Influence of volunteer-led net step exercise class on older people’s self-rated health in a depopulated town: A longitudinal study

In a depopulated region where population aging is advancing, it is necessary to establish a method so local residents themselves can be actively involved in older people's health promotion. Net Step Exercise, a novel dual-task walking program, introduced residents to opportunities for physical activities and social participation without any health specialist support. In one depopulated town (Ikeda, Nakagawa-gun, Hokkaido, Japan), volunteer residents have held Net Step Exercise classes throughout the town since 2007. We longitudinally examined the influence of volunteer-led Net Step Exercise class participation on subsequent self-rated health in all individuals aged 70-79 years living in Ikeda. A total of 662 people who completed a baseline mail-in questionnaire survey in 2012 were followed until 2014. Logistic regression analysis was performed to examine the association with self-rated health after two years of class participation once a month or more at baseline, after controlling for confounds such as age, sex, years of education, living alone, baseline self-rated health, regular exercise, and other physical activities. The odds ratio of poor self-rated health in older people who participated in classes was 0.53 (95% confidence interval [CI]: 0.34-0.85) compared to older people not participating in classes. Even after confounding factors were adjusted, the odds ratio of class participation was 0.50 (95% CI: 0.29-0.85). This study showed that participation in volunteer-led Net Step Exercise might prevent poor self-rated health. Such Net Step Exercise classes are a feasible method for older people's health promotion in depopulated municipalities.