman’s Wharf was chosen for observation.  78  4.2.2.1  Northwest Corner of Bayview Street in Steveston  A marked pedestrians’ intended crossing is present in this segment. No traffic light, no stop sign, and no yield sign are observed in this section, although a pedestrian’s sign is observed. There is no pedestrian’s activated or non-activated signal in sight. A one-sided ramp or curb cut is visible on one side of the segment; however, this ramp has almost no colour or material contrast with the ground surface, has no grooves or bumps to prevent slipping, does not have a broad apron when connecting to the street, and has a height of five inches. The features of the ramp not only fail to accommodate the needs of older citizens who might have mobility issues, but also create a hazardous area for older people with different abilities (Figure 4.8). Figure 4.8  Northwest Corner Crossing, Bayview Street, Steveston  Figure 4.8. Photo by Fay Bigloo, 2012.  79  4.2.2.2  Mid-Block Crossing Area  There is no intended mid-block crossing for pedestrians although from one side the street is connected to another street (Figure 4.9). Figure 4.9  Mid-Block Crossing, Steveston  Figure 4.9. Photo by Fay Bigloo, 2012.  4.2.2.3  Southeast Corner in Steveston  There is an intended marked pedestrians’ crossing with a stop sign. No pedestrians’ signals, activated or non-activated, are present. A one-sided curb exists in this area with grooves on it; however, no colour contrast is present to offer a better visual depth perception to the older pedestrians (Figure 4.10).  80  Figure 4.10  Southeast Corner Crossing, Steveston  Figure 4.10. Photo by Fay Bigloo, 2012.  4.2.2.4  Buffer Area  There is a short buffer area on one side of the sidewalk, with four trees separating the pedestrians from the existing buildings (Figure 4.11). There is also an area on the southeast corner with about seven to ten trees on the building side of the sidewalk.  81  Figure 4.11  Buffer Area, Steveston  Figure 4.11. Photo by Fay Bigloo, 2012.  4.2.2.5  Land Use  Low-rise multi-family housing is the only form of housing in this section. The village benefits from a traditional or complete neighbourhood characteristic. There are no gyms or fitness centres, movie theatres, or other recreational facilities in view in this segment. Although many services and facilities are in close proximity, no school, no community centre, and no library is present at this segment. The point of interest in this section is the Fisherman’s Wharf and the restaurant and eateries, which attract many people. Restaurants and bars are the predominant form of business in this section in addition to several gift and souvenir shops. Plenty of coffee shops and places for people to sit are in sight; however, there is only one  82  public area, shown in figure 4.12 in the entrance of Fisherman’s Wharf, with some benches offering sitting and resting areas to passersby. Figure 4.12  Public Seating at Fisherman’s Wharf, Steveston  Figure 4.12. Photo by Fay Bigloo, 2012.  The predominant building height in this area is one to two stories with some vertical-mixed use. For example, some coffee shops are situated on the main floor of residential buildings. There are lots of social gathering places such as restaurants, coffee shops, bars/breweries, and Fisherman’s Wharf. There is an abandoned parcel of land in view. No awnings are present on the sidewalks to offer pedestrians shelter from the elements. The sidewalks are very narrow, but in good shape; the street is in good condition as well with no signs of repair. There is no bike lane available for the bicycles, and no traffic-calming devices with the exception of a marked crosswalk. Pedestrians’ signs are in sight.  83  There are ten streetlights in this block. In the older section of the village, the business establishments do not provide more lighting for the street while in the newer section of the village plenty of light fixtures are attached to the new buildings. A transit stop with no cover is present in this section. Although no public washroom is available in this segment, many coffee shops, restaurants, and eateries offer restrooms to their customers. There is also public parking available. Buildings are in good shape and no graffiti or signs of vandalism are observed; however, some storefronts have protective bars on their windows.  4.2.2.6  Summary  At the time of assessment I observed that the area was being utilized by a significant number of older adults. For a number of reasons this place is a wonderful area for older adults to live in. The following features demonstrate the suitability of this area for older adult populations. •  The area offers flat surfaces for older adults’ navigation.  •  The proximity of places such as Garry Point Park, West Dyke Trail, and Terra Nova Trail Park provides the residents with an ample supply of interesting walking trails and opportunities, as was mentioned by the older adult participants in the study.  •  The village itself, with a mixed-use structure, creates an atmosphere in which networking opportunities are available and that leads to creation of social capital (Leyden, 2003).  84  •  The Steveston Farmers and Artisan Market, Fisherman’s Wharf, and many other places invite a huge number of diverse domestic and international visitors, which adds to the diversity of the area.  •  The village’s design is a traditional or complete design with short distances to services and shops. This design enables the older adults to walk for the purpose of performing their IADLs (Leyden, 2003).  •  In general, built and social environments are conducive to walking for the residents, and for older adults in specific. Considering the number of elderly people walking in the village, improving the  condition of the sidewalks and streets for their benefit, makes this place more senior walking friendly. Focusing on safety and convenience, some minor but important details are in need of immediate attention. With five inches curb height, wide apron ramps linking the sidewalks to the streets are a must in prevention of falls. Sitting areas and benches are also a determinant factor in the engagement of older adults in walking, since due to physiological decline the elderly are in need of more frequent rests. Wider sidewalks also provide the elderly, especially those with mobility issues, with a safer surface to walk on. More traffic taming and pedestrians’ signage makes this place a safer place to walk in. It is evident that attention has been paid to these details in the construction of the new sections in the village. The combination of old charm and new convenience is a plus for the village since it creates a social environment that is very appealing to many people regardless of their age. This diverse population also creates an energetic mix and atmosphere in which many older adults desire to become active participants.  85  5  Chapter: Conclusions & Implications  Common sense reveals that bodies are important for understanding old age, in particular since so many people equate old age with physical inabilities and decline (Calasanti & Selvin, 2001). There is abundant research linking physical activity to better health (Lee, Ewing, & Sesso, 2009). This paper, through a comprehensive literature review, unveiled some of the many benefits of physical activity on the health and QOL in older adults, but it also demonstrated the need for further multilevel studies such as this one. The physiological benefits of physical activity are the issues that most researchers have focused on since these effects are easier to detect. As reported previously, only a portion of functional decline in older patients is the result of disease and the rest is actually the result of inactivity, or disuse (Wykle et al., 2005). In other words, there is a general presumption that getting old requires the body to slow down, whereas research has demonstrated that there is a benefit in continuing to make choices that allow the body to continue to function as it has in the past. Research has reported that older adults are more susceptible to the adverse health effects of a sedentary lifestyle (Pescatello, 1999). Thus, it is more vital for older adults to remain as physically active as possible. The effects of physical activity on a person’s bone mineral density, was reported earlier in this paper. In addition to the direct positive effects of physical activity on older adult bodies, other effects of physical activity such as increase in QOL in older adults were reported. A study by Daly, Ahlborg et al. (2008), which measured the effects of exercise in later years, reported a measurable improvement in QOL in active older adults. Some of 86  the factors that contributed to this improvement included a reduced level of fatigue, improved mobility and balance, reduced incontinence, and reduced depression. Physical activity results in numerous physiological health benefits, but the emotional benefits of physical activity surpass the physiological ones. As mentioned by Kubzansky et al. (2005, p. 254), “elderly mental health may be particularly sensitive…because, as a group, elderly persons tend to be less mobile and more reliant on locally provided services and amenities, as well as sources of social support and contact.” Thus, the elderly may be more likely to be subject to differential risks, for example lacking the will to access care, and those risks increase with poverty and connected lack of mobility. It was also mentioned that emotional well-being is positively affected by physical activity among the elderly. The emphasis earlier in this thesis was that wellness is a continuum of physical, psychological, social, and environmental health indicators, which individuals strive to advance. The importance of these positive health indicators was reported, and it was explained that they are not static, but rather are part of a dynamic, everchanging process of trying to achieve one’s individual potential and thereby increase one’s QOL (Saxon et al., 2009). Evidence was also presented in earlier sections, through the results of a 2009 study by Garatachea et al., indicating clear connections between seniors’ body strength, dynamic balance, aerobic endurance, self-reported weekly energy expenditure, total time spent on physical activity, and a sense of both material and subjective well-being. Garatachea et al. (2009) also reported an increased level of self-confidence among active older adults due to physical activity, enabling them to  87  move towards more positive choices in their lives. The Garatachea et al. (2009) study also found that the same results were shown irrespective of demographic factors, which meant that there is a strong link between positive outlooks, positive life outcomes, and physical activity. It was also suggested that more comprehensive information can be revealed not only by considering the effects of physical activity on the health of older adults and their quality of life but also by including other factors, such as physical and built environments and their created social environment. This holistic approach may facilitate the understanding of the true impacts of environmental factors on the level of older adults’ engagements in physical activity. It may also highlight the intricacy of the issue of physical activity and quality of life. It was equally important to the study to explore the issue of connectivity, generating of social capital, and its impacts on QOL in later years. It was through the literature review that I realized the importance of a holistic approach. Consequently, a multi-level exploratory study was formed in the hope that better understanding would be achieved by focusing on environmental factors impacting physical activity in older adults, and by observing these factors through the lens of older adult participants themselves. Thus, the following four questions were designed and asked of the participants in the study in order to explore and understand their needs and desires. 1- What are the effects of a community based physical activity such as the Walkabout on the quality of life in older adults?  88  The following are summaries of the participants’ responses to this question. •  The older adults announced health as the most important contributing factor to their quality of life. They believed that by engaging in the Walkabout they became more physically active which contributed to their good health and their QOL.  •  The participants also mentioned that being active and engaged was of tremendous value to them. They claimed that Walkabout provided them with the opportunity to become physically and socially active and engaged. This created satisfaction in life, which contributed to their quality of life.  •  Other effects of the program also were observed in the life of the older adults. One of these effects was that the OA participants demonstrated levels of physical literacy since they exhibited and reported understanding and growth in physical, social, cognitive, spiritual, and affective domains in their lives through physical activity.  2- What are the effects of the social environment created through the walkabout on the QOL in OA participants? The contributors’ responses to this question highlighted the following: •  The participants emphasized the importance of the social responsibility that they each felt towards their team’s performance and the enjoyment they received from participating in the program in a social setting which presented them with the opportunity to work towards a common goal, to 89  enjoy camaraderie and social networking, and to benefit emotionally from the generated social capital. All of these made them more satisfied with their lives, which consequently increased their QOL.  3- What are the impacts of physical and built environments on the level of OAs’ engagements in physical activity, in particular on walking? •  All the OA participants mentioned that their physical and built environments impact their level of engagements in physical activity. Safety, noise, aesthetics, convenience, proximity, and diversity of the physical and built environments were environmental attributes that the participants mentioned having impacted their engagements in physical activity.  4- What are the impacts of the social environment created through physical and built environments on the quality of life in OA participants? •  The OA participants mentioned the importance of the diversity of physical and built environments. The implication could be made that diverse physical and built environments were exciting, appealing, and enticing to the OA participants. Diverse environments attracted an array of people, needs, and services, which led to the creation of complete neighbourhoods. In these types of neighbourhoods a social environment, in which more networking opportunities and generating of social capital were possible, helped the OAs who rely on the local services to stay  90  connected. This consequently elevated their level of satisfaction in life and their QOL. A physical activity community-based program for exploring the effects of physical activity in older adults was employed. Thus, the Walkabout Program became one of the focuses of the study. The program served two purposes for the research: 1. The Walkabout Program provided an opportunity to explore physical activity in an environment. 2. The program created a social environment that was very important to the research. Walkabout created an environment in which the older adult participants could stay active and healthy, could network, which led to their satisfaction in life, and could make positive developments in physical, cognitive, social, affective, and spiritual domains of their lives through physical activity.  5.1  Health, QOL, and Walkabout After the private interviews were conducted and the audiotapes recorded in the  interviews were transcribed, the domains of good health and life satisfaction were revealed as the two factors that were overwhelmingly expressed by the older adult participants as contributing to their quality of life. For example, Jo-Anne explained the link between health and enjoying life, which ultimately contributed to the quality of her life, and Kathy reported having an excellent quality of life due to being healthy and not having any worries. Mariam also reported a fantastic quality of life because of many factors such as having friends, family and a garden, which made her satisfied in life. She also mentioned  91  having life and health as factors contributing to her quality of life. Susan made a direct reference to the link between health, walking, and her quality of life, which she scaled at a perfect ten. Cindy attributed her quality of life to her satisfaction in life due to many factors, such as having friends and being in a good relationship. She also made a reference to mental health as a contributing factor to her quality of life. Christine also believed that she benefited from a good quality of life. She looked at walking as a tool that helped her to deal with some of the pressure that she has in life. George, a very physically active participant, reported a very good quality of life; however, he reported that he would have been more satisfied if he could have done more after retirement. Beverly also made a direct link between her quality of life and her health. Beverly is dealing with a health issue, and she viewed her health as the most important factor contributing to the quality of her life. Being physically active and socially engaged for the purpose of self-health was another factor the older adults in the study reported as a contributor to their quality of life. The perspectives of the participants in regards to activity were very well aligned and were supported by Activity Theory, developed by Robert J. Havinghurst in the 1960s. This theory suggests that it is through activity and connectivity of individuals to the society that people can age successfully (Chappell et al., 2008). The older adult participants made a strong connection between mobility, walking as a physical activity, and their quality of life. They also linked their level of connection to the society with quality of life. In other words, the participants enjoyed being busy and connected which contributed to their life satisfaction and their quality of life. The following are examples of this connection as reported by the participants:  92  •  Jo-Anne, who reported enjoying walking specifically in a park-like setting, emphasized being active as a contributing factor to her quality of life.  •  Mariam partially attributed her excellent quality of life to being active and said: “I am able to do so much and I have a lot of energy and I am always busy.” Both JoAnne and Mariam made reference to walking as a physical activity that rewards them with physical, spiritual, and mental health.  •  Lili made a reference to having a good QOL due to having a balanced life, which resulted in her satisfaction in life. She listed physical activities such as lifting weights, skiing, and walking as her favourite activities.  •  As was mentioned previously, Susan made a direct reference to walking and mobility as an important factor contributing to her and her husband’s quality of life. She also showed a high degree of satisfaction about her living arrangement since it provided her and her husband with many activities that kept them connected and happy.  •  Beverly, who reported her favourite activity as not physical at all, also mentioned that she liked gardening and walking. However, she said that she liked walking when it is spiced with a purpose.  •  George, who mentioned having a very good quality of life, linked his quality of life to his level of activity. Although George chose swimming as his favourite activity, he admitted that he performs lots of walking in meeting the needs of his Instrumental Activities of Daily Living, IADLs. Conclusions can be made that the participants viewed physical activity as a  factor that contributed to their life satisfaction, which consequently had a positive  93  effect on their quality of life. The participants unanimously and enthusiastically showed their support for staying active and being connected. They viewed being active, whether physically or socially, as an avenue that kept them connected to each other and to the society. This connectivity had a profound effect on their life satisfaction and quality of life. Overall, there were suggestions that there is an important interplay between living longer, living better, physical activity, and social engagement among the older adult participants. This has been associated with improvements in longevity and aspects of health related quality of life, as found by Motl & McAuley (2010). It was also reported by the participants and implied from what they said that maintaining mobility and self-efficacy due to physical activity has increased their quality of life, a perspective supported in studies by McAuley, Konopack, & Molt (2006) and White, Wojcicki, & McAuley (2009). The findings from this study suggest that physical activity should become a central agent to promote healthy aging as a behavioral approach that maximizes the likelihood of quality years along with longevity, as noted by Molt & McAuley (2010).  5.2  Created Social Environment Social responsibility, and social engagement and networking were two other  important themes emerging from the transcripts. Reading and re-reading of the transcripts identified the enormous effects of these two factors in the creation of life satisfaction. Without exception all the older adult participants felt a sense of responsibility for the team doing well, in addition to their appreciation for the  94  positive effects of the physical activity at a personal health level. The participants understood the meaning of their connectivity to the team and were well aware of the responsibility they faced through this connectivity. Some of the participants’ behaviours and thoughts partially supported Social Exchange Theory, which focuses on negotiations and calculations between individuals as people try to maximize rewards and minimize costs in social exchanges (Chappell et al., 2008). However, the results of this negotiation were different than what was suggested in the theory. The theory suggested that in any social exchange between individuals, if the losses are greater than the rewards people tend or are forced into compliance or to leave the exchange. Beverly, however, who claimed to have made the least contribution to her team in terms of step count, did not make a decision to leave her social exchange with the team. Instead, she decided to take advantage of even the smallest opportunities to become more physically active. Thus, she improvised when the opportunity arose. Contrary to what the social exchange theory suggested, Beverly did not view her departure from her team as a viable option. The decision that Beverly made was also connected to the sense of responsibility and connectivity that she felt towards the team. Heather found counting the daily steps fun and she attributed this feeling to her nature as a competitive person. Heather mentioned two reasons behind her score’s contribution to the team. She believed that she walked for personal benefits as well as for the team’s performance.  95  Susan made a direct reference to the social connections and interactions she made through comparing notes being the part of the Walkabout Program she enjoyed the most. She also viewed the pedometer as a determining factor in her engagement in walking. Susan reported camaraderie and the sense of reciprocity and commitment as important factors contributing to the level of her engagement in walking. Mariam enjoyed the closing ceremony the most. She identified the final gathering, the introduction of the teams, their achievements, and the social actions and interactions as what she looked forward to every year. Jo-Anne, like the other participants, was impacted by her connection to the team and felt responsible towards her them. At first, Jo-Anne said that she did not enjoy any particular aspects of the Walkabout Program and she did not give very much thought to it, but she conceded later in the interview that she liked walking and she increased her activity for the benefit of the team. Lili believed that the timing of the program was what she enjoyed the most and the least. She also mentioned not having walking people around when she travelled as a deterring factor in her engagement in walking. The majority of the participants enjoyed the social gathering and social networking of the Walkabout Program the most. They also mentioned the commitment to one’s health and the responsibility for the team as two important factors contributing to their level of engagement in the walking. Generally, the older adult participants’ perspectives suggested a smaller social network in the later years of life. This reduced social network was due to  96  various reasons such as retirement, decline in health, life course factors, and being distant from children and friends as a result of urbanization (Cornwell, 2008). Although the older adult participants understood and appreciated the physiological benefits of the Walkabout Program, they reported enjoying the created social environment of Walkabout the most. They believed that it was the sense of belonging to the team that elevated their feeling of responsibility, which ultimately increased their activity level. The participants also reported long-lasting lifestyle changes in their lives in addition to the short-term effects of the Walkabout Program. This result is in alignment with the findings of various studies (Altman, Evans, Flora, King, & Fortmann, 1986; Hammond, Long, Fowler, Ryan, & Volansky, 1997; King, Carl, Birkel, & Haskell, 1988; Knadler & Rogers, 1987) arguing that work-based physical activity programs which have included individual and group-based incentives have yielded promising short-term results.  5.3  Walkabout and Physical Literacy Physical literacy, physical, cognitive, social, and affective developments, and  growth in individuals through physical activity (Mandigo & Francis, 2009) was the ultimate effect of the Walkabout Program on the life of older participants. The older adult participants in the study exhibited different levels of physical literacy. For example, the team from Richmond exhibited a high level of physical literacy due to long-term exposure to the program. The members of this team analyzed the program in detail and offered constructive criticism to make the program better. They also understood the complexity of running such a program  97  and expressed their respect and appreciation for the organizers. They exhibited a high level of commitment to their team and the program’s social gatherings, and they positively responded to re-participation for the next year. Therefore, they demonstrated development in physical, cognitive, social, and affective domains, which showed their growth and physical literacy after long-term exposure to the Walkabout Program. Walkabout also created physical literacy in the individuals in the other team although they were being exposed to the program for the first time. The members of this team claimed that the program was informative, challenging, enabling, and rewarding. All the participants made direct reference to the importance of the team. They also appreciated and enjoyed the social gatherings and networking opportunities available to them through participation in the program. Some aspects of the programs were not as clear to them as they were to the other team’s participants due to the short-term exposure to the program. Although some of this team’s participants announced that they probably would not participate in the program next year, they claimed that they understood the importance of being active and that they just keep walking. Other participants in this team believed that if the timing of the program could have been different they would have participated again since the weather would have been more conducive to walking. The knowledge the program provided the participants with enabled and motivated them to capitalize on their movement potential, which it is one of the physical literacy characteristics described by Whitehead (2007), and cited in Mandigo and Francis (2009). This  98  understanding of the concept and their ability to capitalize on their movements contributed in large measure to their quality of life.  5.4  Physical and Built Environments, Physical Activity, and Older Adults The older participants were united in agreeing that the physical and built  environments impacted their quality of life. It was also concluded that the environment had a tremendous impact on the level of physical activity the older adult participants engaged in. For example, George believed that when he lived in his previous neighbourhood he tended to walk more often, since the beach was closer to his home. This feature of the physical environment quickly became a common theme emerging from the participants’ comments. The majority of the participants referred to proximity to water as an important factor adding to their quality of life. Having flat surfaces such as the dyke for walking was also very important to the older participants. Being close to Pacific Spirit Park was another important physical environment factor that contributed to the participants’ QOL by directing affecting their well-being and by increasing their engagement in quality walking. As described by Jo-Anne, the quality walk the forest provided her with by stimulating her senses was the reason that she kept walking in the park. The participants also pointed to the built environment attributes in the quality of their life. Safety of the neighbourhood was a contributing factor in having the desire to walk. Mariam, an avid runner, found her neighbourhood safe and secure even in the early hours of the morning when she goes jogging.  99  Jo-Ann and George discussed the safety and condition of the sidewalks in Wesbrook Mall Village in some detail. They explained the negative impacts that their unpleasant experiences on these sidewalks have had on their satisfaction with the neighbourhood and their desire to walk in the village or on the UBC campus. Another factor that impacted the participants’ desires to walk in their neighbourhood was the accessibility of services, which was a positive feature of the built environment. Cindy regarded the proximity of the Wesbrook Mall village to the UBC campus and the services it provided as one of the most important reasons that she moved to the area. In general, aesthetics, safety, accessibility, diversity, short distances and security were physical and built environmental factors that impacted the older adult participants’ quality of life. Those participants who found their neighbourhood supportive of walking became satisfied with living there. This satisfaction ultimately resulted in the elevation of their quality of life. In addition, these environmental factors impacted the level their engagement in physical activity, in particular walking, which consequently influenced their quality of life.  5.5  Physical and Built Environments, Social Capital, and the Older Adults The participants’ frame of reference to the social environment was that it was  a crucial factor in making important decisions such as choosing their place of residence. The diversity of physical and built environments created an energetic stimulating atmosphere in which the participants had a greater chance to integrate,  100  to stay healthy, to become more stimulated, to stay active, and to stay connected, which was very important to them. For example, some of the participants emphasized the importance of the diversity their place of residence offered them by being close to such places as the museums and entertainment centres. In addition, the close proximity to UBC and its vibrant youth-oriented social environment stimulated them emotionally and increased their life satisfaction. Other participants believed that it was the urban living close to a natural setting such as the Pacific Spirit Park that increased their quality of life. The Wesbrook Mall Village environment enabled its residents to walk for the purpose of performing their IADLs, which provided them with independence. This environment also stimulated their senses and maintained their spiritual wellness. Furthermore, almost all the participants enjoyed the opportunity the convenient and diverse environment created for them provided for social connection. The socializing and networking had a tremendous value in the life of older adult participants. The aesthetic also played an important role in the creation of a desired social environment. The aesthetic of the physical and built environments had at least two functions: first, it stimulated and energized the older adults’ bodies and minds, and second it compelled them to become involved and active. In conclusion, themes such as diversity of the physical and built environments including the mixed uses, aesthetics, safety, proximity to services, noise, and convenience emerged from the private interviews. These themes were important in the older adult participants’ perspectives about their created social environments,  101  which gave them opportunities to meet and greet other people in addition to enabling them to maintain mobility and independence. Table 5.1 highlights and concludes the findings of the study. Table 5.1  Summary of the Study’s Findings Health  Activity  Physical Literacy / Environmental Factors  Social Capital  Walkabout  Walkabout contributed to the health of the OAs, which was very important to them by encouraging them to become more physically active.  Walkabout provided the OAs with an opportunity of becoming physically & socially active which positively affected their life satisfaction, health, & QOL.  Walkabout developed physical, cognitive, social, & affective domains in the OAs by fully engaging them in the program.  Walkabout created a social environment in which social networking & reciprocity were possible. This led to the generation of social capital & increasing QOL for the OAs.  Physical and Built Environments  The diverse physical & built environments of the two areas encouraged the OAs to become more active, which contributed to their health & QOL.  In their diverse complete neighbourhoods the OAs became more physically active, more socially involved, & generally more satisfied with their life.  The OAs identified safety, noise, aesthetics, convenience, close proximity, diversity in physical & built environments as factors impacting their engagements in PA & their QOL.  Mixed-use neighbourhood structures provided the OAs with walking opportunities, meeting people, & generating of social capital, & increased their QOL.  5.6  Implications for Health, Physical & Social Activity, and the Walkabout Despite of the acknowledgement of physical activity as an important  contributing factor to the health and quality of life in later years, many older adults are still struggling to maintain a healthy active lifestyle. The older adult participants in this study exhibited a tremendous desire and will to stay active. In fact, they made direct and indirect connections between their social and physical activities, their 102  health, their life satisfaction, and the increase of their quality of life. Although the participants reported performing a variety of social and physical activities, such as swimming, gardening, jogging, hiking, skiing, weight-lifting, dancing, and so on, the study found that walking was the most commonly performed and sustainable form of physical activity they performed. The participants in this study walked for two main purposes. First, they walked in order to perform their Instrumental Activities of Daily Living, IADLs. Second, they walked for the purpose of physical, spiritual, and emotional health. The participants in the study reported benefiting in different ways from their participation in the Walkabout Program. Links were made by the participants between their participation in Walkabout and the increase in their quality of life. This increase in QOL in older adult participants was due to the physiological benefits, the emotional well-being, and the social advantages that the program provided them with. In general, these positive changes led to their satisfaction with their lives and consequently increased their quality of life. Thus, the implication can be drawn that a physical activity community-based program such as Walkabout has multiple positive impacts on QOL in the older adult participants. First, the program provided the older participants with an opportunity of physical activity, which resulted in physiological and emotional health. These health benefits are very important contributing factors to QOL in older adults. Second, being active, another contributing factor to the participants’ quality of life was served by the Walkabout Program. This program offered fun social and physical activity opportunities that at the same time kept the mind and body of the participants engaged. Third, the participants’ socializing was enhanced through their involvement  103  with the Walkabout Program. It was through teamwork that the program created a social environment in which social responsibility and reciprocity were developed. This sense of connectivity and belonging elevated the participants’ satisfaction with life and motivated them to become more active. These cascading effects resulted in the increase of QOL, according to the older adult participants. The program’s nature, intention, and ability to include, support, and value even the very basic functional movements of older adults such as walking enabled the participants to become motivated to capitalize on their behavioural physical activities to increase autonomy, self-esteem, self-actualization, and quality of life.  5.7  Implications for the Environmental Factors Although physical activity occurs in the context of the environment, it is only in  recent years that researchers have paid attention to environmental factors. Currently, the importance of place during the later years in life has become more evident in the studies. This study indicated the importance of physical and built environments on the increase of quality of life in older participants. From one side, these environmental factors directly affected the level of their satisfaction with life. From the other side, by having an impact on the level of the participants’ engagements in physical activity, environmental factors affected both life satisfaction and quality of life. For instance, the following anecdotal report written by Mariam on week six of the program indicated the impacts of physical environment on Mariam’s feelings: Today I ran early my usual 8 km. It was cold and crisp, with a HUGE yellowy golden full moon setting near the horizon. What a treat!  104  The built environment also had profound impacts on both teams’ participants. The team from the Tapestry independent living centre was more positively impacted by their environment due to Tapestry’s created social environment. The opportunities available through the built environment at Tapestry for social greeting, social gatherings and fitness programs provided the participants not only with the opportunity of involvement in different programs, but also the opportunity of more networking with their team members and other older adults. For example, Jo-Anne wrote in her anecdotal report on March 16, 2012 that she recorded a total of 14,534 steps, which included walking with Susan, working on the NuStep machine and weight training in the company of George, and playing Ping Pong with Susan. These results exhibit the impacts of a built environment such as Tapestry, which has created a special dynamic environment in which the older adults have a better chance of networking. These networking opportunities are through physical activity or other forms of activity. Either way, the activities result in an increase in the quality of life. The environmental domains—aesthetics, safety, accessibility to services and programs, diversity of the physical and built environments, and created social environment—were factors that directly and indirectly impacted the level of older adults’ participation in physical activity, in particular walking, and consequently had an impact on their quality of life. In addition, the research suggested that mixed-use diverse physical and built environments, which offer convenience and services besides the opportunity to meet other people, was what the older adult participants sought and enjoyed the most.  105  The argument can also be made that although physical activity is a contributing factor to health and quality of life in later years, it is the place and its influences that play a crucial role in the implementation and maintenance of physical activities.  5.8  Implications for Research Due to time and resource limitations, the study examined the opinions and  interests of a small group of people. Therefore, the results may or may not be of the prevalent opinions and interests of all older adults. The small number of participants was also an advantage for the study since this made it possible for the researcher to scrutinize the transcriptions thoroughly to ensure the accuracy of the understandings and the implications. The complexity and the intricacies of the issue of QOL and the multi-level structure of the study also required spending extra time in reading and rereading of the transcripts for validity of data and quality assurance of the results. The study results reemphasized the importance of place in individuals’ lives and in particular in their later years. This was aligned with the “Landfull Framework,” emphasizing the importance of integrating physical and built environment factors in further studies. The research also recommended a more holistic approach in future research into physical activity and its influence on QOL in later life by including factors such as the ecological influences. The study also suggested that future longitudinal research on the effects of the Walkabout Program on the quality of life in older adults would be beneficial. This  106  is because some of the short- and long-term effects of the Walkabout Program were reported and implied in this study. The suggestion was also that more research is required to understand when a sedentary lifestyle manifests itself in people’s lives. Thus, studies that include people of middle age may identify new factors affecting the engagement of individuals in physical activity in earlier stages in life. The findings from these studies may influence the current approaches to physical activity and its effects on QOL in older adults. Finally, for better understanding of physical activity and the programs that advocate it and their influences on the life of older adults, further studies are required to explore the concept of physical activity through innovative approaches such as “Teaching Games for Understanding” (TGfU). This approach to teaching physical education was introduced two decades ago by Bunker and Thorpe in 1982 and by Thorpe, Bunker, and Almond in 1984 (Griffin & Butler, 2005). The TGfU approach is a learner-centred teaching method that views and values the teachers as facilitators. It is in this constructivist method that the learners become fully involved in the process of learning. Benefiting from a constructivist perspective, the Walkabout Program structure, operation, and goal also encourage the engagements of the participants in all aspects of the program. The intention is that through their involvement participants become informed about different aspects of physical activity and their benefits. In addition, participants understand the reasons and challenges for and behind staying active and maintaining it. This awareness and understanding, along with enough exposure to the program, may result in more practical ways of maintaining physical activity by the participants. It is from the  107  foundations of TGfU and the Walkabout Program that “Teaching Physical Activity for Understanding” for adults can arise. 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Lumping and splitting: Notes on social classification. Social Forum, 11, 421–433.  118  Appendices Appendix A UBC Ethics Certificate of Approval  The University of British Columbia Office of Research Services Behavioural Research Ethics Board Suite 102, 6190 Agronomy Road, Vancouver, B.C. V6T 1Z3  CERTIFICATE OF APPROVAL - MINIMAL RISK PRINCIPAL INVESTIGATOR:  INSTITUTION / DEPARTMENT: UBC BREB NUMBER: UBC/Education/Curriculum and Joy Butler H11-02622 Pedagogy INSTITUTION(S) WHERE RESEARCH WILL BE CARRIED OUT:  Institution  UBC  Site  Vancouver (excludes UBC Hospital)  CO-INVESTIGATOR(S): Fay Bigloo SPONSORING AGENCIES: N/A PROJECT TITLE: Walking, Social & Built Environments and Quality Of Life in Older Adults CERTIFICATE EXPIRY DATE: December 16, 2012 DOCUMENTS INCLUDED IN THIS APPROVAL:  DATE APPROVED: December 16, 2011  .  119  Appendix B List of Questions for the Private interviews  Personal Information Section Age  Marital Status  Gender  Education  Home Ownership Heath Problems  Working Status  Private Interview Questions 1- How would you describe the quality of your life? 2- How would you describe your health? 3- How active would you describe yourself in general? 4- What are your favourite activities? Why? 5- What do you think about the Walkabout program? 6- Is this the first year that you have participated in the Walkabout? 7- What did you enjoy about the program the most? 8- What did you enjoy about the program the least? 9- Would you participate in the Walkabout again? 10- If you can make a change to the program, what would that be? 11- What were the determining factors in the level of your engagement in walking? 12- Did you find the built environment a determining factor in the amount of your engagement in the walking? How? 13- Is your neighbourhood supportive of walking? How? Please note that the nature of private interviews will be semi-structured. This will allow the interviewees to have real voice in the interviews. The participants will also be asked to bring their own questions, concerns, and possible solutions.  120  Appendix C Senior Walking Environmental Tool Audit-Revised (SWEAT-R) Used and reproduced with permission from SWEAT-R creators Dr. Habib Chaudhury and Dr. Atiya Mahmood.  C.1  SWEAT-R Data for Wesbrook Mall Village  121  122  123  124  125  126  127  128  129  C.2  SWEAT-R Data for Steveston Village  130  131  132  133  134  135  136  137  138  Appendix D Transcript of Interview With Beverly  Transcription, edited by Beverly You have the opportunity at the beginning if you wish or at the end you can leave that for any comments, anything that was important and left a mark in your mind about the program, about the process of the study. Interviewee: Are you talking about the program or your research? Interviewer: Both Interviewee: I don’t know that much about your research, but I am a big supporter of research, of you know medical students, of like anywhere where there is going to be knowledge that comes out at the end, I think whatever we can do to facilitate that is a good idea. As far as the walkabout program goes, I don’t know how I feel you know as a community team. I don’t really feel that I am involved. I don’t think the community teams are very involved. I think it’s a UBC thing. This is our fifth one, but I think it’s really focused on UBC. All the guided walks are at UBC. Everything is at UBC. It’s really really focused on that. So I am not quite sure why there are community teams although I do have to say we enjoy being part of it. The first year we joined it’s just because we are friends of Joy and she asked us, so we said ok. But we enjoy doing it you know, it’s kind of fun to see how we do as a team, you know. Some of us are more competitive than the others. That’s not me, but you know you want to do well for your team, and hold up your end of the team, so, yes, it’s a good thing. Interviewer: So nonetheless, you enjoyed being in it. Interviewee: Yes. Interviewer: The first question is that how would you describe the quality of your life?  139  Interviewee: Uh, interesting. Um, well, you know currently I have a very bad medical diagnosis and that is affecting a part of my life and it’s affecting what I can do with my hands, but if I take that piece away, my life in general, I love my life! I love my life! I have someone who loves me, whom I love. I have a nice house. I have a pension. You know it’s not a great pension, but 85% of Canadians don’t have pensions, so I…I have no complaints about my life other than the recent medical diagnosis. I have a fabulous family and a fabulous group of friends, so I feel very very blessed. Interviewer: That leads us to second question unfortunately. How would you describe your health? Interviewee: Generally speaking, I’m strong, I have asthma, but it’s very well controlled, so it’s not a problem for me. All the regular things, blood pressure, cholesterol, all those things, they are all good. My hemoglobin has always been really really good, so in those aspects, I am very healthy. Unfortunately, I have the diagnosis of ALS which is a progressive degenerative neuromuscular disease which won’t get any better. There is nothing I can do to make it better. It will only get worse, and the only thing I can hope for is slower progression, so as far as general health things go I am carrying some extra weight. That prevents me sometimes wearing some clothes I want to wear, but it doesn’t prevent me from doing anything. Interviewer: How active would you describe yourself in general? Interviewee: I’m moderately active. I’m not one of those people who get up in the morning and says oh I’ve got to go do something. I don’t run off to the gym to do this or to do that, but given an opportunity, like when my partner says oh, let’s go for a walk or let’s go do aquasize or something else, I go and do it. Certainly, when we travel, we do a lot of walking. I would say moderately active. Interviewer: What are your favourite physical activities and why? Interviewee: My favourite activities aren’t that physical. My favourite, my absolute favourite thing to do is to cook. I really enjoy cooking and I am a good cook. That’s 140  not that active. I liked gardening because you can see the fruits of your labours. And I like walking more when we are on holiday to see other places. You know we have done some fabulous walks. We walked in the Cotswolds from village to village. We walked in Abel Tasman Park in New Zealand and that was absolutely incredible. Those are probably my favourite physical activities. Physical activity to be able to do, but somewhere else. Some place that is new and the trees, the flowers, the animals, and the birds, and everything else is different and exciting. Interviewer: What do you think about the walkabout program? Interviewee: I think it is good. I think it’s good. I think it makes people aware, gets them moving. If they’re the competitive type, that want to get more social points, then it gets them to be more social, and I think that’s a good benefit too. They’ll go out, because I don’t really don’t think you can go walking with somebody and not talk, and walking and talking is a good thing. Interviewer: Is this the first year that you have participated in the walkabout? Interviewee: No, this is our fifth year. Interviewer: What did you enjoy about the program the most? Interviewee: I think the most was just getting together with my friends and walking. Interviewer: The social part. Interviewee: Yes. Interviewer: what did you enjoy about the program the least? Interviewee: The least was the feeling of not being able to fully participate. In previous years there’s been a thing on the website where they would plot the teams on the map. Like when we did the Trans Canada Trail, you could see where you were on the Trans Canada Trail. But this year the only plotting of teams was in the Scarfe building, and of course, we are nowhere near the Scarfe building.  141  Interviewer: So there was nothing on the website? Interviewee: No. There was a map of BC parks, but there was never anything to show where the teams were. I really enjoyed that and I know my team members did too. They liked to go on and see where we are and where the other teams are. Interviewer: Is that the way you felt you were isolated or there were other things too? Interviewee: Well, yah, the fact that all the guided walks were out of Scarfe. You know when you’ve got community teams and you’ve old peeps, Twitter is what birds do. You know (laughing) that I’m more I’m more computer savvy, but you also know there are members of my team who aren’t, so when it’s more simple and just one website that they can go to, that’s a little bit easier for them. Interviewer: So, you, you found it a little more complicated this year in comparison to previous years. Interviewee: It was, yah, and to tell you the truth I never understood this whole bonus park thing. I had no idea what the bonus park was, but I know that if you took a picture, or you did this and did that, you got a bonus park. It really didn’t make a lot of sense to me. Interviewer: Would you participate in the walkabout again? Interviewee: I would. Interviewer: If you can make a change to the program, what would that be? Interviewee: The only I would do would be—if you want to invite the community teams, then make it an equal playing field for all the teams. Have less things that are only available at UBC. Other than that I wouldn’t change anything else. I like the spreadsheets that we get. They work very nicely, I don’t have to do the addition. Submitting steps is easy easy. Uh, you know just logging in and submitting my team’s steps. No there is nothing else I would change.  142  Interviewer: What were the determining factors in the level of your engagement in walking? Interviewee: ….. Interviewer: By that I mean what were the factors that one day you get up in the morning and you say oh, it’s a good day, I am going to do more walking or, no not today. I won’t do anything. Interviewee: The determining factor for me not, you know on the days that I had poor steps, were just because I was busy. Because there were appointments, or there were things like that. Interviewer: Time Interviewee: Yah, but there were a number of times that I chose to walk when normally I wouldn’t have, just to increase my steps because I’m the lowest on my team. They are really good walkers. They are much better walkers than I am, so you know, just maybe not to be so embarrassed by such a having such low number (for the team) I had to do that. Recently I had to go up to drop off something to somebody up at Minoru Senior’s Centre and they have a track there, so while I was there, I just got out and I walked around the track a few times. First time I’ve ever been on that track. The spill over is that this Sunday, when counting steps was over, I said to Heather let’s walk to the market and go see the market. Before we would have always gotten into the car and driven down to the market which is in the village. We might have walked on the boardwalk or something, but this time we walked down to the market and we met whole bunch of people, visited with people, we had something to eat, we walked around the boardwalk, down to see the boats and the fish, came back up, walked throughout the village, and then came home and it was lovely. Interviewer: Was the weather ever a factor?  143  Interviewee: …No, no because in my biggest job which was thirty years as a letter carrier, I walked in all sorts of weather. So we walk many many times in the rain, and I’ve got a good Gore Tex jacket. We all do, so we just put our hoods up and off we go. Interviewer: So you were trained for it all these years. Interviewee: Yah, there was one day we went for a walk and the wind was like, we felt we should get extra steps for the endurance, because the wind was so hard and we were pushing against it that we did not go around Garry Point because we knew it would be really really hard to walk, so we, we came up 7th Avenue instead of around the point, but then we walked up and down a few more streets just to get our steps in. So the the rain and the wind didn’t stop us, but the wind did one day adjust our route. Interviewer: And did you find the built environment a determining factor in the amount of your engagement in the walking? (more explanation was provided about the meaning of built environment). Interviewee: Um,…….. yah, yah. I think what we have here, we are so lucky. Just to be able to go down the street and to get on the dike and to have that nice flat wide area which goes for miles and miles, and miles with no motorized vehicles on it, I think that is really really helpful and you know on a sunny day you can’t believe the number of people out there. You know on bikes or walking. I think we are very very lucky here to have that. Interviewer: If you have the choice to do you physical activity in the gym, or at a park, or incorporate it into your daily routine instead, which one would you choose? Further explanation was provided to make the question clearer). Include physical activity in your routine or go to the gym? Interviewee: I think I prefer the other as I doing that adds a few social aspects and I am a very social person, but also medically, I‘ve been told my physician that I am not to do any exercise that causes any burn to the muscle (the difference between 144  exercise and physical activity), so you know going to the gym I think are days past. Before this diagnosis, I had started to see a personal trainer and was working very hard and was many pounds lighter than I am now. But I am not allowed to do that anymore. Interviewer: Um, was there any lifestyle change after the walkabout program? You have been doing it for five years. Do you see any positive changes in your life due to the program? Interviewee: Yah, I think what it is is that sometimes consciously deciding to walk somewhere instead of driving somewhere. In previous years the pattern would have been to drive there and do something, and you know like walking to the market. I don’t know if that was the first time we walked to the market, but you know I don’t know if that’s not something that we do often. If I had to go over to the SevenEleven to mail something, I know in the past I got in my car. It’s only couple of blocks away, but now I just walk. It’s not far. Yah. Interviewer: Do you think you would stay as active after the program as you were during the program? Interviewee: I think so, I think so, until something happens and I am not able to walk, but as long as I am able to walk I am going to walk…………………….. you see for thirty years I had a job where I did a lot of walking, and now I have to consciously make sure that I do some walking because I don’t have that job any more. I could easily spend the day in the house and get four or five thousand steps, but I believe that I should get at least 10,000 steps a day, so but when I was working (type of work) it was no problems to get 14,000 just at work. Interviewer: Would you like to see similar programs to walkabout in your neighbourhood? Interviewee: Oh yah, I think that would be a good idea.  145  Interviewer: What percentage of your physical activity came from actual walking and what percentage from other activities? In your case like gardening, or if you did any yoga Interviewee: So you mean in the way that we got equivalency? I’d say the majority of my steps were real steps. Equivalences I got just a few times when we went to aquasize. Heather would have more equivalencies, but I think, most of my steps would be actual steps. Interviewer: If you can make only one change in your life to become more active, what would that be? Interviewee: That would be to waive the magic wand and to become healthy. Interviewer: You never know. Interviewee: You never know, I mean strange things happen. I could go to this point and then have it stop for ten years. I don’t know, but I’ll continue to walk as long as I can. I think that is the motivator as well because I know I am going to lose the ability to do that, so now it’s like yah, you better do it while you can because one day it is going to be a memory. Interviewer: What is the earliest memory that you can recall that you might say shaped who you are when it comes to activity. Let’s say for instance going out when you were very young with your family or a family member to the forest and having picnics. I am looking for something that puts emphasis on the importance of place in your life. For instance, if you are exposed to trees early in life you might develop love for nature. Do you remember that? Interviewee: I don’t remember specific incidents, but my parents were both school teachers, so we were in Montreal and so the whole family had two months off for the summer and we always had a house in the Laurentians right by the lake. We rented for a number of years when I was very young, and then my parents bought a house and the house that we bought was probably eight feet from the lake, and as kids 146  growing up there, we’d be out all day. I mean we’d get called in by our parents for lunch, and then would be back out playing. We went on hikes through the woods, and every year we walked the five miles down the gravel road to George’s restaurant and had a hamburger and walked back. And we would swim until our mother said our lips were blue and we had to get out to get warmed up. You know everybody had a float out away from their docks and we’d just spend all our time jumping off the float into the water. Yah, we were non-stop active. We had the opportunity, we had two months. Interviewer: And it wasn’t secluded, just your family. Interviewee: No, no, we were a gang. Yah, yah, there were bunch of families and we were all sort of in the same age range and we had fun. Every year we put on a community fair, and all the people around the lake would come, you know they pay 5 cents to guess how many rocks are in that jar, and that kind of stuff. We were all Catholic families, so as kids we were raising money for the Holy Childhood or something. They were missionaries. I remember they used to come to our school and they had blue belts on. But anyhow we raised money for charity, for kids in some under privileged country. I am glad you reminded me of those times because it was fabulous. You know we had big bonfires and sing songs and… Interviewer: And it does shape who we are. Interviewee: Yah. Interviewer: I am very happy to ask that question. Interviewee: Well, made me feel very happy. Interviewer: Anything else you like to add? Interviewee: When you talk about built environment…you know when we were driving home from UBC yesterday, Christine made a comment, sort of a sarcastic comment, about our city hall and maintaining green spaces because it’s not  147  happening. Every time we turn around there are former green spaces that are turning into developments and um, Interviewer: The city hall, you mean Richmond. Interviewee: Richmond, Yah, yah, yah, it seems to be the friend of the developer. We all were worrying because we drove down Railway and they’ve cleaned out all the roadside area that used to be bush. You never saw the houses on the other side or anything. You didn’t see much, but it’s all being cleared out now. So Christine hopes they are clearing out because they are going to put community gardens in there, and Lili thinks they are clearing out because they are going to put another row of houses closer to the road. So we’ll have to wait and see what is going to happen. Interviewer: Thank you so much. Interviewee: Thank you Fay.  148  

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