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

ObjectiveThe 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. MethodsWe 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. ResultsSeventy-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. ConclusionsHigher 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.