Background
In recent years various studies have been conducted for the Australian context assessing the relationship between built environment attributes and physical activity. However, syntheses of the literature are necessary to conclude on the strength of such links. Reviews have been published, however, none of them focuses exclusively on Australia and international evidence is not necessarily applicable due to the highly context specificity of these relationships. This systematic review aimed at summarising Australian evidence for adults, adolescents and children for the relationship between built environment (BE) attributes and physical activity (PA) outcomes.
Methods
The literature was systematically searched using: Web of Science, Scopus, EBSCOHost, GeoRef and Leisure Tourism. Google was also used to search for Government reports, and experts in the field were consulted. A combination of BE attributes and PA related terms were applied in the searches.
Results
Thirty studies met the inclusion criteria, 24 focusing exclusively on adults, 5 on children and 1 on adolescents. For adults a total of 141 associations were assessed, 49 for children and only 4 associations for adolescents. BE attributes were classified in 7 categories (density, diversity, design, destination, distance to transit, safety and aggregated neighbourhood characteristics) and summary scores were calculated to express the strength of the associations in the expected direction for objectively measured BE results. Sufficient evidence (>50% in expected direction) of an association with physical activity was found only for adults for the cases of destinations (proximity and number), aggregated neighbourhood measures of walkability, land use diversity and distance to transit.
Conclusions
Our results are in line with the international literature for the BE attributes with sufficient evidence of a positive association with PA behaviours. However, for the cases of density and design the evidence is mixed with some international literature indicating a positive impact on PA outcomes.