Table 4.
Results of studies included in comparison 1: Green or other spaces
| Study ID Study design (Country) |
Comparison | Participants at baseline (n)* | Outcome measure reported | Intervention | Control | Effect measure reported | Effe ct direction | Time of outcome measure | ||
|---|---|---|---|---|---|---|---|---|---|---|
| Baseline value | Follow-up | Baseline value | Follow-up | |||||||
| Primary outcome: Physical activity | ||||||||||
| Short term effects (< 3 months) | ||||||||||
|
1. D’Haese 2015 [46] CBA study (Belgium) |
Play streets vs no intervention | 167 children (Playstreet: 71; control: 96) | MVPA (minutes/day) | 54.92 (24.94) | 67.05 (38.00) | 57.41 (33.68) | " 52.87 (27.98) | Regression coefficient, 0.854, 95% CI: 0.204 to 1.504, SE = 0.332, p-value = 0.01 | ▲ | 1 week |
|
2. Ward Thompson 2019 [49] CBA study (Scotland) |
Physical changes to the woodland environment to facilitate access to and use of the woods vs no intervention | Cross-sectional sample of 5460 participants (wave 1, n = 2117; wave 2, n = 1672) | Overall PA (MET-minutes per week) | NR | NR | NR | NR |
b = –282.4 95% CI –732.1 to 167.3 |
▽ | 2 months |
| Medium-term effects (3–6 months) | ||||||||||
| 3. Cortinez O'Ryan 2017 [45] (CBA) (Chile) | Neighbourhood with street closed for play vs control neighbourhood | 100 children (intervention neighbourhood: 51, control neighbourhoods: 49) | Meeting pedometer-derived physical activity guidelines | 27.5% | 52.8%; | 49% | 53% |
Change in IG: 25.3%; Change in CG: 4.0%; Between group comparison: p > 0.05 Significant increase in intervention sites and non-significant increase in control sites |
△ | 3 months |
| Long-term effects (> 6 months) | ||||||||||
|
4. Bohn-Goldbaum 2013 [51] CBA study (Australia) |
Upgrade of playgrounds in a park vs Parks not renovated/with similar pre-renovation playgrounds as intervention park | NR | MVPA (mean number of children engaged in MVPA per 2-h observation period) | mean (SD?) 1.17 (2.21) | mean (SD?) 0.67 (1.18) | mean (SD?) 2.86 (3.95) | mean (SD?) 1.98 (3.03) | “After the park upgrade, there was no detectable difference between parks in the number of children engaged in MVPA (interaction between park and time: P = 0.73); the proportion of physically active children had decreased by 41% at the intervention playground and by 32% at the comparison playground” | ▽ | 9 months |
| 5. Slater 2016 [54] CBA study (USA) | Park renovation (which involved replacing old playground equipment and ground surfacing and community engagement) vs no renovations and no community engagement | Intervention – 39 parks; Control – 39 parks | Park-based MVPA (mean number of people observed per day) | Mean (SD) 17.07 (21.87) | Mean (SD) 24.95 (23.93)" | Mean (SD) 12.33 (19.59)" | Mean (SD) 15.33 (20.44)" |
beta = 0.199 SE = 0.089 p < 0.10 95% CI [calculated] 0.02456 to 0.37344 |
▲ | 1 year |
|
6. Quigg 2012 [47] CBA study (New Zealand) |
Playground upgrade vs no intervention | 184 children (intervention: 96; control: 88) | Total daily PA (total daily accelerometer counts/child day) | NR | NR | NR | NR | Ratio of geometric means = 1.11; 95% CI 0.85 to 1.44, p-value = 0.456 | △ | 12 months |
|
7. Tester 2009 [52] CBA study (USA) |
Park renovations (artificial turf, new fencing, landscaping, lighting, and picnic benches were added. In Park A, permanent soccer goals were installed, and in Park B, a walkway around the field was restored) vs no intervention | 523 people observed in intervention parks; 483 people observed in control park (children, teens, adult males/females, seniors) |
● Mean number of park visitors engaging in sedentary PA per observation period ● Mean number of park visitors engaging in moderate PA ● mean number of park visitors engaging in vigorous PA Note: Data only presented for each park and per gender separately |
NR | NR | NR | NR | "There were statistically significant increases among males and females who were observed at each respective PA level in the intervention parks. Sedentary visitors increased 5 + fold, moderately active visitors increased 3 + fold, and vigorously active visitors increased 2 + fold ( Table 3). On the control playfield, only moderately active males increased" | △ | 1 year |
| 8. Cohen 2009 [53] CBA study (USA) | Park improvements ( e.g. new or refurbished gymnasiums, field improvements in watering and landscaping; improvements to picnic areas, upgrades to a walking path, and enhancements to a play-ground area..” vs No intervention |
10 parks: 5 intervention and 5 comparison parks Two cross-sectional samples of park users interviewed: 768 at baseline and 712 at follow-up |
Proportion exercising regularly [reporting exercising at least three times per Week] | 0.616 | 0.419 | 0.667 | 0.482 |
Ratio of OR: 0.99 p = 0.812 |
▽ | Approximately 1 year |
| 9. Veitch 2018 [43] (cRCT) (Australia) | Park refurbishment vs no infrastructure changes | Total visitor counts: 4756 ( intervention park: 2374; control park: 2382 | Proportion engaging in MVPA at the park | n (%) 789 (33.2) | n (%) 907 (28.7) | n (%) 1028 (43.2) | n (%) 583 (35.2) | IRR 2.28 (95% CI 1.19 to 4.38, p = 0.013) | ▲ | 2 years |
| 10. Kubota 2019 [48] CBA study (Japan) | Construction of a new multipurpose exercise facility including indoor facilities (25 m pool, 170 m walking trail, multi-purpose gym, and group exercise rooms) and outdoor facilities (multi-purpose athletic field, 875 m walking trail, and park), accessible to all residents for a small fee + PA promotion vs No new exercise facility or PA promotion but with routine health promotion program |
Intervention: 1107 adults Control: 1125 adults |
Percentage engaging in MVPA | N (%) 821 (42.6) | N (%)1018 (39.6) | N (%) 845 (44.5) | N (%)924 (43.3) |
OR 0.96 95% CI (0.84, 1.09) p = 0.51 |
▽ | 2 years |
|
11. Richardson 2020 [50] CBA study (USA) |
Public housing development and greenspace landscaping, including changing the streetscape surrounding the developments, providing improved aesthetics (e.g. trees, grass) and walkability (e.g. sidewalks, street crossings). Renovation of current greenspace, including multiple parks, six outdoor stairwells, and three trails connecting parks vs Fewer investments, exclusively related to housing |
17 parks (8 intervention, 9 control) Participants: 673 in intervention, 330 in control |
MVPA (minutes /day) (Dubowitz 2019) [accelerometer data] | Mean (SE) 6.89 (0.90) | Mean 6.06 | Mean (SE) 6.18 (1.22) | Mean 5.12 |
DID: 0.24 p = 0.813 |
△ | 3 years |
| 12. Branas 2011 [39] CBA study (USA) | Greening of abandoned vacant lots (involved removing trash and debris, grading the land, planting grass and trees to create a park-like setting, and installing low wooden post-and-rail fences around each lot’s perimeter vs No greening of vacant lots |
"Greened vacant lots (intervention)—n = 4,436 Control vacant lots—n = 13,308" |
Low Exercise (proportion responding < 2 times/week) | NR | NR | NR | NR |
Beta = 0.25 SE = 0.12 95% CI [calculated]: 0.0148 to 0.4852 |
▼ | 10 years |
| Primary outcome: Body weight and related measures | ||||||||||
| 1. Goldsby 2016 [44] CBA (USA) | living in close proximity (near) to new inner-city park (within 1.5 miles) vs living farther away from the park (further than 5 miles) | 1443 children 2 to 17.9 years old (intervention – “near”: 45, control – “far”: 935) | BMI z-score change (for all children and subgroups: overweight/obese vs normal weight at baseline) | 0.61(1.00) | 0.66(1.09) | 0.83(1.09) | 0.87(1.11) | Regression coefficient = -0.0033, 95% CI: -0.115 to 0.109, SE = 0.0572, p-value = 0.4804 | △ | 16 months |
|
2. Richardson 2020 [50] CBA (USA) |
Public housing development and greenspace landscaping, including changing the streetscape surrounding the developments, providing improved aesthetics (e.g. trees, grass) and walkability (e.g. sidewalks, street crossings). Renovation of current greenspace, including multiple parks, six outdoor stairwells, and three trails connecting parks vs Fewer investments, exclusively related to housing |
17 parks (8 intervention, 9 control) Participants: 673 in intervention, 330 in control |
Proportion overweight or obese (BMI > 25 kg/m2) | 79.46% | 77.11% | 79.30% | 75.52% |
DiD = 1.43 p = 0.568 |
▽ | 3 years |
| Primary outcome: Blood pressure | ||||||||||
|
1. Branas 2011 [39] ITS |
Greening of abandoned vacant lots (involved removing trash and debris, grading the land, planting grass and trees to create a park-like setting, and installing low wooden post-and-rail fences around each lot’s perimeter vs No greening of vacant lots |
"Greened vacant lots (intervention)—n = 4,436 Control vacant lots—n = 13,308" |
Proportion self-reporting high BP | NR | NR | NR | NR |
Beta = 0.63 SE = 0.16 95% CI 0.32 to 0.94 [calculated] |
▼ | 10 years |
| Secondary outcome: Satisfaction | ||||||||||
|
1. Richardson 2020 [50] CBA (USA) |
Public housing development and greenspace landscaping, including changing the streetscape surrounding the developments, providing improved aesthetics (e.g. trees, grass) and walkability (e.g. sidewalks, street crossings). Renovation of current greenspace, including multiple parks, six outdoor stairwells, and three trails connecting parks vs Fewer investments, exclusively related to housing |
17 parks (8 intervention, 9 control) Participants: 673 in intervention, 330 in control |
Neighborhood satisfaction | 69.49% | 73.38% | 42.64% | 52.42% |
DiD estimator: -5.89% p-value: 0.342 |
▽ | |
| Secondary Outcome: Safety issues | ||||||||||
|
1. Slater 2016 [54] CBA (USA) |
Park renovation (including replacing old playground equipment and ground surfacing, and community engagement) vs no renovations or community engagement | Intervention – 39 parks; Control – 39 parks | Neighborhood safety (crime count) | mean (sd) 747.89 (904.68) | Mean (sd) 622.58 (721.28) | Mean (sd) = 579.41 (385.11) | mean (sd) 498.90 (297.18) |
NR Crime count reduced in both groups but slightly more in the intervention group |
△ | 1 year |
|
2. Cohen 2009 [53] CBA (USA) |
Park improvements ( e.g. new or refurbished gymnasiums, field improvements in watering and landscaping; improvements to picnic areas, upgrades to a walking path, and enhancements to a play-ground area..” vs No intervention |
10 parks: 5 intervention and 5 comparison parks Two cross-sectional samples of park users interviewed: 768 at baseline and 712 at follow-up |
Proportion reporting Perceived park safety | 0.696 | 0.913 | 0.860 | 0.774 |
Ratio of ORs = 1.35 p < 0.001 |
▲ | 3–14 months |
|
3. Richardson 2020 [50] CBA (USA) |
Public housing development and greenspace landscaping, including changing the streetscape surrounding the developments, providing improved aesthetics (e.g. trees, grass) and walkability (e.g. sidewalks, street crossings). Renovation of current greenspace, including multiple parks, six outdoor stairwells, and three trails connecting parks vs Fewer investments, exclusively related to housing |
17 parks (8 intervention, 9 control) Participants: 673 in intervention, 330 in control |
Perceived neighbourhood safety | 3.03% (SE 0.03) | 3.18% | 2.55% (SE 0.06) | 2.78% |
DiD estimator = -0.08 p-value = 0.280 |
▽ | 3 years |
*Where provided, we report the number of participants in the intervention group and control group, separately. Where this is not provided, we report the total sample. Where the number of participants is not reported in the study, we could not provide it here