Journal of Clinical Geropsychology

, Volume 5, Issue 1, pp 51–62 | Cite as

Identifying Psychological, Physiological, and Environmental Barriers and Facilitators to Exercise Among Older Low Income Adults

  • Daniel O. Clark


Little is known regarding barriers and facilitators to exercise among older adults in general, and low income and minority older adults in particular. This report summarizes the results of four focus group sessions with low income adults aged 55–70: one session each with African-American males and females, and White males and females. None of the participants was exercising at the aerobic level or frequency recommended by the Centers for Disease Control and Prevention. The type of physical activity and exercise most preferred by all groups was walking. Barriers and facilitators of walking varied considerably by gender, but tended to be similar for African-Americans and Whites. Environmental barriers (e.g., time, places for activity, sidewalk conditions, and weather) generally were not as commonly mentioned or apparently as influential as physiological and psychological barriers. These barriers were numerous among women and included perceived ability, and social discomforts and bodily pain or fear of pain. Men discussed motivation as their primary barrier, although shortness of breath was clearly an issue. Women, but not men, overwhelmingly endorsed group exercise, but only if the group consisted of “like” individuals. By virtue of its anticipated impact on motivation and self-efficacy, exercise prescription that assures some initial success appears to be the most promising facilitator.

exercise older adults low SES 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. American College of Sports Medicine (1995). ACSM's Guidelines for Exercise Testing and Prescription. American College of Sports Medicine (5th ed.), Williams and Wilkins, Medina, PA.Google Scholar
  2. Basch, C. E. (1987). Focus group interview: An underutilized research technique for improving theory and practice in health education. Health Educ. Quart. 14: 411–448.Google Scholar
  3. Blair, S. N., Kampert, J. B., Kohl, H. W., Barlow, C. E., Macera, C. A., Paffenbarger, R. S., and Gibbons, L. W. (1996). Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA 276(3): 205–210.Google Scholar
  4. Blair, S. N., Kohl, H. W., Barlow, C. E., Paffenbarger, R. S., Gibbons, L. W., and Macera, C. A. (1995). Changes in physical fitness and all-cause mortality. JAMA 273(14): 1093–1098.Google Scholar
  5. Blair, S. N., Kohl, H. W., Barlow, C. E., Paffenbarger, R. S., Gibbons, L. W., and Macera, C. A. (1995). Changes in physical fitness and all-cause mortality. JAMA 273(14): 1093–1098.Google Scholar
  6. Blair, S. N. (1993). Evidence for success of exercise in weight loss and control. Ann. Intern. Med. 119(7)(part 2): 702–706.Google Scholar
  7. Blair, S. N. (1993). Workshop V. Circulation 88(3): 1403–1405.Google Scholar
  8. Bouchard, C., Shephard, R. J., and Stephens, T. (1994). Physical Activity, Fitness, and Health. International Proceedings and Consensus Statement.Google Scholar
  9. Brownson, R. C., Remington, P. L., and Davis, J. R. (1993). Chronic Disease Epidemiology and Control, American Public Health Association, Washington, DC.Google Scholar
  10. Buchner, D. M., and Wagner, E. H. (1992). Preventing frail health. Health Prom. Dis. Prevent. 8(1): 1–17.Google Scholar
  11. Buchner, D. M., Beresford, S. A. A., Larson, E. B., LaCroix, A. Z., and Wagner, E. H. (1992). Effects of physical activity on health status in older adults II: Intervention studies. Annu. Rev. Publ. Health 13: 469–88.Google Scholar
  12. Centers for Disease Control and Prevention (1996). U.S. Surgeon General's Executive Summary of Physical Activity and Health. U.S. Department of Health and Human Services.Google Scholar
  13. Clark, D. O., Mungai, S. M., Stump, T. E., and Wolinsky, F. D. (1997). Prevalence and impact of risk factors for lower body difficulty among Mexican-Americans, African-Americans, and Whites. J. Gerontol.: Med. Sci. 52A(2): M97-M105.Google Scholar
  14. Clark, D. O. (1995a). Racial and educational differences in physical activity among older adults. Gerontologist 35: 472–480.Google Scholar
  15. Clark, D. O. (1996b). Age, socioeconomic status, and exercise self-efficacy. Gerontologist 36: 157–164.Google Scholar
  16. Evans, W. J. (1995). Effects of exercise on body composition and functional capacity of the elderly. J. Gerontol. 50A: 147–150.Google Scholar
  17. Fiatarone, M. A., O'Neill, E. F., Ryan, N. D., Clements, K. M., Solares, G. R., Nelson, M. E., Roberts, S. B., Kehayias, J. J., Lipsitz, L. A., and Evans, W. J. (1994). Exercise training and nutritional supplementation for physical frailty in very elderly people. NEJM 330(25): 1769–1775.Google Scholar
  18. Hiss, R. G., and Greenfield, S. (1996). Changes in the U.S. health care system that would facilitate improved care for non-insulin dependent diabetes mellitis. Ann. Int. Med. 1(124): 180–183.Google Scholar
  19. U.S. Bureau of the Census (1996). Current Population Reports, Special Studies, P23–190, 65+ in the United States. U.S. Government Printing Office, Washington, DC.Google Scholar
  20. House, J. S., Strecher, V., Metzner, H. L., and Robbins, C. A. (1986). Occupational stress and health among men and women in the Tecumseh Community Health Study. J. Health Soc. Behav. 27: 62–77.Google Scholar
  21. Jette, A. M., Harris, B. A., Sleeper, L., Lachman, M. E., Heislein, D., Giorgetti, M., and Levenson, C. (1996). A home-based exercise program for nondisabled older adults. J. Am. Geriat. Soc. 44(6): 644–649.Google Scholar
  22. Jonas, S. (1992). Exercise. In Woolf, S. H. (ed.), Health Promotion and Disease Prevention in Clinical Practice (Chap. 7), Williams & Wilkens, Baltimore, pp. 176–192.Google Scholar
  23. King, A. C., Haskell, W. L., Taylor, C. B., Kraemer, H. C., and DeBusk, R. F. (1991). Group-vs. home-based exercise training in healthy older men and women. JAMA 266(11): 1535–1542.Google Scholar
  24. Kohrt, W. M., Obert, K. A., and Holloszy, J. O. (1992). Exercise training improves fat distribution patterns in 60-to 70-year-old men and women. J. Gerontol.: Soc. Sci. 47(4): M99-M105.Google Scholar
  25. Kriska, A. M., LaPorte, R. E., Patrick, S. L., Kuller, L. H., and Orchard, T. J. (1991). The association of physical activity and diabetic complications in individuals with insulin-dependent diabetes mellitus: The epidemiology of diabetes complications Study—VII. J. Clin. Epidemiol. 44(11): 1207–1214.Google Scholar
  26. LaCroix, A. Z., Leveille, S. G., Hecht, J. A., Grothaus, L. C., and Wagner, E. H. (1996). Does walking decrease the risk of cardiovascular disease hospitalizations and death in older adults? J. Am. Geriat. Soc. 44(2): 113–120.Google Scholar
  27. Lorig, K. R., and Holman, H. R. (1993). Arthritis self-management studies: A twelve year review. Health Educ. Quart. 20: 17–28.Google Scholar
  28. Marcus, B. H., and Owen, N. (1992). Motivational readiness, self-efficacy and decision-making for exercise. J. Appl. Soc. Psychol. 22(1): 3–16.Google Scholar
  29. Marcus, B. H., Banspach, S. W., Lefebvre, R. C., Rossi, J. S., Carleton, R. A., and Abrams, D. B. (1992). Using the stages of change model to increase the adoption of physical activity among community participants. Am. J. Health Prom. 6(6): 424–429.Google Scholar
  30. Marcus, B. H., Rakowski, W., and Rossi, J. S. (1992). Assessing motivational readiness and decision making for exercise. Health Psychol. 11(4): 257–261.Google Scholar
  31. Marcus, B. H., Selby, V. C., Niaura, R. S., and Rossi, J. S. (1992). Self-efficacy and the stages of exercise behavior change. Res. Quart. Exercise Sport 63(1): 60–66.Google Scholar
  32. McAuley, E., Lox, C., and Duncan, T. E. (1993). Long-term maintenance of exercise, self-efficacy, and physiological change in older adults. J. Gerontology: Psychol. Sci. 48(4): 218–224.Google Scholar
  33. McDonald, C. J., Tierney, W. M., Overhage, J. M., Martin, D. K., and Wilson, G. A. (1992). The Regenstrief Medical Record System: 20 years of experience in hospitals, clinics, and neighborhood health centers. M.D. Comput. 9: 206–217.Google Scholar
  34. NIH Consensus Development Panel (1996). Physical activity and cardiovascular health. JAMA 276(3): 241–246.Google Scholar
  35. Pate, R. R., Pratt, M., Blair, S. N., Haskell, W. L., Macera, C. A., Bouchard, C., Buchner, D. M., Ettinger, W., Heath, G. W., King, A. B., Kriska, A., Leon, A. S., Marcus, B. H., Morris, J., Paffenbarger, R. S., Jr., Patrick, K., Pollock, M. L., Rippe, J. M., Sallis, J., and Wilmore, J. H. (1995). Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 273(5): 402–407.Google Scholar
  36. Sallis, J. F., Hovell, M. B., Hofstetter, C. R., and Barrington, E. (1992). Explanation of vigorous physical activity during two years using social learning variables. Soc. Sci. Med. 34: 25–32.Google Scholar
  37. Simonsick, E. M., Lafferty, M. E., Phillips, C. L., Mendes de Leon, C. F., Kasl, S. V., Seeman, T. E., Fillenbaum, G., Hebert, P., and Lemke, J. H. (1993). Risk due to inactivity in physically capable older adults. AJPH 83(10): 1443–1450.Google Scholar
  38. Stewart, A. L., King, A. C., and Haskell, W. L. (1993). Endurance exercise and health-related quality of life in 50–65-year-old adults. Gerontologist 33(6): 782-789.Google Scholar

Copyright information

© Plenum Publishing Corporation 1999

Authors and Affiliations

  • Daniel O. Clark
    • 1
  1. 1.Department of Medicine, Regenstrief Institute, RG-6Indiana University, Center for Aging ResearchIndianapolis

Personalised recommendations