Getting Older Adults OUTdoors (GO-OUT)

NCT03292510 | Completed DMC

• 1 other identifier: G-16-00013978
• Study Type: interventional
• Target: 190
• Locations: 1 country
• Sites: 1

Brief Summary

Community walking is an issue that older adults with chronic conditions have described as important to participation in the community. Walking outside the home is a universally accessible form of physical activity that has multiple health benefits. Walking for 150 minutes per week can help reduce the risk of cardiovascular disease, hypertension, stroke, diabetes, osteoporosis, and depression, as well as falls. Practice walking across roads, slopes and curbs, while talking, and dealing with crowds and traffic, is safe and feasible and can improve confidence, balance and walking ability. Being physically active outdoors in nature appears to improve mental health more than being active indoors. Despite these health benefits, the majority of older Canadians do not walk outside on a regular basis. Barriers to walking outside include fear, physical disability due to chronic disease, the appropriateness of footwear and walking aids, and the physical environment, such as uneven pavement, weather and temperature. To date, the best strategy for getting people to walk outdoors regularly is unknown. The investigators propose to evaluate the effectiveness of a dynamic 1-day workshop, at which older adults who infrequently walk outdoors learn strategies to facilitate outdoor walking, such as appropriate use of footwear, ambulatory aids and equipment, goal setting, and practice skills related to increasing outdoor walking. The workshop will be compared to the workshop plus involvement in a walking group for 3 months. Outcomes include outdoor walking activity, total physical activity, walking ability, participation, and health-related quality of life. Each participant will have four evaluations: baseline, 3, 5.5 and 12 months later. The investigators will interview select participants at 6 and 12 months to ask them about their opinions of what worked and didn't work. Increasing outdoor walking is expected to improve health and well-being, and help people live independently in the community for longer.

Conditions

Older Adults With Decreased Outdoor Walking Ability

Outcome Measures

Primary Outcomes (1)

• Change in average number of minutes per week spent walking outdoors

  The ActiGraph GT3X+ activity monitor (www.actigraphcorp.com/products/wgt3x-monitor/, ActiGraph, Pensacola, FL) and Qstarz BT-Q1000XT A-GPS Travel Recorder (http://www.qstarz.com/Products/GPS%20Products/BT-Q1000XT-F.htm) will be worn by each participant, clipped onto their waist band over the right hip during waking hours for 8 consecutive days at each evaluation timepoint (baseline, 3, 5.5, and 12 months).

  baseline, 3, 5.5, 12 months

Secondary Outcomes (14)

• Change in the mean time per week spent walking outdoors on the Community Health Activities Model Program for Seniors (CHAMPS) Questionnaire

  baseline, 3, 5.5, 12 months

• Change in the mean time per week spent in meaningful activity on the Community Health Activities Model Program for Seniors (CHAMPS) Questionnaire

  baseline, 3, 5.5, 12 months

• Change in the mean self-reported time per week spent in moderate- to vigorous-intensity physical activity on the Community Health Activities Model Program for Seniors (CHAMPS) Questionnaire

  baseline, 3, 5.5, 12 months

• Change in the mean time per week spent in moderate- to vigorous-intensity physical activity directly measured using ActiGraph and GPS devices

  baseline, 3, 5.5, 12 months

• Change in the mean score on the Life Space Assessment Questionnaire

  baseline, 3, 5.5, 12 months

Study Arms (2)

GO-OUT Group

EXPERIMENTAL

Participants attend 1-day walking workshop followed by a 3-month outdoor walking group intervention, twice weekly for 60-minutes. The same activities are completed during both sessions within the same week. Each session includes a 10-minute warm-up, a distance walk, practice of a specific outdoor walking skill, a distance walk, and a 10-minute cool down. The warm up and cool down include stretching, functional strengthening exercises and balance exercises taught during the workshop. The program incorporates the principles of task-specific training by emphasizing repetitive practice of progressively more difficult outdoor walking tasks. The outdoor walking program is conducted in one or more large park settings given the mental health benefits of exercising in a natural environment.

Other: GO-OUT Group

Workshop Group

ACTIVE COMPARATOR

The 1-day workshop will be 5 hours with breaks. Participants will complete a series of stations learning information, strategies and skills related to safely walking outdoors. Stations include: pedometer use; walking pole use; footwear; footcare; fall prevention; balance exercises; proper use of walking aids; correct posture; self-management of exercise intensity; goal setting; and walking safely outdoors. Participants will receive a workbook with Canadian Physical Activity Guidelines, benefits of outdoor walking, information for each workshop station and a pedometer. Participants will use the workbook as an information resource and to record their community ambulation goals, planning routes, and walking time. All participants will be encouraged to walk outside with a partner, for safety.

Other: Workshop Group

Interventions

GO-OUT Group OTHER

Following a baseline assessment, eligible participants will be stratified by site, and randomly assigned to receive the 1-day educational workshop and 3-month outdoor mobility program (GO-OUT intervention). Follow-up evaluations will occur at 3, 5.5 and 12 months from baseline.

GO-OUT Group

Workshop Group OTHER

the 1-day workshop plus reminders. Follow-up evaluations will occur at 3, 5.5 and 12 months from baseline

Workshop Group

Eligibility Criteria

• Age: 65 Years - 100 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

• older adults defined as age 65 years or older;
• living independently in the community;
• ambulatory defined as self-reported ability to walk at least one block (\~50 m) continuously on a flat surface with or without a walking aid and without supervision;
• self-reported difficulty walking in the outdoor community environment (this could include physical impairments or decreased confidence);
• willingness to sign a liability waiver (required at three sites) or send a letter to their physician (required at one site) regarding clearance to exercise;
• mental competency defined by a score of at least 18 out of 22 on the Mini-Mental State Exam telephone version;
• available for a scheduled workshop and at least 5 of 10 weeks of the outdoor walking program; and
• ability to speak and understand English

You may not qualify if:

• physically active defined as self-reported participation in physical activities, such as walking and playing golf, 150 min per week;
• currently receiving rehabilitation treatment, such as physical or occupational therapy, for goals related to walking (self-report);
• at high falls risk defined by meeting one or more of the following American Geriatric Society criteria: (A) ≥2 falls in the last 12 months or presents with an acute fall; (B) cardiac, respiratory, peripheral vascular or other health conditions that would prevent safe and full participation in the interventions (self-report); (C) postural hypotension defined as a drop in systolic BP of \>20 mm Hg or a drop in diastolic BP of \>10 mm Hg taken after lying supine for 5 min and after standing for 2 min; (D) resting HR \<45 or \>100 beats per minute; and (E) severe limitation in visual acuity defined as self-reported difficulty reading the newspaper while wearing regular reading glasses or bifocals, or self-reported inability to distinguish a person's facial features from across a room while wearing glasses.

Sponsors & Collaborators

• University of Toronto: lead
• University of Manitoba: collaborator
• University of Alberta: collaborator
• McGill University: collaborator

Study Sites (1)

Knowledge to Action Lab, Department of Physical Therapy, University of Toronto

Toronto, Ontario, M5G 1V7, Canada

Location

Related Publications (4)

• Kokorelias KM, Ripat J, Barclay R, Jones CA, Mayo NE, Grant T, Scodras S, Alsbury-Nealy K, Ryder-Burbidge C, Salbach NM. A park-based group mobility program for older adults with difficulty walking outdoors: a qualitative process evaluation of the Getting Older Adults Outdoors (GO-OUT) randomized controlled trial. BMC Geriatr. 2025 Jan 8;25(1):16. doi: 10.1186/s12877-024-05611-z.

  PMID: 39780066 DERIVED

• Salbach NM, Mayo NE, Webber SC, Jones CA, Lix LM, Ripat J, Grant T, van Ineveld C, Chilibeck PD, Romanescu RG, Scott S, Barclay R. Short-term effects of a park-based group mobility program on increasing outdoor walking in older adults with difficulty walking outdoors: the Getting Older Adults Outdoors (GO-OUT) randomized controlled trial. BMC Geriatr. 2024 Sep 6;24(1):740. doi: 10.1186/s12877-024-05331-4.

  PMID: 39243012 DERIVED

• Barclay R, Webber SC, Hahn F, Jones CA, Mayo NE, Sivakumaran S, Liu Y, Chilibeck PD, Salbach NM. A park-based group mobility program for older adults with difficulty walking outdoors: a quantitative process evaluation of the Getting Older Adults Outdoors (GO-OUT) randomized controlled trial. BMC Geriatr. 2023 Dec 11;23(1):833. doi: 10.1186/s12877-023-04524-7.

  PMID: 38082248 DERIVED

• Salbach NM, Barclay R, Webber SC, Jones CA, Mayo NE, Lix LM, Ripat J, Grant T, van Ineveld C, Chilibeck PD. A theory-based, task-oriented, outdoor walking programme for older adults with difficulty walking outdoors: protocol for the Getting Older Adults Outdoors (GO-OUT) randomised controlled trial. BMJ Open. 2019 Apr 20;9(4):e029393. doi: 10.1136/bmjopen-2019-029393.

  PMID: 31005945 DERIVED

Study Officials

• Nancy Salbach, PhD

  Associate Professor

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: A 2-group mixed methods stratified randomized controlled trial following CONSORT criteria is proposed. Group allocation will be concealed and outcome evaluation blinded
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Model Details: Experimental: GO-OUT program An outdoor walking workshop with stations to learn various outdoor walking skills and information, followed by a supervised, group based outdoor walking program, twice a week for 60 minutes, for 10 weeks. Intervention: Other: GO-OUT program Active Comparator: Task-oriented outdoor walking workshop An outdoor walking workshop with stations to learn various outdoor walking skills and information. Intervention: Other: Task-oriented outdoor walking workshop

Study Record Dates

• First Submitted: September 20, 2017
• First Posted: September 25, 2017
• Study Start: February 26, 2018
• Primary Completion: August 31, 2020
• Study Completion: August 31, 2020
• Last Updated: October 4, 2023

Record last verified: 2023-10

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)