Mall walking: Evaluating the evidence to create an Evidence-Informed Mall Walking Program Resource Guide

Background: Older adults are the fastest growing, most physically inactive demographic in the United States. Walking is a preferred activity for older adults, however providing safe places to walk is often a challenge. Mall walking programs (MWPs) can address that gap, although the elements for maximizing reach, effectiveness, and adoption of MWPs are unknown. Purpose: To understand essential programmatic features, environments, and policies that are necessary to provide sustained and well-attended MWPs. Method: We applied the RE-AIM framework, the socio-ecological model, and a health equity lens to conduct a scoping review of the MWP literature. Findings: Thirty-seven articles were reviewed and abstracted. Programmatic features of MWPs included blood pressure checks, mileage logs, warm-up exercises, walking route maps, and educational materials. Appealing MWP environments were described as safe, accessible to the local community, and well-lit. Partnerships were noted with hospitals, city governments, non-profits, and senior housing. MWPs were perceived as a benefit for both mall businesses and walkers by “promoting the central role malls have in improving the health of local residents.” Benefits of MWPs to local communities included socialization and fitness at low cost. Barriers were transportation and cost. Few cultural adaptations were mentioned. Implications: These findings will inform our planned systematic observation of malls, informant interviews, and the development of an Evidence-Informed MWP Resource Guide for use by mall managers, community coalitions, and public health professionals in the adoption and implementation of MWPs. MWPs may potentially increase the number of older adults meeting the Physical Activity Guidelines for Americans.