Championing mall walking groups: Experiences from the Edmonton West Primary Care Network

Championing mall walking groups

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By Kevin Thomson, CSEP-CEP, ACSM-CCEP, Exercise Specialist, Edmonton West Primary Care Network, and Joe Hoffman, BScKin, ACSM-CCEP

Summary

Walking groups provide an opportunity for all to be physically active. As such, the Edmonton West Primary Care Network began their first mall walking group three years ago.

Experiences from the perspective of the facilitator are shared, including benefits, challenges and lessons learned on the delivery of the mall walking program.

Introduction

Physical inactivity and sedentary behaviour have been reported extensively as contributing to chronic health conditions, global economic costs and a lower quality of life for individuals.1 In physical activity counselling, there are many factors that influence whether a program will be effective and sustainable for an individual. These factors can include: time, location, environment, cost, social supports, chronic disease and injury, activity, speed, intensity, competence, accountability, and most importantly, enjoyment in participation.2 Walking groups, such as a mall walking program, provide a flexible option for people, especially when trying to become more active during the winter season.

A recent review of mall walking programs found various physical and social benefits including3:

  • Decreased BMI, waist-to-hip ratio and resting heart rate.
  • Increased flexibility.
  • Reduced perception of exertion.
  • Reduced barriers to walking such as falling, inclement weather, inaccessibility, and cost.
  • Providing non-competitive, non-judgmental, social, and friendly atmosphere for participants regardless of pace, attire and physique.

Although women have been found to enjoy mall walking for its social aspect, many individuals who continued mall walking as a routine felt they were part of a community that provided social and emotional benefits.3

Three years ago, the Edmonton West Primary Care Network (PCN) began its first mall walking group. This program has supported patients to increase their weekly physical activity levels. Patients who joined the group often began with little to no physical activity time per week. Over time, and with continued participation, patients have been seen to accumulate over 300 minutes per week and to sustain this level over the years. This article highlights the experiences of forming the Edmonton West PCN Mall Walking Group, including the benefits, challenges and lessons learned from the perspective of the facilitator overseeing the program.

Forming a Mall Walking Group

In 2015, the Centers for Disease Control and Prevention (CDC) published a mall walking program resource guide. This guide identifies key aspects to consider when forming and sustaining such a program, including4:

  • Lessons learned and best practices from various mall walking programs
  • Mall management support
  • Personnel that may be needed
  • Partnerships that may enhance a mall walking program
  • Transportation
  • Programmatic characteristics of a mall walking program
  • Community diversity and culture
  • Safety
  • Costs and economic factors
  • Attraction and retention of mall walking program participants
  • Evaluation

Walking groups can be offered in a variety of different ways, which can suit almost all population groups.

Based on the experiences from the Edmonton West PCN Mall Walking Group, to begin a program, a champion is needed — someone that everyone knows will be there walking even when no one else shows up. This champion dedicates their time and effort to organize and support the group. It is important for the champion to consult with the participants to determine the type of walking group that will cater to the group’s preferences. Similar to the key aspects listed above, examples of key factors considered by the Edmonton West PCN mall walking group were:

  • Time of day (e.g., early morning or lunchtime break)
  • Purpose (e.g., health, social community, or training for a race)
  • Location (e.g., indoor mall, local neighbourhood, or parks and trails)

When starting the Edmonton West PCN walking groups, all walkers’ speeds needed to be accommodated to ensure participants were not left out, and that all participants were able to achieve their goals. To support this, the program arranged participants into either a fast or slow group. The fast group would walk ahead at their own pace. Once this group was far enough ahead or out of sight, they would turn around to walk towards the slower group, “touch base”, and then continue off again. This versatility in intent and target audience, while being challenging, is one of the greatest strengths of the walking groups.

Over time and through seasons, the location of the walking group may change based on the group preferences. In the summertime, the Edmonton West PCN Mall Walking Group left the PCN building and decided to walk around the community. In the winter, the group would walk inside the West Edmonton Mall to avoid the ice and cold temperatures. During the winter, shopping malls provide a safe option to host a walking group, especially since malls tend to be open before the stores.

Sustainability – Why do participants keep coming back?

As the Edmonton West PCN facilitator, Kevin has the good fortune to work and engage with people while they are exercising. Through his experience of running the mall walking program, he has found that the social aspect of walking with others has been incredibly important for several reasons.

  1. Free and Safe – Malls provide a free and open space to walk. Research has shown that older populations feel safe, both in regards to their belongings and physical health.3 If anything were to go wrong, they are surrounded by friends and have places to sit. Mall walking programs have also reported very low levels of adverse effects or injury.5
  2. Accountability – Being part of a group can provide that bit of motivation to participate. For example, on a day when you are feeling unmotivated, a simple text message or call from a fellow group member asking if you will be joining that day can often provide that gentle push you need to show up. Also this form of accountability is free, versus paying a healthcare provider.
  3. Social Comparison - When someone else is doing the same thing you are doing, you tend to be motivated to keep up. When a younger patient was asked how the Edmonton West PCN Mall Walking Group motivates them, their response was, “I am the youngest one in the group, and when I see how much these older ladies can do, it inspires me to keep coming.”
  4. Distraction - When our brain is distracted during physical activity, we tend to work harder, go further, and exercise for longer.6 Based on the Edmonton West PCN Mall Walking Group, none of the members pursue walking for an hour, either on their own outside or on a treadmill. Rather, the mall walking group provides a social atmosphere that increases time spent walking.
  5. Mental Health - Sometimes we just need to talk. Research suggests that walking groups provide a social opportunity, which has been shown to benefit emotional and mental health.3

Successes, Challenges and Opportunities

Successes of the program include its continuation. This will be the third consecutive year that the program has been offered, running all year round. Although members of the program have come and gone, the program is regularly open for others to join and has sustained a group of five to eight participants, with the most at 10 to 12 participants at one time.

Through the program, friendships have grown with each other, and participants keep each other accountable to participate, even when it is very cold outside. The strong sense of belonging to the group has also been seen. For example, when one member developed a knee injury and was unable to walk, this member began to miss participating with the group. After a few weeks, this member bought a wheelchair and was able to continue “walking” with the group. As part of the recovery process, including physiotherapy and a knee brace, the member is now physically walking with the group for three times per week. Although members may face setbacks, the support of a close group of people is something that walking groups can offer, which encourages sustainability.

Starting any kind of community can be hard work. The first few months can certainly test perseverance and present great challenges personally. Once there is a dedicated group of people, the momentum of their commitment can act as the force needed for continuation.

Another challenge of the program is recruiting new people on a continual basis. Also it can be hard to be the new person entering an existing group with established relationships. Working together to welcome and support new members helps to overcome this challenge.

The most important lesson learned was that walking groups need to be individualized. Most notably, these programs work because they accommodate the specific demands of unique individuals in terms of schedule, location, ability, and personality.

Conclusion

Walking groups are one of many physical activity options available. In the cold Alberta climate, mall walking is a great, safe option for people of all ages to get their recommended amount of physical activity. There may be opportunity for the development of more walking groups around Alberta, especially in small communities, with friends, family or co-workers. These small walking communities can encourage and support each other to do something that many Albertans have a difficult time doing — obtaining the nationally recommended amount of physical activity.

Every group needs someone to start it — will you be that Champion?

The Edmonton West PCN offers a mall walking program at West Edmonton Mall on Mondays, Wednesdays, and Fridays from 12–1 PM. The meeting point is 100 metres in from entrance 32. The Edmonton Southside PCN also offers mall walking out of Millbourne Market Mall on Mondays from 6–7 PM and Wednesdays from 9–10 AM — please contact 780-395-2626 to register. The programs are free to join and the members would love to have new participants.


About the Authors

Kevin Thomson is an Exercise Specialist at the Edmonton West Primary Care Network. He counsels patients on making lifestyle changes around physical activity, provides exercise prescription and supervised exercise training in the community, and leads physical activity education groups. Kevin started working in cardiac rehab in Calgary and now enjoys working in Primary Care focusing on preventing and managing diseases to prevent cardiovascular disease.
Joe Hoffman is an exercise specialist at the Edmonton West Primary Care Network. He counsels patients on making lifestyle changes around physical activity, as well as provides exercise prescription and supervised exercise training in the community.

References

  1. Lee IM SE, Lobelo F, Puska P, Blair SN, Katzmarzyk PT, Lancet Physical Activity Series Working Group. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219-229.
  2. Franco MR, Tong A, Howard K, et al. Older people’s perspectives on participation in physical activity: a systematic review and thematic synthesis of qualitative literature. Br J Sports Med. 2015;49(19):1268-1276.
  3. Farren L, Belza B, Allen P, et al. Mall walking program environments, features, and participants: a scoping review. Prev Chronic Dis. 2015;12.
  4. Belza B, Allen P, Brown DR, et al. Mall Walking: A Program Resource Guide. Seattle, WA: University of Washington Health Promotion Research Center; 2015: http://www.cdc.gov/physicalactivity/downloads/mallwalking-guide.pdf.
  5. Hanson S, Jones A. Is there evidence that walking groups have health benefits? A systematic review and meta-analysis. Br J Sports Med. 2015;bjsports-2014.
  6. Deforche B, De Bourdeaudhuij I. Attentional distraction during exercise in overweight and normal-weight boys. Int J Environ Res Public Health. 2015;12(3):3077-3090.

February 2017, Volume 28, No. 2


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