title: Social and environmental predictors of walking among older adults.
abstract: Regular physical activity (PA) is a major factor in maintaining health in aging populations. This study examines the influences of sociodemographic, health, and environmental characteristics on older adults' walking behaviors, and the role physicians can play in promoting physical activity.
  
  
  
  Online and paper surveys (n = 272) were distributed to community-dwelling older (age ≥ 60) adults from a large integrated healthcare system in two counties in Central Texas. Descriptive statistics were utilized to characterize participant's walking behaviors and places. Multivariate logistic regression was employed to predict being: 1) a frequent walker (i.e., walking at least three times a week); and 2) meeting the Centers for Disease Control and Prevention (CDC) PA recommendation through walking (i.e., walking ≥150 min per week), while considering sociodemographic, health, and environmental factors.
  
  
  
  Individuals had a median age of 69 years, were of both genders (50.37 % female), and were primarily non-Hispanic White (84.87 %). While the majority (59.55 %) walked at least three times a week, only 27.86 % walked ≥150 min a week. Factors associated with a lower likelihood of being frequent walkers included experiencing poor mental health in the past month (OR = 0.345, 95 % CI = 0.185-0.645) and residing in areas with low or moderate (versus high) perceived neighborhood cohesion (OR = 0.471, 95 % CI = 0.228-0.974), while those in Census Tracts reflecting populations with a lower median age were more likely to report frequent walking behavior (OR = 1.799, 95 % CI = 1.034-3.131). Factors associated with a lower likelihood of meeting the CDC PA recommendation included being 60-69 years (versus 70 years or older) (OR = 0.538, 95 % CI = 0.290-0.997), experiencing poor mental health in the past month (OR = 0.432, 95 % CI = 0.198-0.944), and lacking social support for walking (OR = 0.383, 95 % CI = 0.154-0.957).
  
  
  
  Given the health benefits, PA promotion must be seen as a national responsibility. In particular, physicians have a major role to play in communicating the importance of PA to their older patients and making discussions about strategies for overcoming barriers to walking an integral part of their clinical encounter with these patients.
authors.affiliation: Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center School of Public Health, College Station, Texas, 77843, USA.
authors.forename: Marcia G
authors.initials: MG
authors.lastname: Ory
authors.affiliation: Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center School of Public Health, College Station, Texas, 77843, USA. towne@sph.tamhsc.edu.
authors.forename: Samuel D
authors.initials: SD
authors.lastname: Towne
authors.affiliation: Department of Landscape Architecture and Urban Planning, Texas A&M, College Station, Texas, USA.
authors.forename: Jaewoong
authors.initials: J
authors.lastname: Won
authors.affiliation: Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center School of Public Health, College Station, Texas, 77843, USA.|Department of Family & Community Medicine, Texas A&M Health Science Center, College Station, Texas, USA.|Baylor Scott & White Health, Temple, Texas, USA.
authors.forename: Samuel N
authors.initials: SN
authors.lastname: Forjuoh
authors.affiliation: Department of Landscape Architecture and Urban Planning, Texas A&M, College Station, Texas, USA.
authors.forename: Chanam
authors.initials: C
authors.lastname: Lee
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology / Q000523:psychology*; D004777:Environment; D015444:Exercise / Q000523:psychology; D005260:Female; D006293:Health Promotion / Q000379:methods / Q000458:organization & administration; D006801:Humans; D057187:Independent Living / Q000523:psychology / Q000592:standards; D008297:Male; D010819:Physician's Role; D012931:Social Environment; D012944:Social Support; D011795:Surveys and Questionnaires; D013781:Texas / Q000453:epidemiology; D016138:Walking / Q000502:physiology / Q000523:psychology*
keywords: Health and place; Healthy aging; Older adults; Physical activity; Social environment; Walking