Improving Current Practice in Reviews of the Built Environment and Physical Activity

Abstract

Over the last decade, there has been a marked increase in studies about built environments and physical activity. As the number of publications is growing rapidly, literature reviews play an important role in identifying primary studies and in synthesizing their findings. However, many of the reviews of effectiveness in this field demonstrate methodological limitations that might lead to inaccurate portrayals of the evidence. Some literature reviews a priori excluded intervention studies even though they provide the strongest level of evidence. The label 'systematic review' has mostly been used inappropriately. One of the major criteria of a systematic review that is hardly ever met is that the quality of the primary studies needs to be assessed and this should be reflected in the synthesis, presentation and interpretation of results. With few exceptions, 'systematic' reviews about environments and physical activity did not refer to or follow the QUO-RUM or PRISMA statements. This commentary points out the usefulness of the PRISMA statement to standardize the reporting of methodology of reviews and provides additional guidance to limit sources of bias in them. The findings and recommendations from this article can help in moving forward the synthesis of evidence of effectiveness not only in built environments and physical activity, but also more broadly in exercise science and public health. Key PointsMany reviews about built environments and physical activity have methodological limitations.The label 'systematic review' has mostly been used inappropriately.The PRISMA statement is useful to standardize the reporting of methodology and limit bias in systematic reviews of effectiveness.

Moving to an active lifestyle? A systematic review of the effects of residential relocation on walking, physical activity and travel behaviour

“…One of the strengths of this systematic review is that it adheres to the PRISMA statement for systematic reviews,31 which is not standard practice in the field of built environments and physical activity/travel behaviour 24. In addition, we developed methodologies to account for multiple publications of the same study along with several risk of bias analyses to determine how sensitive our overall findings are to specific studies, measurements, study design and quality.…”

“…For ethical and practical reasons, randomisation is virtually impossible in research examining the impact of neighbourhood built environments on walking and physical activity 24. Several alternative designs may be considered to extend the current evidence base built primarily on cross-sectional studies.…”

Promoting Healthy Lifestyle and Well-Being in Adolescents through Outdoor Physical Activity

“…It appears that environment has and will continue to have an increasing influence on the promotion of healthy lifestyles across all population groups, including children and adolescents [5,18]. Research into the environment of physical activity devotes most attention to the built environment [19,20], parks and urban green spaces [21,22,23], the urban environment [24], and the less typical natural environment outside urban agglomerations [25,26]. …”

The effect of moving to East Village, the former London 2012 Olympic and Paralympic Games Athletes' Village, on mode of travel (ENABLE London study, a natural experiment)

“…For example, we have recently validated such an approach, making use of a gradient boosting machine learning tool [22]. There have been calls for high quality evidence to evaluate the effect of environmental interventions on health behaviours, particularly physical activity, making use of natural experiments where the population effects of change in travel infrastructure can be examined [23][24][25]. However, sizeable alterations in travel infrastructure and studies with sufficient numbers are needed to demonstrate change in active travel behaviour, and given the practical difficulties and high costs involved in making marked changes to the built environment, few opportunities arise [26].…”