The relationship between built environments and physical activity: a systematic review.
OBJECTIVE
We conducted a systematic review of the literature examining the relationship between built environments (e.g., parks, trails, sidewalks) and physical activity (PA) or obesity rates.


METHODS
We performed a 2-step inclusion protocol to identify empirical articles examining any form of built environment and any form of PA (or obesity rate) as the outcome. We extracted data from included abstracts for analysis by using a standard code sheet developed for this study.


RESULTS
Of 169 included articles, 89.2% reported beneficial relationships-but virtually all articles utilized simple observational study designs not suited for determining causality. Studies utilizing objective PA measures (e.g., pedometer) were 18% less likely to identify a beneficial relationship. Articles focusing on children in community settings (-14.2%), those examining direct measures of obesity (-6.2%), or those with an academic first author (-3.4%) were less likely to find a beneficial relationship.


CONCLUSIONS
Policymakers at federal and local levels should encourage more rigorous scientific research to determine whether altered built environments will result in increased PA and decreased obesity rates.
Department of Health Care Organization and Policy, University of Alabama at Birmingham, USA.
Alva O
AO
Ferdinand
Bisakha
B
Sen
Saurabh
S
Rahurkar
Sally
S
Engler
Nir
N
Menachemi
D002958:City Planning; D004779:Environment Design; D006801:Humans; D009043:Motor Activity; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control; D014481:United States / Q000453:epidemiology