Recommendations for research

The guideline committee has made the following recommendations for research.

1 Public transport provision and ticketing

How effective and cost effective are changes to public transport provision and ticketing in creating and sustaining an increase in physical activity at a population level?

Why this is important

Increased use of public transport increases physical activity at a population level, and use can be increased by interventions to improve provision and facilities. But there is little information on how effective changes to public transport provision or ticketing policies (such as age of eligibility for passes and fare integration) are at sustaining an increase, and whether this is cost effective.

Longitudinal research of public transport and ticketing interventions is needed, using objective measures of physical activity with a follow-up period of at least a year and preferably with a matched control group.

Research is also needed on the effects on physical activity of:

  • location, such as rural or urban, and how easy it is for people to walk around the local area

  • individual characteristics, such as mobility, health, age, ethnicity

  • service characteristics, such as density and coverage, frequency, reliability, journey time

  • accessibility of public transport, in terms of physical access, information, and affordability

  • links with other forms of transport (cycling, walking, other modes of public transport)

  • overall quality of service and infrastructure.

2 Changes to public open spaces

How effective and cost effective are environmental changes to public open spaces (including blue, green and grey spaces) in creating and sustaining an increase in physical activity at a population level?

Why this is important

There is evidence that open space that is accessible, well maintained, and engaging will be used more often by more people, and so could increase physical activity at a population level. But we found little information on how effective changes to public open spaces are at sustaining an increase, and whether this is cost effective.

Longitudinal research of interventions to increase the use of public open spaces, with a follow-up period of at least a year and preferably with a matched control group, is needed to provide a better understanding of how investment in public open space can best enable increases in physical activity at a population level. Objective measures of physical activity are valuable even if increasing activity is not a focus of the intervention.

Research is also needed on the effects on physical activity of:

  • accessibility by active travel

  • availability and quality of public transport to open space

  • features and activities available

  • involvement of local community in designing changes

  • ongoing 'ownership' by local community

  • management and maintenance.

3 Use of public open spaces by particular groups

How effective and cost effective are environmental changes to increase physical activity through use of public open spaces (including blue, green and grey spaces) by the following groups:

  • black and minority ethnic groups

  • groups with low socioeconomic status

  • groups experiencing other forms of disadvantage, for example carers, people with severe mental health conditions?

Are effects maintained over time?

Why this is important

Some groups, such as those listed above, use open spaces less than others even when these are publicly available. However, we found very little good quality evidence on environmental interventions that influence physical activity in these groups. We also found no cost effectiveness data for interventions among these population groups.

Longitudinal research is needed of environmental interventions specifically targeting groups who use open spaces less than others, with a follow-up period of at least a year and preferably with a matched control group. This should provide a better understanding of how changes can best promote the use of public open spaces and so increase physical activity in these groups. Objective measures of physical activity are valuable even if increasing activity is not a focus of the intervention.

Research is also needed on the effects of cultural acceptability of environmental interventions to increase physical activity.

4 People with limited mobility

How effective and cost effective are environmental changes to increase physical activity among people with limited mobility because of either enduring or life-stage specific factors (for example, small children, parents with prams or buggies, disabled people including those with sensory impairments and learning disabilities, older people, people with dementia and their carers)? Are effects maintained over time?

Why this is important

People who do little physical activity benefit most from becoming more active, and this may include people with limited mobility. But we found very little evidence on interventions specifically targeting them.

Longitudinal research is needed on environmental interventions specifically targeting those with limited mobility, with a follow-up period of at least a year, and preferably with a matched control group. Objective measures of physical activity are valuable even if increasing activity is not a focus of the intervention.

Research is also needed to determine other factors affecting the observed results. This includes variation in the effectiveness of interventions among people with different needs, for example those with sensory impairments and learning disabilities. Interventions might include:

  • audio-visual announcements on public transport services and at stops or stations

  • changes to the design of pedestrian crossings, for example increasing the length of time given for crossing

  • solutions to allow comfortable use of contested space by various groups, including those with limited mobility.

5 Reducing car ownership

Does reducing car use or ownership change physical activity levels? Are effects maintained over time?

Why this is important

People who use more public transport can build physical activity into their daily lives through walking or cycling between stops and stations. There was some evidence from expert testimony that in London people who own cars are less likely to do half an hour of active travel in a day than those who don't own them. However, this evidence is limited and did not consider factors such as the effects on different groups, and in different areas. For example not all areas have ready access to public transport; and for some groups, such as some older people, having access to a car may provide an opportunity for incidental physical activity at destinations reached by car.

Longitudinal research on interventions to reduce car ownership or use, with a follow-up period of at least a year and a matched control group, is needed to understand how it interacts with physical activity and, in the longer term, health status. An objective measure of physical activity is valuable even if that is not a focus of the intervention.

Research is needed on the effects of:

  • the location – for example, rural or urban, and how easy it is for people to walk around their local area; and availability of public transport

  • individual characteristics, such as baseline mobility, health, age, ethnicity.

6 Interaction between behavioural and environmental interventions

What is the effectiveness and cost effectiveness of interventions to change the environment alone, compared with interventions to change the environment that are supported by interventions to change people's behaviour?

Why this is important

Behavioural and environmental interventions are sometimes conducted in isolation. But there is some evidence that environmental interventions alone may support existing physical activity behaviours but may not be enough to change behaviour. Conversely, behavioural interventions implemented without any supporting environmental interventions may not be enough to change behaviours.

Longitudinal research is needed on the relative effectiveness and cost effectiveness of environmental interventions – that include system changes such as congestion charging and street closures – in isolation compared with those supported by behavioural interventions. Research should have a follow-up period of at least a year because there is currently little evidence on whether changes are sustained in the longer term.

  • Public Health England