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Restructuring the built environment to change adult health behaviors: a scoping review integrated with behavior change frameworks

Lookup NU author(s): Professor Tim Townshend



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Built environment restructuring can improve public health through increased opportunity for healthy behaviors. Behavioral science targets individual health behaviors within place, suggesting the potential to integrate these approaches. This scoping review was one of the first to summarise the impact built environment restructuring has on health outcomes and behaviors and integrate these findings with the Capability-Opportunity-Motivation-Behavior model and Theoretical Domains Framework of behavior change. Potential studies were identified from 12 academic databases in urban design, psychology, and public health. Search parameters involved 50 environment types, for example green space or healthy cities, combined with both an intervention (e.g. green infrastructure, active transport) and a measurable health outcome (e.g. exercise, wellbeing). Searches were limited to North America, Europe, or Australia/New Zealand. Of 536 potential studies reviewed against defined inclusion/exclusion criteria, 23 contributed to the findings. Evidence supported the positive influence of restructuring on varied health outcomes, many of which were drivers and domains of health behavior. Most studies indicated a clear contribution to increased physical activity. Recommendations include the need for explicit communication of theories guiding restructuring project design, consideration of health outcomes beyond physical activity, and better investigation of unanticipated barriers to health behaviors arising from built environment restructuring projects.

Publication metadata

Author(s): Wilkie S, Townshend T, Thompson E, Ling J

Publication type: Article

Publication status: Published

Journal: Cities and Health

Year: 2018

Volume: 2

Issue: 2

Pages: 198-211

Online publication date: 20/02/2019

Acceptance date: 16/01/2019

Date deposited: 17/01/2019

ISSN (print): 2374-8834

Publisher: Taylor & Francis


DOI: 10.1080/23748834.2019.1574954


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Funder referenceFunder name
Centre for Translational Research in Public Health
MR/K02325X/1Medical Research Council (MRC)
NIHR School for Public Health Research
Public Health England Behavioural Insights Team
UKCRC Public Health Research of Excellence