Engaging older adults as advocates for age-friendly, walkable communities: The Senior Change Makers Pilot Study

Abstract

As the U.S. population ages, communities must adapt to help older adults thrive. Built environment features, like safe sidewalks and crosswalks, provide the foundation for age- and physical activity-friendly communities. Controlled studies are needed to evaluate advocacy training programs that instruct and support seniors to advocate for more walkable neighborhoods. The Senior Change Makers Pilot Study evaluated an advocacy program that taught seniors to evaluate pedestrian environments using the validated MAPS-Mini audit tool, identify barriers, and advocate for improvements. Participants (n = 50) were recruited from four low-income senior housing sites in San Diego, CA, which were randomly assigned to an 8-week advocacy program or physical activity (PA) comparison intervention. Evaluation included surveys, accelerometers to assess PA, and direct observation. Primary outcomes were seniors' advocacy confidence and skills. Main analyses used repeated measures ANOVAs. Seniors in the advocacy condition (n = 17) increased their advocacy outcome efficacy (p = .03) and knowledge of resources (p = .04) more than seniors in the PA condition (n = 33). Most seniors in the advocacy condition completed a street audit (84%), submitted an advocacy request (79%), or made an advocacy presentation to city staff (58%). Environmental changes included repairs to sidewalks and crosswalks. City staff approved requests for lighting, curb cuts, and crosswalk markings. Seniors' accelerometer-measured PA did not significantly increase, but self-reported transportation activity increased in the PA condition (p = .04). This study showed the potential of advocacy training to empower seniors to make communities more age- and activity-friendly.

Trial registration: ClinicalTrials.gov NCT02944838.

Keywords: Age-friendly; Built environment; Exercise; Older adult; Policy; Walkability; Walking.