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NICE Underpinning Review
"A review of NICE guideline PH8 on physical activity and the environment identified that some sections of the guideline were in need of update as new evidence was available (see review decision). The update also has a particular focus on those who are less able to be physically active (see scope). The update focuses on interventions in the following environments:
Built environment including roads, pavements, the external areas of buildings and open 'grey' space, such as urban squares and pedestrianised areas.
Natural environment, including 'green' and 'blue' spaces. Green spaces include: urban parks, open green areas, woods and forests, coastland and countryside, and paths and routes connecting them. Blue spaces include: the sea, lakes, rivers and canals. A series of evidence reviews was undertaken to support the guideline development.
This second evidence review focuses on the effectiveness and cost effectiveness of the following interventions – trails, safe routes to schools and ‘Ciclovia’ (the closure of streets to motorised traffic for the purpose of increasing physical activity)."
Dywed yr awduron "Overall, the quality of the studies was poor. As noted in section 3.3, none of the studies were graded [++] and only 6 studies were graded [+]. The remaining 24 studies were graded [-]. 5 economic evaluations were identified. Consistent themes do emerge across the studies:
Improvements to walking and cycling infrastructure are more likely to impact on the physical activity of people living close by.
While on street cycle lanes may significantly increase levels of cycling, the absolute increase, in terms of number of individuals, is likely to be very small.
Changes to physical infrastructure did not always result in participants increasing their physical activity levels significantly more than control groups, this may have been the result of the groups not being different enough in terms of distance to observe an effect.
Increases in physical activity levels may not be in those people who were previously inactive but rather the result of infrastructure changes funnelling existing cyclists and walkers to new paths/streets/trails. Insufficient follow up times may impact of whether interventions were found to significantly increase physical activity levels; adequate time is required to allow behaviour change to take place.
There is a need to be mindful of what else might be happening in an intervention area; one of the trail studies observed a sharp increase in physical activity levels at midintervention owing to a promotional campaign, after which levels tailed off.
Although health economics data was of low quality, interventions in this review tend to be cost effective."