[Healthy walks, beyond physical exercise: evaluation of an experience in older population from Gipuzkoa (Spain)]

Abstract

Introduction: In 2011 the Tipi-Tapa initiative was endorsed by the Public Health Department of Gipuzkoa to promote physical exercise through healthy walks in community-dwelling older adults, in collaboration with municipalities, citizens associations and primary care.

Objective: To evaluate, from the participants' perspective, the Tipi-Tapa experience during 2012-2017 to identify the main successes and failures and share proposals of continuity and improvement.

Method: Mixed methods design with a qualitative core component and a supplementary questionnaire to all participants from 13 municipalities. The Chi-squared test was used to compare percentages. In the qualitative study, a purposive sampling was applied considering participants' profiles through nine focus groups and 10 individual interviews. The interviews were audio recorded with previous consent. A thematic analysis was performed using conceptual maps and the MAXQDA software. Triangulation among researchers was done in a research-learning context.

Results: We analysed 464 questionnaires; 64% from women and 36% from men. The participants' mean age was 69.8 years; 75% were older than 65 years. The general satisfaction was 9.05/10 with significant differences in favour of women, older age groups and widows. In the qualitative study, 43 women and 37 men participated. Three main thematic areas were identified based on category coding and overlap: a) it is not just walking; b) organization, values and persons; and c) collaborative keystones and future challenges.

Conclusions: The health benefits perceived by participants go beyond physical exercise, with important implications for social interaction and cohesion. The complexity of the processes assessed entails methodological, organizational and collaborative requirements.

Keywords: Atención primaria; Community health; Community integration; Ejercicio físico; Envejecimiento saludable; Health promotion; Healthy aging; Integración comunitaria; Investigación cualitativa; Physical exercise; Primary care; Promoción de la salud; Public health; Qualitative research; Salud comunitaria; Salud pública.