Table 4

Summary of existing literature reviews* on built environments and physical activity/travel behaviour among adults (n=28)

First author (year)Included articles (search period), nDesign of included studiesScope of studyMain findings
Arango (2013)15 (1990 to August 2012)All CSTo review the association between perceived environments and adult PA in Latin AmericaMost associations were non-significant. Strongest evidence for leisure-time PA with day safety and transport PA with street lighting presence.
Bancroft (2015)20 (1990 to June 2013)17 CS, 3 PLTo review the association between park access and objectively measured PA in the USA (all ages)Associations varied between studies. Reported park characteristics and smaller buffer sizes more predictive of PA.
Barnett (2017)100 (2000 to September 2016)95 CS,
5 PL,
1 QE
(1) To review and meta-analyse the association between BE attributes, PA and/or walking (older adults); (2) To examine potential moderatorsAssociations differ by BE attributes and PA measures. Strongest evidence for: walkability, safety from crime, access to destinations, recreational facilities and parks/public open space. No consistent moderators.
Butler (2011)29 (2005 to December 2009)All CSTo review PA studies which included one or more GIS measure of the BEIncrease in studies using PA-relevant GIS BE measure, but lack of standardisation among BE; difficult to synthesise evidence
Casagrande (2009)10 (1966 to July 2007)All CSReview of BE association with PA, diet and obesity among adult African-AmericansAll BE PA studies (n=7) measured perceptions of BE. Safety from crime had the strongest association with PA among urban dwellers (not consistent across studies). Light traffic and the presence of sidewalks were positively but inconsistently associated with meeting PA recommendations in metro and non-metro areas.
Cerin (2017)42 (2000 to September 2016)All CSReview and meta-analysis of BE associations with active travel in older adults (aged ≥65 years)Strong links between neighbourhood BE and active travel. Sufficient evidence for positive associations between total walking for transport and residential density/urbanisation, walkability, street connectivity, overall access to destinations/services, land use mix, pedestrian friendly features and access to several types of destinations.
Cunningham (2004)27 (1966 to 2002)All CSTo identify theoretical models and key concepts used to predict the association between BE and seniors’ PALimited # of studies focused on seniors (n=6). Range of theoretical models and BE measurement methods. Positive relationships for: PA, safety and aesthetics; findings mixed for PA associations with sidewalks or convenience of facilities.
Ewing (2010)62 (up to 2009)Not describedA meta-analysis of the associations between BE and travel (VMT, walking, transit)Travel variables are generally inelastic with respect to change in measures of the BE. Walk trips are most strongly associated with the design and diversity dimensions of BEs.
Ferdinand (2013)169 (1990 to April 2011)All observtnlReview relationship between BE and PA or obesity rates (all ages)89.2% of studies found a beneficial relationship between BE and PA. Studies using objective (vs self-report or other) PA measures were 18% less likely to identify a beneficial relationship.
Foster (2008)41 (up to July 2007)All CS(1) To summarise the individual, social and BE characteristics that are associated with perceived safety; (2) to examine the association between real and perceived crime-related safety, and between factors known to influence crime-related safety and PAPerceived safety tends to affect the PA of groups already known to exhibit greater anxiety about crime (women, elderly). BE PA findings inconsistent, likely due to measurement limitations. More specific measures warranted.
Fraser (2011)21 (up to June 2009)8 CS, 7 surveys with exptl measures,
2 RL,
2 ecological,
1 pre–post,
1 qual
To review observtnl and exptl studies examining association between objectively measured BE and cycling behaviour (all ages)No studies rated strong on study quality and none from low-income/middle-income countries. Significant positive findings for objective BE measures and higher rates/frequency of cycling in 11 studies, including cycle routes, Safe Routes to School initiatives, proximity of destinations, separation from traffic, population density, proximity of cycle paths and presence of green space/recreational land. Significant findings with cycling: traffic danger, sloping terrain and long trip distance. 10 studies found no positive association between BE and cycling.
Frost (2010)20 (up to June 2008)19 CS,
1 PL
To review the association between BE and PA in adults in rural settingsPositive associations found among pleasant aesthetics, trails, safety/crime, parks and walkable destinations. Measures of PA varied.
Grasser (2013)34 (up to August 2010)33 CS,
1 PL
To review objectively measured walkability and active transport and weight-related outcomes in adultsBE measures consistently associated with walking for transport: gross population density, intersection density and walkability indexes. Inconsistent results on weight-related measures.
Heath (2006)3 separate reviews (see scope)CS QE time seriesTo review studies addressing environmental and policy strategies to promote PA: (1) community scale urban design and land use (n=12, 1993–2003); (2) street-scale urban design and land use (n=6, 1987–2003); (3) transportation and travel (n=1, 1990–1998)Two interventions were effective in promoting PA (community-scale and street-scale urban design and land use policies and practices). Evidence is insufficient to assess transportation policy and practices to promote PA.
Humpel (2002)19 (up to 2002)18 CS,
1 PL
To review the relationships between BE attributes and PA behaviours in adultsSelf-report BE studies more frequent than studies incorporating objective BE. Variables representing access to facilities and specific opportunities for PA, and aesthetics were associated with PA.
Kaczynski (2007)50 (1998 to December 2005)All CSTo review what types of PRSs are most related to PA and how proximity to PRSs is related to PA (all ages)Diverse operationalisations of both parks or recreation and PA were employed (eg, proximity definitions) as were a range of PA variables. Mixed associations were observed for different types of PRSs, with parks, trails and other open spaces (eg, golf courses) having more consistent positive relationships. Proximity to PRSs were generally found to be associated with increased PA.
Kaczynski (2008)50 (1998 to December 2005)All CSTo review what types of PRSs are most related to PA and how PRSs were related to different functions and intensities of PA (all ages)PRSs were more likely to be positively associated with PA for exercise or utilitarian functions than for recreational PA. PRSs were commonly associated with walking; mixed results with moderate and vigorous PA.
Mayne (2015)37 (January 2005 to January 2014)13 natural expts,
24 QE
A review of studies in the medical literature relating to natural or QE in obesity research (all ages)PA studies (n=17) generally found stronger impacts when the intervention improved infrastructure for active transport or had a longer follow-up period (>6 months).
McCormack (2004)12 (2000 to 2004)All CSA review of associations between BE and PA among adults incorporating self-report and objective measures of BE and PAPositive associations between both perceived and objectively measured BE and PA. Availability, access and convenience of destinations, neighbourhood functionality and aesthetics were associated with PA. Lack of association between specific types of PA and specific setting in which it is performed.
McCormack (2011)33 (1996 to 2010)20 CS,
13 QE
To review the relationship between objective measures of BE and PA among adults for studies attempting to control for neighbourhood self-selectionBE PA associations were either in the expected direction or null. Land use mix, connectivity, population density and overall neighbourhood design were important PA determinants. BE more likely to be associated with transport-related walking than other types of PA. Self-selection adjustment attenuated relationships.
Moran (2014)31 (1996 to2012)All qualTo review qualitative studies of BE and PA in older adultsStudies combined interviews with spatial qualitative methods that added depth to understanding of BE PA relationships. Themes identified: pedestrian infrastructure, safety, access to facilities, aesthetics and environmental conditions.
Ogilvie (2004)22 (up to end of 2002)3 RCTs, 7 non-rand cont PL, 11 uncontrolled PL, 1 cont RLTo review the effects of population level interventions to promote a shift from using cars towards walking and cyclingEngineering measures were not found to be effective in a modal shift from cars to walking and cycling.
Owen (2004)18 (up to 2004)16 CS,
2 PL
To review association between objective and perceived environment and walkingAesthetics, convenience of walking facilities, accessibility, level of traffic and composite BE measures were associated with walking for different purposes. Attributes associated with walking for exercise different from those associated with walking to get to/from places.
Pucher (2010)139 (1990 to 2010)CS,
PL (#s not provided)
To review interventions targeting increased levels of cyclingFindings suggested positive impacts of interventions, but increases in cycling are generally small. Large variation in estimated impacts by type of intervention and study design, location and timing. Most studies limited due to study design adopted.
Saelens (2003)14 (up to 2003)All QE/CSReview of transport, urban design and planning literature to determine associations between BE variables and transport walking and cyclingHigher density, greater connectivity and more land use mix is associated with higher rates of walking and cycling for transport. Transport, urban design and planning fields can contribute to multidisciplinary research on environmental contributions to PA levels in the population.
Saelens (2008)13 reviews (2002 to 2006) and 29 studies (2005 to May 2006)CSTo review the evidence of BE correlates of walkingPrevious reviews and newer studies document positive associations of walking for transport with density, distance to destinations and land use mix. Associations between network connectivity, parks and open space and personal safety and transport walking are mixed. Relationships with recreational walking are less clear.
van Cauwenberg (2011)31 (2000 to March 2010)28 CS,
3 LP
To review the association between BE and PA in older adultsResults were inconsistent with most of the BE characteristics reporting non-significant relationships with PA, possibly reflecting limited number of studies and methodological issues.
van Holle (2012)70 (January 2000 to August 2011)69 CS,
1 LP
To review European specific studies on the relationship between BE and PA domains in adultsConvincing evidence on positive relationships with several PA domains: walkability, access to destinations and composite factor environmental quality. Transport PA more consistently related to BE. Lack of association with domain specific PA and access to recreation facilities, aesthetics, crime and traffic-related safety.
  • *The reviews were selected from previous reviews of reviews,67 68 and an updated literature search using the same methodology outlined in this paper.

  • –, negative; BE, built environment; cont, controlled; CS, cross-sectional; expts, experiments; exptl, experimental; GIS, Geographic Information System; observtnl, observational; PA, physical activity; PL, prospective longitudinal; PRSs, parks and recreational settings; qual, qualitative; quant, quantitative; QE, quasi-experimental or quasi-experiments; rand, randomised; RCT, randomised controlled trial; RL, retrospective longitudinal; VMT, vehicle miles travelled.