Taking sound steps: a community partners to promote walking among older adults.

Physical activity provides significant health benefits to older adults, and walking is by far the most accessible and popular form of activity. Promoting walking can be a challenge, however, and effective programs can require the collaboration of multiple, diverse partners. Sound Steps, a walking program for more than 500 older adults implemented in the summer of 2003 through Seattle Parks and Recreation, Wash., illustrates the benefits of park and recreation departments working in collaboration with community partners.

The Healthy Aging Partnership (HAP), a well-established coalition of 35 Seattle area not-for-profit and public organizations dedicated to the health and well-being of older adults, had long targeted promotion of physical activity as a goal. However, its efforts had primarily focused on encouraging such activity through social marketing and seminars for senior-care professionals, rather than implementing actual programs. Spurred by interest from AARP, one of HAP's member organizations, the partnership decided to make Sound Steps its first venture into developing and implementing a community-based program for older adults.

Engaging Seattle Parks and Recreation as a key partner in implementing Sound Steps was a natural given its mission and structure. The Senior Adult Program of Seattle Parks and Recreation is dedicated to providing a wide range of activities for Seattle's older residents. HAP launched Sound Steps through the Senior Adult Program, working with staff at six geographically diverse community centers throughout the city. The joint effort boosted physical activity among older adults, as well as generating more awareness of other Seattle Parks and Recreation programs among the 50-plus population.

Sound Steps provided options for the walkers. Participants could walk on their own, walk with organized groups from the local community center, and/or walk with friends, neighbors or other Sound Steppers outside of the organized walks. Weekly walks were arranged at each of the sites, led either by a volunteer or by the Seattle Parks and Recreation Senior Adult Program staff. At registration, participants were supplied with monthly walking logs to track how long they walked each day.

Incentives were given to walkers, such as a pedometer, a neck wallet with a name tag, a brochure about the benefits of walking and a variety of other items. Each month, participants were given an additional gift, such as a hand exerciser or first aid kit, when they turned in their completed monthly walking logs.

Benefits from Sound Steps

What was the impact of Sound Steps? Another HAP partner, University of Washington Health Promotion Research Center (UW-HPRC), evaluated the effectiveness of Sound Steps by collecting both quantitative and qualitative information from participants, volunteers and Seattle Parks and Recreation staff. UW-HPRC worked with an evaluation team comprised of representatives from several of the partnering organizations to develop a questionnaire used at registration to collect baseline information and monthly walking logs to assess change in the level of walking over the summer. UWHPRC also conducted six focus groups of walkers from each of the community centers and interviewed 53 people including parks and recreation staff, volunteers, walkers who did not participate in the organized walks and people who had left Sound Steps. Both qualitative and quantitative data were collected for the program evaluation point of increased walking, which was the primary goal of the program. Below are other ways that Sound Steps made a difference in participants' lives.

* Increased physical activity. A significant number of people joined Sound Steps because they needed a jump start to return to a routine of walking and being physically active after having been inactive for a number of years. "I just knew I would need to have some motivation to start walking again, because I knew I wasn't going to do it on my own," says a participant. Many people mentioned that the scheduled walking routine motivated them to be active. One man said, "I've been trying to entice my wife to walk with me, but 15 years ago, she wouldn't walk. Since we came down here, joined this group, she started walking. Now she gets me out. Now she enjoys it."

Walkers were also motivated by filling out their walking logs. Simply having the visual reminder of how much they had walked helped to increase their activity level. "They (walking logs) made you get out and walk, especially on the days when there was nothing recorded. I would make sure I went out to the store or something."

The monthly walking logs did not accurately show how much participants truly walked over the summer, since many regular walkers reported that they did not turn them in or fill them out completely. However, the results of the logs that were received did show an increase in activity as compared to what participants reported at registration. Of those who indicated at registration that they had not walked at all, 41 percent turned in at least one or more walking logs indicating that they had become active walkers. It is very likely that this percentage is higher given that many people reported that they didn't turn in logs. Previous walkers showed a modest increase both in the amount they walked each day and in the number of times walked per week. The average minutes these participants walked per day increased from 30 to 39 minutes, and the average number of times they walked per week went from 3.75 to 4.19.

* Socialization and safety. Walkers frequently spoke of how much easier it was to walk with other people than to walk by themselves--they were more likely to walk farther and longer if they had a companion. The commitment to others in the group helped keep walkers motivated to return each week. One walker commented, "What does it is the social aspect, and being committed to a schedule where others expect to see you."

They looked out for one another and noticed when someone was missing. They spoke of the camaraderie that developed over the summer and how they looked forward to the weekly walk. Many people also felt safer walking with others. Older adults often feel isolated due to safety concerns, and being a visible presence on the street with other older adults was very empowering.

* Health improvements. A number of walkers reported noticeable improvement in their health and stamina over the course of the summer. People found it much easier to walk a longer distance. One woman who had felt pain when walking up a slight hill early in the summer remarked, "There's been a big improvement in breathing since walking this summer. I'm an ex-smoker--no more chest pains on inclines." Another commented on her ability to sleep, "I normally have a lot of trouble sleeping, but days I walk a lot, I sleep. It really makes a difference. Exercise itself doesn't seem to do it. The long walking does--you'll sleep better." Other walkers experienced decreased back pain, more energy and boosted spirits.

* Community Building. People were very enthusiastic about having the program in their neighborhood. They did not want to drive, or drive far, for a walking program. In addition to the organized group walks, people made connections with each other and walked together other times during the week. As one walker described, "I liked it because you met more people in your neighborhood and you could get together with them and walk at other times. I've been in groups where you meet in different parts of town and you get together and meet, but then they are in their direction and I'm in mine. This is a lot easier to get together with other people."

They were excited about getting to know their neighborhoods better as exemplified by the following comment: "I've lived here for 50 years and just discovered the park in the neighborhood. And you go down that path and you see nature at its best." They also expressed a great deal of pride in their own neighborhood. A walker from a center that had an undeveloped senior program remarked, "We were excited when we got the flier ... that something was happening in our own community. It's just a pleasure meeting all the people, we just have a lot of fun out there on the street. Plus you get a good workout, you get the exercise. I hope that the program continues."

* Increased Program Exposure. Seattle Parks and Recreation offers many programs specifically designed for older adults. A theme heard from staff, organized walkers, and people who walked on their own, was one of learning about existing programs and seeing new faces at the community centers. At four out of the seven community centers, a vast majority of the walkers had never participated in any parks and recreation programs. One Senior Adult Program staff member reported that Sound Steps built a senior program at a community center that previously had very little participation. Many older adults were very excited to learn about other programs offered, particularly exercise classes, line dancing and other organized walking programs. Exposure to community programs not only enhances the likelihood that these older adults will be more physically active; it also addresses the increased need in older age to avoid social isolation.

Building Capacity

The original vision of Sound Steps was to be primarily led by volunteers, with minimal involvement by the parks and recreation staff. Developing a strong volunteer base for a walking program would build capacity in Parks and Recreation programming, as well as provide a means for older adults to feel useful and engaged.

One staff person spoke of the positive experience of the Sound Steps older adult volunteers and the benefits of the connections they made: One of my volunteers, a former nurse, helped register two women who had just lost their husbands. She kept in touch with them to make sure they were OK. When the volunteers registered the people, they got the human stories. The people who came to walk, they had a story to tell. They felt more rapport with a senior who has gone through this already.

For adults over 65, volunteering has been shown to lower depression levels because of increased social contact, and is also a positive response to the frequently diminished roles of older adults. Empowering the older adults as volunteers was an important secondary benefit to Sound Steps.

Recruitment for this pilot was a success, with close to 500 participants signing up during the one-week registration period in May. Walkers discussed ways in which they, as current Sound Steppers, could act as ambassadors for the program. Simply being a visible presence in the neighborhood helps to plant the seed for others to join. They spoke of inviting their neighbors and talking about the program at neighborhood council meetings or in their faith communities.

HAP partner organization AARP contributed to recruitment efforts by sending 5,000 postcards to their members in the zip codes immediately surrounding the community center hosts of Sound Steps. This mailing, along with other publicity campaigns, reached people not previously involved in park and recreation programs.

Ultimately, professionals from pubic health organizations, senior service, and park and recreation departments have similar goals regarding the health of their communities; therefore, blending their unique areas of expertise is a good recipe for a successful health-promoting program, such as Sound Steps. Sound Steps was strengthened by drawing on the technical, financial and in-kind support of the member organizations, as well as accessing a broad audience through the membership of partnering agencies. Coalitions that focus on aging services exist in many areas, and departments of parks and recreation programs could tap these partnerships by contacting their local Area Agency on Aging.

Lessons Learned

Based on the Sound Steps experience, here are suggestions for others attempting to build a volunteer-driven walking program for seniors:

* Partner with other service providers that work with older adults as a potential source of volunteers. This collaboration is one way to increase capacity for both organizations. Senior centers are a gathering spot for many older adults. Park and recreation programs could augment the programs offered by senior centers while benefiting from the increased exposure and building a volunteer base for walking programs.

* A Start recruiting early from existing park and recreation programs. Let people know their help is needed. Demonstrating to older adults that they have the skills and ability to take on the task gives them the message that you have confidence in them. Volunteers come from building relationships over time.

* Have a variety of concrete tasks for volunteers. Have volunteers register walkers so that they make contact with the seniors from the start. Volunteers could also be used to make phone calls to check on and encourage walkers throughout the program. Think of it as seniors building connections with other seniors in the neighborhood. Use volunteers in a variety of ways on the walks. They can lead groups, make sure that everyone has a partner, or walk with those who aren't walking with someone.

* A Keep it simple. Empower the older adults to make it their program. Walking is not a complicated physical activity and can be done by most older adults, including those with some mobility limitations.

If you would like more information on Sound Steps, please log on to www.4elders.org/soundsteps.htm.