Designing Communities to Support Healthy Living in Aging Residents

The Housing for Health team is making evidence-based recommendations to the developer and design team of an upcoming congregate-living development to support the healthy living of older adults who will be moving into the new building. There may also be opportunities to improve the surrounding neighbourhood by collaborating with the municipality where the development is located. We will evaluate whether the intervention leads to changes in the perceived, micro-scale, and macro-scale physical built environment (BE), and whether there are impacts on the physical activity (PA), healthy eating, and social connections of residents. In parallel, we will gather qualitative data to provide a more in-depth understanding of how the BE may facilitate or hinder resident's healthy living behaviours.

Study Overview

• Status: Completed
• Conditions: Healthy Aging
• Intervention / Treatment: Behavioral: Residents moving into a congregate-living development with more features that support healthy living

Detailed Description

Background: The Housing for Health team is making evidence-based recommendations to the developer and design team of an upcoming congregate-living development to support the healthy living of older adults who will be moving into the new building. There may also be opportunities to improve the surrounding neighbourhood by collaborating with the municipality where the development is located. We will evaluate whether the intervention leads to changes in the perceived, micro-scale, and macro-scale physical built environment (BE), and whether there are impacts on the physical activity (PA), healthy eating, and social connections of residents. In parallel, we will gather qualitative data to provide a more in-depth understanding of how the BE may facilitate or hinder resident's healthy living behaviours.

Methods: This project employs a quasi-experimental pre-post design. The quantitative built environment (BE) evaluation includes assessments of macroscale (e.g., layout of communities) and microscale (e.g., street details and characteristics) changes as measured using Geographical Information Systems (GIS) and Microscale Audit Pedestrian Streetscapes (MAPS) audits, respectively. For the quantitative resident evaluation, residents moving into the intervention site or who currently live at a control site will be invited to participate. Study outcomes will be measured using self-report (i.e., surveys) and objective tools (i.e., accelerometers, Global Positioning System). The qualitative resident-environment component will be conducted using in-depth semi-structured interviews with building residents, family members, and stakeholders involved in the design/development and/or operation of the intervention site and others living in the developments' neighbourhoods. Participant observations will be completed in the building and neighbourhood environments of the intervention site.

Discussion: Findings will provide evidence on whether and how comprehensive changes to the BE of a building, site, and/or neighbourhood of a congregate living facility can impact PA, healthy eating, and social connections of older adults. Successful aspects of interventions will be scaled up in future work. We will disseminate findings to a broad audience including the scientific community via peer-reviewed publications, conference presentations, and discussion panels; and private, public, and non-profit sectors via reports, public presentations and/or communications via our partners and their networks.

• Study Type: Interventional
• Enrollment (Actual): 155
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Alberta
    • Edmonton, Alberta, Canada, T6G 2C8
      • University of Alberta

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 110 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Men or women aged 18 years or older that are either moving into the intervention site(s), or living in a control site.

Exclusion Criteria:

• Residents who have been told by a health care provider that they have Alzheimer's or dementia.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Non-Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Residents moving into a congregate-living development with more features that support healthy living; Residents moving into a congregate-living development designed for older adults with more design and amenities features in the building, site, and/or neighbourhood that support physical activity, healthy eating, and social connections.	Behavioral: Residents moving into a congregate-living development with more features that support healthy living; Our team is making evidence-based recommendations to the developer and design team of an upcoming congregate-living development to support the physical activity, healthy eating, and social connections of residents moving into the new building(s). We hope for the developer to integrate into the new building(s) as many as possible of our team's built environment design and amenity recommendations into their site and/or building plans. Additionally, discussions with the municipality are also occuring on built environment design and amenity recommendations to improve the neighbourhood surrounding the site. Although our team has provided these recommendations, it is ulimatily up to the discretion of the developer and the municipality as to whether and what design and amenity changes are made.
No Intervention: Residents living in a standard congregate-living development; Residents living in a standard community-based congregate-living development designed for older adults.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in self-reported physical activity from baseline to 3-6-months post-move-in	Self-reported physical activity will be adapted from the Neighborhood - International Physical Activity Questionnaire (N-IPAQ)	baseline and 3-6-months post-move-in
Change in self-reported physical activity from baseline to 9-12-months post-move-in	Self-reported physical activity will be adapted from the Neighborhood - International Physical Activity Questionnaire (N-IPAQ)	baseline and 9-12-months post-move-in
Change in accelerometer-measured physical activity from baseline to 9-12-months post-move-in	Accelerometer-measured physical activity will be measured using Actigraph accelerometers.	baseline and 9-12-months post-move-in
Change in accelerometer-measured physical activity from baseline to 3-6-months post-move-in	Accelerometer-measured physical activity will be measured using Actigraph accelerometers.	baseline and 3-6-months post-move-in
Change in location-measured physical activity from baseline to 3-6-months post-move-in	Location-measured physical activity will be measured using Qstarz Travel Recorder Geographical Positioning System (GPS) devices.	baseline and 3-6-months post-move-in
Change in location-measured physical activity from baseline to 9-12-months post-move-in	Location-measured physical activity will be measured using Qstarz Travel Recorder Geographical Positioning System (GPS) devices.	baseline and 9-12-months post-move-in
Change in healthy eating from baseline to 3-6-months post-move-in	Healthy eating will be adapted from the Nutritional Environment Measures Survey - Perceived Nutrition Environment (NEMS-P)	baseline and 3-6-months post-move-in
Change in healthy eating from baseline to 9-12-months post-move-in	Healthy eating will be adapted from the Nutritional Environment Measures Survey - Perceived Nutrition Environment (NEMS-P)	baseline and 9-12-months post-move-in
Change in unhealthy eating from baseline to 3-6-months post-move-in	Unhealthy eating will be adapted from the Nutritional Environment Measures Survey - Perceived Nutrition Environment (NEMS-P)	baseline and 3-6-months post-move-in
Change in unhealthy eating from baseline to 9-12-months post-move-in	Unhealthy eating will be adapted from the Nutritional Environment Measures Survey - Perceived Nutrition Environment (NEMS-P)	baseline and 9-12-months post-move-in
Change in social connections from baseline to 3-6-months post-move-in	Social connections will be derived from several self-report items.	baseline and 3-6-months post-move-in
Change in social connections from baseline to 9-12-months post-move-in	Social connections will be derived from several self-report items.	baseline and 9-12-months post-move-in
Change in the micro-scale built environment from baseline to 3-6-months post-move-in	The actual micro-scale built environment is measured using the Microscale Audit of Pedestrian Streetscapes (MAPS) audit tool	baseline and 3-6-months post-move-in
Change in the micro-scale built environment from baseline to 9-12-months post-move-in	The actual micro-scale built environment is measured using the Microscale Audit of Pedestrian Streetscapes (MAPS) audit tool	baseline and 9-12-months post-move-in
Change in the macro-scale built environment from baseline to 3-6-months post-move-in	The actual macro-scale built environment is measured using Geographical Information Systems (GIS)	baseline and 3-6-months post-move-in
Change in the macro-scale built environment from baseline to 9-12-months post-move-in	The actual macro-scale built environment will be measured using Geographical Information Systems (GIS)	baseline and 9-12-months post-move-in
Change in the perceived neighbourhood built environment from baseline to 3-6-months post-move-in	The perceived neighbourhood built environment will be measured using the Physical Activity Neighborhood Environment Scale (PANES)	baseline and 3-6-months post-move-in
Change in the perceived neighbourhood built environment from baseline to 9-12-months	The perceived neighbourhood built environment will be measured using the Physical Activity Neighborhood Environment Scale (PANES)	baseline and 9-12-months post-move-in
Change in the perceived neighbourhood food environment from baseline to 3-6-months	The perceived neighbourhood food environment will be measured using the Nutritional Environment Measures Survey - Perceived Nutrition Environment (NEMS-P)	baseline and 3-6-months post-move-in
Change in the perceived neighbourhood food environment from baseline to 9-12-months	The perceived neighbourhood food environment will be measured using the Nutritional Environment Measures Survey - Perceived Nutrition Environment (NEMS-P)	baseline and 9-12-months post-move-in

Collaborators and Investigators

• Sponsor: University of Alberta
• Collaborators: University of Alberta, Physical Education

Publications and helpful links

General Publications

• Stearns JA, Ren H, Spence JC, Avedzi H, Lee KK. Protocol for an evaluation of the Designing Communities to Support Healthy Living in Aging Residents Study. Arch Public Health. 2021 Oct 7;79(1):172. doi: 10.1186/s13690-021-00691-4.

Helpful Links

• Housing for Health website

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2021
• Primary Completion (Actual): September 26, 2023
• Study Completion (Actual): September 26, 2023

Study Registration Dates

• First Submitted: June 29, 2021
• First Submitted That Met QC Criteria: August 26, 2021
• First Posted (Actual): September 1, 2021

Study Record Updates

• Last Update Posted (Actual): November 29, 2023
• Last Update Submitted That Met QC Criteria: November 28, 2023
• Last Verified: November 1, 2023

More Information

Terms related to this study

• Keywords: Physical activity; Older adults; Healthy eating; Social connections; Built environment
• Other Study ID Numbers: 1819-HQ-000051

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No