Case Studies

RiAT

Design Feature

Type of project
Masterplan
State
Western Australia
Location
Urban, Regional
Physical activity can help older adults maintain physical health, independence, psychological wellbeing, and cognitive function. However, the majority of older adults do not engage in enough physical activity to attain these health benefits. Retirement villages provide an ideal setting to promote group-based physical activity.
Motivating active lifestyles
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.


Project team

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:

  • Professor Cecilie Thøgersen-Ntoumani (Curtin University)
  • Professor Nikos Ntoumanis (Curtin University)
  • Dr Eleanor Quested (Curtin University)
  • Dr Elissa Burton (Curtin University)
  • Professor Keith Hill (Monash University)
  • Professor Stuart Biddle (University of Southern Queensland)
  • Professor Ester Cerin (Australian Catholic University)
  • Associate Professor Joanne McVeigh (Curtin University)
  • Dr Jenny Olson (Curtin University)
  • Ms. Marlene Kritz (Curtin University)

Project cost
  • $141 per participant (including pedometers, walk maps, printing of resources, workshop catering).

Health value

Older adults who regularly walk with others in their neighbourhood environment can improve social functioning, psychological well-being, confidence, motivation, and physical functioning.


Economic value
  • The program was designed to be delivered by volunteers recruited from the retirement village community and is therefore low-cost and self-sustainable.
  • By promoting the health and maintaining the independence of retirement village residents, the program may lead to health care cost savings through lower rates of hospital admissions, GP visits, etc.

Environmental value

The program seeks to make better use of opportunities in the local neighbourhood environment to promote physical activity among older adults. Such programs could benefit the environment, via, for example, reduced reliance on cars for short journeys. Increased walking in neighborhoods can support efforts to maintain and increase walkable environments.


Social value
  • The program can serve to improve social connectedness among its residents by facilitating meaningful social interactions through peer-support. It can also help residents feel safe to walk in their local environments.
  • The recruitment of volunteer PWLs helped to develop social capital, and the resulting wellbeing and health benefits contribute to improved individual and community resilience.

Use value
  • Program resources can be used to promote physical activity and social connection in physically inactive older adults, who are at an increased risk of experiencing age-related physical and mental decline, and social isolation.
  • The results can inform the design of more appropriate physical environments around retirement villages in the context of safe and accessible walking paths (in particular access to places where older adults can walk side by side, as they engage in conversation on walks).
  • The resources developed in this project may add value to existing community physical activity programs and can contribute to the development of new programs.

References

Cunningham, C., O’ Sullivan, R., Caserotti, P., & Tully, M. A. (2020). Consequences of physical inactivity in older adults: A systematic review of reviews and meta-analyses. Scandinavian Journal of Medicine & Science in Sports, 30(5), 816-827. https://doi.org/10.1111/sms.13616

Thøgersen-Ntoumani, C., Ntoumanis, N., Uren, H., Stathi, A., Wold, C., & Hill, K. D. (2017). Perceptions of group-based walks and strategies to inform the development of an intervention in retirement villages: Perspectives of residents and village managers. Journal of Ageing Physical Activity, 25(2), 261-268. https://doi.org/10.1123/japa.2015-0138

Thøgersen-Ntoumani, C., Quested, E., Biddle, S. J. H., Kritz, M., Olson, J., Burton, E., Cerin, E., Hill, K. D., McVeigh, J., & Ntoumanis, N. (2019, Jun 17). Trial feasibility and process evaluation of a motivationally-embellished group peer led walking intervention in retirement villages using the RE-AIM framework: The residents in action trial (RiAT). Health Psychology and Behavioral Medicine, 7(1), 202-233. https://doi.org/10.1080/21642850.2019.1629934

Thøgersen-Ntoumani, C., Wright, A., Quested, E., Burton, E., Hill, K. D., Cerin, E., Biddle, S. J. H., & Ntoumanis, N. (2017). Protocol for the residents in action pilot cluster randomised controlled trial (RiAT): Evaluating a behaviour change intervention to promote walking, reduce sitting and improve mental health in physically inactive older adults in retirement villages. BMJ Open, 7(6), e015543. https://doi.org/10.1136/bmjopen-2016-015543

United Nations. (2019). 2019 Revision of World Population Prospects. Retrieved from: https://www.population.un.org/wpp/Download/Standard/Population


Stay informed. Sign up to our newsletter.

I agree that I have read and I accept the Heart Foundation's Privacy Statement.



Share by: