A Grounded Theory of Walking for Health Promotion in Older Urban Adults.

Abstract

Background and objectives: Walking enhances the health, quality of life, and independence of older adults. However, a global decline in urban walking necessitates a reevaluation of segmented, quantitative approaches to policies and theoretical frameworks in geriatric medicine for promoting walking among older adults. This study conceptualized the perceptions, experiences, and behaviors regarding walking, from a health promotion perspective, among older urban adults.

Research design and methods: Pedestrian-friendly communities were explored for older adults in Seoul, South Korea, using a grounded theory. Thirty-eight older adults actively engaged in walking were recruited between July and December 2020. A qualitative multi-method approach was used, and the collected data were analyzed using open, axial, and selective coding, with axial coding integrating textual and spatiobehavioral information.

Results: The open-coding process yielded 92 concepts, 47 subcategories, and 19 categories. Using axial and selective coding principles, a conceptual framework was developed to explain how walking shaped the daily lives of older urban adults and provided multidimensional health benefits. Walking perception attributes were characterized by "embodied subjectivity as a healthy older adult," "autonomy of movement," and "walking as a way to enrich or sustain life." Active walking facilitated interactions between older adults and their neighborhood environment within the context of compact and accessible urban living.

Discussion and implications: A healthy and age-friendly community encourages interactions between older adults and their neighborhood environment by providing opportunities for daily walking for several purposes, such as providing a sense of autonomy, increasing health-promoting behaviors, and creating a sense of community.