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What works to promote walking at the population level? A systematic review
  1. Charlie Foster1,
  2. Paul Kelly2,
  3. Hamish A B Reid3,
  4. Nia Roberts4,
  5. Elaine M Murtagh5,
  6. David K Humphreys6,
  7. Jenna Panter7,
  8. Karen Milton8
  1. 1Centre for Exercise Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
  2. 2Physical Activity for Health Research Centre, Institute of Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh, UK
  3. 3The Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Medical Sciences Division, University of Oxford, Oxford, UK
  4. 4Nuffield Department of Population Health, University of Oxford, Oxford, UK
  5. 5Department of Arts Education and Physical Education, Mary Immaculate College, Limerick, Ireland
  6. 6Department of Social Policy and Intervention, University of Oxford, Oxford, UK
  7. 7MRC Epidemiology Unit and CEDAR, University of Cambridge School of Clinical Medicine, Cambridge, UK
  8. 8Norwich Medical School, University of East Anglia, Norwich, UK
  1. Correspondence to Dr Charlie Foster, Centre for Exercise Nutrition and Health Sciences, School for Policy Studies, University of Bristol, BS8 1TZ, UK; charlie.foster{at}


Objective Interventions to promote walking have focused on individual or group-based approaches, often via the randomised controlled trial design. Walking can also be promoted using population health approaches. We systematically reviewed the effectiveness of population approaches to promote walking among individuals and populations.

Design A systematic review.

Data sources 10 electronic databases searched from January 1990 to March 2017.

Eligibility criteria Eligibility criteria include pre-experimental and postexperimental studies of the effects of population interventions to change walking, and the effects must have been compared with a ‘no intervention’, or comparison group/area/population, or variation in exposure; duration of ≥12 months of follow up; participants in free-living populations; and English-language articles.

Results 12 studies were identified from mostly urban high-income countries (one focusing on using tax, incentivising the loss of parking spaces; and one using policy only, permitting off-leash dogs in city parks). Five studies used mass media with either environment (n=2) or community (n=3) approaches. Four studies used environmental changes that were combined with policies. One study had scaled up school-based approaches to promote safe routes to schools. We found mass media, community initiatives and environmental change approaches increased walking (range from 9 to 75 min/week).

  • walking
  • public health
  • review

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  • Contributors CF and DKH conceived the idea for the study. NR, CF, KM, HABR and PK conducted the review, data extraction and analysis. CF, KM, PK, DKH, EMM and JP drafted the manuscript. HABR contributed to the writing of the manuscript. All authors contributed to revising the final draft of the manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.