Table 2.

Summary of Walking Barriers and Facilitators

BARRIERS THEME	FACILITATORS THEME
Physical barriers Limiting health conditions (pain, weakness, shortness of breath) “I walk 4–5 times a week but when I have pain it is hard to walk. I used to walk well but it is getting harder now.”	Physical facilitators Tailored walking program “I would walk if it does not cause pain in my legs, perhaps light, gentle exercise for people like me… Are there alternate exercises?”
External/environmental barriers Subtheme: No good place for exercise (safety, weather/temperature, long distance to park) “It is not safe to walk around in your neighborhood here. I prefer walking early in the morning and in the evening, but it is scary.” “I think morning hours are ideal but some say walking early in the morning is not good for old people. I stopped walking in the winter.” Subtheme: No one to walk with “It is a long distance to park from home and I have nobody to walk with; it would be really good to have an exercise buddy or a group.” “I love to walk on beach sand but it gets harder to travel long distance and no one can go to walk with me.”	External/environmental facilitators Subtheme: Good/safe environment “I am fortunate to be able to exercise anytime because I live in a good neighborhood.” Subtheme: Suitable place to exercise and socialize “If we were provided a free, safe, suitable place to gather together to exercise, like some calisthenics, and do some talking, that would satisfy older people and it will force them to set up a goal and exercise.” “We want to talk because we are lonely.” Subtheme: Having someone to exercise with/walking club “I was able to exercise for decades because I did it with my wife. We hike together.” “Three of us have been walking together once a week for more than 5 years.” “If I had an exercise buddy to walk with, and have fun while walking, that would be more conducive for older people. Making one’s own circle and meeting up every day provides motivation to exercise consistently.”
Internal/perceived barriers Subtheme: Lack of motivation “Especially for older people, it is really hard to make plans and set up goals to do something. I live in a senior housing, and it is hard to get people to go places together, we had fun once we did it but they just do not want to do it. We get lazy at the senior housing. Older adults do not want to move.” Subtheme: Boredom “It is hard to exercise just for the sake of being healthy. If I go to mountain I feel good because I enjoy it. Exercise should be exciting and fun. Health itself is not good enough to drive older people to exercise.” “If you do walking exercise with others it will help. It would not feel like too long a walk. You can easily walk for 40–50 min. If you walk alone, it becomes boring. It would be better for you to suggest doing walking exercise with others, as a group.” Subtheme: Belief that exercise may cause harm “Exercise and walking should be done differently depending on your age. Too much exercise, beyond normal walking for daily activities, can be dangerous for older adults.” Subtheme: Fatalism “Longevity depends on personal efforts but still mainly it is on God’s will. Can we choose to live longer? Sometimes it won’t happen even if we exercise all the times.”	Internal/perceived facilitators Subtheme: Having a primary goal (fun, enjoyable, meaningful) to achieve for which walking is necessary “I go to a store to walk and to do brain exercise (check the prices and compare the items) to prevent dementia.” “I walk the dog and pray while walking. It is like killing three birds with one stone. If I think of it as a responsibility, it would not work well.” “I like dancing. I used to walk to go to a Zumba class.” “I pick up garbage on the street while walking. If we gather at some places and do it together, that will give us a motivation. We can walk while we pick up some garbage on the street and help make streets clean.” Subtheme: Positive reinforcement and/or encouragement “If you can make this program done at a university and have them participate in the (stroke) prevention walking program it would be good. That would help older people to come out from their homes and exercise.” “What older people need is something that will motivate and interest them.” “If teachers like you could come to where we exercise once in a while and give good education lessons about health, and that would be a good way to encourage older people to walk and exercise.” Subtheme: Reward/gift “I think some sort of reward or gift would help.” Subtheme: Seeing positive results; Better health and looking good “I care about my look and body shape. Walking keeps me in good health and look.” “I exercise to release my muscle for better blood circulation and see good blood sugar control with walking.” “It helps with maintaining health after surgery combined with stretching. It becomes really good exercise when I see walking is good for my body.” Subtheme: Personal desire to live healthy until death without losing dignity/having to go to nursing home “It is not very important to live just long but how you live; to live healthy and happy, not to be burden on family.” “Yes, live healthy and active independently, not having to go to a nursing home.” “You have to focus on healthy life not to cause a lot of medical expenses to your family and society.”