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Public health policy and practice
The challenges of evaluating environmental interventions to increase population levels of physical activity: the case of the UK National Cycle Network
  1. D A Lawlor1,
  2. A R Ness1,
  3. A M Cope2,
  4. A Davis3,
  5. P Insall3,
  6. C Riddoch4
  1. 1Department of Social Medicine, University of Bristol, Bristol, UK
  2. 2Sustrans North, Newcastle, UK
  3. 3Sustrans, Bristol, UK
  4. 4Department of Exercise and Health Sciences, University of Bristol
  1. Correspondence to:
 Dr D Lawlor, Department of Social Medicine, University of Bristol, Canynge Hall, National Travel Survey suggested an increase in national Whiteladies Road, Bristol BS8 2PR, UK;
 D.A.lawlor{at}bristol.ac.uk

https://doi.org/10.1136/jech.57.2.96

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    PHYSICAL ACTIVITY AND PUBLIC HEALTH

    Regular, physical activity is associated with increased life expectancy and reduced risk of coronary heart disease, stroke, diabetes, hypertension, obesity, and osteoporosis.1–3 It has been suggested that promoting physical activity is “public health's best buy”.4 However, most people are not regularly active and the challenge remains as to how “more people” can be encouraged to be “more active, more often”.5 To date, most public health interventions to increase levels of physical activity, such as media campaigns or primary care based “exercise on prescription schemes”, have focused on individual behaviour change. At worst these have no overall effect and at best they result in increased levels of activity in only a small proportion of the population and that are seldom maintained long term.6–9 This may not be surprising as these interventions are in effect trying to persuade individuals to participate in activities in environments that are (or are perceived to be) hostile to the very activities they promote.10,11 Modification of social, economic, and environmental factors may yield greater population health dividends than individual lifestyle approaches.12 Indeed such interventions may be necessary before individual lifestyle approaches can be effective.10

    In this paper we will discuss the potential role of environmental strategies to increase population levels of cycling and walking; describe one such UK intervention—the UK National Cycle Network; discuss the challenges of evaluating this project and suggest appropriate ways of assessing its effect on population levels of physical activity.

    THE POTENTIAL PUBLIC HEALTH IMPORTANCE OF CYCLING AND WALKING

    Regular participation in moderately intense activity, such as brisk walking and cycling, is associated with health benefits.1,3 Activities that can become part of every day life, such as walking or cycling to work or school, are more likely to be sustained than activities that require attendance at specific venues.13 Therefore, …

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    Footnotes

    • Funding: The National Cycle Network is a Millennium project supported by funds from the National Lottery. The local authority surveys of National Cycle Network users were supported by a grant from the Sainsbury Trust and funds from Sustrans*. DAL is funded by the Medical Research Council. The views expressed in this publication are those of the authors and not necessarily those of any of the funding bodies.

      • Sustrans is a registered charity (number 326550) dedicated to practical measures for the promotion of non-motorised transport. Sustrans stands for Sustainable Transport.

    • Competing interests: AC and PI work for Sustrans; AD is a health adviser to Sustrans. All authors walk or cycle regularly.

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