Is there evidence that walking groups have health benefits? A systematic review and meta-analysis

Sarah Hanson, Andy Jones
9 November 2014

Regular physical activity positively impacts health potentially offering similar effects to some drug interventions in terms of mortality benefits. Indeed, it has been suggested as an alternative or adjunct to conventional drug therapy. Walking at a pace of 3–5 m/h (5–8 km/h) expends sufficient energy to be classified as moderate intensity2 and is an easy and accessible way of meeting physical activity recommendations.

Systematic reviews and meta-analyses have shown walking to have various health benefits including:

•  positive effects on fitness
• fatness and resting blood pressure
• blood pressure control
• weight loss
• depression
• cardiovascular disease risk prevention

ABSTRACT

Objective
To assess the health benefits of outdoor walking groups.

Design
Systematic review and meta-analysis of walking group interventions examining differences in commonly used physiological, psychological and well-being outcomes between baseline and intervention end.

Data sources
Seven electronic databases, clinical trial registers, grey literature and reference lists in English language up to November 2013.

Eligibility criteria
Adults, group walking outdoors with outcomes directly attributable to the walking intervention.

Results
Forty-two studies were identified involving 1843 participants. There is evidence that walking groups have wide-ranging health benefits. Meta-analysis showed statistically significant reductions in mean difference for systolic blood pressure −3.72 mm Hg (−5.28 to −2.17) and diastolic blood pressure −3.14 mm Hg (−4.15 to −2.13); resting heart rate −2.88 bpm (−4.13 to −1.64); body fat −1.31% (−2.10 to −0.52), body mass index −0.71 kg/m2 (−1.19 to −0.23), total cholesterol −0.11 mmol/L (−0.22 to −0.01) and statistically significant mean increases in VO2max of 2.66 mL/kg/min (1.67 3.65), the SF-36 (physical functioning) score 6.02 (0.51 to 11.53) and a 6 min walk time of 79.6 m (53.37–105.84).

A standardised mean difference showed a reduction in depression scores with an effect size of −0.67 (−0.97 to −0.38). The evidence was less clear for other outcomes such as waist circumference fasting glucose, SF-36 (mental health) and serum lipids such as high density lipids.

There were no notable adverse side effects reported in any of the studies.

Conclusions
Walking groups are effective and safe with good adherence and wide-ranging health benefits. They could be a promising intervention as an adjunct to other healthcare or as a proactive health-promoting activity.

Open Access
Original Source BJSM

Does active commuting improve psychological wellbeing?
Longitudinal evidence from eighteen waves of the British Household Panel Survey
Adam Martin, Yevgeniy Goryakin, Marc Suhrcke

Abstract

Highlights

The aim of this study is to explore the relationship between active travel and psychological wellbeing.

• Impact of commuting behaviour on wellbeing was explored using individual fixed effects analyses.
• Compared to driving, wellbeing was higher when using active travel or public transport.
• Use of active travel reduced the likelihood of two specific GHQ12 psychological symptoms.
• Switching from car driving to active travel improved wellbeing.
• Wellbeing increased with travel time for walkers, but decreased for drivers.

Objective

The aim of this study is to explore the relationship between active travel and psychological wellbeing.

Method

This study used data on 17,985 adult commuters in eighteen waves of the British Household Panel Survey (1991/2–2008/9). Fixed effects regression models were used to investigate how travel mode choice, commuting time and switching to active travel impacted on overall psychological wellbeing and how (iv.) travel mode choice impacted on specific psychological symptoms included in the General Health Questionnaire.

Results

After accounting for changes in individual-level socioeconomic characteristics and potential confounding variables relating to work, residence and health, significant associations were observed between overall psychological wellbeing (on a 36-point Likert scale) and (i.) active travel (0.185, 95% CI: 0.048 to 0.321) and public transport (0.195, 95% CI: 0.035 to 0.355) when compared to car travel, (ii.) time spent (per 10 minute change) walking (0.083, 95% CI: 0.003 to 0.163) and driving (−0.033, 95% CI: −0.064 to −0.001), and (iii.) switching from car travel to active travel (0.479, 95% CI: 0.199 to 0.758). Active travel was also associated with reductions in the odds of experiencing two specific psychological symptoms when compared to car travel.

Conclusion

The positive psychological wellbeing effects identified in this study should be considered in cost–benefit assessments of interventions seeking to promote active travel

Full article click here (Open Access)

Original source Michael Evans

Applicants are invited for a Research Associate position in an exciting cross-faculty research project: Street mobility and accessibility: developing tools for overcoming older people’s barriers to walking to develop tools to measure and model community severance. The main responsibility will be to analyse questionnaire data from the case studies, and assist with project management.

Community severance (CS) arises when transport infrastructure or the speed or volume of traffic prevent people from accessing goods, services or people. Effects include reduction in social networks and psychological barriers to use of streets for walking or social spaces. Health effects are assumed but have not been studied. More information about the project can be found at www.ucl.ac.uk/street-mobility 

This is a full-time post however we will consider applicants who wish to work less than full time.

The post is funded until 31st December 2016 and is available from 1st July 2015 (or by negotiation) in the first instance.

Key Requirements

Applicants must have a PhD in a relevant area or equivalent research experience, experience in working in surveys and/or analysing survey data (including larger data sets), and an understanding of the process of carrying out academic research and surveys. Proven ability and commitment to carry out and complete high quality original research and publication of original research papers in peer reviewed journals are essential, as are excellent interpersonal, oral and communication skills. Project management experience is desirable.

The closing date is 28th April 2015 & interviews will probably be first week of May.

For more information: click here (Reference 1458689)

The strong links between transport and health are becoming better understood and, in April 2013, they were given formal recognition through the transfer to English local authorities of responsibility for public health.  For the first time in decades, there is the opportunity for local policies relating to transport and public health to fit together.

This is a challenge: during the years of policy separation, practitioners in the two fields developed different languages and cultures.  England is not unique in this: transport and health have a habit of not talking to each other in many parts of the world.

This MSc is a practical response to this situation and has been developed by staff at UCL whose expertise in the areas of both transport and public health is recognised globally. Those undertaking the MSc in Transport, Health and Policy will be equipped with the skills to generate, design and implement policies that will exploit the positive links between the two areas.

The four core modules take the student from the identification of problems and opportunities, through the generation and appraisal of responses, to championing and delivering policies in the real world.  The course content and teaching methods take proper account of the need for “hard” and “soft” skills so, for example, students will learn both how to analyse large data sets and how to lead multi-disciplinary teams in policy delivery.  And the novel course structure uses distance learning extensively and so will suit busy people and those far from London.

During the course, students will learn the latest evidence on the role of sustainable transport and its promotion, on increasing safe mobility and on the transport impacts of health policies such as the location of facilities.  At all times the focus will be on harnessing the potential for transport and health policies to support one another and on preventing them from undermining each other.

To find out more, visit the course webpage.  For details of entry requirements, fees, application procedures and possible funding, visit the course page on the UCL Prospectus website.  If you have a question, contact Programme Director Dr Catherine Holloway (c.holloway@ucl.ac.uk).

This event in York will focus on addressing the perceived barriers and obstacles to cycling in Britain: featuring presentations, roundtable workshops and discussion about the current projects, campaigns and research.

Those in involved in the promotion, design and delivery of UK cycling infrastructure are encouraged to attend and help make our routes appeal universally.

Who should attend:

• Transport Planners
• Transport Engineers
• Cycle Campaigners
• Academics
• Councillors
• Bicycle Retailers
• NGOs
• Workplace Facility Managers
• Travel Planners
• Bicycle Wholesalers
• School teachers
• Cycle trainers

Confirmed Speakers include:

Kersten England, Chief Executive, York City Council

Carlton Reid, author of “Roads were not built for cars”

Rachel Aldred, Senior Lecturer, Westminster University

Isla Roundtree, Founder, Isla Bikes

Chris Garrisson, UK Media Relations, Trek Bikes

…and many more

Why attend?

Learn about the current initiatives that are working to give cycling facilities universal appeal. The latest research on the impact of issues such as bike maintenance, safety, cycle training, confidence, community, culture.

Meet practitioners from around the UK that are working in the field.
The objective for this event is to develop a network of women working across all areas of cycling.

Delegate Rates

First Private Sector Delegate
£195 + VAT

First Public Sector Delegate
£145 + VAT

Additional Delegates
£95 + VAT

Book now

Email organiser: conferences@landor.co.uk

World Health Organisation (WHO) Health Economic Assessment Tool for Walking and Cycling are running free online training courses on the 1st (in English) and 9th (in German) of April – sign up click here

To facilitate evidence-based decision-making, WHO has developed, in collaboration with experts, an online tool to estimate the value of reduced mortality that results from regular walking or cycling.

The health and economic assessment tool (HEAT) for cycling and walking:

• is intended to be part of comprehensive cost–benefit analyses of transport interventions or infrastructure projects;
• complements existing tools for economic valuations of transport interventions, for example on emissions or congestion;
• can also be used to assess the current situation or past investment;
• is based on best available evidence, with parameters that can be adapted to fit specific situations. Default parameters are valid for the European context.
• HEAT calculates the answer to the following question: if x people cycle or walk y distance on most days, what is the economic value of mortality rate improvements?

A guidance book and summary address practitioners and experts, focusing on approaches to the economic valuation of positive health effects related to cycling and walking.

Applications

HEAT can be applied in many situations, for example:

• to plan a new piece of cycling or walking infrastructure: it models the impact of different levels of cycling or walking, and attaches a value to the estimated level when the new infrastructure is in place;
• to value the mortality benefits from current levels of cycling or walking, such as benefits from cycling or walking to a specific workplace, across a city or in a country;
• to provide input into more comprehensive cost–benefit analyses, or prospective health impact assessments: for instance, to estimate the mortality benefits from achieving national targets to increase cycling or walking, or to illustrate potential cost consequences of a decline in current levels of cycling or walking.

The tool has already been applied in several countries.

Health economic assessment tools (HEAT) for walking and for cycling. Methodology and user guide. Economic assessment of transport infrastructure and policies. 2014 Update

HEAT for cycling and walking
Access the tool to estimate the value of reduced mortality that results from regular walking or cycling

Development of the health economic assessment tools (HEAT) for walking and cycling
WHO/Europe, 2014

Acknowledgements
HEAT was developed within the Transport, Health and Environment Pan-European Programme (THE PEP) and in close collaboration with HEPA Europe

Health in All Policies in practice: guidance and tools to quantifying the health effects of cycling and walking
Article in the Journal of Physical Activity and Health presents guidance and some practical applications of HEAT.

Examples of applications of HEAT
How countries have used the health economic assessment tool (HEAT) for cycling

The 1st International Conference on Transport and Health is designed as a direct participatory experience.

Policy-makers, practitioners and academics from multiple disciplines involved with transport planning and engineering, public health, urban planning, spatial and architectural design, environmental planning, economics and beyond will convene on the University College London campus to share their stories of success and failure; build world-wide collaborative friendships; but most importantly, leave inspired!

Throughout this three-day conference experience, interactive ‘Hot Topic Workshops’ will kick-off delegate oral and poster sessions.

Each workshop will be led by a cross-disciplinary team of international experts to demonstrate how non-traditional thinking can lead to creative problem solving.

There will also be a series of business-related workshops that are meant as a twist to the traditional transport or health conference proceedings. In these sessions, you will learn that to be an effective innovator of change, you must also be an entrepreneur.

For further information: click here

Registration Timeline
Early : 1 February – 31 March
Late:   1 April – 31 May
Final:   1 June – 8 July

Registration Fees (excludes 20% VAT)
General Registration
Early        Late       Final
£395       £445      £500

One Day Registration
Early      Late       Final
£200      £250      £300

Public Agencies,Government,Universities
Early       Late       Final
£295       £345      £400

NGO
Early      Late        Final
£275       £325      £380

Full-Time Student
Early      Late       Final
£165       £195      £225

(Current Student ID Required to Complete Registration)

Optional Fees for Social Activities (excludes 20% VAT). Delegates will be issued an admission ticket for each planned social activity. If you would like to bring a guest(s), an additional event ticket is required.

Walking Tour King’s Cross/St. Pancras Redevelopment
(Sun, 5 Jul) £20
Red Carpet Welcome Reception at London Transport Museum
(Mon,Jul) £25
Salsa & Dance Party at World Famous Shakespeare’s Underglobe
(Tue, Jul) £40
Walking Tour Central London – Alternative to Salsa & Dance Party
(Tue,Jul) £20

A rare opportunity to do a PhD based in both a leading public health university and a world-class transport authority is currently being advertised.

The Bloomsbury DTC for the Social Sciences is a consortium of four institutions located in Bloomsbury, central London.

It is led by the Institute of Education and the partner institutions are Birkbeck, University of London; London School of Hygiene & Tropical Medicine; and, SOAS, University of London.

The Bloomsbury Doctoral Training Centre (DTC) is accredited by the Economic and Social Research Council (ESRC).

The successful candidate will get 3 years funding to support full-time PhD study, starting in October 2015.

The Transport PHD topic is: Transport systems, social inclusion and citizenship: a case study in London

Closing date for applications is February 27^th 2015

See more: click here

2 Febuary 2015, Birmingham

Public health England has organized a free one-day seminar on Air pollution and Public Health.

Public Health England (PHE) are to develop a programme in support of national and local government to reduce the 25,000 deaths each year in England attributable to air pollution.

The aims of the event are:

• To share good practice in local and national interventions to reduce the effects of air pollution on health.
• To develop proposals for PHE’s work programme focussing on advocacy, awareness-raising and the development of public health evidence to support national and local government.
• To explore how efforts to reduce mortality attributable to air pollution can maximise
• indirect public health benefits related to climate change mitigation and healthy living

Full details of seminar: click here