Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany.
Eur J Public Health. 2018 Feb 1;28(1):105-118. doi: 10.1093/eurpub/ckx174.
Despite the large number of studies and reviews available, the evidence regarding the policy determinants of physical activity (PA) is inconclusive. This umbrella systematic literature review (SLR) summarizes the current evidence on the policy determinants of PA across the life course, by pooling the results of the available SLRs and meta-analyses (MAs).
A systematic online search was conducted on MEDLINE, ISI Web of Science, Scopus and SPORTDiscus databases up to April 2016. SLRs and MAs of observational studies investigating the association between policy determinants of PA and having PA as outcome were considered eligible. The extracted data were assessed based on the importance of the determinants, the strength of evidence and the methodological quality.
Fourteen reviews on 27 policy determinants of PA were eligible for this umbrella SLR. The majority of the reviews were of moderate quality. Among children, a clear association between time spent outdoors and PA emerged. Among adults, working hours were negatively associated with PA, though evidence was limited. At the population level, community- and street-scale urban design and land use policies were found to positively support PA levels, but levels of evidences were low.
With this umbrella SLR the policy determinants of PA at individual-level and population-level have been summarized and assessed. None of the investigated policy determinants had a convincing level of evidence, and very few had a probable level of evidence. Further research is needed, preferably by using prospective study designs, standardized definitions of PA and objective measurement of PA.
尽管有大量的研究和综述，但关于体力活动（PA）政策决定因素的证据仍不明确。本伞式系统文献综述（SLR）通过汇总现有的 SLR 和荟萃分析（MA）的结果，总结了整个生命过程中 PA 政策决定因素的当前证据。
在 2016 年 4 月之前，我们在 MEDLINE、ISI Web of Science、Scopus 和 SPORTDiscus 数据库上进行了系统的在线搜索。合格的 SLR 和 MA 是针对观察性研究，这些研究调查了 PA 政策决定因素与作为结果的 PA 之间的关联。提取的数据是基于决定因素的重要性、证据的强度和方法学质量来评估的。
有 14 篇关于 27 个 PA 政策决定因素的综述符合本伞式 SLR 的条件。大多数综述的质量为中等。在儿童中，户外活动时间与 PA 之间存在明显的关联。在成年人中，工作时间与 PA 呈负相关，但证据有限。在人群层面上，社区和街道尺度的城市设计和土地利用政策被发现可以积极支持 PA 水平，但证据水平较低。
通过本伞式 SLR，我们总结和评估了个人和人群层面的 PA 政策决定因素。没有一个被调查的政策决定因素有令人信服的证据水平，很少有很可能的证据水平。需要进一步研究，最好使用前瞻性研究设计、PA 的标准化定义和 PA 的客观测量。
