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Abstract
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Question
What interventions are effective in improving population health and encouraging people to walk and cycle as an alternative to using cars?Study design
Systematic review with narrative synthesis.Main results
Twenty two studies were included in the review. One targeted behaviour change programme offering an interactive self-help package increased weekly walking compared with control (duration 1.93 times greater in intervention group, 95% CI 1.06 to 3.52). Another, which offered maps, bus tickets and other resources, led to 5.5% (p<0.01) of trips being switched from car to cycling and walking. Giving free bikes and bus passes to targeted car drivers led to a 25% absolute change in mode of transport. One targeted programme offering cash subsidies for not driving and one programme that promoted an alternative mode of transport (a new railway station) also led to a shift away from car driving (1% absolute change in all trips from car to cycling and walking with cash subsidies; p<0.01; 5% shift with new station; p<0.01). Publicity campaigns targeting whole populations and engineering measures (e.g. redesigning or improving cycling routes) were not effective in achieving positive behaviour change in populations. Evidence about population level health improvements was not conclusive in any type of intervention.Authors' conclusions
Health promotion programmes to encourage people to walk or cycle as an alternative to using their cars have not been effective at a population level unless they target motivated sub-groups of the population. |