Abstract

Built environment restructuring and urban planning are approaches to improve public health by providing opportunity for healthy behaviours. Another approach targets individual behaviour within places using behavioural science. How well these approaches intersect is unclear but recent reports suggest potential for integration. We reviewed evidence from environmental restructuring projects and their impact on health outcomes was synthesized using behavioural science frameworks: the COM-B model of behavior change (Michie, van Stralen, & West, 2011) and the Theory Domains Framework (Cane, O’Connor, & Michie, 2012). Established scoping review methods were implemented. Findings were based on 23 studies reporting both built environment restructuring and measured behavior change related health outcomes in adults identified in public health, architecture, psychology, and urban design database searches. Projects targeted active travel (43.5%), urban green facilities development (34.8%), or New Urbanist neighbourhoods (21.7%). Evidence supported positive impacts on physical activity, as well as some impact on stress, general health, quality of life, and social isolation. Explicit mention of underpinning theory was lacking generally. Reported outcomes were highly relevant to drivers of health behaviour (COM-B) and domains of behaviour change (TDF), including social/physical opportunity, automatic/reflective motivation, and physical/psychological capabilities through beliefs, emotion, environmental context/resources, intention, skills, and social influences. Few reports included outcomes other than physical activity; we recommend use of more varied outcomes based on national/international indicators to facilitate comparison. There was limited exploration of barriers and nuisances that arose from projects, suggesting this as an area of future enquiry. One pressing recommendation is that relevant theory guiding design should be clear; cross-disciplinary teams should consider how to integrate these over the varying layers of influence on health behavior.