ReviewThe international journal of behavioral nutrition and physical activity2016
The effect of changing the built environment on physical activity: a quantitative review of the risk of bias in natural experiments.
Review in The international journal of behavioral nutrition and physical activity, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
51 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- Impacts of built environment changes on physical activity in Canada: a systematic review of natural experiments.Health promotion and chronic disease prevention in Canada : research, policy and practice · 2026Pooled it
- Impact of structural-level environmental interventions on physical activity: a systematic review.International archives of occupational and environmental health · 2023Pooled it
- The Effectiveness of Interventions to Increase Participation and Physical Activities in Parks: A Systematic Review of the Literature.International journal of environmental research and public health · 2022Pooled it
- Objectively measuring the association between the built environment and physical activity: a systematic review and reporting framework.The international journal of behavioral nutrition and physical activity · 2022Pooled it
- Using natural experiments to improve public health evidence: a review of context and utility for obesity prevention.Health research policy and systems · 2020Pooled it
- Title: Can changing the physical environment promote walking and cycling? A systematic review of what works and how.Health & place · 2019Pooled it
- Do Natural Experiments of Changes in Neighborhood Built Environment Impact Physical Activity and Diet? A Systematic Review.International journal of environmental research and public health · 2018Pooled it
- Systematic literature review of built environment effects on physical activity and active transport - an update and new findings on health equity.The international journal of behavioral nutrition and physical activity · 2017Pooled it
- Multi-use physical activity trails in an urban setting and cardiovascular disease: a difference-in-differences analysis of a natural experiment in Winnipeg, Manitoba, Canada.The international journal of behavioral nutrition and physical activity · 2022Trial
- Field Experiments on Health and the Built Environment in Urban Settings: A Scoping Review.Current environmental health reports · 2026Article
- Long-term impacts of co-designed sustainable park improvements on physical activity and other wellbeing behaviours: a 7-year natural experimental study in a deprived urban area.The international journal of behavioral nutrition and physical activity · 2026Article
- The impact of revitalized urban and rural recreation infrastructure on usage levels: evidence from a longitudinal quasi-experimental study in Alberta, Canada.Health promotion and chronic disease prevention in Canada : research, policy and practice · 2026Article
- Natural experiments in the built environment: evaluating impacts on health.Health promotion and chronic disease prevention in Canada : research, policy and practice · 2026Article
- Article
- Article
- Scaling up natural experimental studies: harnessing emerging technologies to transform physical activity and built environment research.The international journal of behavioral nutrition and physical activity · 2025Article
- Using Video Cameras to Assess Physical Activity and Other Well-Being Behaviors in Urban Environments: Feasibility, Reliability, and Participant Reactivity Studies.JMIR public health and surveillance · 2024Article
- Untapped Potential of Unobtrusive Observation for Studying Health Behaviors.JMIR public health and surveillance · 2024Article
- Prioritizing a research agenda on built environments and physical activity: a twin panel Delphi consensus process with researchers and knowledge users.The international journal of behavioral nutrition and physical activity · 2023Article
- Does the Installation or the Improvement of Existing Outdoor Parks Increase Physical Activity Levels? A Systematic Review.Sports (Basel, Switzerland) · 2023Review
Corrections and comments
- Commented on by
Authors and funding
4 authors.
Funding
Abstract
backgroundEvidence regarding the association of the built environment with physical activity is influencing policy recommendations that advocate changing the built environment to increase population-level physical activity. However, to date there has been no rigorous appraisal of the quality of the evidence on the effects of changing the built environment. The aim of this review was to conduct a thorough quantitative appraisal of the risk of bias present in those natural experiments with the strongest experimental designs for assessing the causal effects of the built environment on physical activity.
methodsEligible studies had to evaluate the effects of changing the built environment on physical activity, include at least one measurement before and one measurement of physical activity after changes in the environment, and have at least one intervention site and non-intervention comparison site. Given the large number of systematic reviews in this area, studies were identified from three exemplar systematic reviews; these were published in the past five years and were selected to provide a range of different built environment interventions. The risk of bias in these studies was analysed using the Cochrane Risk of Bias Assessment Tool: for Non-Randomized Studies of Interventions (ACROBAT-NRSI).
resultsTwelve eligible natural experiments were identified. Risk of bias assessments were conducted for each physical activity outcome from all studies, resulting in a total of fifteen outcomes being analysed. Intervention sites included parks, urban greenways/trails, bicycle lanes, paths, vacant lots, and a senior citizen's centre. All outcomes had an overall critical (n = 12) or serious (n = 3) risk of bias. Domains with the highest risk of bias were confounding (due to inadequate control sites and poor control of confounding variables), measurement of outcomes, and selection of the reported result.
conclusionsThe present review focused on the strongest natural experiments conducted to date. Given this, the failure of existing studies to adequately control for potential sources of bias highlights the need for more rigorous research to underpin policy recommendations for changing the built environment to increase physical activity. Suggestions are proposed for how future natural experiments in this area can be improved.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.