Promoting walking and cycling as an alternative to using cars: systematic review

Objectives: To assess what interventions are effective in promoting a population shift from using cars towards walking and cycling, and to assess the health and distributional effects of such interventions. Data sources: Published and unpublished reports in any language identified from electronic databases, bibliographies, websites and reference lists. Review methods: Systematic search and appraisal to identify experimental or observational studies with a prospective or controlled retrospective design that evaluated any intervention applied to an urban population or area by measuring outcomes in members of the local population. Results: 22 studies met the inclusion criteria. We found some evidence that targeted behaviour change programmes can change the behaviour of motivated subgroups, resulting (in the largest study) in a modal shift of around 5% of all trips at a population level. Single studies of commuter subsidies and a new railwy station have also shown modest effects. The balance of best available evidence about publicity campaigns, engineering measures and other interventions suggests that they have not been effective. Participants in trials of active commuting experienced short-term improvements in certain health and fitness measures, but we found no good evidence about the health effects of any effective population-level intervention. Conclusions: The best available evidence of effectiveness is for targeted behaviour change programmes, but the social distribution of their effects is unclear and some other types of intervention remain to be rigorously evaluated. We need a stronger evidence base for the health impacts of transport policies, preferably based on properly conducted prospective studies