Background: In response to climate change, cities across Canada are investing over $1B in new cycling infrastructure to support more active transportation. Little empirical evidence exists describing the effectiveness of adding protected cycling trails on changes in cycling or physical activity (PA) levels. Hypothesis: We hypothesized that areas with new infrastructure would experience increased PA and trail use by cyclists and pedestrians compared to areas without new infrastructure. Design and Methods: We searched CINAHL, EMBASE (Ovid), MEDLINE (Ovid), SPORTDiscus, TRD/Transportation Research Information Services (TRIS), Web of Science and Google Scholar for articles published from 2010 to 2023. We included studies with an experimental pre-post design that reported a PA outcome or trail counts for an intervention and control area. The interventions were limited to protected and/or separated bike lanes, including cycle tracks, multi-use trails, greenways, and bike lanes with concrete barriers. Our primary outcomes were individual level physical activity (PA) and trail use counts (cyclists and pedestrians). A modified risk of bias tool will be employed to assess the methodological quality of each selected study. We followed PRISMA reporting guidelines and the review was pre-registered with Prospero (CRD42023438891) Results: Three independent reviewers screened abstracts from 3936 articles, of which 58 were included in a full text review. After resolving conflicts, 28 articles describing natural experiments of new cycling infrastructure met eligibility criteria were included for data extraction. We extracted data for population characteristics in both intervention and control areas, such as socioeconomic status, mean age, race, and the percentage of females, as well as outcomes related to physical activity. 1/28 papers used accelerometer data, 12/28 used survey data, 3/28 used eco counter data, 2/28 used manual counters. Of the 15 studies that reported it, sample size ranged from 70 to 21,488. Due to high variance in data reporting style, not all studies could be meta-analyzed. We found a high risk of bias for all natural experiments studies and very few adhered to TREND reporting guidelines for quasi-experimental studies. Conclusions: Changes in built environment preliminarily appear to increase cycling and pedestrian counts. Reporting style varies too greatly across research studies for an effective meta-analysis. As a scientific community, we need to work together to follow reporting standards.
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