Effectiveness of interventions for modal shift to walking and bike riding: a systematic review with meta-analysis

Abstract

Background: Identification of priority interventions to support modal shift to walking and bike riding is challenged by the myriad of interventions available, and a lack of synthesised evidence for what types of interventions are most effective. With increasing investments in active travel, there is substantial demand for synthesised evidence of efficacy between intervention types. This systematic review aimed to measure the effectiveness of interventions to increase active travel with a primary outcome of modal shift. Methods: The electronic databases MEDLINE, PsycINFO and Web of Science were searched. Eligible study designs included randomised and non-randomised studies of interventions with specific study design features that enabled the estimation of causality with minimal risk of bias. Studies were categorised by intervention types described within the Behaviour Change Wheel. Results: 106 studies that assessed the impact of an intervention on walking, cycling or active transport overall were included. Findings demonstrate that physical environmental restructure interventions, such as protected bike lanes and traffic calming infrastructure, were most effective in increasing cycling duration (OR = 1.70, 95% CI 1.20–2.22). Other intervention types, including individually tailored behavioural programmes, and provision of e-bikes, were also effective (OR = 1.33, 95% CI 1.23–1.43, OR = 1.13, 95% CI 1.02–1.22). An intensive education programme intervention demonstrated the greatest impact on walking (OR = 1.96, 95% CI 1.68–2.21). This body of research would benefit from more rigors in study design to limit lower quality evidence with the potential for bias. Conclusion: This review provides evidence for investment in high-quality active transport infrastructure, such as protected bike lanes, to improve cycling and active transport participation overall. It also provides evidence for investment in other non-infrastructure interventions. Active transport research needs to move towards trials with consistent outcome measures to inform which combinations of interventions (including disincentives) are most effective. Study registration: PROSPERO CRD42023445982.