Walking trail access, exercise behavior, and going out-of-home among older adults: Examining longitudinal associations and mediators.

• We tested associations of walking trail access with exercise and going out-of-home. • We conducted a longitudinal questionnaire survey of older adults. • In longitudinal examinations, their associations were insignificant. • Awareness and use of walking trails were mediators in their associations. Although the presence of a walking trail within a neighborhood would be an important environmental determinant of health behaviors, such as exercise and going out-of-home, their longitudinal associations and mediators are still unconfirmed. This study examined the longitudinal associations of walking trail access with exercise behavior and going out-of-home and mediating roles of awareness and use of walking trails on their associations among older adults. A four-wave questionnaire-based longitudinal survey was conducted among Japanese older adults (Wave 1: baseline; Wave 2: after one year; Wave 3: after three years; and Wave 4: after five years). Each survey measured weekly exercise time and frequency of going out-of-home. Wave 4 survey also measured awareness and use of walking trails. This study calculated distance to nearest walking trail using geographic information systems. This study analyzed the data from all waves (n = 834) for longitudinal associations and the data from Wave 4 (n = 567) for mediated associations. Latent growth modeling showed insignificant longitudinal associations of walking trail access with weekly exercise time and frequency of going out-of-home. The path analyses showed that a shorter distance to the walking trail was indirectly and significantly associated with longer weekly exercise time (standardized indirect effect=-0.03, p <.001) and a higher weekly frequency of going out-of-home (standardized indirect effect=-0.03, p <.001), mediated by awareness and use of walking trails. These findings indicate that the influence of walking trail access on exercise behavior and going out-of-home would be attenuated by awareness and use of walking trails among older adults. [ABSTRACT FROM AUTHOR]