Mulligan H1, Wilkinson A1, Bowen L1, Littleton N1, McCormick J1, Tammgren J2, Thompson M1, Ward C2, Mulligan K3
1Otago University, Physiotherapy, Dunedin, New Zealand, 2Umea University, Community Medicine and Rehabilitation, Umea, Sweden, 3Ara Institute, Engineering and Architectural Studies, Christchurch, New Zealand
Background: Physical activity has positive effects on health and well-being, and a preventive effect on the development of secondary conditions, for people living with long-term conditions (LTCs). A combination of regular physical activity and social connection promotes people's health and well-being through better physical, mental, and emotional function. In general, walking is the most preferred and the most promoted way of being physically active. Therefore, it seems important for physiotherapists to take into account opportunities for social connections via walking when encouraging people with LTCs to be physically active.
Purpose: The aim of this study was to conceptualise ways to incorporate walking into daily life whilst fostering social connections within neighbourhoods for people with LTCs.
Methods: We recruited participants with LTCs resulting in breathing and/or mobility impairments through electronic and newsletter flyers, direct invitation to attendees at a coffee and exercise group, and via word of mouth. Participants gave written informed consent to participate in semi-structured individual interviews which asked them about getting out and about in their neighbourhood. We also measured their neighbourhood walkability by entering their home address into the online 'WalkScore' tool. The WalkScore is a public access walkability index developed to calculate 'neighbourhood walkability'. We transcribed interviews verbatim and analysed this data thematically. The study was approved by the New Zealand national Health and Disability Committee (17/NTB/2016).
Results: The seventeen participants (12 women; five men), with an age range of 50-79 years, lived with one to four LTCs. Analysis of interview data resulted in one overarching theme, 'A Major Point of Change' in people's lives, and three interconnected themes of 'Resignation', 'Resilience', and 'Resources'. All participants identified how a major change (e.g. diagnosis or death of a spouse) affected their daily life. Those participants who realized the benefits of being physically and socially active talked in a more positive way about life overall. In contrast, participants who reported a lack of positively experienced community engagement described feelings of disconnection and isolation. Access to resources such as finances, suitable transport, meaningful support from others, and the opportunity to give to others, appeared to enable participants to develop greater community engagement and connection. Neighbourhood walkability (WalkScore out of 100) ranged from 5 (very car-dependent) to 76 (very walkable). Eleven participants whose homes fell into the bottom two categories of the 'WalkScore' did not walk in their neighbourhoods. The remaining participants, despite living in a theoretically 'walkable' neighbourhood, still preferred driving over walking.
Conclusion(s): The ability to get around in one's neighbourhood allows people to develop and maintain connections. However, we know that people with LTCs walk much more slowly, and may not sustain walking for as long as the general population. This may explain why even those participants with theoretically good neighbourhood walkability preferred motorised transport.
Implications: Physiotherapists could consider combining use of the WalkScore with the 6MWT. This would inform what capacity patients have to walk to neighbourhood amenities, and could be used in partnership with the patient to identify and target achievable opportunities for walking and for social connection with others.
Keywords: Physical activity, social connection, long-term conditions
Funding acknowledgements: This research was supported (in part) by a contract from the Health Research Council of New Zealand
Purpose: The aim of this study was to conceptualise ways to incorporate walking into daily life whilst fostering social connections within neighbourhoods for people with LTCs.
Methods: We recruited participants with LTCs resulting in breathing and/or mobility impairments through electronic and newsletter flyers, direct invitation to attendees at a coffee and exercise group, and via word of mouth. Participants gave written informed consent to participate in semi-structured individual interviews which asked them about getting out and about in their neighbourhood. We also measured their neighbourhood walkability by entering their home address into the online 'WalkScore' tool. The WalkScore is a public access walkability index developed to calculate 'neighbourhood walkability'. We transcribed interviews verbatim and analysed this data thematically. The study was approved by the New Zealand national Health and Disability Committee (17/NTB/2016).
Results: The seventeen participants (12 women; five men), with an age range of 50-79 years, lived with one to four LTCs. Analysis of interview data resulted in one overarching theme, 'A Major Point of Change' in people's lives, and three interconnected themes of 'Resignation', 'Resilience', and 'Resources'. All participants identified how a major change (e.g. diagnosis or death of a spouse) affected their daily life. Those participants who realized the benefits of being physically and socially active talked in a more positive way about life overall. In contrast, participants who reported a lack of positively experienced community engagement described feelings of disconnection and isolation. Access to resources such as finances, suitable transport, meaningful support from others, and the opportunity to give to others, appeared to enable participants to develop greater community engagement and connection. Neighbourhood walkability (WalkScore out of 100) ranged from 5 (very car-dependent) to 76 (very walkable). Eleven participants whose homes fell into the bottom two categories of the 'WalkScore' did not walk in their neighbourhoods. The remaining participants, despite living in a theoretically 'walkable' neighbourhood, still preferred driving over walking.
Conclusion(s): The ability to get around in one's neighbourhood allows people to develop and maintain connections. However, we know that people with LTCs walk much more slowly, and may not sustain walking for as long as the general population. This may explain why even those participants with theoretically good neighbourhood walkability preferred motorised transport.
Implications: Physiotherapists could consider combining use of the WalkScore with the 6MWT. This would inform what capacity patients have to walk to neighbourhood amenities, and could be used in partnership with the patient to identify and target achievable opportunities for walking and for social connection with others.
Keywords: Physical activity, social connection, long-term conditions
Funding acknowledgements: This research was supported (in part) by a contract from the Health Research Council of New Zealand
Topic: Health promotion & wellbeing/healthy ageing; Non-communicable diseases (NCDs) & risk factors
Ethics approval required: Yes
Institution: New Zealand national Health and Disability Committee
Ethics committee: Northern B Ethics Committee
Ethics number: 17/NTB/2016
All authors, affiliations and abstracts have been published as submitted.
