Page 11 - JCAU-6-2

Journal of Chinese
Architecture and Urbanism Leisure-time physical activity

1. Introduction developing countries (Sallis et al., 2020), further emphasizing
the need for comprehensive investigations across diverse
Urbanization often brings about heightened economic geographical and socioeconomic contexts.
efficiency, bolstering human productivity, health, and
overall well-being. However, when urbanization occurs too China’s urbanization rate represents a unique
rapidly and without proper planning, it can yield numerous phenomenon globally, marked by complex heterogeneity
negative effects on both the environment and human across multiple developmental stages. Therefore, we aim
health (Organization, 2021). The 2023 Chinese Statistical to conduct a systematic review of international literature
Bulletin reports that 65.2% of Chinese citizens already live to answer the following research questions: “Have Chinese
in urban areas (China, 2023). Despite the economic benefits, academic circles found solid evidence regarding the
urbanization has also led to an alarming prevalence of chronic impact mechanism of urban BE on residents’ LTPA in
diseases among the Chinese population, with rates soaring Chinese cities?” and “Do previous studies reveal specific
as high as 81.1% (Su et al., 2023). The rapid expansion of BE elements that play an important role in improving
urban areas often results in the depletion of green spaces and LTPA among distinct resident demographics?”
public areas due to high-density settlement patterns. This
lack of accessible green and public spaces has contributed to 2. Methods
a decline in physical activity levels among residents, thereby In this systematic review, we followed the criteria outlined
exacerbating the incidence of chronic diseases and premature in the Preferred Reporting Items for Systematic Reviews
mortality (Nieuwenhuijsen, 2016; 2020). and Meta-Analyses (PRISMA) guidelines (Li et al., 2023;
An increasing number of studies have focused on Page et al., 2021). Before commencing the literature search,
the association between the built environment (BE) and we developed and registered the systematic review protocol
residents’ physical activity levels. The 5D elements, namely, with PROSPERO (PROSPERO ID: CRD42023457679).
density, diversity, design, destination accessibility, and 2.1. Search terms and search strategy
distance to transit, represent initial efforts in characterizing
the BE and have been validated as key factors that influence In December 2022, we meticulously conducted a thorough
residents’ physical activities (Sallis et al., 2020). According search across eight databases, namely, PubMed, ProQuest,
to the World Health Organization (WHO), physical activity the Cumulative Index to Nursing and Allied Health Literature
encompasses any bodily movement driven by skeletal (CINAHL) Plus, PsycNet, SPORTDiscus, the Cochrane
muscles that require energy expenditure, occurring across Library, Web of Science, and the China National Knowledge
four domains: leisure time, occupation, household, and Infrastructure (CNKI). Given that terms associated with BE
transportation. Research has underscored the benefits of and LTPA may include medical terminology, we identified
leisure-time physical activities (LTPAs) for both physical and search terms collaboratively from both the Medical Subject
mental health, surpassing those of other forms of physical Headings (MeSH) and Chinese Medical Subject Headings
activity such as transportation, occupational, and household (CMeSH) databases. In addition, we searched synonyms
activities (Wens & Hansen, 2017). Elevated levels of LTPA related to BE and LTPA to ensure a comprehensive search
have demonstrated a significant effect on suppressing (Peters et al., 2020). Our search strategy adhered to the
increases in waist circumference as well as blood triglyceride combined Boolean search strategy commonly used in
and glucose levels (Fong, 2021). However, the considerable systematic evaluation articles (Van Cauwenberg et al., 2011).
heterogeneity in personal and BE characteristics has To ensure the inclusivity of the latest studies, we updated
clouded our understanding of the impacts and mechanisms our search in June 2023. Detailed tables outlining our
underlying the relationship between LTPA and urban comprehensive and refined search strategies are available
BE characteristics (Kärmeniemi et al., 2018). It remains from the authors through reasonable request.
uncertain whether the above-mentioned effects of the five
BE characteristics on physical activity are equally applicable 2.2. Inclusion and exclusion criteria for selecting
to LTPA (Booth et al., 2009; Cervero & Kockelman, 1997; articles
Ewing & Cervero, 2010). Furthermore, the majority of Eligible articles had to meet six inclusion criteria:
relevant empirical studies have predominantly focused on (i) participants were aged ≥18 years, (ii) at least one urban
developed countries, such as the United States, Canada, and BE characteristic was examined, (iii) primary or secondary
various regions in Europe (Ding & Gebel, 2012; Van Dyck LTPA outcomes were reported, and (iv) studies included
et al., 2013), raising questions regarding the generalizability leisure-time walking or other forms of LTPA. We excluded
of these findings to other regions. Significant disparities articles that did not focus specifically on LTPA or a particular
exist between urban BE characteristics in developed and type of LTPA, even if physical activity was included as a

Volume 6 Issue 2 (2024) 2 https://doi.org/10.36922/jcau.2427