Evidence of the impact of sport policies on physical activity and sport participation: a systematic mixed studies review

Participation in sport contributes to increased physical activity (PA) levels. Increasing PA is a public health concern due to its recognised impact on health outcomes. International policy actors such as the Council of Europe, the World Health Organisation (WHO) and the International Society for Physical Activity and Health (ISPAH) have recommended that ‘sport for all’ is promoted both for public health and as a basic right. This review aims to evaluate sport related policies aimed at maximising the opportunity to participate in PA and sporting activity. Six electronic databases were systematically searched for quantitative, qualitative and review studies investigating how public sport policy affects PA outcomes. The scientific literature was screened according to predetermined eligibility criteria. Following study selection and data extraction, the quality was assessed using modified versions of existing quality assessment tools. Results were synthesised and the context in which policy actions occurred analysed using the Context and Implementation of Complex Interventions (CICI) framework. Database searches identified 3705 unique articles. A total of 93 full-text articles were assessed, with 22 meeting our inclusion criteria. Seven unique ‘policy actions’ were identified and were categorised into the ‘policy areas’ Facilities, Financial, Collaboration and Exhortation. Policy actions to promote PA and sport participation have demonstrated qualified success but there is limited evidence of success in engaging hard to reach groups. Therefore, policymakers utilising sport to increase PA should treat it as a complementary intervention alongside other policy actions based on a systems perspective.