title: A community-based walking trial to improve neighborhood quality of life in older adults: a multilevel analysis.
abstract: BACKGROUND
  Few studies have considered the neighborhood as a context in which to examine the physical activity and quality of life relationship.
  
  
  OBJECTIVE
  The goal of this study was to evaluate the effects of a neighborhood walking program on quality of life among older adults. It was designed as a randomized trial involving a multilevel design with neighborhoods corresponding to primary sampling units and residents to secondary units.
  
  
  METHODS
  Five hundred eighty-two community-dwelling senior residents (65 years of age or older) in neighborhoods in the northeast metropolitan area of Portland, Oregon, were recruited through telephone, direct mail, and referrals. The walking intervention was delivered at the neighborhood level. Neighborhoods (N = 56) were randomly assigned to a 6-month, 3 times per week, leader-led walking group activity (n = 28) or an information-only control group (n = 28). Primary outcome measures included SF-12 (Physical, Mental summary scores) and life satisfaction (SWLS); the secondary outcome measure was neighborhood walking activity, assessed at baseline, 3 months, and 6 months of the study period.
  
  
  RESULTS
  Compared to the control neighborhoods, results from multilevel, longitudinal analyses indicated significant improvements in the primary outcomes of SF-12 Physical (p < .05), SF-12 Mental (p < .05) summary scores, and SWLS (p < .05), over the course of the 6-month intervention. A significant increase was also observed in the secondary outcome of walking activity (p < .05).
  
  
  CONCLUSIONS
  Implementing a neighborhood-based walking program of low to moderate intensity is feasible and beneficial for promoting quality of life among senior residents at a community level.
authors.affiliation: Oregon Research Institute, Eugene, OR 97403, USA. johnf@ori.org
authors.forename: K John
authors.initials: KJ
authors.lastname: Fisher
authors.forename: Fuzhong
authors.initials: F
authors.lastname: Li
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology* / Q000523:psychology; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009922:Oregon; D010809:Physical Fitness / Q000502:physiology; D011788:Quality of Life; D012111:Residence Characteristics; D012944:Social Support; D016138:Walking / Q000502:physiology*