Do Interventions to Increase Walking Work? A Systematic Review of Interventions in Children and Adolescents

Background Physical activity (PA) levels decline aschildren move into adolescence, with this decline morenotable in girls. As a consequence, many young people arefailing to meet current PA guidelines. Walking has been acornerstone of PA promotion in adults and may provide aneffective means of increasing PA levels among youngerpeople.Objective Our objective was to conduct a systematicreview of interventions aimed at promoting increasedlevels of walking among children and adolescents.Methods Eight electronic databases—CINAHL,Cochrane Library CENTRAL database, EMBASE,Medline OVID, PsycINFO, Scopus, SPORTDiscus andWeb of Knowledge—were searched from their inceptionup to January 2015 using predefined text terms:walking terms AND intervention terms ANDpopulation terms AND (physical activity OR exercise).Reference lists of published systematic reviews andoriginal articles included in the review were alsoscreened. Included studies were randomised and nonrandomisedcontrolled trials reporting a specific measureof walking levels (self-reported or objective) toassess the effectiveness of interventions aimed atpromoting walking in children and adolescents (aged5–18 years). Only full articles published in English inpeer-reviewed journals were included. Risk of bias andbehaviour change techniques of included studies wereassessed.Results Twelve studies were included in this review. Themajority of studies assessed interventions delivered withinan educational setting, with one study conducted within thefamily setting. Nine of the included studies reported significantincreases in walking in intervention groups versuscontrols. Commonly employed behaviour change techniqueswithin successful interventions included goals andplanning, feedback and monitoring, social support andrepetition and substitution.Conclusions Walking interventions, particularly thoseconducted in the school environment, have the potential toincrease PA in children and adolescents. Conclusions onwhich interventions most effectively increased walkingbehaviours in this population were hindered by the limitednumber of identified interventions and the short duration ofinterventions evaluated. The short-term effectiveness of themajority of included studies on levels of walking in thispopulation is promising and further research, particularlywithin non-educational settings and targeted at sub-groups(e.g. adolescent girls and overweight/obese children andadolescents), is warranted.