Active travel, particularly walking and cycling, has been recommended because of the health benefits associated with increased physical activity. Use of public transport generally involves some walking to bus stops or train stations. This paper is a systematic review of how much time is spent in physical activity among adults using public transport. It also explores the potential effect on the population level of physical activity if inactive adults in NSW, Australia, increased their walking through increased use of public transport. Of 1,733 articles, 27 met the search criteria, and nine reported on absolute measures of physical activity associated with public transport. A further 18 papers reported on factors associated with physical activity as part of public transport use. A range of 8–33 additional minutes of walking was identified from this systematic search as being attributable to public transport use. Using “bootstrapping” statistical modelling, if 20% of all inactive adults increased their walking by only 16 minutes a day for five days a week, we predict there would be a substantial 6.97% increase in the proportion of the adult population considered “sufficiently active”. More minutes walked per day, or a greater uptake of public transport by inactive adults would likely lead to significantly greater increases in the adult population considered sufficiently active.
The Get Healthy Information and Coaching Service® (GHS) is a population-wide telephone-based program aimed at assisting adults to implement lifestyle improvements. It is a relatively uncommon example of the translation of efficacious trials to up-scaled real-world application. GHS participants who completed the 6-month coaching program made significant initial improvements to their weight, waist circumference, Body Mass Index (BMI), physical activity and nutrition behaviours. This study examines the maintenance of anthropometric and behaviour change improvements 6-months after program completion. GHS coaching participants (n=1088) were recruited between February 2009 and June 2011. Participants were eligible if they completed the 6-month coaching program and had available data at 12-month follow-up (n=277). Weight, waist circumference, BMI, fruit and vegetable consumption and physical activity were collected at baseline and 6-months by GHS coaches and 12-months (6-months post program) by independent evaluators. Matched pair t-tests, mixed linear regression and logistic regression analyses were performed to assess maintenance of program effects. Improvements in weight (−2.9 kg, 95% CI: -3.6, -2.1), waist circumference (−5.4 cm, 95% CI: -6.7, -4.1), BMI (−1.1units, 95% CI: -1.5, -0.8), and fruit (+0.3 serves per day, 95% CI: 0.2, 0.3) and vegetable (+0.5 serves per day 95% CI: 0.3, 0.6) consumption were observed from baseline to 12-months. Apart from vegetable consumption, there were no significant differences between 6-month and 12-month changes from baseline, indicating these risk factor improvements were maintained from the end of the coaching program. There were also improvements in the proportion of participants undertaking recommended levels of physical activity from baseline to 12-months (increase of 5.2%), however the improvements made at end of the coaching program were not maintained at the 6-month follow up. This study provides preliminary evidence that the GHS has potential to contribute to substantial improvements in the chronic disease risk factor profile of program completers and facilitates sustained maintenance six months after completing the coaching program.