Associations between parental perceptions of neighbourhood environment and physical activity in children and adolescents: a systematic review including 149 studies

Background: Parental perceptions of the neighbourhood environment can be of particular importance for physical activity of children and adolescents, because parents act as the gatekeepers of their children’s behaviour. However, knowledge gaps remain regarding the associations between parental perceptions of neighbourhood environment and physical activity among children and adolescents. Therefore, the aim of this study was to systematically review and summarise evidence on the association between parental perceptions of the neighbourhood environment and physical activity among children and adolescents (5 – 17 years of age). Methods: Literature searches were conducted in: CINAHL, Embase, Environmental Science, MEDLINE/PubMed, PsycInfo, Scopus, SPORTDiscus, Transportation Research Information Services, and Web of Science. The associations were coded as: mostly favourable (for 60% – 100% of studies showing a positive association); mostly unfavourable (for 60% – 100% of studies showing a negative association); and mostly non-significant, indeterminate, or inconsistent. Results: Out of 30,162 records identified in the search, 162 papers from 149 studies were included in the review. The most consistent finding was that a greater distance to school is unfavourably associated with active travel. Evidence of this association was found in children (5/7 associations; pooled sample size in the studies showing significant association [n] = 14,113), adolescents (3/4; n = 2328), and mixed-age group (8/13; n = 5410). There was some consistency in evidence on favourable associations of: (1) access to public transport, good street lighting, and presence of crossing guards with active travel among children; (2) access to sports and recreational facilities, parks and/or playgrounds with sports participation among children; and (3) access to sports and recreational facilities, parks, and/or playgrounds with non-type-specific physical activity among adolescents. Several associations were found in individual studies only, while others were mostly non-significant, indeterminate, or inconsistent. The quality of evidence ranged from very low to low. Conclusions: Parental perceptions of traffic safety and access to destinations and services are associated with different types of physical activity among children and adolescents. There is a need for longitudinal and experimental studies, more research among adolescents, more studies from low- and middle-income countries, and exploring a wider range of neighbourhood environment attributes.