Do Natural Experiments of Changes in Neighborhood Built Environment Impact Physical Activity and Diet? A Systematic Review

Abstract

Physical activity and diet are major modifiable risk factors for chronic disease and have been shown to be associated with neighborhood built environment. Systematic review evidence from longitudinal studies on the impact of changing the built environment on physical activity and diet is currently lacking. A systematic review of natural experiments of neighborhood built environment was conducted. The aims of this systematic review were to summarize study characteristics, study quality, and impact of changes in neighborhood built environment on physical activity and diet outcomes among residents. Natural experiments of neighborhood built environment change, exploring longitudinal impacts on physical activity and/or diet in residents, were included. From five electronic databases, 2084 references were identified. A narrative synthesis was conducted, considering results in relation to study quality. Nineteen papers, reporting on 15 different exposures met inclusion criteria. Four studies included a comparison group and 11 were pre-post/longitudinal studies without a comparison group. Studies reported on the impact of redeveloping or introducing cycle and/or walking trails (n = 5), rail stops/lines (n = 4), supermarkets and farmers’ markets (n = 4) and park and green space (n = 2). Eight/15 studies reported at least one beneficial change in physical activity, diet or another associated health outcome. Due to limitations in study design and reporting, as well as the wide array of outcome measures reported, drawing conclusions to inform policy was challenging. Future research should consider a consistent approach to measure the same outcomes (e.g., using measurement methods that collect comparable physical activity and diet outcome data), to allow for pooled analyses. Additionally, including comparison groups wherever possible and ensuring high quality reporting is essential.

Evaluating the impact of improvements in urban green space on older adults’ physical activity and wellbeing: protocol for a natural experimental study

“…They identified 12 natural experimental studies (15 physical activity outcomes) on the basis of having strong experimental designs from three existing systematic reviews; nine of these studies evaluated urban green space interventions. They found that all outcomes had an overall critical ( n = 12) or serious ( n = 3) risk of bias, thus suggesting that the strongest studies conducted to date are weak, a conclusion in line with other recent systematic reviews in this area that included risk of bias assessments [ 15 , 25 , 26 ].…”

Using Accelerometer/GPS Data to Validate a Neighborhood-Adapted Version of the International Physical Activity Questionnaire (IPAQ)

“…The IPAQ is a non-location specific physical activity tool that has acceptable reliability and moderate concurrent validity when compared with accelerometers (Cerin et al, 2016;Craig et al, 2003). Further, observational (Sundquist et al, 2011) and natural experiment (MacMillan et al, 2018) studies have found associations between IPAQ measured physical activity and neighborhood built characteristics.…”

Strategies for Healthy Eating Promotion and Behavioral Change Perceived as Effective by Nutrition Professionals: A Mixed-Methods Study

“…However, studies have proposed that consuming a health-promoting diet is not necessarily more expensive than unhealthy diet patterns, suggesting that cost may be a perceived rather than an actual barrier to healthy eating (47,48). Changes to the built environment, such as farmers markets, supermarket availability, and menu labeling, have had a generally positive effect on healthy lifestyle behaviors (49,50). Thus, it may be possible to overcome the practical barriers mentioned by nutrition professionals through appropriate environmental and policy changes.…”