A life course examination of the physical environmental determinants of physical activity behaviour: A "Determinants of Diet and Physical Activity" (DEDIPAC) umbrella systematic literature review.

Angela Carlin,Astrid Steinbrecher,Giorgio Napolitano,Camille Perchoux,Aileen Kennedy,Marieke De Craemer,Holger Schulz,Sylvia Hansen,Rhoda Sohun,Johann Issartel,Laura Capranica,Tara Coppinger,Licia Iacoviello,Fiona Chun Man Ling,Donatella Ciarapica,Christoph Buck,Simon Chantal,Lina Jaeschke,Sara D’Haese,Pascal Izzicupo,Jeroen Lakerveld,Alessandra Sannella,Con Burns,Cristina Cortis,Stefania Boccia,Agnes Luzak,Giancarlo Condello,Wolfgang Schlicht,Martina Kanning,Tobias Pischon,Anna Puggina,Walter Ricciardi,Angela Polito,Greet Cardon,Katina Aleksovska,Andrea Di Blasio,Julie Anne Nazare ,Ciarán Macdonncha

doi:10.1371/journal.pone.0182083

Abstract

BackgroundParticipation in regular physical activity is associated with a multitude of health benefits across the life course. However, many people fail to meet PA recommendations. Despite a plethora of studies, the evidence regarding the environmental (physical) determinants of physical activity remains inconclusive.ObjectiveTo identify the physical environmental determinants that influence PA across the life course.MethodsAn online systematic literature search was conducted using MEDLINE, ISI Web of Science, Scopus and SPORTDiscus. The search was limited to studies published in English (January 2004 to April 2016). Only systematic literature reviews (SLRs) and meta-analyses (MAs) of observational studies, that investigated the association between physical determinants and physical activity outcomes, were eligible for inclusion. The extracted data were assessed on the importance of determinants, strength of evidence and methodological quality.ResultsThe literature search identified 28 SLRs and 3 MAs on 67 physical environmental characteristics potentially related to physical activity that were eligible for inclusion. Among preschool children, a positive association was reported between availability of backyard space and outdoor toys/equipment in the home and overall physical activity. The availability of physical activity programs and equipment within schools, and neighbourhood features such as pedestrian and cyclist safety structure were positively associated with physical activity in children and adolescents. Negative street characteristics, for example, lack of sidewalks and streetlights, were negatively associated with physical activity in adults. Inconsistent associations were reported for the majority of reviewed determinants in adults.ConclusionThis umbrella SLR provided a comprehensive overview of the physical environment determinants of physical activity across the life course and has highlighted, particularly amongst youth, a number of key determinants that may be associated with overall physical activity. Given the limited evidence drawn mostly from cross-sectional studies, longitudinal studies are needed to further explore these associations.RegistrationPROSPERO CRD42015010616

Highlights

Participation in regular physical activity (PA) is associated with a multitude of health benefits across the life course [1,2] and plays a key role in the prevention and management of noncommunicable diseases (NCDs); including cardiovascular disease, type 2 diabetes, depression, osteoporosis and some cancers [2,3]
The literature search identified 28 systematic literature reviews (SLRs) and 3 MAs on 67 physical environmental characteristics potentially related to physical activity that were eligible for inclusion
Within the present umbrella SLR, ‘access/proximity parks/playgrounds and open space’ was positively associated with preschool children’s overall PA and moderate-to-vigorous PA (MVPA) [47,48]. These findings suggest that the provision and proximity of areas for recreational play, such as playgrounds may have an impact on PA at this stage of the life course, and should be considered within polices for neighborhood design

Summary

Introduction

Participation in regular physical activity (PA) is associated with a multitude of health benefits across the life course [1,2] and plays a key role in the prevention and management of noncommunicable diseases (NCDs); including cardiovascular disease, type 2 diabetes, depression, osteoporosis and some cancers [2,3]. A large proportions of the population fail to meet these guidelines, with approximately one third of adults (31%) and the majority of young people aged 13–15 years (80%) worldwide classed as physically inactive [5]. Conservative estimates indicate that physical inactivity cost health-care systems $53.8 billion globally in 2013 [7]. Participation in regular physical activity is associated with a multitude of health benefits across the life course. Despite a plethora of studies, the evidence regarding the environmental (physical) determinants of physical activity remains inconclusive

Methods

Results

Discussion

Conclusion