Systematic literature review of built environment effects on physical activity and active transport – an update and new findings on health equity

Melody Smith; Jamie Hosking; Alistair Woodward; Karen Witten; Alexandra MacMillan; Adrian Field; Peter Baas; Hamish Mackie

doi:10.1186/s12966-017-0613-9

International Journal of Behavioral Nutrition and Physical Activity

Table 3 Key findings and strength of evidence^a for impact of built environment on physical activity, active transport, and visitation or use of settings

From: Systematic literature review of built environment effects on physical activity and active transport – an update and new findings on health equity

Intervention mechanism	Intervention medium	Active transport (total walking, total cycling, walking or cycling for transport)			Physical activity (total physical activity, moderate physical activity, moderate-to-vigorous physical activity, recreational physical activity)			Visitation/use of settings
		Adults	Children	All ages	Adults	Children	All ages	Adults	Children	All ages
Active transport infrastructure	Bicycle boulevard/bike lane installation	↓[62]			~ [62]			↑↑[58, 91]		↑[93]
	Multiple streetscape components for walking or cycling (including two or more of: crosswalk and sidewalk improvements, improved and covered bike parking, installation of traffic calming features (raised platforms, zebra crossings) and parking bays; creating safe places to walk)	↑[92] ~ ⁺ [63]	↑ ⁺⁺ [64] ↑[85]		↑↑[90, 92] ↑ ⁺ [63]					↑↑[92, 95]
	New greenways		~[90]^b	↑[89]	↑[98] ~ [60]		↑[89]
	Traffic free bridges and boardwalks	↑[56]			↑[56]
	Wayfinding and distance signage on community trails									~ [61]
Parks and playgrounds	Installation of fitness equipment/playground equipment	↑ ⁺ [57] ~+ [63]			↑ ⁺ ↑ ⁺ [57, 63]
	Multiple component park renovations (including two or more of: new equipment, walking track, fencing, landscaping, surfaces, lights)				↑[90]	~ ^+c [65]	↑↑↑[86, 96, 97] ~ [88]			↑↑↑[88, 96, 97]
	Removal of seating				↑[94]	~ [94]				↓[94]
	Retrofiting existing green space into pocket parks				↑[87]			↑[87]
	Temporary road closures and play equipment					↑⁺ [66]
Walkability components	Access to/availability of public transit	↑[71]			↑[86]
	Destination accessibility	↑↑[69, 71]			↑[69]
	Land-use mix	↑[71]
	Recreation facility density				↑⁺ [59]
	Residential density	↑[70] ~ [71]
	Street connectivity	↑[71]			↑[70]

^aStrength of evidence determined by quality assessment rating of each study using a modified version of the Evaluation of Public Health Practice Projects Quality Assessment Tool (EPHPP) as described in the supplementary information (Additional File 3)
^bEffect for school transport mode only
^cModerating effect of body size, whereby intervention was effective in increasing activity in children of lower body size, and decreased activity in children of higher body size
⁺Moderate evidence
⁺⁺Strong evidence
~ Inconsistent results or no impact of built environment on physical activity behaviour(s) or visitation/use of setting(s)
↓ Negative impact of built environment on physical activity behaviour(s) or visitation/use of setting(s); weak evidence
↑ Positive impact of built environment on physical activity behaviour(s) or visitation/use of setting(s); weak evidence

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