Direct and Indirect Associations Between the Built Environment and Leisure and Utilitarian Walking in Older Women.
BACKGROUND
The built environment predicts walking in older adults, but the degree to which associations between the objective built environment and walking for different purposes are mediated by environmental perceptions is unknown.


OBJECTIVE
We examined associations between the neighborhood built environment and leisure and utilitarian walking and mediation by the perceived environment among older women.


METHODS
Women (N = 2732, Mage= 72.8 ± 6.8 years) from Massachusetts, Pennsylvania, and California completed a neighborhood built environment and walking survey. Objective population and intersection density and density of stores and services variables were created within residential buffers. Perceived built environment variables included measures of land use mix, street connectivity, infrastructure for walking, esthetics, traffic safety, and personal safety. Regression and bootstrapping were used to test associations and indirect effects.


RESULTS
Objective population, stores/services, and intersection density indirectly predicted leisure and utilitarian walking via perceived land use mix (odds ratios (ORs) = 1.01-1.08, 95 % bias corrected and accelerated confidence intervals do not include 1). Objective density of stores/services directly predicted ≥150 min utilitarian walking (OR = 1.11; 95% CI = 1.02, 1.22). Perceived land use mix (ORs = 1.16-1.44) and esthetics (ORs = 1.24-1.61) significantly predicted leisure and utilitarian walking, CONCLUSIONS: Perceived built environment mediated associations between objective built environment variables and walking for leisure and utilitarian purposes. Interventions for older adults should take into account how objective built environment characteristics may influence environmental perceptions and walking.
Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, MA, USA. phil.troped@umb.edu.
Philip J
PJ
Troped
Department of Population Health, New York University School of Medicine, New York, NY, USA.
Kosuke
K
Tamura
Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
Meghan H
MH
McDonough
Department of Kinesiology, California Polytechnic State University, San Luis Obispo, CA, USA.
Heather A
HA
Starnes
Departments of Environmental Health and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.|Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Peter
P
James
Department of Urban Studies and Planning, School of Architecture and Planning, Massachusetts Institute of Technology, Cambridge, MA, USA.
Eran
E
Ben-Joseph
Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, CT, USA.
Ellen
E
Cromley
Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
Robin
R
Puett
Drexel University, Dornsife School of Public Health, Philadelphia, PA, USA.
Steven J
SJ
Melly
Departments of Environmental Health and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.|Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Francine
F
Laden
D000368:Aged; D000369:Aged, 80 and over; D004779:Environment Design; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008875:Middle Aged; D009042:Motivation; D012111:Residence Characteristics; D016138:Walking
Exercise; Mediator; Neighborhood; Older adults; Perceptions; Physical activity