Gretchen Swanson Center for Nutrition, Omaha, Nebraska (Dr Balis); University of Nebraska Medical Center, Omaha, Nebraska (Dr Porter); and Montana State University, Bozeman, Montana (Dr Grocke-Dewey).
J Public Health Manag Pract. 2024;30(4):490-500. doi: 10.1097/PHH.0000000000001822. Epub 2024 Jun 12.
Built environment interventions (pedestrian/bicycle infrastructure and enhanced access) mitigate barriers to physical activity by making the healthy choice the default choice. Demonstration projects (eg, temporary pedestrian lanes or sidewalks marked with tape) are used to test these interventions before making permanent changes. However, it is unknown whether demonstration projects lead to desired built environment changes.
To systematically review the literature to determine outcomes and overall public health impacts of demonstration projects and whether they lead to permanent changes to the built environment.
Systematic review, conducted from March to September 2022 by searching PubMed and EBSCOhost for peer-reviewed literature and Google for gray (non-peer-reviewed) literature. Inclusion criteria were policy, systems, or environmental interventions; temporary implementation; and presence of evaluation data. Exclusion criteria were individual/interpersonal-level interventions, permanent implementation, and absence of evaluation data. Two authors coded for inclusion/exclusion and resolved discrepancies, coded a portion of included sources and resolved discrepancies, refined coding guide definitions, and coded remaining sources.
Data were extracted based on the expanded RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework, which incorporates constructs of the Implementation Outcomes Framework (acceptability, appropriateness, feasibility).
Gray (N = 23) and peer-reviewed (N = 1) sources describing unique demonstration projects (N = 31) met inclusion criteria. Projects tested built environment interventions including traffic calming measures, crosswalks, bike lanes, intersection design, and trails. Sources primarily reported effectiveness (typically improved safety), maintenance, acceptability, and appropriateness. Most sources did not report projects leading to permanent changes to the built environment.
Based on inconsistent reporting of key outcomes (number of community members reached, changes to physical activity levels), overall impacts are unknown. Most demonstration projects captured community members' feedback, which was typically positive, but it is unknown whether feedback led to long-term changes. We recommend providing improved demonstration project guidance for practitioners to facilitate robust data collection, including suggested evaluation methods and tools.
通过改善基础设施（如行人/自行车道和增加可达性）使健康选择成为默认选择，可以减轻身体活动的障碍。示范项目（例如临时行人道或用胶带标记的人行道）用于在进行永久性改变之前测试这些干预措施。然而，目前尚不清楚示范项目是否会导致预期的建筑环境变化。
系统地回顾文献，以确定示范项目的结果和整体公共卫生影响，以及它们是否会导致建筑环境的永久性改变。
系统评价，于 2022 年 3 月至 9 月在 PubMed 和 EBSCOhost 上搜索同行评议文献，在 Google 上搜索灰色（非同行评议）文献进行。纳入标准为政策、系统或环境干预措施、临时实施以及存在评估数据。排除标准为个人/人际层面的干预措施、永久性实施和缺乏评估数据。两位作者对纳入/排除标准进行编码，并解决差异，对纳入来源的一部分进行编码并解决差异，细化编码指南定义，并对其余来源进行编码。
根据扩展的 RE-AIM（Reach、Effectiveness、Adoption、Implementation、Maintenance）框架提取数据，该框架纳入了实施结果框架（可接受性、适当性、可行性）的构建。
符合纳入标准的灰色（N=23）和同行评议（N=1）来源描述了 31 个独特的示范项目。项目测试了建筑环境干预措施，包括交通平静措施、横道线、自行车道、交叉口设计和步道。来源主要报告了有效性（通常是安全性提高）、维护、可接受性和适当性。大多数来源未报告项目导致建筑环境的永久性改变。
由于关键结果（接触到的社区成员人数、身体活动水平的变化）报告不一致，整体影响尚不清楚。大多数示范项目都收集了社区成员的反馈，这些反馈通常是积极的，但尚不清楚反馈是否会导致长期变化。我们建议为从业者提供改进的示范项目指南，以促进强有力的数据收集，包括建议的评估方法和工具。
