Department of Health Care Organization and Policy, University of Alabama at Birmingham, USA.
Am J Public Health. 2012 Oct;102(10):e7-e13. doi: 10.2105/AJPH.2012.300740. Epub 2012 Aug 16.
We conducted a systematic review of the literature examining the relationship between built environments (e.g., parks, trails, sidewalks) and physical activity (PA) or obesity rates.
We performed a 2-step inclusion protocol to identify empirical articles examining any form of built environment and any form of PA (or obesity rate) as the outcome. We extracted data from included abstracts for analysis by using a standard code sheet developed for this study.
Of 169 included articles, 89.2% reported beneficial relationships-but virtually all articles utilized simple observational study designs not suited for determining causality. Studies utilizing objective PA measures (e.g., pedometer) were 18% less likely to identify a beneficial relationship. Articles focusing on children in community settings (-14.2%), those examining direct measures of obesity (-6.2%), or those with an academic first author (-3.4%) were less likely to find a beneficial relationship.
Policymakers at federal and local levels should encourage more rigorous scientific research to determine whether altered built environments will result in increased PA and decreased obesity rates.
我们对文献进行了系统回顾，以研究建筑环境（如公园、步道、人行道）与身体活动（PA）或肥胖率之间的关系。
我们采用两步纳入方案，以确定考察任何形式的建筑环境和任何形式的 PA（或肥胖率）作为结果的实证文章。我们从纳入的摘要中提取数据，以便使用为本研究制定的标准代码表进行分析。
在 169 篇纳入的文章中，89.2% 报告了有益的关系-但实际上所有文章都采用了不适合确定因果关系的简单观察性研究设计。利用客观 PA 测量（如计步器）的研究发现有益关系的可能性降低了 18%。关注社区环境中儿童的文章（-14.2%）、直接测量肥胖的文章（-6.2%）或第一作者为学者的文章（-3.4%）发现有益关系的可能性较低。
联邦和地方各级的决策者应鼓励进行更严格的科学研究，以确定改变建筑环境是否会导致 PA 增加和肥胖率降低。
