Abstract
Purpose: There is strong evidence of the links between car-dependence and the physical inactivity pandemic. Physical inactivity accounts for 6–10% of major non-communicable diseases. Research consistently shows that unlike passive transport, active transport is associated with higher total daily physical activity (PA). While there are public policies that support PA in transport and, as a result, overall PA levels, the specific quantitative effect of such policies on PA behaviour has not been sufficiently investigated. The aim of this systematic review is to determine the level and type of evidence for policies in the area of transport that contribute to higher PA levels of the whole of society. Methods: Six databases (MEDLINE (Ebsco), SportDiscus, Cinahl, Cochrane library, Web of Science, and Scopus) were searched for key concepts of policy, transport, evaluation and PA. Methodological quality was assessed using standardized tools. The strength of the evidence of policy impact was described based on pre-determined categories of positive, negative, inconclusive or untested. Results: 17 of 2549 studies were included in the data synthesis. The authors identified three main transport policy areas with 51 individual policy actions that had a direct or indirect effect on PA. These were: convenient transport infrastructure development, active travel promotion, and shift of transport mode. More than half of the policy actions identified had a positive effect on PA. Study quality ratings were moderate to good. Conclusions: PA levels can be increased by implementing policies that provide convenient, safe, and connected walking and cycling infrastructures, promote active travel and give strong support to public transport. There is also clear evidence that active travel policies work best when implemented in a comprehensive way. This may include infrastructure and facility improvements as well as educational programmes to achieve substantial shifts towards active modes of travel.
| Original language | English |
|---|---|
| Article number | 101488 |
| Journal | Journal of Transport and Health |
| Volume | 27 |
| DOIs | |
| Publication status | Published - Dec 2022 |
Keywords
- Active travel
- Physical activity
- Transport mode
- Transport policy
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In: Journal of Transport and Health, Vol. 27, 101488, 12.2022.
Research output: Contribution to journal › Review article › Academic › peer-review
TY - JOUR
T1 - Which transport policies increase physical activity of the whole of society? A systematic review
AU - Zukowska, Joanna
AU - Gobis, Anna
AU - Krajewski, Piotr
AU - Morawiak, Agnieszka
AU - Okraszewska, Romanika
AU - Woods, Catherine B.
AU - Volf, Kevin
AU - Kelly, Liam
AU - Gelius, Peter
AU - Messing, Sven
AU - Forberger, Sarah
AU - Lakerveld, Jeroen
AU - den Braver, Nicole
AU - Bengoechea, Enrique Garcia
AU - PEN consortium, null
N1 - Funding Information: Although transport policies that prioritise walking, cycling and public transport are regularly recommended due to their direct and indirect effect on PA (Rupprecht Consult, 2019; The European Commission, 2017), the many publications that are relevant in this field often have conflicting or inconsistent results. It is relevant to systematically summarize appraise the current evidence. This study aims to fill this gap and provide a full and accurate picture of all those policies that actually affect behaviour change that contribute to improved population PA. The systematic review focuses therefore only on transport policies that had a robust and measurable impact on PA and determines the level and type of quantitative evidence for this type of policies. This is also the first study in the area of PA in transportation where only policies are considered, not all interventions or activities undertaken to increase PA levels. The reason is the review will contribute to the development of the Physical Activity Environment Policy Index (PA-EPI), which aims to support policy makers by facilitating the development and benchmarking of all policies which work towards achieving WHO's public health targets regarding PA participation. The contribution of transport is an important part of these policies.Standardized definitions and terminology for policy-related concepts and their inter-relations (Fig. 2) were used (Lakerveld et al., 2020). Previous reviews have noted the importance of separating “policies” from “interventions” (Gelius et al., 2020; Rütten et al., 2016; Volf et al., 2020). Thus, the expression ‘Intervention’ means an action, programme or environmental change used to promote PA. ‘PA Programme’ determines specific opportunities for increasing PA behaviour, attitudes or knowledge in a target population for a specific period of time. ‘PA Environment’ stands for relevant physical and social features of the transport environment that are hypothesized to support changes in PA behaviour. ‘PA Policy’ includes decisions, plans and actions that are enforced by national or regional governments, or their agencies which may impact PA directly or indirectly. ‘Policy Level’ determines laws, national/state, regional/local-level codes and regulations. ‘Policy Area’ indicates specific content areas for policy actions within the transport system, e.g. development of convenient infrastructure. ‘Policy Action’ includes actions defined as actual options selected by policymakers. They are specific actions put into place by any level of government and associated agencies to achieve the PA objective directly or indirectly. They may be written into broad strategies, action plans, official guidelines/notifications, calls to action, legislation, or rules and regulations. An action may have its own exclusive policy document, or may be part of a larger document (Volf et al., 2020).The research results published in this article are a part of the project PEN funded by the Joint Programming Initiative (JPI) “A Healthy Diet for a Healthy Life”, a research and innovation initiative of EU member states and associated countries. The funding agencies supporting this work are (in alphabetical order) Germany: Federal Ministry of Education and Research (BMBF); Ireland: Health Research Board (HRB); Italy: Ministry of Education, University and Research (MIUR); The Netherlands: The Netherlands Organisation for Health Research and Development (ZonMw); Norway: Research Council of Norway (RCN); and Poland: National Center for Research and Development (NCBR). Funding Information: The research results published in this article are a part of the project PEN funded by the Joint Programming Initiative (JPI) “A Healthy Diet for a Healthy Life”, a research and innovation initiative of EU member states and associated countries. The funding agencies supporting this work are (in alphabetical order) Germany: Federal Ministry of Education and Research (BMBF); Ireland: Health Research Board (HRB); Italy: Ministry of Education, University and Research (MIUR); The Netherlands: The Netherlands Organisation for Health Research and Development (ZonMw); Norway: Research Council of Norway (RCN); and Poland: National Center for Research and Development (NCBR). Publisher Copyright: © 2022 The Authors
PY - 2022/12
Y1 - 2022/12
N2 - Purpose: There is strong evidence of the links between car-dependence and the physical inactivity pandemic. Physical inactivity accounts for 6–10% of major non-communicable diseases. Research consistently shows that unlike passive transport, active transport is associated with higher total daily physical activity (PA). While there are public policies that support PA in transport and, as a result, overall PA levels, the specific quantitative effect of such policies on PA behaviour has not been sufficiently investigated. The aim of this systematic review is to determine the level and type of evidence for policies in the area of transport that contribute to higher PA levels of the whole of society. Methods: Six databases (MEDLINE (Ebsco), SportDiscus, Cinahl, Cochrane library, Web of Science, and Scopus) were searched for key concepts of policy, transport, evaluation and PA. Methodological quality was assessed using standardized tools. The strength of the evidence of policy impact was described based on pre-determined categories of positive, negative, inconclusive or untested. Results: 17 of 2549 studies were included in the data synthesis. The authors identified three main transport policy areas with 51 individual policy actions that had a direct or indirect effect on PA. These were: convenient transport infrastructure development, active travel promotion, and shift of transport mode. More than half of the policy actions identified had a positive effect on PA. Study quality ratings were moderate to good. Conclusions: PA levels can be increased by implementing policies that provide convenient, safe, and connected walking and cycling infrastructures, promote active travel and give strong support to public transport. There is also clear evidence that active travel policies work best when implemented in a comprehensive way. This may include infrastructure and facility improvements as well as educational programmes to achieve substantial shifts towards active modes of travel.
AB - Purpose: There is strong evidence of the links between car-dependence and the physical inactivity pandemic. Physical inactivity accounts for 6–10% of major non-communicable diseases. Research consistently shows that unlike passive transport, active transport is associated with higher total daily physical activity (PA). While there are public policies that support PA in transport and, as a result, overall PA levels, the specific quantitative effect of such policies on PA behaviour has not been sufficiently investigated. The aim of this systematic review is to determine the level and type of evidence for policies in the area of transport that contribute to higher PA levels of the whole of society. Methods: Six databases (MEDLINE (Ebsco), SportDiscus, Cinahl, Cochrane library, Web of Science, and Scopus) were searched for key concepts of policy, transport, evaluation and PA. Methodological quality was assessed using standardized tools. The strength of the evidence of policy impact was described based on pre-determined categories of positive, negative, inconclusive or untested. Results: 17 of 2549 studies were included in the data synthesis. The authors identified three main transport policy areas with 51 individual policy actions that had a direct or indirect effect on PA. These were: convenient transport infrastructure development, active travel promotion, and shift of transport mode. More than half of the policy actions identified had a positive effect on PA. Study quality ratings were moderate to good. Conclusions: PA levels can be increased by implementing policies that provide convenient, safe, and connected walking and cycling infrastructures, promote active travel and give strong support to public transport. There is also clear evidence that active travel policies work best when implemented in a comprehensive way. This may include infrastructure and facility improvements as well as educational programmes to achieve substantial shifts towards active modes of travel.
KW - Active travel
KW - Physical activity
KW - Transport mode
KW - Transport policy
UR - http://www.scopus.com/inward/record.url?scp=85137283585&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jth.2022.101488
DO - https://doi.org/10.1016/j.jth.2022.101488
M3 - Review article
SN - 2214-1405
VL - 27
JO - Journal of Transport and Health
JF - Journal of Transport and Health
M1 - 101488
ER -