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Activity spaces in studies of the environment and physical activity: A review and synthesis of implications for causality.

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Activity spaces are increasingly used to understand how people interact with their environment and engage in activity but their use may raise challenges regarding causal inference. We conducted a systematic review of findings and the methodological, analytical and conceptual issues relevant to causal inference. Studies were included if they comprised a spatial summary of locations visited, assessed any part of the causal pathway between the environment, physical activity and health, and used quantitative or qualitative methods. We searched seven electronic databases in January 2018 and screened 11910 articles for eligibility. Forty-seven studies were included for review. Studies answered research questions about features of or environmental features within activity spaces using a range of spatial and temporal summary techniques. The conceptual challenge of using activity spaces to strengthen causal inference was rarely considered, although some studies discussed circularity, temporality, and plausibility. Future studies should use longitudinal and experimental designs and consider the potential and actual use of spaces for physical activity, and their relationship with total levels of activity.



Activity space, Causal inference, Environment, Individual exposure, Physical activity, Research methods, Environment Design, Exercise, Humans, Residence Characteristics

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Health Place

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Elsevier BV
Medical Research Council (MR/K023187/1)
Medical Research Council (MC_UU_12015/6)
Department of Health (via National Institute for Health Research (NIHR)) (16/137/34)
Wellcome Trust (087636/Z/08/Z)
TCC (None)
Economic and Social Research Council (ES/G007462/1)
LS and JP are supported by the Medical Research Council (MC_UU_12015/6) and Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research (NIHR), and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged (grant numbers 087636/Z/08/Z, ES/G007462/1, MR/K023187/1). LF is supported by the NIHR Global Health Research Group and Network on Diet and Activity. Funding from NIHR is gratefully acknowledged (grant number 16/137/34). No funder had any role in the study design; data collection, analysis, or interpretation; in the writing of the report; or in the decision to submit the article for publication.