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Physical Activity: Street-Scale Urban Design Land Use Policies

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What the Task Force Found

About The Systematic Review

The Task Force finding is based on evidence from a systematic review of 6 studies (search period 1987 to 2003).

The review was conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice, and policy related to increasing physical activity.

Context

There is no information for this section.

Summary of Results

More details about study results are available in the published evidence review.

Six studies were included in the review.

  • The way in which people perceive their environment affects their activities in that environment. Reviewed studies assessed the relationship between perception and activity in the studied areas and populations. The studies also assessed whether improvements in the outdoor environment created the appearance of a safer and more inviting place for physical activity.
  • Overall, the median improvement in some aspect of physical activity (e.g., number of walkers or percent of active individuals) was 35%.
  • Additional benefits that could have resulted from these interventions:
    • Improvements in green space
    • Increased sense of community and decreased isolation
    • Reductions in crime and stress
  • Increased walking and bicycling on urban streets, although beneficial, also increase risk of injury to pedestrian or cyclist, because of increased exposure to motor vehicles.

Summary of Economic Evidence

An economic review of this intervention was not conducted.

Applicability

This type of intervention is likely to be applicable across diverse settings and population groups, provided appropriate attention is paid to adapting the intervention to the specific setting and target population.

Evidence Gaps

Additional research and evaluation are needed to answer the following questions and fill existing gaps in the evidence base. (What are evidence gaps?)

  • What community characteristics are needed for optimal use of policy and environmental interventions?
  • Does effectiveness vary by type of access (e.g., to a worksite facility or a community facility) or socioeconomic group?
  • How can the necessary political and societal support for this type of intervention be created or increased?
  • Does creating or improving access motivate sedentary people to become more active, give those who are already active increased opportunities to be active, or both?
  • Which neighborhood features (e.g., sidewalks, parks, traffic flow, proximity to shopping) are the most crucial in influencing activity patterns?
  • How does proximity of places such as trails or parks to residences affect ease and frequency of use?
  • What behavioral changes not involving physical activity can be shown to be associated with changes in physical activity?
  • Does an increase in the use of public transportation mean an increase in physical activity or will users drive to the transit stop?
  • Can reliable and valid measures be developed to address the entire spectrum of physical activity, including light or moderate activity?
  • Does the level or scale of an intervention significantly affect effectiveness?
  • What are the effects of each intervention in various sociodemographic subgroups, such as age, gender, race, or ethnicity?
  • Do these approaches to increasing physical activity increase awareness of opportunities for, and benefits of, physical activity?
  • Are there other benefits from an intervention that might enhance its acceptability?
  • Are there any key harms?
  • Is anything known about whether or how approaches to physical activity could reduce potential harms (e.g., injuries or other problems associated with doing too much too fast)?
  • What is the cost-effectiveness of each of these interventions?
  • How can effectiveness in terms of health outcomes or quality-adjusted health outcomes be better measured, estimated, or modeled?
  • How can the cost–benefit of these programs be estimated?
  • How do specific characteristics of each of these approaches contribute to economic efficiency?
  • What combinations of components in multicomponent interventions are most cost-effective?
  • What are the physical or structural (environmental) barriers to carrying out these interventions?
  • What resource (time and money) constraints prevent or hinder the implementation of these interventions?

Study Characteristics

  • Included studies used quasi-experimental pre-post or cross-sectional study designs.
  • Evaluated interventions all involved issues related to access, aesthetics, and safety (e.g., redesigning streets, installing new lighting, and improving street aesthetics)
  • One study each was conducted in the United States, Australia, Belgium, Canada, England, and Germany.

Publications

Heath GW, Brownson RC, Kruger J, Miles R, Powell KE, Ramsey LT, Task Force on Community Services. The effectiveness of urban design and land use and transport policies and practices to increase physical activity: a systematic review. Journal of Physical Activity and Health. 2006;3(Suppl 1):S55-76.