Interventions to increase active travel: A systematic review

Introduction

Active travel is beneficial to human and planetary health. This systematic review aims to synthesise the evidence on interventions aiming to promote active travel.

Methods

Studies that included an intervention aiming at increasing active travel with pre- and post-intervention measurement of active travel levels were identified through searches of seven databases, with methodological quality assessed using the Mixed Methods Appraisal Tool.

Results

Of 3895 studies (3934 papers) identified, 78 were eligible for inclusion and synthesised narratively within five categories: studies relating to children (n = 10), social/behavioural/policy interventions (n = 18), interventions offering access to/subsidies for bicycles (n = 16), interventions including infrastructure/environmental change without other interventions (n = 20) and those that included multicomponent interventions (n = 14). Most studies (72/78) had a medium or high risk of bias often due to small sample sizes or high participant loss at follow-up. Multicomponent interventions had the highest impact on active travel levels. Interventions that only included social/behavioural/policy elements generally had little impact and had to be repeated/sustained for any impact to be maintained. Increasing the walkability of an area increases walking rates, but small-scale cycling infrastructure improvements without other supportive measures often leads to route substitution rather than an increase in cycling rates. E-bike loans increased active travel and reduced car use, at least in the short term. In studies targeting children, walking buses/cycle trains showed positive impacts.

Conclusion

Interventions combining infrastructure change with behavioural/social programmes, interventions involving e-bikes, and cycle-sharing schemes had most impact on active travel levels. Policy makers and planners should ensure that interventions that only address behavioural or social aspects of active travel have long- not short-term funding. If population level change is to be achieved, such interventions should also be accompanied by environmental and infrastructure changes, including road space reallocation and access to e-bikes. This requires political buy-in and public engagement.