Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified , providing a set of specific evidence -based strategies that deserve close attention and prioritization for wider implementation .
Effective interventions included specific approaches in all 6 domains evaluated for improving diet , increasing activity , and reducing tobacco use .
The writing group also identified several specific interventions in each of these domains for which current evidence was less robust , as well as other inconsistencies and evidence gaps , informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies .
This systematic review identified and grade d the evidence for a range of population -based strategies to promote lifestyle change .
BACKGROUND Poor lifestyle behaviors , including suboptimal diet , physical inactivity , and tobacco use , are leading causes of preventable diseases globally .
Although even modest population shifts in risk substantially alter health outcomes , the optimal population -level approaches to improve lifestyle are not well established .
Urban trails and physical activity: a natural experiment.
BACKGROUND The built environment in which a person lives and works is thought to have a strong influence on his or her level of physical activity . However , this belief is largely based on cross-sectional studies underlining the need for prospect i ve studies using natural experiments . DESIGN This study adopted a quasi-experimental research design with multiple control neighborhoods and was conducted between 2005 and 2007 . Data were analyzed in 2008 . SETTING / PARTICIPANTS The subjects were children , adolescents , and adults in free-living conditions within one experimental and two control neighborhoods . INTERVENTION An urban greenway/trail was retrofitted in a neighborhood that lacked connectivity of the residential pedestrian infrastructure to nonresidential destinations . MAIN OUTCOME MEASURES The main outcomes were 2-hour counts of directly observed physical activity in the general neighborhood and , at the school level , active transport to school . RESULTS At the neighborhood level , the 2-hour counts of physical activity significantly increased between 2005 and 2007 ( p=0.000 ) in the intervention neighborhood , with a median increase of 8.0 counts . The control neighborhoods had a significant decrease in counts ( p=0.000 ) . The pre- and post-intervention changes between experimental and control neighborhoods were significantly different for total physical activity ( p=0.001 ) ; walking ( p=0.001 ) ; and cycling ( p=0.038 ) . There was no noted change over time for active transport to school in either the intervention or control neighborhoods . CONCLUSIONS Changes to the pedestrian connectivity of the built environment infrastructure may lead to greater levels of physical activity . However , this positive effect was limited to physical activity at the neighborhood level and not to active transport to school
Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified , providing a set of specific evidence -based strategies that deserve close attention and prioritization for wider implementation .
Effective interventions included specific approaches in all 6 domains evaluated for improving diet , increasing activity , and reducing tobacco use .
The writing group also identified several specific interventions in each of these domains for which current evidence was less robust , as well as other inconsistencies and evidence gaps , informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies .
This systematic review identified and grade d the evidence for a range of population -based strategies to promote lifestyle change .
BACKGROUND Poor lifestyle behaviors , including suboptimal diet , physical inactivity , and tobacco use , are leading causes of preventable diseases globally .
Although even modest population shifts in risk substantially alter health outcomes , the optimal population -level approaches to improve lifestyle are not well established .