Doctor of Philosophy in Interdisciplinary Studies (PhD)
Loneliness and social connection: A community-engaged study with older adults during the COVID-19 pandemic using visual and traditional methods
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Mobility enables older adults to maintain their physical health, independence and participation in society. In general, mobility has predominantly been understood in functional terms. Mobility is most often measured as physical movement and/or travel behaviour. Less attention has been paid to the subjective and temporal dimensions of older adults’ mobility experiences. In addition, older adults with low incomes are under-represented in mobility research. This dissertation uses a constructivist grounded theory methodology to describe the mobility experiences of active older adults with low income. The studies within this dissertation are set in Metro Vancouver; they utilize data from a group of 6 participants selected from a cross-sectional study of 161 older adults of low income.The first study demonstrates how a novel approach (grounded visualization) can be used to explore sociospatial and temporal complexities of older adults' mobility. A grounded visualization approach can provide a deeper understanding of the multi-faceted nature of older adults' mobility experiences. Findings illustrate that time is necessary for older adults' engagement with place; familiarity influences spatial perceptions of local and distant ‘neighbourhoods’; and older adults prioritize destinations that allow them to engage in multiple activities.The second study provides an in-depth qualitative description of the mobility experiences of older adults living with low income. The following themes were found to support mobility: maintaining a sense of self, being resourceful, openness to engagement, engaging in superficial contact, experiencing social capital, accessing transportation, leaving the immediate neighbourhood and facing affordability influence active mobility choices over time.The third study adapts a mobility conceptual framework to re-frame our understanding of older adults’ mobility experiences. The adapted framework offers a physiological, subjective, contextual and temporal approach that provides a more comprehensive conceptualization of the nature and processes of older adults’ mobility. The adapted framework uses a sliding scale in order to demonstrate the fluid, multi-faceted and interrelated nature of the various elements that influence mobility over time.Taken collectively, these studies fill methodological and conceptual gaps in the literature and provide data on an understudied population. The adapted framework can be incorporated into new approaches to study older adults’ mobility.
Introduction: Physical activity (PA), the movement of one’s body, and mobility, moving one’s body through space using a variety of modes, allow older adults to participate in their communities, cultivate social connections, maintain their health, and access services. Segments of the population, however, have been overlooked. While a growing body of research has focused on older adults, we know surprisingly little about the PA and mobility of foreign-born older adults (FBOAs).Objective: This dissertation uses a focused ethnographic approach to characterize the PA and mobility of 49 visible minority FBOAs in South Vancouver, Canada. Methods: The research was conducted in Hindi, Punjabi, Cantonese, Mandarin, and English. Forty-nine participants completed surveys about their PA habits; of these 49, 46 wore accelerometers and 18 completed in-depth interviews. I also developed a novel interview tool “interactive interpreted interviews”, neighbourhood walking interviews that included professional interpreters, which 13 participants completed. Results: Participants’ mean daily step count was 7,876 (women: 8,172; men: 7,164; Chinese: 8,291; South Asian: 7,196). The bulk of their time is spent in light and sedentary activities. Physical activity is principally acquired through walking for errands and work performed in/around the home. Participants walk for physical and mental wellbeing, and have access to a supportive social environment, which includes culturally familiar and linguistically accessible shops and services.Conclusions: This study challenges the assumption that FBOAs are less active than their non-immigrant peers and confirms the role of “nonexercise” and low activity, rather than moderate to vigorous activity, in older adults’ PA acquisition. Building on the Webber (2010) model of mobility in older adults, this study also highlights how gender and personal biography, including work history and family context, impact participants’ PA and mobility behaviours.
Background: Despite numerous proven health benefits of physical activity, there is a physical inactivity pandemic. This is particularly true in individuals with mood disorders. Although research has shown the therapeutic and preventative effects of physical activity in people with mental illnesses, the levels of physical activity in this population remains lower than the general population. Considering the overwhelming evidence, the question is not whether physical activity is beneficial, but how can we better engage persons with mental illness in physical activity. In this study, I explored facilitators and barriers to being physical active in these individuals. The primary aim was to understand the experiences of individuals who took part in a 14-week long Group Medical Visit with a focus on physical activity. The secondary aim was to better understand the key features of such a program.Methods: I interviewed 24 participants clinically diagnosed with mood disorders - Major Depressive Disorder or Bipolar II Disorder. Participants were aged 32-64 years. I evaluated qualitative data from participants with a mood disorder who participated in an exercise program. The interviews were transcribed and managed using NVivo 10™. Thematic analysis was used to analyze the data.Results: The results of this study detail participants’ preferred content and method of delivery of a physical activity program and identify facilitators and barriers to being physically active. The main facilitators are social support, building a routine in daily life, and exposure to nature. The barriers include the mood disorder itself, finances, and fear from stigmatization. The preferred exercise program comprises a variety of light-to-moderate activities, offers the opportunity to connect with other participants with a mood disorder, and being in nature. Conclusion: The individuals in this study felt that key features of a physical activity program for individuals with a mood disorder must utilize a social network approach, take into account preferences of potential participants, and incorporate nature (both green and blue spaces) as a health promotion resource. Green spaces are places such as parks and forests, while blue spaces are attributed to places close to a body of water such as the sea, lake, etc.
Mobility disability increases the need for assistance with daily tasks, lowers quality of life, and elevates mortality risk in older adults. Prevention of mobility disability is vital for this expanding population.Physical activity (PA) prevents mobility disability and chronic disease, improves cognitive function and mental health, and extends life. Adults ≥ 65 years old need 150 minutes of moderate-to-vigorous (MVPA) intensity aerobic PA weekly for health benefits, with balance training and muscle/bone strengthening activities twice weekly. Yet only 13% of Canadian older adults meet the MVPA guidelines. Though community-based interventions increase older adults’ PA, older men are less likely than women to participate in gender-inclusive programs. More research is needed to understand their lower rates of participation. This thesis aimed to describe older mens’ experiences with PA (barriers and facilitators) and provide insight about the preferred features of PA programs for older men. I reviewed interview transcripts of fourteen older men from a PA intervention study called, Men on the Move, and conducted an additional five interviews with a sample of community-dwelling older men (who did not participate in the intervention but who had similar characteristics). I then described and discussed similarities and differences between these men-only interviews and the literature on older adults (men and women) using content analysis. Socio-ecological perspective and hegemonic masculinity frameworks guided the research. Barriers to PA included lack of motivation, health, time, interests, finances, knowledge, fear of injury, social influences, lack of convenience, weather, caregiving, built and natural environments, low quality fitness instructors, and program structure.Facilitators to PA included chores, improved health, interests, time, a motivation to engage in PA, social influences, active transportation, built and natural environment, weather, program structure, and skilled and knowledgeable fitness instructors.Older men described their preferred features of a PA program as a small group atmosphere, individualized attention and programming, equal gender distribution, sports programming, gym and fitness classes, experienced fitness instructors who make classes fun, and fitness instructors who could take criticism. These findings, specific to older men, can be used to inform PA intervention design and program implementation.