Evidence synthesis - A systematized literature review on the associations between neighbourhood built characteristics and walking among Canadian adults.

Introduction: Evidence to date suggests that the built environment has the potential to facilitate and even discourage physical activity. A limitation of previous reviews is that they have typically not been country-specific. We conducted a systematized literature review of quantitative studies that estimated associations between the built environment-which were objectively measured-and walking among Canadian adults.

Methods: Five scientific databases were searched for peer-reviewed studies published in all years up to December 31, 2016, that estimated the association between the built environment (i.e. objectively measured using audits and Geographic Information Systems [GIS]) and physical activity among a sample of Canadian adults. The database searches, title and abstract screen, full-text review and data extraction were undertaken by two reviewers.

Results: Of 4140 articles identified, 25 met the inclusion criteria. Most studies included data from a single Canadian province. All but two studies were cross-sectional. Most studies captured self-reported walking for transportation and walking for any purpose. Overall walkability and land use were consistently associated with walking for transportation, while proximity to destinations was associated with walking for any purpose.

Conclusion: Our review findings suggest that the built environment is potentially important for supporting adult walking. Overall walkability, land use and proximity to destinations appear to be important given their association with transportation walking and walking for any purpose.