Evidence and Practice of Mall Walking Programs for Midlife and Older Adults
Background: Older adults are the fastest growing and most physically inactive demographic. Walking is a preferred activity for older adults, however providing safe places to walk is often a challenge. Mall walking programs (MWP) can address that gap, although the elements for maximizing reach, effectiveness, adoption and sustainability of MWPs are less known. Given the abundance of malls, the potential for promoting more walking is immense. Because mall environments are variable, it is necessary to understand the environment and program characteristics that will draw more adults to shopping malls for walking and develop resources to maximize their use for walking as well as potentially spread the mall walking concept to other public venues.
Methods: We applied the RE-AIM framework and the socio-ecological model and conducted: 1) a systematic review of the MWP literature; 2) walking audits in 10 shopping malls and 6 public venues and systematic observations of 530 walkers; and 3) interviews of 50 walkers and managers in malls and public venues in 5 states.
Results: Thirty-seven articles were reviewed and abstracted. Programmatic features of MWPs included mileage logs, warm-up exercises, walking route maps, and blood pressure checks. Appealing MWP environments were described as safe, accessible to the local community, and well-lit. Partnerships were noted with hospitals, city governments, non-profits, and senior housing. MWPs were perceived as a benefit for both mall businesses and walkers by promoting the central role malls have in improving the health of local residents. Our systematic observations revealed that all 16 venues had public transit and accessible parking. Most had wayfinding aids, walking routes, even floor surfaces, and benches. Venues varied in hours of access, programming, tripping hazards, traffic control near entrances, and lighting adequacy. Despite diversity in location, size, and purpose, venues were consistent with regard to environmental features conducive to mid-life and older adult walking. Walkers reported health and social benefits from participating in MWP; liked being able to set their own time, distance and pace; and expressed feeling a strong sense of community with other walkers. Program providers reported walkers bring sales to the malls and provide “extra eyes” as security measures. All informants indicated satisfaction with their program and environmental features.
Implications: These findings have informed our Evidence-informed MWP Resource Guide which has the potential to inform policy makers, planners, mall/building managers, community coalitions, aging service providers, and public health professionals in the development and enhanced utilization of mall walking programs. MWPs have the potential to achieve the Healthy People 2020 objective to “reduce the proportion of adults who engage in no leisure-time physical activity” and to simultaneously increase the number of people who meet the Physical Activity Guidelines for Americans.