Senior Change Makers Study: Improving Physical Activity Environments

Senior Change Makers is an intergenerational intervention that compares two, 8-week programs: (1) an advocacy program wherein senior participants perform audits of their physical activity environments, identify an advocacy project, and advocate for improvements; and (2) a walking program designed to increase participant physical activity through education and guided walks. The investigators expect that the advocacy program will produce greater improvements in seniors' advocacy skills, confidence, and attitudes at 8 weeks.

The proposed study will be conducted at six senior centers in San Diego, California and will involve 132 senior participants, 16 student participants, and 12 decision maker participants (N = 160). Three senior centers will be randomized to an advocacy program and three will be randomized to a walking program.

The participants at the advocacy intervention sites will undergo an 8-week advocacy program during which they will (1) learn about the connection between the built environment and physical activity, (2) conduct a field audit of their physical activity environment using the Microscale Audit of Pedestrian Streetscapes (MAPS) Mini tool, (3) select an advocacy issue related to a physical activity barrier, and (4) engage in advocacy actions, such as communicating with decision makers or public officials. The group sessions will include topics such as how the environment affects walking, potential pedestrian hazards and solutions, how to conduct an audit of the walking environment, what advocates do, local examples of successful advocacy projects, creating an advocacy action plan, creating a fact sheet about the advocacy issue, writing letters to representatives, making an advocacy presentation. The student participants will work with the senior participants throughout the program to help accomplish the advocacy goals. The program will culminate with the presentation of the advocacy issue to a "decision maker" (e.g., a city planner, engineer, city council member, etc.).

In the other study condition, the walking groups, participants will undergo an 8-week program that provides participants with information about safe physical activity, strategies to increase physical activity, and guided walks. The group sessions will address topics such as the benefits of walking, fall prevention tips, goal setting, positive thinking, social support, sedentary behavior and health, barriers to walking, handling setbacks, and overcoming challenges to physical activity. Comparing two beneficial programs helps with participant recruitment and retention, and ensures that between-group differences in outcomes are not due solely to participation in a group program.

Eligibility Criteria:
Inclusion Criteria:

* 50 years or older
* have not had a fall that resulted in a hospitalization in the past 12 months
* able to walk 3 meters within 30 seconds (Shumway-Cook, et al., 2000)
* able to walk without human assistance (cane or walker use okay)
* able to read and write in English
* able to complete written surveys without assistance
* able to attend regular study activities at the center
* able to provide written informed consent

Exclusion Criteria:

* Older adult participants will be excluded if they:
* are younger than 50 years
* have had a fall that resulted in a hospitalization in the last 12 months
* cannot complete the walking test within 30 seconds
* are not able to read and write in English
* are not able to complete written surveys without assistance
* cannot regularly attend study activities at the center
* are not willing to complete study activities
* are not willing to complete study assessment and wear the activity meter
* are not able to provide written informed consent
* cannot walk without human assistance.