Physical Activity of Older Women Living in Retirement Communities: Capturing the Whole Picture through an Ecological Approach

Background and Purpose: Interventions to increase physical activity among older populations may prevent or delay disability in activities of daily living and premature death. In our research, we focused on older women living independently in retirement communities, who commonly experience declining health. The purpose was to identify factors influencing physical activity in older women and to create a practical checklist to guide physical therapists in physical activity interventions within retirement communities. Methods: The study was qualitative and guided by the Vancouver School of Doing Phenomenology. The data set comprised 12 in-depth interviews with 10 women, as 2 of the women were interviewed twice to deepen the understanding of their experience. They were aged 72 to 97 years (median = 84 years, interquartile range = 11 years) and lived in 7 different apartment buildings in the same urban area. The interviews were recorded, transcribed, and analyzed to identify factors influencing the physical activity behavior of the women. We then linked these factors to the Bronfenbrenner's ecological model and finally constructed a checklist for mapping the influencing factors. Results: The physical activity experience of the older women reflected both facilitating and hindering factors from all layers of the ecological model. The largest part of the women's description was constructed around personal factors and the immediate physical and social environment. Yet, important influencing factors were expressed reflecting community, society, and the lifespan. Finally, the practical checklist created to guide physical activity interventions included 40 questions reflecting 24 influencing factors covering important layers of the ecological model. Conclusion: To deal with the epidemic of a sedentary lifestyle in older populations, physical therapists must join forces with health authorities and work with the complexities of physical activity promotion at appropriate levels. Our results and the checklist are a potential resource to aid in identifying physical activity influencing factors that are appropriate for physical therapy intervention, within retirement communities. Moreover, this checklist may be used to recognize factors that are more suitable for public health interventions at the community or national levels.