Mall Walking Program Environments, Features, and Participants: A Scoping Review.
BACKGROUND
Walking is a preferred and recommended physical activity for middle-aged and older adults, but many barriers exist, including concerns about safety (ie, personal security), falling, and inclement weather. Mall walking programs may overcome these barriers. The purpose of this study was to summarize the evidence on the health-related value of mall walking and mall walking programs.


METHODS
We conducted a scoping review of the literature to determine the features, environments, and benefits of mall walking programs using the RE-AIM framework (reach, effectiveness, adoption, implementation, and maintenance). The inclusion criteria were articles that involved adults aged 45 years or older who walked in indoor or outdoor shopping malls. Exclusion criteria were articles that used malls as laboratory settings or focused on the mechanics of walking. We included published research studies, dissertations, theses, conference abstracts, syntheses, nonresearch articles, theoretical papers, editorials, reports, policy briefs, standards and guidelines, and nonresearch conference abstracts and proposals. Websites and articles written in a language other than English were excluded.


RESULTS
We located 254 articles on mall walking; 32 articles met our inclusion criteria. We found that malls provided safe, accessible, and affordable exercise environments for middle-aged and older adults. Programmatic features such as program leaders, blood pressure checks, and warm-up exercises facilitated participation. Individual benefits of mall walking programs included improvements in physical, social, and emotional well-being. Limited transportation to the mall was a barrier to participation.


CONCLUSIONS
We found the potential for mall walking programs to be implemented in various communities as a health promotion measure. However, the research on mall walking programs is limited and has weak study designs. More rigorous research is needed to define best practices for mall walking programs' reach, effectiveness, adoption, implementation, and maintenance.
Health Promotion Research Center, University of Washington, 1107 NE 45th St, Suite 200, Box 354804, Seattle, WA 98105. Email: laf2163@columbia.edu. Ms Farren is now affiliated with the Mailman School of Public Health, Columbia University, New York, New York.
Laura
L
Farren
Health Promotion Research Center, University of Washington, Seattle, Washington.
Basia
B
Belza
Brown School, Washington University in St. Louis, St. Louis, Missouri.
Peg
P
Allen
Health Promotion Research Center, University of Washington, Seattle, Washington.
Sarah
S
Brolliar
Centers for Disease Control and Prevention; Atlanta, Georgia.
David R
DR
Brown
Department of Orthopaedics, Division of Physical Therapy, and Injury Control Research Center, West Virginia University. Dr Cormier is now affiliated with the Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky.
Marc L
ML
Cormier
University of Illinois at Chicago, Chicago, Illinois.
Sarah
S
Janicek
Department of Orthopaedics, Division of Physical Therapy, and Injury Control Research Center, West Virginia University.
Dina L
DL
Jones
Center for Behavioral Health Research and Services, University of Alaska Anchorage.
Diane K
DK
King
University of Illinois at Chicago, Chicago, Illinois.
David X
DX
Marquez
Health Promotion Research Center, University of Washington, Seattle, Washington.
Dori E
DE
Rosenberg
D000328:Adult; D000368:Aged; D003132:Commerce; D057186:Comparative Effectiveness Research; D004059:Diffusion of Innovation; D004779:Environment Design; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000191:economics / Q000379:methods; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D015397:Program Evaluation; D011788:Quality of Life; D016138:Walking / Q000523:psychology*