Division of Epidemiology and Public Health, School of Medicine, The University of Nottingham, Nottingham, UK.
The Nottingham Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, The University of Nottingham, Nottingham, UK.
JBI Evid Synth. 2022 Oct 1;20(10):2410-2444. doi: 10.11124/JBIES-21-00295.
The objective of this review was to synthesize the association between built environment constructs and physical activity among children and adolescents in Africa.
Previous reviews have found that several built environment constructs, such as residential density, crime safety, and availability of physical activity facilities and infrastructure, are associated with physical activity in children and adolescents; however, these reviews have tended to focus on non-African countries. Therefore, this systematic review synthesized the association between the built environment and physical activity among children and adolescents in Africa.
This systematic review included comparative observational studies that assessed the relationship between built environmental constructs and physical activity among children and adolescents (between the ages of 5 and 19 years) in Africa.
Comprehensive electronic searches of MEDLINE, Embase, CINAHL, Web of Science, PsycINFO, Scopus, SPORTDiscus, EThOS, and ProQuest Dissertations and Theses from inception to October 22, 2021, were conducted to identify relevant published and unpublished studies. Two reviewers independently screened papers, assessed the quality of the included studies using the JBI standard critical appraisal tool, and extracted data using a pre-piloted form. Where possible, data were synthesized using random effects meta-analyses, with effect sizes reported as mean differences (MDs) with 95% confidence intervals (CIs). The Grading of Recommendations Assessment, Development and Evaluations (GRADE) was used to assess the certainty of the findings.
Of the 10,706 identified records, six cross-sectional studies were included, which comprised 4628 children and adolescents. Three of the studies had a high-quality score of 7 or 8 out of 8. Seven built environment constructs were reported within the included studies, namely, residential density, street connectivity, crime safety, availability of physical activity facilities and infrastructure, walkability, esthetics, and traffic safety. Three of the constructs were assessed with objective measures. Results from individual studies found significant associations between physical activity and objective measure of traffic safety (MD 2.63 minutes per day; 95% CI 0.16 to 5.1; one study) and an objective measure of crime safety (MD 2.72 minutes per day; 95% CI 0.07 to 5.37; one study). No significant associations were found between active transportation and any of the built environment constructs. The GRADE evidence for all of the assessed constructs was either low (the built environment constructs may lead to little or no difference in physical activity or active transportation) or very low (it was uncertain whether the built environment constructs affect physical activity).
In African settings, the evidence base for the association between built environment constructs and physical activity is limited, with no consistent evidence of an association. Therefore, further high-quality studies should be conducted before firm conclusions can be drawn.
PROSPERO CRD42019133324.
本综述的目的是综合分析非洲儿童和青少年的建筑环境结构与身体活动之间的关联。
先前的综述发现，几个建筑环境结构，如居住密度、犯罪安全以及体育活动设施和基础设施的可用性，与儿童和青少年的身体活动有关；然而，这些综述往往侧重于非非洲国家。因此，本系统综述综合了非洲儿童和青少年的建筑环境与身体活动之间的关联。
本系统综述包括了评估建筑环境结构与非洲儿童和青少年（5 至 19 岁）身体活动之间关系的比较观察性研究。
全面检索 MEDLINE、Embase、CINAHL、Web of Science、PsycINFO、Scopus、SPORTDiscus、EThOS 和 ProQuest Dissertations and Theses，从建库至 2021 年 10 月 22 日，以确定相关的已发表和未发表的研究。两名审查员独立筛选论文，使用 JBI 标准评估工具评估纳入研究的质量，并使用预先制定的表格提取数据。在可能的情况下，使用随机效应荟萃分析综合数据，效应大小以 95%置信区间（CI）表示的均值差异（MD）报告。使用推荐评估、制定和评估（GRADE）对研究结果的确定性进行评估。
在 10706 条确定的记录中，纳入了 6 项横断面研究，共纳入了 4628 名儿童和青少年。其中 3 项研究的评分达到了 7 或 8 分（满分 8 分）。纳入的研究报告了 7 种建筑环境结构，分别是居住密度、街道连通性、犯罪安全、体育活动设施和基础设施的可用性、可步行性、美观和交通安全。其中 3 种结构采用了客观测量方法进行评估。个别研究的结果发现，身体活动与客观测量的交通安全（每天增加 2.63 分钟；95%CI 0.16 至 5.1；一项研究）和客观测量的犯罪安全（每天增加 2.72 分钟；95%CI 0.07 至 5.37；一项研究）之间存在显著关联。然而，在积极交通与任何建筑环境结构之间未发现显著关联。所有评估结构的 GRADE 证据均为低（建筑环境结构可能导致身体活动或积极交通几乎没有差异）或极低（不确定建筑环境结构是否会影响身体活动）。
在非洲环境中，建筑环境结构与身体活动之间关联的证据基础有限，且没有一致的关联证据。因此，在得出明确结论之前，应进行更多高质量的研究。
PROSPERO CRD42019133324。
