The current study used walk-along interviews to investigate the perceived environmental factors influencing walking for transportation among Flemish older adults. This novel method resulted in detailed and context-specific insights in the influence of previously studied and new environmental factors.
Our finding that good access to facilities (i.e. shops and services) encourages walking for transportation supports results from previous qualitative [20, 22, 23, 25] and quantitative studies [35, 40, 41]. Findings from the current study suggest that convenience (short distances) might not be the only explanation why the presence of facilities promotes walking for transportation. The presence of other people in shops and shopping streets might as well evoke feelings of safety from crime and provide opportunities for social contacts. Furthermore, our participants enjoyed looking at the show windows of shops. When designing new neighborhoods or senior housing, planners should foresee facilities within walkable distances from the residences. Integrating shops and services into existing neighborhoods might be more difficult to establish. However, the disappearance of local shops and services should be avoided as this might negatively affect walking for transportation among older adults.
Another category of environmental factors which are more amenable to change are walking facilities. Sidewalks were present in most of the streets walked along. However, almost all participants complained about the sidewalks’ quality. In line with previous qualitative studies, elements encompassing an increased risk of falling (e.g. uneven sidewalks, cracked tiles, snow…) were feared by our participants [20, 21, 24, 25]. Additionally, in the current study the width of the sidewalks and separation of the sidewalks from streets and cycling paths appeared to be important components of sidewalk quality. Next to the presence of well-maintained sidewalks the provision of safe crossings (e.g. zebra crossings, traffic lights…) emerged as an important factor. This latter is also in support of previous qualitative studies [20, 21, 23, 25].
Traffic safety, encompassing the subcategories “busy traffic” and “behavior of other road users”, emerged as a major issue during the walk-along interviews. In agreement with previous qualitative studies [20, 23, 25] participants preferred walking along streets with little traffic. This is in contrast to the positive relationship between objectively measured traffic volume and utility of a street section for transportation walking among older adults reported by Borst et al. . A possible explanation for this contradiction might be that important walking destinations (e.g. shops) are often located in busy streets. Consequently, although older adults prefer to walk in streets with little traffic, they are often obliged to walk in more busy streets in order to reach their destinations. Next to busy traffic, speeding traffic emerged as another source of traffic insecurity and dislike. This is consistent with previous qualitative research [20, 25]. Similar to findings by Grant et al. , our participants did not only fear careless car drivers but also careless cyclists. This explains the importance of sidewalks being clearly separated from cars and cyclists as described above. No quantitative study has examined the relationship between fear from collisions with cyclists and walking for transportation yet.
The presence of other people did not only influence feelings of safety from crime but was also liked because it provides opportunities for social contact. Gallagher et al.  concluded that the presence of familiar and friendly people in the neighborhood does influence walking, whether or not these people are engaging in PA themselves. This is supported by a quantitative study in the US which reported neighborhood social cohesion to be positively related to neighborhood walking . In the current study, the presence of other people was stated to facilitate walking for transportation, while the presence of a large crowd or youngsters displaying antisocial behavior possibly has the opposite effect. In the context of ecological models, research has primarily focused on the relationship between the physical environment and PA and less on the social environment. Based upon the above described findings, future studies investigating the relationship between the social environment and older adults’ walking for transportation should be encouraged.
Concerning aesthetics, in accordance with previous qualitative studies, noiseless, clean and well-maintained streets with attractive sights (e.g. historic buildings) or natural elements were perceived as attractive to walk through by our participants [21, 23, 24].
Weather conditions were discussed across the categories walking facilities, safety from crime and aesthetics. The quality of walking facilities was reduced by rain causing puddles and mud and by snow and ice causing danger to slip and fall. The increase in fear of falling during snowy and icy conditions was also thoroughly described in a Canadian study using a photovoice methodology . However, during data collection the winter was harsh in Belgium and the influence of snow and ice might have been less apparent when data were collected during another winter. Early darkness and diminished greenery are two other reasons why the winter was the least liked season for walking. These factors might explain the lower PA rates observed during fall and winter .
Although participants discussed several environmental factors separately, our findings also point to the importance of combinations of factors. Studying adults, Sallis et al.  reported that the presence of at least four favorable environmental factors is required to find a significant relationship with PA. In addition, our results suggest that the anticipated positive influence of certain factors (e.g. the presence of trees and high-quality sidewalks) might be outweighed in the presence of a negative factor (e.g. busy traffic). Furthermore, some environmental factors might influence walking for transportation stronger than others. Possibly, this is partially explained by the influence of some environmental factors on walking for transportation through several ways. For example, busy traffic has an effect on traffic safety but also on aesthetics through increasing cars’ exhausts. The same environmental factor might also simultaneously exert a positive and negative influence on the attractiveness for walking for transportation. For example, the presence of greenery might increase the aesthetic appeal of a street but possibly also provides hiding places for potential offenders which might increase feelings of insecurity. Interactions between and possible unanticipated effects of environmental factors have not yet been studied but warrant attention in future research.
Findings from the current and previous qualitative studies are clearly not confirmed by quantitative studies. Whereas qualitative studies consistently point to the importance of high-quality walking facilities, safety from traffic and crime and aesthetics, findings from quantitative studies are inconsistent . First, this might be explained by difficulties in measuring environmental perceptions and walking behaviors (e.g. how to define an older adults’ neighborhood in which perceptions should be assessed?). Additionally, it might be difficult to capture perceptions of environmental factors when the participants are not simultaneously exposed to these factors. This was overcome in the current study by conducting walk-along interviews and might explain the obtained richness and detail in data. Second, as described above, the absence of statistical relationships in previous quantitative studies might result from investigating environmental factors individually rather than in combination or in interaction with one another.
Future research could benefit from walk-along interviews for several reasons. First, they provide rich, detailed and context-specific information on how and why previously studied environmental factors influenced walking for transportation among older adults. Second, they revealed “new” (not yet studied) environmental factors of relevance to older adults’ PA behaviors (i.e. openness, hiding places and familiarity). Third, the participants appreciated the use of walk-along interviews, which, compared to traditional interviews, create a more egalitarian relationship between researcher and participant [26, 27]. Fourth, the vivid stories linked to certain neighborhoods or situations can help convince policy makers to make the environmental changes to promote PA.
An additional strength of the current study is the relatively large sample size which led to a saturation of information. Furthermore, the study captured a large sample of the environment; three different (semi-)urban regions and two different walking routes per participant. Hence, participants were exposed to a wide variety of environmental factors.
Regarding the limitations, as the study was conducted in fall and winter, the degree to which similar results would emerge in spring or summer is unclear. Because our sample consisted of (semi-)urban dwelling, highly educated, active and functionally fit older adults, one should also be cautious in extrapolating the results to rural dwelling, less educated, less active or functionally impaired older adults. For example, busy traffic might be less an issue in rural areas and quality of sidewalks might be even more important in functionally impaired older adults with great fear of falling. Furthermore, since the (semi-)urban environmental context differs between cities, countries or continents findings of the current study are not necessarily generalizable to other regions. More research is definitely needed to test how well our results apply to other seasons and subgroups in different parts of the world.
In conclusion, our findings indicate that in order to promote walking for transportation among older adults, a neighborhood should provide good access to shops and services, well-maintained walking facilities, aesthetically appealing places, streets with little traffic and places for social interaction. In addition, the neighborhood environment should evoke feelings of familiarity and safety from crime. The on-site exposure of participants enabled us to collect detailed information about specific environmental factors contributing to the above described conditions of an “ideal neighborhood” to walk for transportation. Future quantitative studies should investigate if (changes in) these environmental factors are related to (changes in) older adults’ walking for transportation.