Outdoor areas of Australian residential aged care facilities do not facilitate appropriate sun exposure
Objective The aim of the present study was to assess whether the outdoor areas of residential aged care facilities used for a sunlight intervention trial had the design features that encouraged participants’ use of these spaces. Methods The design principles recommended in the ‘Vitamin D and the Built Environment in Victoria’ guidelines were used to assess the outdoor spaces of residential aged care facilities that were used in a randomised controlled trial (RCT) of sunlight exposure. Attendance rates in the sunlight RCT were analysed in relation to global impression scores of the facilities using one-way analysis of variance. Results Thirty-six outdoor areas of 31 facilities were assessed. The facilities met the guidelines for sun exposure, and were generally safe and accessible. However, many lacked privacy, security and aesthetic appeal. Most of the outdoor spaces were not used for regularly scheduled activities. Attendance rates were higher in those facilities with the highest global impression scores compared with those with the lowest scores (F(2,367) = 3.262, P = 0.039). Conclusions The physical environment of the outdoor areas of residential aged care facilities was associated with their use for sunlight exposure. Suitably designed or modified spaces have the potential to encourage their greater use, and residential aged care facilities should also plan regular activities in those areas. These measures can facilitate safe sun exposure, as well as physical activity and social interaction in older people. What is known about the topic? Older people living in aged care facilities have inadequate outdoor sun exposure and vitamin D deficiency. The outdoor spaces of aged care facilities are not well used by residents. Design features that encourage greater use of outdoor spaces have been identified. What does this paper add? Participation rates in a trial of outdoor sun exposure in residents of aged care facilities were found to be higher in those facilities with better design features in their outdoor spaces. Most facilities do not schedule their regular activities outdoors. What are the implications for practitioners? Suitable design or modification of outdoor spaces of residential aged care facilities can encourage their greater use. Regular scheduling of leisure and social activities can further promote their utilisation.