Victoria | Urban
The Residents in Action Trial (RiAT) was an outdoor group walking program which aimed to increase walking and reduce sitting in physically inactive older adults in retirement villages. The program worked to achieve this by increasing motivation and confidence to walk in local neighbourhood environments.
RiAT was developed in 2015-16 and implemented from 2017-2018 in 14 retirement villages in Metropolitan and Regional Areas of Perth, including Australind, Mandurah and Busselton.
To establish RiAT, retirement village walkability was audited by two trained researchers. Using the Pathway Environmental Audit Tool, the physical environment was rated according to land use/destinations (e.g., number of amenities in walking distance), streetscape (i.e., pedestrian safety such as sheltered bus stops), aesthetics and social environment (i.e., appearance of surroundings and whether others walk in the area), footpath features (e.g., width, slope maintenance of footpath), and crossings (e.g., presence of an intersection control). From this assessment, three safe and accessible walking routes per village were risk-assessed and mapped for use.
Older adults from the retirement village communities were recruited as volunteer “Peer Walk Leaders” (PWLs) to lead group walking sessions. Training resources were produced to assist PWLs to motivate groups to be physically active and to overcome confidence barriers. The resources additionally helped walkers to motivate themselves and feel empowered by walking. The PWLs led outdoor group-walks three times a week, for a minimum of ten weeks. Retirement village residents engaged in group-based and individual outdoor walks for 16 weeks, aiming to sustain these levels of activity.
The RE-AIM framework was used to evaluate the program. A mixed methods approach (using a combination of accelerometers, surveys, and interviews) was adopted to examine the feasibility, reach, efficacy, adoption, implementation and maintenance of the program.
The majority (92%) of walkers who started the program completed it, and those who participated increased their daily step count by 750 steps/day and additionally reduced their sitting time by 32 minutes/day.
The village audit indicated that neighbourhood walkability varied across sites, and the program can work well in environments across different levels of walkability. However, access to a walkable environment, in particular a safe and walk-and-talk friendly environment, was shown to facilitate program implementation.
Findings also indicated that social support was critical for success. Participants differed in whether they preferred to walk as a group, with a partner, or alone. Those walking with others at least weekly achieved greater improvements in terms of physical activity levels, confidence, motivation, and functional health, compared to people mainly walking alone. Supportive peer interactions were perceived to be important for motivating older adults to take part in, and maintain, group-based walking activities.
The project and its evaluation were designed with input from key stakeholders including Amana Living and Council on the Ageing Western Australia (COTA WA). Both organisations were represented on the project steering committee.
The project was supported by the Western Australian Health Promotion Foundation (Healthway), and led by the Physical Activity and Well-Being Research Group at Curtin University (www.pawresearchgroup.com), including the following researchers: