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O. Akinrolie1, S.C. Webber2, N.M. Salbach3, R. Barclay2
1University of Manitoba, Applied Health Sciences, Winnipeg, Canada, 2University of Manitoba, Physical Therapy, Winnipeg, Canada, 3University of Toronto, Physical Therapy, Toronto, Canada
Background: Outdoor walking is important for older adults due to the physical and mental health benefits associated with walking in a natural environment. Several studies have evaluated outdoor walking by using either objective measures or a single item question. The Community Health Activities Model Program for Seniors (CHAMPS), a self-report measure of physical activities that are meaningful to older adults, is not specific to outdoor walking. However, some items may be assumed to occur outdoors. The availability of valid measures for assessing outdoor walking is essential for accurately estimating outdoor walking and evaluating the effectiveness of interventions that target improved outdoor walking. To the best of our knowledge, there are no validated self-reported measures for outdoor walking.
Purpose: To evaluate the construct and known-group validity of the total scores of five outdoor walking items adapted from CHAMPS (CHAMPS-OUTDOORS).
Methods: Data from the year one baseline assessment of the Getting Older Adult Outdoors (GO-OUT) trial were used (Trial no: NCT02339467). The GO-OUT study was designed to increase outdoor walking in older adults who reported having difficulty walking outdoors. We identified five items on the CHAMPS that we assumed occur largely outside and modified the items to include the word “outdoors”. The number of hours of outdoor walking from the five items were summed as CHAMPS-OUTDOORS. For construct validity, Spearman’s correlations were calculated to examine the association between CHAMPS-OUTDOORS, and objective measures of outdoor walking (accelerometry-GPS), ambulatory self-confidence questionnaire, RAND-36 (emotional well-being subscale), 6-minute walk test, 10-metre walk test and mini Balance Evaluation System Test (mini-BESTest). For known group validity, Mann-Whitney U test was used to compare the hours of outdoor walking per week on the CHAMPS-OUTDOORS for those who were able to achieve gait speeds necessary to safely cross a crosswalk (≥1.2m/s) with those with gait speeds <1.2m/s. A Bland-Altman plot was used to determine the agreement between the CHAMPS-OUTDOORS and accelerometer-GPS.
Results: A total number of 65 participants with the mean age of 76.54±7.76. The majority of participants were female (70.8%). The CHAMPS-OUTDOORS was moderately correlated with total outdoor walking time per week (r= 0.33, p= 0.01) and outdoor steps per week (r=0.33, p= 0.01) measured by accelerometer-GPS, and was weakly correlated with total balance score on the mini-BESTest (r= 0.27, p= 0.03). There was no significant difference in the number of hours of outdoor walking on CHAMPS-OUTDOORS based on gait speeds ≥ 1.2m/s versus < 1.2m/s. The Bland-Altman plot showed that CHAMPS-OUTDOORS is likely to overreport the number of hours of outdoor walking.
Conclusion(s): The CHAMPS-OUTDOORS demonstrated moderate correlations with total outdoor walking time per week and outdoor steps per week measured by accelerometry-GPS.
Implications: Researchers or clinicians may choose to use the CHAMPS-OUTDOORS to assess outdoor walking in the absence of accelerometer-GPS data.
Funding, acknowledgements: Canadian Institutes of Health Research- operating grant and the Heart & stroke Foundation
Keywords: psychometrics, community ambulation, older adults
Topic: Health promotion & wellbeing/healthy ageing/physical activity
Did this work require ethics approval? Yes
Institution: University of Manitoba
Committee: University Health Research Ethics Board
Ethics number: HS23419 (H2019:459)
All authors, affiliations and abstracts have been published as submitted.
