Associations between Light Rail Transit and physical activity: a systematic review

Investment in public transport is on the rise as many cities around the world aim to reduce their carbon footprint and improve population health. One such investment is building or extending Light Rail Transit (LRT). Focusing on studies in the USA, Canada, Australia, and New Zealand, this paper reports the results of a systematic review on the associations between LRT and physical activity. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Twenty studies were identified through a search of five bibliographic databases (Web of Science, Transport Research International Documentation (TRID), Scopus, Medline, and SPORTDiscus) (n=5,866) and a systematic Google search (n=446). At least two reviewers conducted the search and reviewed the titles and abstract of each identified article to include in the review. Standardized data extraction forms were used to document information from each selected article. The forms included a risk of bias assessment tool. Two reviewers completed the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies. Our findings show that moderate certainty of evidence exists for the relationship between LRT and walking behaviour. Here, all studies, most of which were natural experiments (n = 6), found a positive association between LRT and walking behaviour, with LRT leading to an increase of 7–40% in walking in most studies (n = 7 out of 8). A positive relationship between LRT and moderate-to-vigorous intensity physical activity (MVPA) and between LRT and cycling was also often identified; however, results were inconsistent, and certainty of evidence is low for MPVA, and very low for cycling. Further, some studies (n = 3) identify differences in physical activity participation at different LRT stations, suggesting that station design, surrounding land use, and built environment play important roles in promoting physical activity around LRT. Given this, practitioners can be relatively confident that LRT investments will result in increased walking behaviour.