Infrastructure, policy and regulatory interventions to increase physical activity to prevent cardiovascular diseases and diabetes: A systematic review

Abstract

Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circum‑ stances in which physical activity occurs may promote physical activity at a population level. We assessed the efects of infrastructure, policy or regulatory interventions for increasing physical activity. We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), con‑ trolled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the efects of these interven‑ tions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evi‑ dence based on efect direction.