Examining the impact of outdoor walk group attendance on health among older adults with mobility limitations in the Getting Older Adults Outdoors (GO-OUT) randomized trial

Abstract

Objective The Getting Older Adults Outdoors randomized trial showed a 10-week outdoor walk group (OWG) program was not superior to 10 weekly phone reminders on increasing physical and mental health; however, OWG attendance varied. This study examined whether a dose-response relationship existed between OWG attendance and improvement in physical and mental health among older adults with mobility limitations. Methods We analyzed data from 98 older adults randomized to a 10-week park-based OWG program. Participants were classified as attending 0–9, 10–15, and 16–20 OWG sessions based on attendance tertiles. Outcomes included change in scores on measures of walking endurance, comfortable and fast walking speed, balance, lower extremity strength, walking self-efficacy, and emotional well-being pre- to post-intervention. Results Seventy-nine older adults with complete information on the seven health outcomes were included (age=74.7±6.6 years, 72% female). Compared to those who attended 0–9 OWG sessions, participants attending 16–20 sessions exhibited a 52.7-meter greater improvement in walking endurance (95% CI:12.3, 93.1); 0.15-meter/second greater improvement in comfortable walking speed (95% CI:0.00, 0.29); and 0.17-meter/second greater improvement in fast walking speed (95% CI:0.02, 0.33). Higher attendance was also associated with higher odds of experiencing an improvement in walking self-efficacy (OR=4.03; 95% CI:1.05, 16.85) and fast walking speed (OR=9.00, 95% CI:1.59, 61.73). No significant dose-response relationships for balance, lower extremity strength, and emotional well-being were observed. Conclusions Higher attendance in outdoor walking interventions is associated with greater improvements in walking endurance, walking speed, and walking self-efficacy among older adults with mobility limitations.