title: Associations between neighbourhood walkability and daily steps in adults: a systematic review and meta-analysis.
abstract: BACKGROUND
  Higher street connectivity, land use mix and residential density (collectively referred to as neighbourhood walkability) have been linked to higher levels of walking. The objective of our study was to summarize the current body of knowledge on the association between neighbourhood walkability and biosensor-assessed daily steps in adults.
  
  
  METHODS
  We conducted a systematic search of PubMed, SCOPUS, and Embase (Ovid) for articles published prior to May 2014 on the association between walkability (based on Geographic Information Systems-derived street connectivity, land use mix, and/or residential density) and daily steps (pedometer or accelerometer-assessed) in adults. The mean differences in daily steps between adults living in high versus low walkable neighbourhoods were pooled across studies using a Bayesian hierarchical model.
  
  
  RESULTS
  The search strategy yielded 8,744 unique abstracts. Thirty of these underwent full article review of which six met the inclusion criteria. Four of these studies were conducted in Europe and two were conducted in Asia. A meta-analysis of four of these six studies indicates that participants living in high compared to low walkable neighbourhoods accumulate 766 more steps per day (95 % credible interval 250, 1271). This accounts for approximately 8 % of recommended daily steps.
  
  
  CONCLUSIONS
  The results of European and Asian studies support the hypothesis that higher neighbourhood walkability is associated with higher levels of biosensor-assessed walking in adults. More studies on this association are needed in North America.
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Avenue West, Montréal, QC, Canada. samantha.hajna@mail.mcgill.ca.
authors.forename: Samantha
authors.initials: S
authors.lastname: Hajna
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Avenue West, Montréal, QC, Canada. nancy.ross@mcgill.ca.|Department of Geography, McGill University, 805 Sherbrooke Street West, Montréal, QC, Canada. nancy.ross@mcgill.ca.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Ross
authors.affiliation: Department of Medicine, Division of Clinical Epidemiology, McGill University Health Centre, 687 Pine Avenue West, Montréal, QC, Canada. anne-sophie.brazeau@mcgill.ca.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Brazeau
authors.affiliation: Department of Medicine, Division of Clinical Epidemiology, McGill University Health Centre, 687 Pine Avenue West, Montréal, QC, Canada. patrick.belisle@clinepi.mcgill.ca.
authors.forename: Patrick
authors.initials: P
authors.lastname: Bélisle
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Avenue West, Montréal, QC, Canada. lawrence.joseph@mcgill.ca.|Department of Medicine, Division of Clinical Epidemiology, McGill University Health Centre, 687 Pine Avenue West, Montréal, QC, Canada. lawrence.joseph@mcgill.ca.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Joseph
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Avenue West, Montréal, QC, Canada. kaberi.dasgupta@mcgill.ca.|Department of Medicine, Division of Clinical Epidemiology, McGill University Health Centre, 687 Pine Avenue West, Montréal, QC, Canada. kaberi.dasgupta@mcgill.ca.
authors.forename: Kaberi
authors.initials: K
authors.lastname: Dasgupta
mesh_terms: D000328:Adult; D001208:Asia; D004779:Environment Design; D005060:Europe; D005260:Female; D040362:Geographic Information Systems; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009656:North America; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012931:Social Environment; D016138:Walking