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Open Access Review

Understanding the relationships between the physical environment and physical activity in older adults: a systematic review of qualitative studies

Mika Moran12*, Jelle Van Cauwenberg345, Rachel Hercky-Linnewiel1, Ester Cerin67, Benedicte Deforche3 and Pnina Plaut1

Author Affiliations

1 Faculty of Architecture and Town Planning, Technion – Israel Institute of Technology, Haifa 32000, Israel

2 School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel 31905, Israel

3 Department of Human Biometry and Biomechanics, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussel, Belgium

4 Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, B-9000 Ghent, Belgium

5 Fund for Scientific Research Flanders (FWO), Egmontstraat 5, B-1000 Brussels, Belgium

6 Institute of Human Performance, The University of Hong Kong, Pokfulam, Hong Kong

7 Center of Physical Activity and Exercise Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia

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International Journal of Behavioral Nutrition and Physical Activity 2014, 11:79  doi:10.1186/1479-5868-11-79

Published: 17 July 2014

Abstract

Background

While physical activity (PA) provides many physical, social, and mental health benefits for older adults, they are the least physically active age group. Ecological models highlight the importance of the physical environment in promoting PA. However, results of previous quantitative research revealed inconsistencies in environmental correlates of older adults’ PA that may be explained by methodological issues. Qualitative studies can inform and complement quantitative research on environment-PA relationships by providing insight into how and why the environment influences participants’ PA behaviors. The current study aimed to provide a systematic review of qualitative studies exploring the potential impact of the physical environment on older adults’ PA behaviors.

Methods

A systematic search was conducted in databases of various disciplines, including: health, architecture and urban planning, transportation, and interdisciplinary databases. From 3,047 articles identified in the physical activity, initial search, 31 articles published from 1996 to 2012 met all inclusion criteria. An inductive content analysis was performed on the extracted findings to identify emerging environmental elements related to older adults’ PA. The identified environmental elements were then grouped by study methodologies [indoor interviews (individual or focus groups) vs spatial methods (photo-voice, observations, walk-along interviews)].

Results

This review provides detailed information about environmental factors that potentially influence older adults’ PA behaviors. These factors were categorized into five themes: pedestrian infrastructure, safety, access to amenities, aesthetics, and environmental conditions. Environmental factors especially relevant to older adults (i.e., access to facilities, green open spaces and rest areas) tended to emerge more frequently in studies that combined interviews with spatial qualitative methods.

Conclusions

Findings showed that qualitative research can provide in-depth information on environmental elements that influence older adults’ PA. Future qualitative studies on the physical environment and older adults’ PA would benefit from combining interviews with more spatially-oriented methods. Multidisciplinary mixed-methods studies are recommended to establish quantitative relationships complemented with in-depth qualitative information.

Keywords:
Physical environment; Physical activity; Older adults; Qualitative research; Systematic review