The association between the built environment and intervention-facilitated physical activity: a narrative systematic review

Abstract

Background A diverse range of interventions increase physical activity (PA) but few studies have explored the contextual factors that may be associated with intervention effectiveness. The built environment (BE) may enhance or reduce the effectiveness of PA interventions, especially interventions that encourage PA in neighbourhood settings. Several studies have investigated the effects of the neighbourhood BE on intervention-facilitated PA, however, a comprehensive review of evidence has yet to be conducted. In our systematic review, we synthesize evidence from quantitative studies that have examined the relationships between objectively-measured neighbourhood BE and intervention-facilitated PA in adults. Method In October 2021, we searched 7 databases (Medline, CINAHL, Embase, Web of Science, SPORTDiscus, Environment Complete, and Cochrane Central Register of Controlled Trials) for English-language studies reporting on randomized and non-randomized experiments of physical activity interventions involving adults (≥18 years) and that estimated the association between objectively-measured BE and intervention-facilitated physical activity. Results Twenty articles, published between 2009 and 2021, were eligible for inclusion in the review. Among the 20 articles in this review, 13 included multi-arm experiments and 7 included single-arm experiments. Three studies examined PA interventions delivered at the population level and 17 examined interventions delivered at the individual level. PA intervention characteristics were heterogeneous and one-half of the interventions were implemented for at least 12-months (n = 10). Most studies were undertaken in North America (n = 11) and most studies (n = 14) included samples from populations identified as at risk of poor health (i.e., metabolic disorders, coronary heart disease, overweight, cancer, high blood pressure, and inactivity). Fourteen studies found evidence of a neighbourhood BE variable being negatively or positively associated with intervention-facilitated PA. Conclusion Approximately 70% of all studies reviewed found evidence for an association between a BE variable and intervention-facilitated PA. The BE’s potential to enhance or constrain the effectiveness of PA interventions should be considered in their design and implementation.

The effect of neighborhood walkability on changes in physical activity and sedentary behavior during a 12-week pedometer-facilitated intervention

“…We hypothesized that changes in self-reported physical activity at 4 weeks and 12 weeks during the intervention would be significantly higher for adults residing in neighborhoods that were more versus less walkable. Adding to the mixed evidence [ 32 ] and contrary to our hypothesis, we found that level of neighborhood walkability did not affect changes in physical activity and sedentary behavior resulting from participation in an individual-level physical activity intervention. Congruent with previous studies [ 3 , 5 , 6 ] we did, however, find increases in physical activity as a result of participating in a short-term internet-delivered pedometer-facilitated intervention, independent of neighborhood walkability.…”

“…Despite the null findings, to our knowledge this is the first study to estimate the effect of an interaction between objectively-measured walkability and a physical activity intervention on context (i.e., neighborhood) specific physical activity [ 32 ]. Our study has several positive attributes such as measuring change in a range of context-specific physical activities over three time points, statistical adjustment for baseline motivational characteristics (intention, self-efficacy), perceived walkability, preference for residing in a walkable neighborhood, self-rated health, and sociodemographic characteristics, using an established walkability index (Walk Score®), and recruitment of adults who were in the contemplation and preparation stages of physical activity change.…”

“…This quasi-experiment compared behavior at baseline and during UWALK (4 weeks and 12 weeks) between two neighborhood groups classified as ‘walkable’ or ‘car dependent’ based on pre-determined Walk Score® cut-points. Studies examining the influence of the built environment on intervention-facilitated physical activity have typically focused on interventions implemented for 6-months or longer with few studies examining interventions of shorter length [ 32 ]. Eligible participants (n = 573) completed a baseline telephone survey capturing sociodemographic characteristics, perceived neighborhood walkability, neighborhood preferences, physical activity motivation (i.e., self-efficacy and intention), physical activity and screen-based leisure.…”

“…A recent systematic review of 20 experimental studies found mixed evidence of the objectively-measured neighborhood built environment affecting the accumulation of physical activity during individual-level interventions [ 32 ]. Seventy percent of the studies reviewed found at least one neighborhood built environment variable that either positively or negatively impacted the effectiveness of a physical activity intervention [ 32 ].…”

“…A recent systematic review of 20 experimental studies found mixed evidence of the objectively-measured neighborhood built environment affecting the accumulation of physical activity during individual-level interventions [ 32 ]. Seventy percent of the studies reviewed found at least one neighborhood built environment variable that either positively or negatively impacted the effectiveness of a physical activity intervention [ 32 ]. For instance, during a 12-month pedometer-facilitated intervention implemented in Scotland, objectively measured neighborhood built features related to dangerous and busy roads and traffic signals and pedestrian signage were negatively associated with steps while features related to commercial and residential land use were positively associated with steps [ 33 ].…”