Identifying Factors That Influence Physical Activity and Healthy Aging Among Older Latino Adults

Abstract

Background

For older Latinos, some benefits of leisure-time physical activity (LTPA) include enhanced cognitive functioning, decreased loneliness, and reduced premature mortality. Despite LTPA benefits, adults ≥50 years are one of the most inactive age groups in the United States.

Methods

This qualitative study aimed to add to the limited evidence of LTPA in older Latino adults by exploring the barriers and facilitators for fitness class uptake and park use. Guided by a Social-Ecological Model of Health and Social Determinants of Health theoretical and a phenomenological research design, qualitative research data were collected via 27 personal interviews with Latino adults using a semistructured interview guide. Participants were recruited using purposive sampling strategies in collaboration with community partners. Bicultural data collectors conducted the semistructured interviews over Zoom. Thematic analysis was performed using Dedoose, following an inductive and deductive approach.

Results

The main barriers to fitness class attendance and park use were family and/or work commitments, perceived safety, and perceived discrimination. Conversely, the critical facilitators for participation were socialization into a group, social connectedness with group members, fitness instructor characteristics, and exercise history.

Conclusions

Findings from this study hold important implications for the design of fitness programming and park-based recreation, including the need to increase the cultural diversity of recreation staff and culturally relevant programming. Future research is needed on time poverty related to family/work commitments and whether discriminatory practices at fitness centers, like ageism and race/ethnicity, influence physical activity behavior.

Keywords

health aging parks fitness classes minority and ethnic groups older adults Latino health

Background

Older adults in the United States are one of the fastest growing sub-populations (Caplan & Rabe, 2023), and leisure-time physical activity (LTPA) is a key behavior for “active aging” (Bauman et al., 2016; Burrows et al., 2020; Kalyani et al., 2015). The minimum recommended amount of LTPA is 150 minutes per week (Piercy et al., 2018). As part of healthy aging, engaging in LTPA includes decreased perceived loneliness and mortality (Mays et al., 2020) and improved cognitive scores (Piedra et al., 2017).

Despite the positive effects of LTPA on health, many U.S. adults and specific racial/ethnic subgroups of economically disadvantaged adults do not engage in sufficient LTPA (Whitfield et al., 2019). Approximately 76% of U.S. adult respondents did not meet the weekly guidelines for LTPA (Centers for Disease Control and Prevention [CDC], 2021). These trends are similar for the state of Texas. Latino adults in Travis County, TX, between 45 and 65 years of age, and those who earned less than $50,000 per year meet LTPA guidelines (21%) compared to their respective counterparts 28% (CDC, 2021; Samega et al., 2020). The disparities in engagement in LTPA among Latino adults and communities experiencing economic disadvantage underscore an ongoing need to understand place-specific factors to increase uptake in LTPA.

Frameworks for Understanding Place-Specific Physical Activity

The Social Determinants of Health (SDOH) and the Social Ecological Model (SEM) are useful frameworks for understanding place-specific factors influencing LTPA uptake in older Latinos in Travis County, TX. The SDOH framework clarifies how economic, social, political, and other factors affect health and health-related behaviors (Healthy People, 2020). SDOH are the conditions in which people are born, live, work, and play (Green & Allegrante, 2011). Social determinants of place and economic stability shape health and health behaviors and may provide further insights into why Latino and economically disadvantaged communities engage or do not engage in LTPA (Chetty et al., 2016; Vaughan et al., 2018). SEM is a meta-model with five levels of influence that posit that health and health-related behaviors are influenced by both individual-level factors (e.g., self-efficacy to engage in LTPA) and ecological-level factors at the interpersonal, organizational, community, and societal levels (Golden et al., 2015; Green & Allegrante, 2011; Sallis et al., 2015) and are maintained by the SDOH. Past research has focused mainly on the SEM’s individual, interpersonal, and community levels to understand LTPA engagement among Latino adults. At the individual level, constructs from Social Cognitive Theory were the strongest psychosocial indicators for LTPA among Latino adults (Griffith et al., 2018; Ickes & Sharma, 2012; Loya, 2018; Mama et al., 2015). At the interpersonal level of the SEM, lower engagement in LTPA among Latino adults may be due to critical cultural principles (Joseph et al., 2018; Larsen et al., 2015; Payán et al., 2019). At the community level, features of the built environment can influence the uptake of LTPA, like access to high-quality recreational facilities (Moore et al., 2008; Vaughan et al., 2018). However, the organizational level of the SEM has received less attention about LTPA in Latinos. Past research identified inconsistent group class scheduling (Cohen et al., 2016) and the cost and location of group classes as barriers to the uptake of group fitness classes (Arevalo & Brown, 2019). The organized group feature of fitness classes and having a place to do group activities could be further enriched at parks (Cohen et al., 2016; Derose et al., 2019; Han et al., 2015). Specifically, for Latinos, parks are a communal space for group activity (Dobbinson et al., 2020; Dolash et al., 2015; Sami et al., 2018; Vaughan et al., 2018).

Given that group-based fitness classes, both indoor and outdoor, represent promising strategies for the promotion of LTPA at the organizational and community levels of the SEM (Springer et al., 2017, 2022), this study aimed to understand the unique place-based barriers and facilitating factors to fitness classes and park-based physical activity among a sample of Latino adults aged 50 years and older in Travis County, TX.

Method

Qualitative Approach and Research Paradigm

A phenomenological approach (Neubauer et al., 2019) to qualitative research was used to understand the lived experiences of older Latinos attending fitness classes and using parks for recreation. The SDOH Framework (Green & Allegrante, 2011) and the SEM (Golden et al., 2015; Sallis et al., 2015) guided the research. The Standards for Reporting Qualitative Research (SRQR; O’Brien et al., 2014) informed reporting.

Study Population and Recruitment Strategy

Recruitment followed purposive sampling strategies based on preselected criteria (Suri, 2011). Eligible participants were (a) age ≥50 and reside in Travis County, TX; (b) fluent in either English or Spanish; (c) self-identified as Latino, and (d) had not been told by a medical provider to avoid physical activity. Before the study, a community advisory board (CAB) was established to review the approach and assist with recruitment. Five CAB members were selected based on their interest in the research topic or knowledge of the geographic area. In addition to providing overall guidance with the study, CAB members also helped distribute flyers about the research project.

Measures and Data Collection Methods

The semistructured interview guide (Table 1) included questions and probes that explored barriers and facilitating factors for LTPA engagement in fitness classes and parks for recreation according to the SEM levels and SDOH Framework. Interviews were conducted between October and December of 2021 via Zoom. Each interview lasted 30 to 45 minutes. Aligned with best practices for recruiting and retaining older adults, eligible participants received a $35.00 incentive, data collectors were bicultural and bilingual, and data collection occurred during an appropriate time for participants (Marquez et al., 2020).

Table 1.

Semistructured Interview Guide, Older Latinos Study, to Explore Barriers and Facilitators for Engagement in Leisure-Time Physical Activity in Travis County, TX, 2021.

OPENING: During today’s interview, I am going to be asking you questions about your attitude toward physical activity, reasons that might prevent you from being physically active, and recommendations that could enhance your uptake of physical activity.
Domain	Open-ended questions
First, I want to ask you about barriers that could hinder your attendance for fitness classes using parks for recreation.	Q1. “What things in your neighborhood make it difficult to attend fitness classes and/or use parks for recreation? (Prompts include access to resources).” Q2. “What aspects of your life make it difficult to attend fitness classes and/or use parks for recreation? Prompts include cost of attendance, characteristics of the instructor, and time in the day)?” Q3. “What would be some of the benefits of attending fitness classes and/or using parks for recreation?” (Prompts include being physically active).
Let us now discuss facilitators for attending fitness classes and using parks for recreation.	Q1. “Share with me some of your thoughts about what motivates you to be physical active/exercise? (Prompt will be better health).” Q2. “What are some of the reasons why you attended, or are currently attending, group-based fitness classes? (Prompt will be friend and family support)?” Q3. “What are your thoughts about taking a group-based fitness class at an outdoor space, like a park?”
Last, we are going to discuss recommendations for using fitness classes and parks for recreation.	Q1. “What can be done to enhance your future uptake of group-based fitness classes?” “What about for your community/friends/family?” Q2. “What can be done to enhance your uptake of park-based physical activity?” “What about for your community/friends/family?”
CLOSING: Is there anything that we did not talk about today that is important to add?

Data Analysis

Qualitative audio data were transcribed by Wreally (n.d.) and analyzed by Dedoose (2016). Interviews were anonymized, with each participant given an identification number. To analyze data, both a deductive and an inductive approach were used (Braun & Clarke, 2006), including six steps for conducting thematic analysis (Braun & Clarke, 2006). The Framework for Reflexivity in Health Promotion (Watt, 2007) and guiding questions for reflexivity (Alexander et al., 2020) were used to explore the research with the author’s interpretation intentionally. Phase 1 included an in-depth data transcript review. Phase 2 included preliminary coding; phase 3 included identifying initial themes. In phase 4, a thematic map was generated for each primary theme, and in phase 5, we named and defined themes according to the data that encapsulated them. Finally, the themes were used to tell a story about the data during phase 6 by embedding data extracts into the analytic narrative. The UTHealth School of Public Health Committee for the Protection of Human Subjects reviewed and approved the study protocols and consent procedures.

Results

Demographic Characteristics of Sample

Among the 33 adults interviewed, six did not meet the inclusion criteria for the study, resulting in a final sample of 27 participants. Most participants were female (70.4%), had a high school education (40.7%), and had an income equal to or less than $65,000 per year (74.1%; Table 2). Emergent themes are presented below according to the primary study domains.

Table 2.

Descriptive Characteristics of the Study Sample (N = 27). Older Latinos Study, Texas, 2021.

Total	N	%/M (SD)
Sex	27	100.00%
Male	8	29.63%
Female	19	70.37%
Age		62.37 (8.12)
Highest level of education
No schooling completed	1	3.70%
High school graduate	11	40.74%
Some college credits	1	3.70%
Associate degree	3	11.11%
Bachelor degree	8	29.63%
Graduate and professional degree	3	11.11%
Annual household income
Less than $25,000	7	25.93%
$25,001–$45,000	3	11.11%
$45,001–$65,000	10	37.04%
$65,001–$85,000	3	11.11%
$85,000+	4	14.81%
Primary language spoken
English	20	74.07%
Spanish	7	25.93%

Note. SD = standard deviation.

Barriers to Fitness Class and Park-Based Physical Activity

Figure 1 presents a summary thematic map of the key barriers to fitness class and park utilization as organized by the levels of the SEM.

Figure 1.

Thematic Map: Barriers for Attending Fitness Classes and Parks for Recreation, Travis County, Texas, Fall, 2021 (N = 27).

Intrapersonal Barriers

Theme 1: Attitudes About Physical Activity

Some participants considered LTPA as part of their work (i.e., manual labor jobs) or through their household maintenance (e.g., yard work) to be equivalent and sufficient LPTA. When describing manual labor jobs, a participant said, “I worked so hard ever since I was a child in the fields,” and explained how she considered working as “a joy because it was physical activity.” Another participant said he is busy “cooking, washing clothes, and putting plants inside and outside.” Participants also cited that those forms of physical activity are part of their culture, “I think that being a Hispanic . . . You come home. You clean. You make dinner. You do this. You do that. You do laundry. It wasn’t in our goals to do this [LTPA].”

Theme 2: Age-Related Ailments

Age-related ailments describe chronic and onset health conditions resulting from natural aging. These conditions sometimes made LTPA challenging for participants to perform. One participant said menopause was a challenge: “At 50-plus years old, going through the change of life for a woman is definitely difficult.” Another participant described the challenge of arthritis: “Yeah, it is arthritis. I have it all over. I do the best I can and deal with it.”

Theme 3: Perceived Safety

Perceived safety means how comfortable and safe participants feel as a precursor for attending fitness classes or using parks. Examples of concerns included COVID-19 infection and neighborhood safety. When discussing COVID-19, one participant said, “I didn’t know how clean the place was, especially right now with the virus.” Neighborhood safety was another subtheme of perceived safety. One participant said: “I live in the high crime area. So, we have to be aware of your surroundings. And that makes it difficult to have a comfortable workout or just a leisure walk.”

Interpersonal Barriers

Theme 1: Family and/or Work Commitments

Family and/or work commitments refer to individual time constraints. For example, time limitations resulted from hours worked for employment and/or hours worked as a caregiver for a family member. One participant mentioned the restrictions of his job: “I’m constrained . . . I got to stay late for work, or I got to work after hours or something like that. I got to be on call.” When discussing caregiving, a different participant described how she could only leave to exercise when she had somebody to watch after her son:

I have a 26-year-old on a ventilator. He’s deaf, and he has a trach and a feeding tube. He’s been like that since birth. So, my schedule is also different because I can only leave when I have somebody to take care of him. Where are all the wellness programs?

Organizational-Level Barriers

Theme 1: Characteristics of Fitness Classes

Characteristics of fitness classes emerged as the main theme at the organizational level of the SEM. This theme included session features, cost of attendance, and information and marketing. Examples of session features included exercise modification, group composition, and times classes were offered. According to one participant: “Some classes do tell you to go at your own pace, but a lot of them are so fast.” Participants also discussed group composition as a session feature. For example, “I think I’ve had previously chosen when there was an option to have an all-female gym that I went to, it closed, so I did not have that option the last few years. [So] it was nice knowing it was all women.” Class timing was also mentioned as a session feature that limited LTPA, “I work from home 8:00 to 5:00—some of the classes the YMCA offers are during those hours. There are not very many options outside of their hours.”

Participants also cited attendance costs as a subtheme of fitness classes’ characteristics: “It’s money, sometimes—financial. Things have gotten expensive. If I feel like $15.00, classes are too much; drop-ins are $20. It’s just too much.” Information and marketing were the final subthemes that emerged from the data. Participants mentioned not knowing when recreation centers are open for use: “We don’t get anything in the mail that says, ‘Do you know what this new center’s opening night is?’”

Community-Level Barriers

Theme 1: Quality and Access

A key barrier at the community level for engagement in LTPA was quality and access to fitness classes and park-based programming. One participant cited existing amenities as unsatisfactory: “I only go to the local parks to run. The weight bars, or iron bars, are sometimes a little slippery or are not ergonomically set correctly for different heights.” Participants also cited the distance to physical activity spaces as a subtheme: “It depends on the distance. I don’t drive. If I caught the bus, I would have to wait long.”

Societal-Level Barriers

Theme 1: Perceived Discrimination

One key societal-level theme that emerged as a barrier to attending fitness classes and using parks for recreation was perceived discrimination. Participants defined perceived discrimination as intentional or unintentional biases against participants based on race/ethnicity and age. For example, when describing her experience with attending fitness classes, one participant said:

I’ve noticed it more in [this area of Texas], but I also came from [another city in Texas]. And so, [in my hometown], they will welcome you. They will say “hello.” They will greet you. They will lower the level of fear just by saying, “Oh my God, I’m so glad you’re here. Thanks for being here.” None of that happens at a class or in a park here [in this area of Texas]. It’s like do they see me? It sometimes feels like nobody even noticed that I showed up. Nobody.

Participants also mentioned age biases. One participant said she does not want to be labeled the “geriatric crowd” because “you can still enable older people without labeling them. You can still empower them and challenge them without labeling them and thinking ‘the senior’.”

Facilitators for Physical Activity

Reasons and motivations for attending fitness classes, using parks for recreation, and being physically active are categorized based on levels of the SEM (Figure 2).

Figure 2.

Thematic Map: Facilitators for Attending Fitness Classes and Parks for Recreation, Travis County, Texas, Fall, 2021 (N = 27).

Intrapersonal-Level Facilitators

Theme 1: Perceived Benefits of Health

Participants described health as improvements in their physical or mental well-being. Two subthemes within health include physical health and mental health. Participants expressed physical health as the prevention of the onset of disease or disease management. Participants noted how LTPA was necessary for their physical health, including strength, mobility, and balance improvements. One participant said, “Physical activity goes hand in hand with nutrition. I believe it prolongs the chronic diseases that will one day affect us all.”

Participants described the mental health benefits of LTPA as improvements in mood and confidence. One participant shared her mood after a workout with her sister: “I’ll tell my sister I feel so much better. I feel more motivated.”

Interpersonal-Level Facilitators

Theme 1: Friend and/or Family Support

Participants described support and accountability from friends and/or family members to attend fitness classes or use parks for recreation. One participant mentioned how he attends fitness classes on certain days: “But ever since I kind of met these groups at [the recreation center], I kind of started going on certain days, so we will always make sure we were there.”

Theme 2: Socialization

Participants described socialization as another motivator for attending fitness classes or using parks for recreation, including engaging in communal gatherings with others and exchanging health-related information. One participant said that when he attends fitness classes to learn skills with friends, he “learns new things, has a sense of being with other people and working toward the same thing [goal].”

Another participant described his 15 years of attending fitness classes:

Fifteen years ago, I didn’t want to talk to anyone. “Just leave me alone.” I just wanted to do my thing here because I got to do it. So, over the years, the social. . .talking to people is a big deal. I want to go talk to those people and be around them.

Theme 3: History of Exercise

Participants explained the history of exercise as engaging in LTPA across various parts of their lives. A typical example of LTPA cited was playing sports. For example, one participant said that he would “practice playing football” when he was young and how that has kept him “active” as an adult. In addition, having active parents was a subtheme that emerged as an added motivator for LTPA. For example, one participant said that her dad “is gonna be 92” and her “mom is going to be 89,” and they still “go to the gym.”

Organizational-Level Facilitators

Theme 1: Characteristics of Fitness Instructor

Participants cited characteristics of fitness instructors as crucial motivators for their participation in fitness classes, including friendliness, proficiency, and relatability. One participant valued knowledge, saying, “Most of the instructors are graduate students or people who have graduated with a Master’s in Kinesiology or Exercise Science.” In addition, positive characteristics of fitness instructors cited by participants included knowing participants by name, having a degree or certificate, and being of the same race/ethnicity and/or having a similar body type as participants. One participant described their instructor as “Hispanic” and described the instructor as having told participants that if “they can’t do this [exercise], you know, don’t do it or do it slower,” meaning that the instructor was knowledgeable of how to modify exercises.

Theme 2: Characteristics of Fitness Class

Participants described the cost of attendance and features of the session as reasons to attend fitness classes. The cost to participate in fitness classes ranged from no cost to having a fee: “Most of those classes [at recreation centers] are free if you’re 55 and over,” said one participant. In addition, participants cited class schedules, class structure, and types of sessions offered as features of the fitness classes that encouraged uptake. For example, one participant noted how she receives her weekly exercises: “I’m happy with the way the structure is set up now. I get an email four days a week. I get an exercise attached to that email, a link to 45 minutes of working out.”

Theme 3: Places, Spaces, and Establishments

Participants cited places, spaces, and establishments as the physical locations where LTPA occurs, and examples of organizations promoting LTPA were “golden rollers,” and “Aging is Cool.”

Theme 4: Amenities

Participants described amenities as features of the park or recreation facilities perceived as enjoyable. For example, one participant described the landscape of a walking trail at a city park, “[The park], it’s so open, and I just feel comfortable. . . It’s so pretty. The ducks and the landscaping and seeing people walk with the little strollers.”

Discussion

This community-informed qualitative study identified and described barriers and facilitators toward participation in fitness classes and recreational park usage among older Latino adults in Travis County, Texas. The main findings in the context of the literature and practice are considered below.

Barriers

This study found that family and/or work commitments, perceived safety, and perceived discrimination were the main barriers to attending fitness classes and/or using parks for recreation in older Latinos in Travis County, TX. Family and/or work commitments have been previously cited as personal barriers to engagement in LTPA among older Latinos (Watson et al., 2016). A possible explanation may be time poverty, initially defined by Hyde and colleagues (2020) as “the time women spend on unpaid activities, leaving little time for leisure activities.” Both genders in this study experienced time poverty. Notably, individuals who worked shift occupations had less time for leisure activity, which supports the definition of time poverty to be expanded to include men, shift work, and commuting (Schutzer & Graves, 2004). These findings differ from past research in older adults, which previously defined insufficient time as ineffective time management (Schuler et al., 2006). These findings underscore the need for further research on work schedules and living wages as critical targets for greater LTPA participation among working-class Latino adults.

Perceived safety is another documented barrier to using parks for recreation and engaging in fitness classes outdoors in lower-income and Latino communities (Heredia et al., 2020; Payán et al., 2019). Like previous research about park use, women have expressed concerns about using parks for recreation because of fear of crime (Derose et al., 2019). In this study, participants also cited safety concerns about COVID-19.

We were surprised to learn about perceived discrimination based on age and race/ethnicity as a barrier to LTPA. The literature review found some support for ageism as a barrier to LTPA (Eswaran & Meisner, 2022; Lineweaver et al., 2018). However, most research about discrimination and LTPA was related to physical ability (Nikolajsen et al., 2021) and weight (Jackson & Steptoe, 2017; Phibbs et al., 2019). We have not found studies supporting or contradicting our findings for race/ethnicity and age and their relationship to physical inactivity. One possible explanation might be the Minority Stress Theory, which hypothesizes that distal and proximal stress factors occur because of minority status and that stigma-related stress leads to increased experiences of stressors like rejection sensitivity, which could impact mental health (Meyer, 2003). These types of discrimination at fitness classes could produce harm by generating more stress for minorities and leading to depression and anxiety.

Facilitators

This study found that socialization, exercise history, and fitness instructor characteristics were key facilitators for attending fitness classes and/or using parks for recreation. The relationship between social support as a motivator for LTPA in Latinos is well known (Craven et al., 2018; Larsen et al., 2015). While social support in previous studies has been characterized as friend and family encouragement for participation in LTPA (Craven et al., 2018; Dellaserra et al., 2018; Mama et al., 2015), this study found support for socialization as a precursor to friend support. This finding contributes to current research on socialization and attending fitness classes (Mehra et al., 2016; Springer et al., 2022). This study and others also revealed that socialization within classes could lead to long-lasting friendships (Costello et al., 2011). Long-lasting friendships could transition into social support for LTPA and reduce social isolation (Schrempft et al., 2019). Because of the strong link between socialization and healthy aging (Kemperman et al., 2019; Lindsay-Smith et al., 2018) and LTPA and healthy aging (Daskalopoulou et al., 2017), additional research is needed to understand if there is a difference between socialization and social support, as it relates to LTPA motivation for older Latino adults.

A surprising theme from this study was a history of exercise as a facilitator for attending fitness classes or using parks for recreation. The link between sports participation in children and youth and later engagement in LTPA has been well documented (Basterfield et al., 2015; Telama, 2009). Findings from this study support previous research on LTPA tracking from childhood to adulthood.

Finally, fitness instructors’ characteristics emerged as a facilitator for fitness class attendance. This theme supports previous research on the importance of the relatability of fitness instructors for fitness class attendees (Manson et al., 2017; Springer et al., 2022).

Strengths and Limitations

This study has two core strengths. First, the study recruited an underrepresented population, using best practices for recruiting and retaining older people (Marquez et al., 2020). Second, the nature of the in-depth interviews provided an opportunity for the research team to understand LTPA within a given setting better (Mack, 2005), which resulted in data saturation in each of the identified themes.

The study has three main limitations. First, the reliability of the results could be impacted by using a single coder with a unique lived experience. We attempted to overcome this limitation by using guided-reflective questions to understand how the first author interpreted the data. Second, interviews were conducted on two types of LTPA. Consequently, we may have missed other types of LTPA that the sample could engage in. The final limitation is generalizability. This study defined “older adult” as 50 years or older, in line with previous work about age and LTPA (Watson et al., 2016). However, “older” adults have been defined by others to range from 40 years and older (Juarbe et al., 2002) to 65 years and older (Wilbur et al., 2012). Because of the differences in how age is defined, future research should explore other differences in barriers and facilitating factors for different age groups.

Conclusion

This study identified several barriers and facilitators to using fitness classes and parks for recreation among older Latinos in Travis County, Texas. Key barriers included family/work commitments, perceived safety, and perceived discrimination. Key facilitators included positive socialization, history with exercise, and fitness instructors’ characteristics. Findings from this study may inform the design and evaluation of current fitness programming and park-based recreation, including varied timing for when fitness classes are offered. Future research should investigate how to mitigate barriers related to age and race/ethnicity in attending fitness classes.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Elena Luna

References

Alexander

S. A.

Jones

C. M.

Tremblay

M. C.

Beaudet

Rod

M. H.

Wright

M. T.

(2020). Reflexivity in health promotion: A typology for training. Health Promotion Practice, 21(4), 499–509.

Arevalo

Brown

L. D.

(2019). Using a reasoned action approach to identify determinants of organized exercise among Hispanics: A mixed-methods study. BMC Public Health, 19(1), 1181. https://doi.org/10.1186/s12889-019-7527-1

Basterfield

Reilly

J. K.

Pearce

M. S.

Parkinson

K. N.

Adamson

A. J.

Reilly

J. J.

Vella

S. A.

(2015). Longitudinal associations between sports participation, body composition, and physical activity from childhood to adolescence. Journal of Science and Medicine in Sport, 18(2), 178–182. https://doi.org/10.1016/j.jsams.2014.03.005

Bauman

Merom

Bull

F. C.

Buchner

D. M.

Fiatarone Singh

M. A.

(2016). Updating the evidence for physical activity: Summative reviews of the epidemiological evidence, prevalence, and interventions to promote “active aging.” The Gerontologist, 56(Suppl_2), S268–S280.

Braun

Clarke

(2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.

Burrows

Andrade

F. C. D.

Piedra

Aguiñaga

Steinberg

Sarkisian

Hernandez

(2020). The influence of evidence-based exercise and age reattribution on physical function in Hispanic older adults: Results from the¡ Caminemos! Randomized Controlled Trial. Journal of Applied Gerontology, 40(3), 278–288.

Caplan

Rabe

(2023). The older population: 2020 Census brief. https://www2.census.gov/library/publications/decennial/2020/census-briefs/c2020br-07.pdf

Centers for Disease Control and Prevention. (2021). BRFSS prevalence & trends data [online]: Explore BRFSS data by topic. https://www.cdc.gov/brfss/brfssprevalence/

Chetty

Stepner

Abraham

Lin

Scuderi

Turner

Bergeron

Cutler

(2016). The association between income and life expectancy in the United States, 2001-2014. JAMA, 315(16), 1750–1766.

10.

Cohen

D. A.

Han

Derose

K. P.

Williamson

Marsh

Raaen

McKenzie

T. L.

(2016). The paradox of parks in low-income areas: Park use and perceived threats. Environment and Behavior, 48(1), 230–245. https://doi.org/10.1177/0013916515614366

11.

Costello

Kafchinski

Vrazel

Sullivan

(2011). Motivators, barriers, and beliefs regarding physical activity in an older adult population. Journal of Geriatric Physical Therapy, 34(3), 138–147.

12.

Craven

M. R.

Keefer

Rademaker

Dykema-Engblade

Sanchez-Johnsen

(2018). Social support for exercise as a predictor of weight and physical activity status among Puerto Rican and Mexican men: Results from the Latino men’s health initiative. American Journal of Men’s Health, 12(4), 766–778.

13.

Daskalopoulou

Stubbs

Kralj

Koukounari

Prince

Prina

A. M.

(2017). Physical activity and healthy ageing: A systematic review and meta-analysis of longitudinal cohort studies. Ageing Research Reviews, 38, 6–17. https://doi.org/10.1016/j.arr.2017.06.003

14.

Dedoose Version 7.0.23, web application for managing, analyzing, and presenting qualitative and mixed method research data . (2016). SocioCultural Research Consultants, LLC. https://www.dedoose.com

15.

Dellaserra

C. L.

Crespo

N. C.

Todd

Huberty

Vega-López

(2018). Perceived environmental barriers and behavioral factors as possible mediators between acculturation and leisure-time physical activity among Mexican American adults. Journal of Physical Activity and Health, 15(9), 683–691.

16.

Derose

K. P.

Han

Park

Williamson

Cohen

D. A.

(2019). The mediating role of perceived crime in gender and built environment associations with park use and park-based physical activity among park users in high poverty neighborhoods. Preventive Medicine, 129, 105846. https://doi.org/10.1016/j.ypmed.2019.105846

17.

Dobbinson

S. J.

Simmons

Chamberlain

J. A.

MacInnis

R. J.

Salmon

Staiger

P. K.

Wakefield

Veitch

(2020). Examining health-related effects of refurbishment to parks in a lower socioeconomic area: The ShadePlus natural experiment. International Journal of Environmental Research and Public Health, 17(17), 6102. https://doi.org/10.3390/ijerph17176102

18.

Dolash

Yin

Sosa

E. T.

(2015). Factors that influence park use and physical activity in predominantly Hispanic and low-income neighborhoods. Journal of Physical Activity and Health, 12(4), 462–469. https://doi.org/10.1123/jpah.2013-0226

19.

Eswaran

Meisner

B. A.

(2022). Influence of ageism on physical activity prescription for prediabetes management. Journal of Aging and Physical Activity, 30(5), 880–885.

20.

Golden

S. D.

McLeroy

K. R.

Green

L. W.

Earp

J. A.

Lieberman

L. D.

(2015). Upending the social ecological model to guide health promotion efforts toward policy and environmental change. Health Education & Behavior, 42(1 Suppl.), 8S–14S. https://doi.org/10.1177/1090198115575098

21.

Green

L. W.

Allegrante

J. P.

(2011). Healthy People 1980-2020: Raising the ante decennially or just the name from public health education to health promotion to social determinants? Health Education & Behavior, 38(6), 558–562.

22.

Griffith

D. M.

Bergner

E. M.

Cornish

E. K.

McQueen

C. M.

(2018). Physical activity interventions with African American or Latino men: A systematic review. American Journal of Men’s Health, 12(4), 1102–1117.

23.

Han

Cohen

D. A.

Derose

K. P.

Marsh

Williamson

Loy

(2015). Effectiveness of a free exercise program in a neighborhood park. Preventive Medicine Reports, 2, 255–258. https://doi.org/10.1016/j.pmedr.2015.03.010

24.

Healthy People. (2020). Social determinants of health. https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health

25.

Heredia

N. I.

Fernandez

M. E.

Durand

C. P.

Kohl

H. W.

III Ranjit

van den Berg

A. E.

(2020). Factors associated with use of recreational facilities and physical activity among low-income Latino adults. Journal of Immigrant and Minority Health, 22(3), 555–562.

26.

Hyde

Greene

M. E.

Darmstadt

G. L.

(2020). Time poverty: Obstacle to women’s human rights, health and sustainable development. Journal of Global Health, 10(2), 020313. https://doi.org/10.7189/jogh.10.02031

27.

Ickes

M. J.

Sharma

(2012). A systematic review of physical activity interventions in Hispanic adults. Journal of Environmental and Public Health, 2012.

28.

Jackson

S. E.

Steptoe

(2017). Association between perceived weight discrimination and physical activity: A population-based study among English middle-aged older adults. BMJ Open, 7(3), e014592.

29.

Joseph

N. M.

Ramaswamy

Wang

(2018). Cultural factors associated with physical activity among U.S. adults: An integrative review. Applied Nursing Research, 42, 98–110.

30.

Juarbe

Turok

X. P.

Pérez-Stable

E. J.

(2002). Perceived benefits and barriers to physical activity among older Latina women. Western Journal of Nursing Research, 24(8), 868–886. https://doi.org/10.1177/019394502237699

31.

Kalyani

R. R.

Rodriguez

D. C.

Yeh

H. C.

Golden

S. H.

Thorpe

R. J.

Jr. (2015). Diabetes, race, and functional limitations in older U.S. men and women. Diabetes Research and Clinical Practice, 108(3), 390–397.

32.

Kemperman

van den Berg

Weijs-Perrée

Uijtdewillegen

(2019). Loneliness of older adults: Social network and the living environment. International Journal of Environmental Research and Public Health, 16(3), 406. https://doi.org/10.3390/ijerph16030406

33.

Larsen

B. A.

Noble

M. L.

Murray

K. E.

Marcus

B. H.

(2015). Physical activity in Latino men and women: Facilitators, barriers, and interventions. American Journal of Lifestyle Medicine, 9(1), 4–30.

34.

Lindsay-Smith

O’Sullivan

Eime

Harvey

van Uffelen

(2018). A mixed methods case study exploring the impact of membership of a multi-activity, multicentre community group on social wellbeing of older adults. BMC Geriatrics, 18(1), 226. https://doi.org/10.1186/s12877-018-0913-1

35.

Lineweaver

T. T.

Kugler

Rabellino

Stephan

(2018). Beliefs about age-related changes in physical functioning across the adult life span and their relationship with physical activity levels of older adults. Neuropsychology, Development, and Cognition: Section B, 25(4), 613–631. https://doi.org/10.1080/13825585.2017.1356903

36.

Loya

J. C.

(2018). Systematic review of physical activity interventions in hispanic adults. Hispanic Health Care International, 16(4), 174–188.

37.

Mack

(2005). Qualitative research methods: A data collector’s field guide. USAID.

38.

Mama

S. K.

McCurdy

S. A.

Evans

A. E.

Thompson

D. I.

Diamond

P. M.

Lee

R. E.

(2015). Using community insight to understand physical activity adoption in overweight and obese African American and Hispanic women: A qualitative study. Health Education & Behavior, 42(3), 321–328. https://doi.org/10.1177/1090198114557128

39.

Manson

J. D.

Tamim

Baker

(2017). Barriers and promoters for enrollment to a community-based Tai Chi program for older, low-income, and ethnically diverse adults. Journal of Applied Gerontology, 36(5), 592–609. https://doi.org/10.1177/0733464815597315

40.

Marquez

D. X.

Aguiñaga

Castillo

Hughes

S. L.

Der Ananian

Whitt-Glover

M. C.

(2020). ¡Ojo! What to expect in recruiting and retaining older Latinos in physical activity programs. Translational Behavioral Medicine, 10(6), 1566–1572. https://doi.org/10.1093/tbm/ibz127

41.

Mays

A. M.

Kim

Rosales

Rosen

(2020). The Leveraging Exercise to Age in Place (LEAP) study: Engaging older adults in community-based exercise classes to impact loneliness and social isolation. The American Journal of Geriatric Psychiatry, 29(8), 777–788.

42.

Mehra

Dadema

Kröse

B. J.

Visser

Engelbert

R. H.

Van Den Helder

Weijs

P. J.

(2016). Attitudes of older adults in a group-based exercise program toward a blended intervention; a focus-group study. Frontiers in Psychology, 7, 1827.

43.

Meyer

I. H

. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697.

44.

Moore

L. V.

Diez Roux

A. V.

Evenson

K. R.

McGinn

A. P.

Brines

S. J.

(2008). Availability of recreational resources in minority and low socioeconomic status areas. American Journal of Preventive Medicine, 34(1), 16–22. https://doi.org/10.1016/j.amepre.2007.09.021

45.

Neubauer

B. E.

Witkop

C. T.

Varpio

(2019). How phenomenology can help us learn from the experiences of others. Perspectives on Medical Education, 8(2), 90–97.

46.

Nikolajsen

Sandal

L. F.

Juhl

C. B.

Troelsen

Juul-Kristensen

(2021). Barriers to, and facilitators of, exercising in fitness centres among adults with and without physical disabilities: A scoping review. International Journal of Environmental Research and Public Health, 18(14), 7341. https://doi.org/10.3390/ijerph18147341

47.

O’Brien

B. C.

Harris

I. B.

Beckman

T. J.

Reed

D. A.

Cook

D. A.

(2014). Standards for reporting qualitative research: A synthesis of recommendations. Academic Medicine: Journal of the Association of American Medical Colleges, 89(9), 1245–1251. https://doi.org/10.1097/ACM.0000000000000388

48.

Payán

D. D.

Sloane

D. C.

Illum

Lewis

L. B.

(2019). Intrapersonal and environmental barriers to physical activity among Blacks and Latinos. Journal of Nutrition Education and Behavior, 51(4), 478–485. https://doi.org/10.1016/j.jneb.2018.10.001

49.

Phibbs

Thorburn

Branscum

A. J.

(2019). Is weight discrimination associated with physical activity among middle-aged and older adults? The Journal of Primary Prevention, 40(3), 279–295.

50.

Piedra

L. M.

Andrade

F. C.

Hernandez

Boughton

S. W.

Trejo

Sarkisian

C. A.

(2017). The influence of exercise on cognitive function in older Hispanic/Latino adults: Results from the “¡ Caminemos!” study. The Gerontologist, 57(6), 1072–1083.

51.

Piercy

K. L.

Troiano

R. P.

Ballard

R. M.

Carlson

S. A.

Fulton

J. E.

Galuska

D. A.

George

Olson

R. D.

(2018). The physical activity guidelines for Americans. JAMA, 320(19), 2020–2028.

52.

Sallis

J. F.

Owen

Fisher

(2015). Ecological models of health behavior. Health Behavior: Theory, Research, and Practice, 5, 43–64.

53.

Samega

Kollar

Shrider

Creamer

(2020). Income and poverty in the United States: 2019. https://www.census.gov/content/dam/Census/library/publications/2020/demo/p60-270.pdf

54.

Sami

Smith

Ogunseitan

O. A.

(2018). Changes in physical activity after installation of a fitness zone in a community park. Preventing Chronic Disease, 15, E101. https://doi.org/10.5888/pcd15.170560

55.

Schrempft

Jackowska

Hamer

Steptoe

(2019). Associations between social isolation, loneliness, and objective physical activity in older men and women. BMC Public Health, 19(1), 74. https://doi.org/10.1186/s12889-019-6424-y

56.

Schuler

P. B.

Roy

J. L.

Vinci

Philipp

S. F.

Cohen

S. J.

(2006). Barriers and motivations to exercise in older African American and European American women. Californian Journal of Health Promotion, 4(3), 128–134.

57.

Schutzer

K. A.

Graves

B. S.

(2004). Barriers and motivations to exercise in older adults. Preventive Medicine, 39(5), 1056–1061.

58.

Springer

A. E.

Castro

Ruiz

Luna

Martinez

McGhee

Ranjit

Bjornaas

Sturrup

McNeely

McGeady

Harrell

(2022). Interweaving adult fitness classes into community settings via stronger Austin’s community partnership model: Increasing access to physical activity and positive social connectedness in underserved communities. Family & Community Health, 45(2), 125–135. https://doi.org/10.1097/FCH.0000000000000321

59.

Springer

A. E.

Evans

A. E.

Ortuño

Salvo

Varela Arevalo

M. T.

(2017). Health by design: Interweaving health promotion into environments and settings. Frontiers in Public Health, 5, 268.

60.

Suri

. (2011). Purposeful sampling in qualitative research synthesis. Qualitative Research Journal, 11(2), 63–75.

61.

Telama

. (2009). Tracking of physical activity from childhood to adulthood: A review. Obesity Facts, 2(3), 187–195. https://doi.org/10.1159/000222244

62.

Vaughan

C. A.

Cohen

D. A.

Han

(2018). How do racial/ethnic groups differ in their use of neighborhood parks? Findings from the National Study of Neighborhood Parks. Journal of Urban Health, 95(5), 739–749. https://doi.org/10.1007/s11524-018-0278-y

63.

Watson

K. B.

Carlson

S. A.

Gunn

J. P.

Galuska

D. A.

O’Connor

Greenlund

K. J.

Fulton

J. E.

(2016). Physical inactivity among adults aged 50 years and older—United States, 2014. Morbidity and Mortality Weekly Report, 65(36), 954–958.

64.

Watt

. (2007). On becoming a qualitative researcher: The value of reflexivity. Qualitative Report, 12(1), 82–101.

65.

Whitfield

Carlson

Usery

Fulton

Galuska

Petersen

(2019). Trends in meeting physical activity guidelines among urban and rural dwelling adults: United States, 2008-2017. Morbidity and Mortality Weekly Report, 68, 513–518. https://www.cdc.gov/mmwr/volumes/68/wr/mm6823a1.htm#:~:text=The%20prevalence%20of%20meeting%20the%20combined%20aerobic%20and,in%202017.%20What%20is%20added%20by%20this%20report%3F

66.

Wilbur

Marquez

D. X.

Fogg

Wilson

R. S.

Staffileno

B. A.

Hoyem

R. L.

Morris

M. C.

Bustamante

E. E.

Manning

A. F.

(2012). The relationship between physical activity and cognition in older Latinos. Journals of Gerontology Series B, 67(5), 525–534.

67.

Wreally. (n.d.). Transcribe by Wreally. https://transcribe.wreally.com