A systematic review of the effect of infrastructural interventions to promote cycling: strengthening causal inference from observational data

• Published in: The international journal of behavioral nutrition and physical activity 2019-10, Vol.16 (1), p.93-31, Article 93
• Main Authors: Mölenberg, Famke J M, Panter, Jenna, Burdorf, Alex, van Lenthe, Frank J
• Format: Article
• Language: English
• Subjects: Adult; Bicycles; Bicycling; Built environment; Causal effects; City Planning; Cycling; Cyclists; Data collection; Environmental aspects; Health aspects; Health Behavior; Health Promotion; Humans; Inequalities; Infrastructure (Economics); Medical research; Methodologies; Metropolitan areas; Natural experiments; Physical fitness; Review
• ISSN: 1479-5868; 1479-5868
• DOI: 10.1186/s12966-019-0850-1

Previous reviews have suggested that infrastructural interventions can be effective in promoting cycling. Given inherent methodological complexities in the evaluation of such changes, it is important to understand whether study results obtained depend on the study design and methods used, and to describe the implications of the methods used for causality. The aims of this systematic review were to summarize the effects obtained in studies that used a wide range of study designs to assess the effects of infrastructural interventions on cycling and physical activity, and whether the effects varied by study design, data collection methods, or statistical approaches. Six databases were searched for studies that evaluated infrastructural interventions to promote cycling in adult populations, such as the opening of cycling lanes, or the expansion of a city-wide cycling network. Controlled and uncontrolled studies that presented data before and after the intervention were included. No language or date restrictions were applied. Data was extracted for any outcome presented (e.g. bikes counted on the new infrastructure, making a bike trip, cycling frequency, cycling duration), and for any purpose of cycling (e.g. total cycling, recreational cycling, cycling for commuting). Data for physical activity outcomes and equity effects was extracted, and quality assessment was conducted following previous methodologies and the UK Medical Research Council guidance on natural experiments. The PROGRESS-Plus framework was used to describe the impact on subgroups of the population. Studies were categorized by outcome, i.e. changes in cycling behavior, or usage of the cycling infrastructure. The relative change was calculated to derive a common outcome across various metrics and cycling purposes. The median relative change was presented to evaluate whether effects differed by methodological aspects. The review included 31 studies and all were conducted within urban areas in high-income countries. Most of the evaluations found changes in favor of the intervention, showing that the number of cyclists using the facilities increased (median relative change compared to baseline: 62%; range: 4 to 438%), and to a lesser extent that cycling behavior increased (median relative change compared to baseline: 22%; range: - 21 to 262%). Studies that tested for statistical significance and studies that used subjective measurement methods (such as surveys and direct observations of cyclists) fou