Summary Mass participation sports event (MPSE)s have been identified as a potential referral pathway for engaging inactive patients in regular physical activity. This study aimed to review evidence of physical activity behaviour and associated health-related outcomes of engaging in MPSEs among the general population. A systematic review was performed of quantitative studies that examined the relationship between MPSEs and physical activity behaviour or secondary outcomes (e.g. physical activity motivation or confidence, physical or mental health) or any intervention to maintain physical activity following MPSEs. Search methods included searching five electronic databases and checking reference lists. Methodological quality was assessed using the Mixed Methods Appraisal Tool. A total of 2079 papers were identified, 142 were independently assessed for eligibility and 39 were included. Data from prospective cohort studies suggested that levels of physical activity achieved in training for MPSEs tended to drop in the months after, but increases were reported in some studies of novice participants. Interventions involving health promotion materials provided post-event led to small increases in physical activity. Perceived benefits of participating in MPSEs included physical and mental health, fitness, self-efficacy and social connections. Existing evidence suggests that MPSEs can act as a motivator to initiate exercise in preparation for the event, but there is limited evidence on how best to sustain physical activity post-event. Given the short duration of most studies, longer prospective analyses are needed to delineate patterns of habitual and event-related activity and account for seasonal effects.
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