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

Durão, S.; Burns, J.; Schmidt, B. et al. BMC Public Health (2023) CC

Background 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 circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity. Methods We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled 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 effects of these interventions 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 evidence based on effect direction. Results We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence). Conclusions Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings. more

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Development of NHSP-3 strategic surveys plan

Ministry of Health & Population, UK Aid (2015) C1

National Infection Prevention and Control Strategy Framework

Department of Health, Republic of South Africa (2020) C1

March 2020

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Practical Manual for Implementation ofthe National Infection Prevention and Control Strategic Framework

Department of Health, Republic of South Africa (2020) C1

How To Add Deworming To Vitamin A Distribution

World Health Organization, UNICEF (2004)

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Technical note for Ebola virus disease preparedness planning for entry screening at airports, ports and land crossings

World Health Organization (2014)

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Quantitative evaluation of essential medicines lists: the South African case study

Velisha Ann Perumal-Pillay & Fatima Suleman BMC Health Services Research (2016) CC

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Responding to a poliovirus event or outbreak - Part 1: General SOPs

Global Polio Eradication Initiative WHO (2017) C_WHO

Responding to a poliovirus event and outbreak, Part 1: General (SOPs) describes the general principles and steps to facilitate timely and effective responses to poliovirus events and outbreaks, and incorporate lessons learned from recent previous outbreak response efforts. This document summarizes r... more

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Malawi Malaria Indicator Survey 2017

Ministry of Health, National Malaria Control Programme (2018) C1

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Findings from othe Global Burden of Disease Study 2017

Institute for Health Metrics and Evaluation (IHME), The Lancet (2019) CC

This booklet provides an overview of all findings from the Global Burden of Disease 2017 study. Published in The Lancet in November 2018, GBD 2017 provides for the first time an independent estimation of population, for each of 195 countries and territories and the globe, using a standardized, repli... more

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National Guidelines for Infection Prevention and Control in Healthcare Facilities

Ministry of Health & Family Welfare Government of India; National Centre for Disease Control (2020) C2

Infection Prevention and Control Programmes January 2020

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Frequently Asked Questions (FAQs) about COVID-19 Candidate Vaccines and Access Mechanisms. Version 3, 6 January 2021

Pan American Health Organisation PAHO (2021) C_WHO

Will COVID-19 vaccines be safe? Will all the COVID-19 candidate vaccines be successful? What are the different phases a vaccine must go through to be approved? This document provides responses to the most frequently asked questions about candidate vaccines and access to COVID-19 vaccination.