“To Be Moving Is to Be Alive”: A Walk-Along Study Describing Older Public Housing Tenants’ Perceptions of Physical Activity

in Journal of Aging and Physical Activity

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Kadia Saint-OngeÉcole de santé publique, Université de Montréal, Montreal, QC, Canada

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Paquito BernardDepartment of Human Kinetic Sciences, Université du Québec à Montréal, Montreal, QC, Canada
Centre de recherche de l’Institut universitaire de santé mentale de Montréal, Montreal, QC, Canada

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Célia KingsburyÉcole de santé publique, Université de Montréal, Montreal, QC, Canada
Centre de recherche de l’Institut universitaire de santé mentale de Montréal, Montreal, QC, Canada

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Janie HouleCentre de recherche de l’Institut universitaire de santé mentale de Montréal, Montreal, QC, Canada
Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada

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Few studies have focused on older public housing tenants’ perceptions of physical activity. Greater understanding of how they define, appreciate, and engage in physical activity could lead to better targeted promotion and reduced health inequalities for this subgroup of the population. We conducted 26 walk-along interviews with older public housing tenants in Montreal (Canada). Tenants were aged 60–93 years and lived in either one of three study sites including a commercial, a residential, and a mixed land-use area. Physical activity was described as a multidimensional construct through six interdependent dimensions: physiological, emotional, interpersonal, occupational, intellectual, and existential. Participants perceived physical activity as having potential for both well-being and ill-being. Perceptions of physical activity were a function of age, physical capacity, gender, culture, revenue, and relation to community. These results support using a life-course perspective and a broader definition in promoting physical activity to older public housing tenants.

Physical activity promotion is widely used to promote healthy aging and well-being (Bauman et al., 2016; Bull et al., 2020; King & King, 2010; McAuley & Rudolph, 1995; World Health Organization, 2015, 2018). Among older adults, physical activity has positive effects on physical and mental health (Bauman et al., 2016; King & King, 2010; Taylor et al., 2004), including improvements in life satisfaction, self-efficacy, and control over one’s health, self-esteem, and sense of purpose (Bauman et al., 2016; Biddle & Mutrie, 2008; Morgan et al., 2019). Equitable and efficacious physical activity promotion requires a deep understanding of physical activity behavior (Sallis et al., 2000) as well as tailored efforts targeting subgroups of the population that universal interventions tend to leave behind (Coveney, 2005; Frohlich & Potvin, 2008; Porcherie et al., 2018; Yap & Davis, 2008) such as older and less fortunate people (Taylor et al., 2004; Yancey et al., 2006). Older public housing tenants present both these characteristics, yet there is a dearth of information on their physical activity (Park et al., 2017; Roman et al., 2009; Scammell et al., 2015).

Older public housing tenants are at greater risk of being inactive than older adults living on the private market because they present many characteristics associated with inactivity: lower income, lower education levels, older age, and higher likelihood of living alone (Apparicio et al., 2008; Digenis-Bury et al., 2008). Prevalence studies consistently show a social gradient of physical activity by which participation levels are proportionately associated with socioeconomic disadvantage including older age as well as lower education and income (Ford et al., 1991; Hughes et al., 2008; King & King, 2010). Moreover, compared with similarly socioeconomically disadvantaged older adults living on the private market and especially to older adults in general, older public housing tenants have higher risk of chronic disease (Chambers & Rosenbaum, 2014; Digenis-Bury et al., 2008; Dunay et al., 2016; Howell et al., 2005; Kalousová & Evangelist, 2019; Manjarrez et al., 2007; Park et al., 2017; Parsons et al., 2011) and, therefore, have much to gain from greater physical activity levels. Yet, older public housing tenants are scarcely represented in the scientific literature (Park et al., 2017; Roman et al., 2009; Scammell et al., 2015), potentially limiting the benefits they receive from physical activity practice and promotion. There is a pressing need to better understand older public housing tenants’ physical activity and to “learn about the different needs of different segments of the population” (Biddle & Mutrie, 2008, p. 355).

Available data suggest that public housing residents of all ages’ physical activity levels are low in comparison with public health recommendations (<150 min of moderate physical activity per week; Buchner et al., 1997; Digenis-Bury et al., 2008; Leach et al., 2014; Lewis et al., 1993; World Health Organization, 2018). In Seattle, the proportion of inactive older adults (i.e., >60 min of weekly physical activity) was significantly higher in older subsidized housing tenants compared with a control group of older adults (75% vs. 51%; Buchner et al., 1997). Among Canadian rural-dwelling older public housing tenants, 56% reported participating in physical activity every day (i.e., 10 min of daily physical activity; Moussa et al., 2020).

Socioecological models of physical activity postulate that factors ranging from societal norms, laws, and regulations to personal beliefs influence actual physical activity as well as perceptions of it (King & King, 2010; Lee & Cubbin, 2009; Spence & Lee, 2003). Research suggests that personal attitude toward physical activity may have a greater influence on participation than social norms (Bauman et al., 2002; Courneya, 1995; Dogra et al., 2015; Hausenblas et al., 1997). Results of a cross-sectional quantitative study conducted in Canada among 170 older adults with low socioeconomic statuses show that more positive aging attitudes related to greater self-reported physical activity levels (Dogra et al., 2015). Together, these data suggest the importance of focusing on individual perceptions to better understand older public housing tenants’ physical activity. Qualitative data could provide a deeper and more nuanced understanding.

Three qualitative studies among older public housing tenants show ambivalent perceptions of physical activity. In the first study using focus groups among public housing residents of all ages in Boston, United States, participants described physical activity as an obligation, “a necessity rather than a choice” (Scammell et al., 2015). Study participants also noted many financial barriers to physical activity participation (Scammell et al., 2015). Similarly, another study using semidirected interviews showed that public housing tenants in Houston, United States, acknowledged its benefits for health yet perceived having little access to physical activity (Eugeni et al., 2011). They felt it is reserved to people of young age and in great physical condition (Eugeni et al., 2011). Participants also described physical activity as more of an indirect effect of a busy lifestyle rather than a goal in itself. Inversely, a third study examining the life goals of 161 older public housing tenants in Boston, United States, found that the two most common goals were improving health and physical activity (Howard & Louvar, 2017). The discrepancy in perceptions of physical activity among older public housing tenants may be attributable to differences in how researchers defined physical activity. This remains unknown, because physical activity was not conceptually defined in these publications. More research is needed to elucidate these divergences.

Not only are studies concerning older public housing tenants’ physical activity rare, but existing studies are also mostly quantitative and fail to document their perceptions of physical activity. In contrast, qualitative research allows to gather rich, detailed, and contextualized descriptions of phenomena from the viewpoint of those who experience it (Patton, 2015). However, existing qualitative knowledge includes few perspectives from socioeconomically disadvantaged older adults (McGowan et al., 2017). The few studies reporting on the physical activity of older public housing tenants were conducted in the United States in specific contexts not representative of those in Montreal, Canada. Finally, researchers categorized physical activity into four domains: (a) active travel, (b) leisure, (c) everyday tasks, and (d) volunteer/work (Defay et al., 2014). Yet, studies on older adults’ physical activity focus on active travel and leisure (King & King, 2010) and tend to dismiss everyday tasks and volunteer/work, which may be more relevant and meaningful to older public housing tenants (King & King, 2010; Morgan et al., 2019). Although their low income may constrain older public housing tenants to resort to active travel, it limits their access to active leisure activities (Apparicio & Séguin, 2006b). Thus, more research is needed to understand what type of physical activity older public housing tenants conceive of and engage in as well as for what purposes if physical activity promotion is to be tailored to their reality.

Study Objectives

As argued above, older public housing tenants could greatly benefit from physical activity promotion that is tailored to their perceptions, needs, and everyday realities. Indeed, tailored promotion efforts can contribute to reduce social inequalities in physical activity and health. This is especially important to older public housing tenants in the current context of a rapid demographic aging process in the province of Quebec, Canada, where the older adult population is expected to triple by the year 2061 (Institut national de santé publique du Québec, 2020). Consequently, older adults represent an increasingly large proportion of public housing tenants rising from 15% in 1981 to 21% in 2006 and predicted to represent 37% of public housing tenants in Quebec by 2061 (Socitété d’habitation du Québec, 2016). Thus, in the greater aim to improve health promotion for older public housing tenants, this study explored their perceptions of physical activity using walk-along interviews in their residential environment.

Materials and Methods

Design

We conducted semistructured individual walk-along interviews with older public housing tenants from three neighborhoods in Montreal, Canada. One pilot interview was conducted at each site. These were informative (Malterud et al., 2016) and were thus included in the study without any major changes to the interview guideline. The main author was the sole interviewer and had previous training and experience conducting sit-down interviews with older adults.

Participants

Participant inclusion criteria were as follows: (a) currently living in one of the three selected sites; (b) being able to speak in French, English, or Spanish; and (c) being able to walk four bouts of 10 min taking as many breaks and using mobility aids as necessary. Exclusion criteria were as follows: (a) having received a medical contraindication to walk for bouts of 10 min at a time and (b) self-reporting an auditory, visual, or intellectual impairment, because these could incur risks to the participant during the walk-along, or encumber the understanding, and responding to interview questions.

This study focused on a specific low-cost housing program in the province of Quebec, Canada, which offers rental units costing 25% of tenants’ monthly income. To access rental units dedicated to older adults, tenants must be aged 60 years or older. These units are meant for people who are relatively autonomous, implying that they have sufficient levels of physical and cognitive health to meet their daily needs. Older adults make up the majority of the province’s public housing tenants (Socitété d’habitation du Québec, 2016). Because it is home to most of the province’s older public housing units, we focused on the physical activity of older public housing tenants living in the city of Montreal. In 2016, the Montreal public housing authority estimated that there were 13,000 older tenants living in 11,002 low-cost housing units (Office Municipal d’Habitation de Montréal, 2020). Data collected by housing authorities show a high concentration of tenants living alone, women, and people from diverse cultural backgrounds (Office Municipal d’Habitation de Montréal, 2020; Socitété d’habitation du Québec, 2016).

Material and Procedures

Partners at the public housing authority in Montreal facilitated access to the study sites also lending researchers trust and legitimacy by proxy (Felsen et al., 2010; Spratling, 2013). In Quebec, Canada, public housing developments are dispersed among the spectrum of neighborhood socioeconomic status and land-mix type. Partners helped to select three diverse study sites in terms of land-use mix, neighborhood socioeconomic status, and racial/ethnic makeup within the building and neighborhood. The sites include commercial (site A), residential (site B), and mixed (site C) areas. Because inclusion of public housing tenants is a methodological challenge (Namageyo-Funa et al., 2014), we combined traditional strategies (i.e., written announcements) with recommended recruitment strategies including on-site face-to-face recruitment (Felsen et al., 2010; Spratling, 2013) and word of mouth (Jones et al., 2009).

Ethical Considerations

Participants’ psychological safety and physical safety were primary concerns. We addressed the former by explicitly and repetitively stating that they could skip any questions or topics they did not wish to expand on. Moreover, the questions were openly worded, giving participants the agency to direct their answers to topics they found relevant and appropriate. We also prepared a list of free and accessible psychosocial support services for each study site in case participants showed signs of unwellness. Two participants were offered and accepted this resource list. Concerning physical safety issues, prior to data collection, the interviewer updated her cardiopulmonary resuscitation (CPR) training and canvassed the study sites to identify areas where participants could take breaks from walking (benches, bus stops, etc.) as well as any potential hazards. The interviewer was a certified physical conditioning instructor with experience leading older adults in aerobic exercise. During data collection, she carried a mobile phone in case of a medical emergency and consciously walked slower than the participants to reduce any pressure to walk at a fast pace. Finally, sociodemographic data were purposively left for last so that the interviewer could observe the participants’ cooldown period in their own homes for at least 20 min before leaving. No further intervention was necessary.

The committee of ethics and research including human subjects at the Université du Québec à Montréal reviewed and approved this study. The interviewer verified selection criteria during brief telephone screenings. Before starting each interview, the interviewer explained the study scope and procedures to potential participants and then sought verbal and written consent to participate in the study. Participants received $20 (canadian dollars [CAN]) at the end of the interview as compensation for their time.

Walk-Along Interviews Following a Constructivist Approach

To highlight older public housing tenants’ perceptions of physical activity within their residential environment, we chose to conduct walk-along interviews within a constructivist approach. In this approach, the researcher and participants’ coconstruct reality and knowledge “through communication, interaction, and practice” (Tracy, 2013, pp. 40). In a walk-along interview, the researcher accompanies the participants on foot through their real-life context, collecting information about the study subject and especially probing for the participant’s experience of the space or activity of study in the format of an informal conversation (Carpiano, 2009; Evans & Jones, 2011; Garcia et al., 2012; Miaux et al., 2010; Van Cauwenberg et al., 2012; Van Holle et al., 2013). The walk builds familiarity between interviewer and interviewees and exposes both to the real-life context. This allows the interviewer to gain a deeper understanding of how interviewees experience a space by watching how they interact with it (Garcia et al., 2012; Miaux et al., 2010). Combining observation methods that are both direct (the participant’s lived-in-time experience) and indirect (the interviewer’s observations), walk-along interviews promote coconstruction of knowledge (Carpiano, 2009). Interviews were audio-recorded and transcribed verbatim.

The interviewer took field notes during and after each interview to summarize key elements of the interview, general impressions, challenges, successes, questionings, and preliminary interpretations (Patton, 2015; Tracy, 2013). Field notes stimulate critical awareness and reflection providing “analytic distance” through a systematic and yet creatively conscious narrating and analyzing of one’s observations, actions, and budding interpretations (Tracy, 2013, pp. 109, 144). These were periodically shared with the research team and included in the data analysis process, linking interview excerpts to field notes and coding the entire corpus as a whole.

The interview guide focused on physical activity within the residential environment, which includes the apartment, building, and close neighborhood because older public housing tenants are typically financially and functionally restrained to this area (Apparicio & Séguin, 2006b). Figure 1 illustrates the data collection protocol. Table 1 presents the main questions that constituted the semidirected interview guide for this study.

Figure 1
Figure 1

Procedures of interviews with older public housing tenants.

Citation: Journal of Aging and Physical Activity 2023; 10.1123/japa.2021-0394

Table 1

Semidirected Interview Guide Used for Walk-Along Interviews With Older Public Housing Tenants

1. To start off, I’d like to know a little about you. Can you describe your daily routine, what you do on a typical day?
2. Are you someone who does physical activity?
3. What is physical activity for you? What does it mean?

 a. Can you give me examples of physical activities?

 b. How would you describe people who participate in physical activity? Who are they, what kind of people are they?
4. Do you consider yourself to be physically active? Why/Why not?
5. Do you enjoy physical activity? Why/Why not?
6. What gets you moving about, what do you do? What activities get you moving about in your apartment/building/neighborhood?
7. Do you do these activities alone or with someone else? Whom?
8. How do you feel in your mind and in your heart when you do those things? How about afterwards? Is it different than if you hadn’t done them?
9. What does physical activity bring to your social life? (In the apartment, building, and neighborhood)
10. How does physical activity affect how you feel about your apartment/building/neighborhood and the people in it?
11. How does the apartment/building/neighborhood around your building affect your moving about?
12. What helps you move about in your apartment/building/neighborhood? How does this help?
13. What makes it difficult to move about in your apartment/building/neighborhood? How does it complicate things?
14. Are there physical activities that you would like to do in your apartment/building/neighborhood, but cannot? What would it take for you to be able to do those things?
15. What is the impact on you, personally, that you cannot do these things here? (positive/negative)

Sociodemographic and Health Characteristics

To allow us to describe our sample, participants orally completed three scales, including a homemade sociodemographic and health questionnaire asking for information such as age, sex, country of birth, education level, and yearly household income as well as perceived social support, physical, and mental health. They also reported presence or absence of the 18 health conditions composing the Functional Comorbidity Index (Groll et al., 2005). Finally, to evaluate participants’ physical activity levels, we used a four-item questionnaire validated among an older adult sample, the Questionnaire d’Activite Physique pour les Personnes Agees (QAPPA; de Souto et al., 2011). Participants reported all the physical activities lasting at least 10 min that they performed over the last 7 days starting with vigorous-intensity activities (e.g., jogging or brisk housework) and ending with moderate-intensity activities (e.g., aquafitness, yoga).

Data Analysis

Coders (first and third author) used a mixed approach (Patton, 2015) combining deductive and inductive thematic analysis (Patton, 2015; Swain, 2018) using NVivo software (versions 11 and 12, QSR International, 2015, 2017). We used deductive content analysis to categorize examples of physical activity according to four domains of physical activity (Defay et al., 2014). An inductive analysis strategy “allows meaningful dimensions to emerge from patterns found in the cases under study, without presupposing in advance what those important dimensions will be” (Patton, 2015, p. 213), which was key to obtain the participants’ own perceptions of physical activity. Thus, coders performed inductive analysis inspired by Braun and Clarke’s (2006) description of thematic analysis. Coders cocoded six interviews and compared their coding strategies twice before coding independently and then met regularly to discus discrepancies until consensus was reached.

Three mechanisms recommended by Smith and McGannon (2018) supported this study’s qualitative analysis rigor: (a) “member reflections,” (b) “critical friends,” and (c) a tailored and flexible set of quality criteria (Smith & McGannon, 2018). Member checking occurred during data collection as the interviewer shared interpretations or questionings emerging from previous interviews with new participants to gain their insight, iteratively testing impressions. The interviewer–coder met with the research team regularly during data collection and analysis to challenge, confirm, or infirm codes and themes throughout the data analysis process. The panel of “critical friends” was composed mostly of graduate students from various fields of expertise (community psychology, clinical psychology, kinesiology, society, and health), allowing to challenge interpretations from various perspectives.

The quality criterion chosen for this study were as follows: (a) to seek consistency between the scientific literature, the research objectives, and the data and interpretations, (b) to honor the participants’ words using an inductive approach and authentic quotes to illustrate themes, (c) to protect participants’ anonymity, (d) to offer a meaningful contribution to the scientific literature and especially to local practitioners, and (e) to produce a nuanced and general representation of perceptions by back-checking data, searching for counterexamples of themes, and perceptions within it.

Results

Study Sample

This paper presents data from 26 participants aged between 60 and 93 years. Interviews were conducted in French (n = 17), English (n = 8), and Spanish (n = 1) between September 11, 2017 and October 25, 2017. One participant could not walk four 10-min bouts as per selection criteria; thus, we excluded this data from analysis. Because they did not meet the housing program’s traditional eligibility criteria and had accessed the housing program because of an exceptional situation, this person did not represent the majority of older public housing tenants. Thus, we deemed that their exclusion from the study would not impact data interpretation. A slightly larger proportion of participants are female (69%) and born in Canada (54%), which is representative of the older public housing population in Montreal, Canada (Apparicio & Séguin, 2012). Table 2 further describes the sample’s characteristics. Interviews lasted between 1 and 2.5 hr.

Table 2

Sociodemographic and Health Characteristics of 26 Older Public Housing Tenants

Total sample
Sample size (N)26
Age (years)
 Mean (SD)71.96 (8.0)
Sex
 Women18 (69%)
Country of birth
 Canada14 (54%)
 Other12 (46%)
Yearly income
 $9,999 or less2 (7.7%)
 10,000–19,999$17 (65.4%)
 20,000–39,999$5 (19.2%)
 Missing2 (7.7%)
Education level
 Secondary or less17 (65.4%)
 College diploma2 (7.7%)
 University diploma7 (26.9%)
Functional comorbidity index
 Mean (SD)3.40 (2.8)
Self-reported physical health
 Very good11 (42.3%)
 Good10 (38.5%)
 Average4 (15.4%)
 Bad1 (3.9%)
 Very bad
Self-reported mental health
 Very good6 (23.1%)
 Good11 (42.3%)
 Average7 (26.9%)
 Bad2 (0.8%)
 Very bad
Self-reported social support
 Very good7 (26.9%)
 Good13 (50.0%)
 Average4 (15.4%)
 Bad1 (3.8%)
 Very bad
 Missing1 (3.8%)
Level of physical activity (QAPPA)
 No activity2 (0.1%)
 Low activity17 (65.4%)
 Moderate activity9 (34.6%)
 High activity

Note. Percentages means and SDs have been rounded off to one decimal place. QAPPA = Questionnaire d'Activite Physique pour les Personnes Agees.

Definitions of Physical Activity

Participants shared wide-ranging examples of physical activity varying not only by domain (Table 3), but also in intensity (e.g., running vs. standing), duration, and intention (leisure vs. obligation). The same physical activities could be categorized in different domains. For example, walking related to all four domains: active travel, leisure, everyday tasks, or volunteer/work. Participants most frequently reported partaking in active travel and everyday tasks to describe their own physical activity. Participants’ general examples of physical activity, on the other hand, frequently pertained to leisure sports and activities.

Table 3

Older Public Housing Tenants’ Examples of Physical Activity Categorized by Domain

1. Active travel2. Leisure3. Everyday tasks4. Volunteer/work
Walking (e.g., 1—going to the doctor, 2—window shopping, 3—walking the dog, and 4—delivering food to neighbors)
Biking (as transportation or for fun)Physiotherapy exercisesInformal volunteering

 • Gathering goods to donate

 • Cooking for others
Taking the stairsSport exercise (e.g., aerobics, bowling, dancing, skiing, yoga, bocce, swimming, etc.)Household choresFormal volunteer work in community organizations

 • Spending time with isolated older adults
Social activities (e.g., board games, socializing, group outings, sexual intercourse)Standing up regularlyParticipating in the tenant committee

Note. Based on the physical activity domains enumerated by Defay et al. (2014).

Inductive thematic analysis of older public housing tenants’ perceptions produced six themes describing physical activity: (a) physiological (body), (b) emotional, (c) interpersonal, (d) occupational, (e) intellectual, and (f) existential. Each theme’s relative importance depended on participants’ personal beliefs, values, and preferences; thus, they should be interpreted as interconnected parts of the same whole.

Theme 1. Physiological: Moving—or Just Using—the Body

Most participants described physical activity in relation to the human body. It was said to be a natural, human endeavor allowing to give their body what it needs and to respect one’s body, including its limits. This included either moving (e.g., walking) or solely soliciting the muscles of their body (e.g., standing). With physiotherapy exercises in mind, one participant defined physical activity saying: “I guess, using the muscles of your body …” [A040].

Participants presented differing perceptions of how much energy expenditure constituted physical activity. For some, the required intensity was as low as breaking up periods of sedentariness by getting up periodically “Well, it means not sitting around all day” [B010]. For others, the effort—be it housework or a leisure walk—had to be intense enough to cause sweating, feeling hot and “needing to shower”, or to rest. For others still, it required much greater physical effort: “[ … ] you have to struggle; you have to challenge yourself [ . . .]” [A060]. The latter view was especially true for younger participants, those who were active in their younger years and those with higher levels of functional capacity. Supplementary illustrative quotes for this theme are presented in Table 4.

Table 4

Supplementary Illustrative Quotes for Theme 1: Physiological

1. Moving—or just using—the body
1.1 Maintaining and treating the body

“While if you are physically active, of course you will stay away from diseases.” [A010]

“So whether I’m in pain or not, I really have to be in bad shape to say, ‘I can’t do my exercises today.’ Sometimes I do them, it hurts to do them, it hurts me, but I do them. Because if I don’t, I’ll end up in a wheelchair.” [C100]
1.2 Wearing the body out

“Like I don’t wanna over do it, because I was going for a class, they had a class at [place], and I joined it, and then my knee started bother me when I was riding the … .What do they call it? The bike thing? I was doing it, and my knee started. And it continues to [hurt].” [C070]

“Because even here in the evening in the summer, they go dancing in the park there. Well yes, it costs nothing. But dancing on the asphalt, forget it, I can’t. You have to be in shape now.” [B060]

“Well sometimes it’s hard because you see all the others doing it and you want to try to do it because not long ago I had capsulitis that called. So there are times that ahhhhh it, it hurt.” [B070]
Theme 1.1: Maintaining and Treating the Body
Most participants stated that general physical activity served to maintain bodily health and strength, as well as hunger, sleep, mobility, and independence. Physical activity was commonly said to have important outcomes for health:

A lot! It brings us youth and health. I have my sister, she is 70 years old, yes 70 years old, she moves a lot. She’s sick, breast cancer, but thanks to God she is cured and that’s good, but she moves, moves, moves, moves! [C010]

Theme 1.2: Wearing the Body Out
Despite being aware of physical activity’s benefits, some participants feared wearing their body out as well as the pain it may cause. For some, working through the pain was worthwhile, because it would lead to more pleasant sensations. For others, pain and wear was revolting and frustrating:

I’ve been exercising all my life and ended up getting both my knees operated on because I’ve been exercising all my life. [A70]

Theme 2. Emotional: Doing What Makes You Feel Good

Some participants described physical activity in terms of pleasure and fun. This theme mostly encapsulates, but is not limited to, leisure activities such as walking, biking, and going on outdoor organized group excursions, exercise, and other active hobbies. These things were said to constitute physical activities because they are enjoyable. For example, a few participants felt that housework or household tasks do not constitute physical activity because these things are obligations, while physical activity is supposed to be a fun break from routine:

For me that [housework] that’s a job. And working out—like when I used to go work out on Saturday mornings with my niece—for me, that’s a pleasure. [B020]

Supplementary illustrative quotes for this theme are presented in Table 5.
Table 5

Supplementary Illustrative Quotes for Theme 2: Emotional

2. Doing what makes you feel good
2.1 Enjoying one’s self

“You know, being a senior and being retired, you know. If you don’t want to do it, you don’t do it. I mean, you don’t have to do it. I don’t want to do that, I’m not going to do that, you know. […] Even if I was still on the work force, I would be doing the same thing, you know. I might be out a little more often because I would have more money to go out with but when you’re limited with money, then you’re stuck to where you can go.” [C020]
2.2 Feeling badly from activity or lack thereof

“Sure. I mean, I know exercise is important you know. And I feel guilty that I’m not doing more but … It takes energy too.” [A040]

“Over there that’s the Y and right there I used to go … we do to […] yes I did join the Y that’s where I used to go swimming. And I used to do um … what they call it this … the Zumba. [ … ] Oh because now there is it … everything the price is up. It’s not cheap like before. Everything going up and then everything you go, you have to pay 10$, I can’t afford it. […] Well it make me feel upset but there’s nothing I could do about it you know.” [C080]
Theme 2.1: Enjoying Oneself
Participants spoke of the joy they experienced walking for leisure, dancing, playing bocce, or basket–cornhole (a team sport combining cornhole and basketball), and so on. They also mentioned feeling pride and contentment from accomplishing everyday tasks through active travel, doing housework, and performing physiotherapy exercises, as well as volunteer/work. Many participants stated that physical activity helps “to feel good” [C080]. They mentioned emotional effects such as helping to reduce anxious and depressive symptoms “placing one’s thoughts” during leisurely walks as well as preventing depressive symptoms by being active and getting out of the house:

And it’s very good, I liked dancing, I used to dance, I was crazy about it [ … .] First of all, it allows you to get dressed and take your mind off things. Let’s say a person is depressed. Do you know how to get depression? It’s easy. It’s when you do nothing! And you juggle all your issues in your head. [B060]

Theme 2.2: Feeling Badly About Inactivity
The subject of physical inactivity can also provoke negative emotional experiences. We observed fear of injury or harm as well as the shame of not being able to be as active as one’s peers:

And I feel kind of like embarrassed in some ways. Cause I have a friend my age, she’s still riding her bicycle and she’s driving her car, you know? She’s doing everything I used to do [A040].

We also observed evidence of resentment and envy, especially from participants who physically could not be as active as they once were. One participant with a serious health condition explained that not being able to be as active as they wanted “makes me angry”:

A lot of time, I envy them [active people]. And a lot of time … I wish I could be like them, and I think they’re just assholes! [A030]

Theme 3. Interpersonal: Socializing and Integrating Culture

Many participants stated that physical activity “It is a form of being social.” [C070] including social activities, the active travel of walking to meet with friends or standing while speaking to them. Thus, physical activities of the interpersonal nature also include walking, standing, chatting, sitting, singing, laughing, and simply having a good time.

A few participants attributed their perceptions of physical activity to cultural heritage as well as the family and socioeconomic conditions growing up. This could be from family traditions growing up in a busy household in Quebec or growing up abroad with activity-minded habits and customs. Explaining that doing benevolent acts for the community—especially cooking—is being physically active, one participant explained it through their growing up “in the bush.” Providing food required hunting as a family. From a young age, they would run to catch wild boar, run to a neighbor’s hut to borrow a cooking utensil, or run to exchange food with neighbors. For them, preparing food was then and still is a physical activity. Supplementary illustrative quotes for this theme are presented in Table 6.

Table 6

Supplementary Illustrative Quotes for Theme 3: Interpersonal

3. Socializing and integrating culture
3.1 Belonging to the neighborhood and the community

“Even when I go out, sometimes I see neighbors, we get to know each other, we talk. Neighbors from here. If I stay here, like this [motionless], I can’t know people. But when I go out, I know people. […] It allows to feel good, at ease, not too many worries. We don’t have any worries. It’s being in the community.” [A020]
3.2 Conforming to social pressure

“Well, my daughter sometimes nags me, she says ‘Mom, you haven’t been out all day,’ no, I say ‘I haven’t been walking around much, but I’m going to change that tomorrow!’” [B010]

“It’s almost if we have to pretend to be normal. Like my daughter, she don’t like to see me with this [walker], so I go down to visit and my neighbor takes it. [] Because it makes me look old and dependant and you know. [] They just want me to be the same as I always was. [] Well, I’m trying to be the same as I always was when I’m with them. But I couldn’t do it on a 365 days schedule.” [A040]
Theme 3.1: Belonging to the Neighborhood and the Community
Describing the relation between moving about and feelings about the neighborhood, a few participants mentioned that physical activity allows them to feel a sense of belonging to the neighborhood. Some participants stated that being active in the building or neighborhood favored “feeling like a family” [B060] and “being in the community” [A020]. Activities said to favor sense of community included socializing with neighbors in the building, active travel in the neighborhood, and everyday tasks completed in the neighborhood. We have such an example from the participant who denounced how vigorous physical activity caused double knee replacements. Yet, they felt satisfied through everyday tasks that make them feel “normal”:

Lots of activities, not mandatory: normal, everyday life. So I feel like my neighborhood, I move like my neighborhood. [A070]

Physical activity was said to allow to observe and adapt to incoming culture. One participant shared that walking his friend’s dog provided exposure to the recently culturally and ethnically diverse individuals moving to the neighborhood. Walking for leisure or for active travel in the neighborhood also allows to observe its specific local culture and thus to better integrate the community. For example, one participant who had moved from a more disadvantaged neighborhood to the current one stated that walks are opportune times to learn how to blend in:

The culture, you look around: how they’re dressed, how it’s different. We’re immigrants here in this neighborhood, in this building. Among the rich. And it’s a push to be like the others. [C060]

Theme 3.2: Conforming to Social Pressure
Some participants described physical activity in opposition to those around them including their friends and family who would get on their case to be more or even less active. One participant mentioned they felt pressure from their children to maintain the same physical condition they have always had and to leave their walker aside when their adult children visit. Another participant stated a common view that older adults should have the right to their choices, their limitations as well as to not feel badly about not meeting public health recommendations:

People should not be made to feel uncomfortable with the way they are if they’re happy the way they are. Then people go up and say, “well you’re not doing enough.” Well, if I was sitting on my couch and not doing anything, then I got something to worry about, but I don’t sit on my couch. You’ve seen: I can walk! I don’t like the way walking makes me feel. [A030]

Theme 4. Occupational: Keeping Busy

There were participants who described physical activity as a means to pass time “ … something to do. It’s an occupation” [C030]. For others, physical activity requires having something to do like visiting the health care clinic. Occupational perceptions encompassed leisure activities such as walking, physical conditioning classes, or group excursions as well as everyday tasks such as one’s physiotherapy. Supplementary illustrative quotes for this theme are presented in Table 7.

Table 7

Supplementary Illustrative Quotes for Theme 4: Occupational

4. Keeping busy

“It’s all a matter of passing time.” [C020]
4.1 Accomplishing something

“It is. When I do it, I feel good, you know. I’m not weak, I’m not lazy, I did them you know. That gives me some sense of accomplishment.” [A040]

“Well yes, self-realization, yes. Yes, because we are in good health, we feel in good health. So we feel available, we feel we are listening to others, we want to listen to others. Because we are in good health we are available and we have more … we have endurance. If someone is in pain, for example, if we are sick, we can’t, we don’t have the strength. But if we are not, we do sports generally we are healthy, we can listen to others.” [A060]
4.2 Fulfilling an obligation

“People here they don’t want to [move]. Everyone is busy with their old . . . . I don’t know how to say it … lifestyle ‘Ah! I have to babysit. Ah I have to go to my daughter’s house. Ah! I have to …’ Yes! I’m not saying otherwise, you shouldn’t abandon your family, but you should take care of yourself.” [C010]

“I need to exercise. That’s why I do it, like I have to. Like it’s something I have to do. Not for pleasure.” [C060]
Theme 4.1: Accomplishing Something
Many participants spoke of the sense of accomplishment they get from physical activity. For a few participants, engaging in one’s community through acts of formal or informal service constitutes physical activity. This included the active travel to formal volunteering in community organizations, or as a part of their involvement in the tenant’s committee, as well as informal volunteering like baking and cooking goods for their neighbors. It also included walking about to gather first- or second-hand goods to donate:

That’s right that’s an activity I call that … yes you do. You move along, you go around, you help people and things like that. At least you’re busy, you’re not sitting one place all the time. [C080]

Theme 4.2: Fulfilling an Obligation
Some participants expressed displeasure of any activity resembling an obligation be it active leisure, rehabilitative walks, physiotherapy exercises, or housework. For example, in response to the question “if we think about [your] general views of physical activity, what comes to mind?” one participant remarked: “Obligations. I don’t like being obligated” [B050]. For others, physical activity is neither enjoyable nor unenjoyable; it is simply a necessary means to a necessary end.

I can’t say, well, I don’t hate it and I don’t love it. I do it out of need, to maintain my joints. I’m going to do it to heal something. But it’s not a hobby. [B070]

Theme 5. Intellectual: Moving the Brains

Participants also described physical activity as “using the brains” or “moving intellectually.” This theme describes physical activity as soliciting intellectual effort including playing board games, preparing food, social dancing, and even chatting with people. It encompasses mostly leisure activities involving other people.

[At] the community center, they move a little bit. Well, not physically, but they move intellectually, if you will. [ … ] they play a board game and talk about it and play games and meet people and all that. [C010]

Participants also spoke of “getting the brains going” during solitary activities in which cognitive processes are involved such as preparing a recipe. Supplementary illustrative quotes for this theme are presented in Table 8.

Table 8

Supplementary Illustrative Quotes for Theme 5: Intellectual

5. Moving the brains
5.1 Broadening the mind

“Well if you move. Like dancing, dancing is … . I love dancing. Of course, when you dance it takes memory because you have to remember the steps. Because it takes memory, it takes all kinds of things.” [B060]
5.2 Needing discipline

“So for me it’s like a discipline to do these exercises.” [C100]

“Well, the other day I had to save someone who had fallen in the tennis court, three months ago. Because he was too enthusiastic. He died. So I started compressions, because I know how to do it. Before the machine [defibrillator] came.” [A010]
Theme 5.1: Broadening the Mind
Concerning the benefits of various forms of physical activity (e.g., conditioning exercises, walking, sport), a few participants noted positive impacts on intellectual ability or “broadening the mind.” The cognitive effect that was most frequently mentioned was that it is stimulating for the mind, which was especially linked to walking in the neighborhood:

You see a lot of architecture, a lot of houses, some beautiful, some not so beautiful, but you look. And you enrich your [brain], because the brain has to work has to collect [information]. [C060]

Participants rarely mentioned physical activity’s benefits to cognitive function spontaneously. When asked directly about the relation between the two, some participants said they were confident physical activity could benefit cognitive function:

Well, for sure it’s good: it makes our brain work. Because our brain, it makes our feet work, our hands, our head, our body, it works everything. [B090]

Despite that perception, few participants mentioned engaging in physical activities specifically to benefit their cognition. Yet, losing cognitive ability was a frequently cited and seemingly deep-rooted fear:

[Physical activity] gives me hope. That’s the fear: that we don’t lose our memory. That we don’t lose our feet. Because if we lose our heads and feet, we’re screwed! The mind, it can go. What is … what life [is that]? Without thinking, without being able to express, without being able to … Just stay looking at others: you don’t recognize them. I don’t want that. I said, “God, give me feet and head until I die.” [C060]

Theme 5.2: Needing Discipline
Participants mentioned the challenge of needing cognitive self-regulatory abilities to be physically active. This was true of many participants who mentioned needing to force themselves to be more active, but also those who needed to learn to pace themselves:

To see how my body will react. Because maybe, I burn myself out. I like to go to the max of everything, but it’s exhausting, you know? I would have to talk to myself and say: “Wow, take it easy!” [B060]

Theme 6. Existential: Feeling Alive

For some participants, more specific activities such as walking to accomplish everyday tasks and observing others doing the same testify to their active existence in the world. Being physically active implies being autonomous and thus alive:

People who are not moving around are people really, really old and can’t move around. Or they’re dead! And at least when I’m moving around, I feel like I’m not dead yet. [A030]

Yes, physical activity is the basis of the soul, [of] psychology […] Because to be moving is to be alive. [A010]

All domains of physical activity could lend to this description depending on the meaning or purpose each participant attributed to the given activity. Examples include dancing, walking, talking with others, and engaging in sexual intercourse.

One participant noted that leisure activities such as physical conditioning classes like yoga and playing adapted sports constitute “play.” They remarked that physical activity is capital in helping adults to stay young at heart. Supplementary illustrative quotes for this theme are presented in Table 9.

Table 9

Supplementary Illustrative Quotes for Theme 6: Existential

6. Existential: Feeling alive

“Physical activity is really important for everyone. And it keeps a childlike side to us, which people tend to lose when they become adults. So, physical activity is the play side.” [C100]
6.1 Cultivating gratitude and hope

“I know to get up, and as long as in the morning I get [moving], I could tell you I just thank [God], that I could get up and make a cup of tea for myself, I feel happy.”
6.2 Anticipating death

“No … I gave up. I said you know, I’m gonna die like this so let it die like this. I’m ready to die anyway.” [C020]
Theme 6.1: Cultivating Gratitude and Hope
In the previous theme, a quote illustrated how physical activity cultivates hope of maintaining cognitive and physical abilities in the future. Participants also stated that accomplishing everyday tasks through active travel constitutes an opportunity to acknowledge and appreciate mobility. Leisure walks, seeing others be active, and noticing improvements in one’s health through physical activity were a source of hope that autonomy and life meaning can be developed and maintained in older age.

It shows me how I see, sometimes I can meet people who have difficulties to walk, who are handicapped, who can’t carry things. I meet many people today. Thank you Lord, you have given me strength. [A020]

Theme 6.2: Anticipating Death
A male participant from each site mentioned they “gave up” on physical activity saying they are “ready to die.” These men varied in age, physical activity level, and physical capacity but were all Caucasian. They stated that in their remaining years they would rather do things they enjoy as opposed to physical activity. One of these participants preferred not to draw out life with healthful habits but rather wanted to live to the fullest for a shorter time, avoiding incapacity and dependence:

It won’t change anything in my life to do that [physical activity]. As they say, you have to die of something and … If they could make me a cocktail of pills so that I wouldn’t wake up, that I would fall asleep and take my cocktail of pills and end it, I would be the first buyer. Not because I’m not in good spirits! Because I don’t want to get to that phase, to get to the diaper phase, to get to the walker phase, to get to the phase of justifying myself for this, justifying myself for that. Because I’m in good spirits, and I live well, and I don’t deprive myself of anything. [A070]

Discussion

This study’s objective was to describe older public housing tenants’ perceptions of physical activity namely their own descriptions and examples of it, their appreciation for it, and its perceived effects using thematic analysis of 26 walk-along interviews. Gathered perceptions cover the range of physical activity domains (active travel, leisure, everyday tasks, and volunteer/work; DeFay et al., 2014) and intensities (high vs. low energy expenditure). However, participants reported that their actual physical activities were mostly active travel and everyday tasks.

Physical activity was described not only as a catalyst to well-being, but also to ill-being depending on preference, access, and functional capacity or, in other words, according to life course. These results are in line with previous work showing an important relation between perceptions of physical activity and aging attitudes (Courneya, 1995; Hausenblas et al., 1997). Our results signal that it could be counterproductive as well as insensitive to promote physical activity (considered a potentially threatening behavior) to a population who has already accumulated socially determined ill health without also providing the necessary support and assurance (i.e., exercise specialists). Using their experiential knowledge to develop recommendations and promotion materials in partnership with older public housing tenants could foster greater informational relevance and lesser emotional distress (Blair & Minkler, 2009).

Despite using an inductive approach, our themes resemble an eight-dimensional model describing the well-being of older adults. Developed using a review of 273 scientific studies, this model not only describes older adults’ well-being as physical, emotional, relational, vocational, cognitive, and spiritual, but also contextual and developmental (Fullen, 2019).The two latter dimensions could make interesting additions to the study of older public housing tenants’ physical activity. The contextual dimension encompasses the availability of resources in the environment and its influence on well-being. Similarly, the financial cost of physical activity was a common thread throughout our study. Future research should further investigate the influence of such contextual factors on older public housing tenants’ perceptions of physical activity. The developmental dimension encompasses individual perspectives of aging and their influence on well-being in later life. This is in line with our results showing that physical activity relates to individual life course and functional capacity. However, our study highlights that aging attitudes and life course can lead to perceiving physical activity as a threat to well-being.

Similar to Eugeni et al.’s (2011) findings among public housing tenants, faith or interest in physical activity’s health benefits varied in our sample. In fact, in line with Scammell et al.’s (2015) study among public housing tenants, traditionally defined physical activity could be seen as an obligation. Though some participants conceptualized their own physical activity in accordance with the traditional definition of physical activity (any movement produced by the musculoskeletal system and exerting a metabolic effort superior to resting level; Caspersen et al., 1985), many did not. Instead, our results support a more recent and broader definition proposed by Piggin: “Physical activity involves people moving, acting, and performing within culturally specific spaces and contexts, and influenced by a unique array of interests, emotions, ideas, instructions and relationships” (Piggin, 2020). Indeed, our results were described in terms of different people doing different actions that relate to various spaces and contexts and intersect with numerous individual characteristics. For example, participants defined physical activity in relation to their age, gender, capacity, culture/ethnicity, financial means, and community. These aspects are important to consider given that older public housing tenants are most often women, living with incapacities, from diverse cultural and ethnic backgrounds having experienced a life trajectory of adversity (Apparicio & Séguin, 2006a).

Thus, the life-course perspective on physical activity promotion (Li et al., 2012) appears particularly relevant among older public housing tenants. Understanding physical activity as contextually anchored, informed by all the life transitions one has and is living, while also considering person–environment fit, or human agency (Bengston et al., 2005), it recognizes the individual’s ability to make their own choices in relation to the resources and the demands they have experienced over time and place (Li et al., 2012).

Furthermore, our results support a broader approach to population-level physical activity promotion emphasizing the need for a multidimensional “holistic understanding” of physical activity and its promotion in line with previous research among older adults living on the private market (Franke et al., 2017; Meisner et al., 2019; Silva et al., 2017). Our existential theme echoes other findings showing that older adults perceive physical activity as the product of a full life (Eugeni et al., 2011) and a means to achieve meaningful life goals (Morgan et al., 2019; Silva et al., 2017). This supports recent research suggesting adopting an approach that is also holistic in focusing on everyday physical activity and using a “wider set of goals” to physical activity promotion that goes beyond its health benefits (Morgan et al., 2019, pp. 1). Indeed, some, but not all, of our participants were uninterested by physical activity’s potential to better their health.

Our results are in line with research showing some older public housing tenants being very interested in improving their health through physical activity (Howard & Louvar, 2017) and others not (Eugeni et al., 2011). An all-encompassing or holistic approach to physical activity promotion is warranted to cover such variance in personal goal preference. For example, researchers summarized European older adults’ hopes for healthy aging as activeness (Guell et al., 2016), which refers to generally maintaining an attitude and lifestyle that favor physical and cognitive health as well as self-realization in older age, as opposed to engaging in distinctive behaviors like physical activity (Guell et al., 2016). Intervention studies are required to test whether such promotion would be better suited to older public housing tenants.

The present study adds to existing literature by showing that older public housing tenants’ nonorganized physical activity positively influences their perceptions of the neighborhood and their sense of community. Physical activity in the building and neighborhood provides contact with like others and exposure to nonlike others, potentially encouraging cultural integration. Social capital is conducive to physical activity among community-dwelling older adults in general (King, 2008; Yu et al., 2018) and older adults living in low socioeconomic conditions (Andrade et al., 2015). Much literature shows that older adults’ physical activity favors developing social capital (King & King, 2010) and depends on characteristics of the social environment such as social cohesion (King, 2008). This highlights the importance of considering community aspects to reach older public housing tenants through physical activity promotion.

Similar to findings among low-income older adults in Southern Thailand (Suwankhong et al., 2020), few participants in our sample associated physical activity to improved cognitive function though all emphasized the importance of maintaining cognitive function. Yet scientific literature is unequivocal: Healthy older adults show cognitive functioning improvements even immediately following acute aerobic physical activity (McSween et al., 2019). This information must be disseminated to older public housing tenants.

Study Strengths and Limitations

To our knowledge, this is the first study to focus on older public housing tenants’ perceptions of physical activity. The walk-along method may have allowed for greater recall and ecological validity. We succeeded in reaching less active and less mobile older public housing tenants with varying degrees of health status and mobility. Still, further research should concentrate on older public housing tenants with minimal mobility. Of course, because of our sample’s small size and its limited generalizability, these results will need to be replicated in other cities and among other samples to bolster its conclusions.

Conclusion

In this study, older public housing tenants described physical activity as a multifaceted construct described in six interrelated dimensions that contribute not only to well-being, but also to ill-being. Physical activity promotion targeting this subgroup of the population should adopt a life-course perspective to avoid adverse effects. Physical activity promotion typically focuses on disseminating its benefits for physical health, but our study suggests that cognitive health should be given greater attention. These are essential data that may serve to tailor physical activity promotion to older public housing tenants.

Practical tools like the Physical Activity Messaging Framework (Williamson et al., 2021) could aid practitioners in translating this study’s knowledge into action. The Physical Activity Messaging Framework guides decision making for the elaboration of tailored promotional messaging. Promoting a coconstructive equity, diversity, and inclusivity-based approach, its three sections respectively hone in on (a) what contextual factors influence physical activity promotion, (b) what message content to prioritize, and (c) how to deliver that message. Concerning older public housing tenants, the present study suggests that contextual factors to consider include age, all forms of capacity, gender, as well as cultural, and community belonging. However, future studies are needed to analyze in depth how these individual characteristics influence older public housing tenants’ perceptions about physical activity. For certain older public housing tenants, promotional message content centered on improving and retaining cognitive ability could be more successful than focusing on avoiding muscle loss. This too needs to be corroborated in future studies.

In sum, this study provides further support to a broader physical activity promotion approach geared toward encouraging personal goal attainment and life purpose not solely health benefits. Future work is needed to investigate the specific contextual factors, message content, and delivery to better promote physical activity for older public housing tenants.

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    Figure 1

    Procedures of interviews with older public housing tenants.

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