Skip to main content


  • Catherine Meads (a1) and Josephine Exley (a2)

Background: Walking is a good way to meet physical activity guidelines. We examined the effectiveness of walking in groups compared with walking alone or inactive controls in physically healthy adults on physical activity and quality of life. (PROSPERO CRD42016033752).

Methods: We searched Medline, Embase, Cinahl, Web of Knowledge Science Citation Index, and Cochrane CENTRAL until March 2016, for any comparative studies, in physically healthy adults, of walking in groups compared with inactive controls or walking alone, reporting any measure of physical activity. We searched references from recent relevant systematic reviews. Two reviewers checked study eligibility and independently extracted data. Disagreements were resolved through discussion. Quality was assessed using likelihood of selection, performance, attrition, and detection biases. Meta-analysis was conducted using Review Manager 5.3.

Results: From 1,404 citations, 18 studies were included in qualitative synthesis and 10 in meta-analyses. Fourteen compared group walking to inactive controls and four to walking alone. Eight reported more than one measure of physical activity, none reported according to current guidelines. Group walking compared with inactive controls increased follow-up physical activity (9 randomized controlled trials, standardized mean difference [SMD] 0.58 [95 percent confidence interval {CI}, 0.34–0.82] to SMD 0.43 [95 percent CI, 0.20–0.66]). Compared with walking alone, studies were too few and too heterogeneous to conduct meta-analysis, but the trend was improved physical activity at follow-up for group walking participants. Seven (all inactive control) reported quality-of-life: five showed statistically significantly improved scores.

Discussion: Better evidence may encourage government policy to promote walking in groups. Standardized physical activity outcomes need to be reported in research.

Hide All
1. World Health Organization. Global Strategy on Diet, Physical Activity and Health Physical activity and adults. (accessed September 22, 2016).
2. World Health Organization. Global recommendations of physical activity for health. (accessed September 22, 2016).
3. Centers for Disease Control and Prevention. National Center for Health Statistics. Exercise or physical activity. accessed (accessed September 22, 2016).
4. Statistics Canada. Directly measured physical activity of adults, 2012 and 2013. (accessed September 22, 2016).
5. Australian Government Department of Health. Research and statistics. This page contains scientific evidence review reports and key facts and figures regarding physical activity and sedentary behaviour. (accessed September 22, 2016).
6. Townsend, N, Wickramasinghe, K, Williams, J, Bhatnagar, P, Rayner, M. Physical Activity Statistics 2015. British Heart Foundation: London; 2015.
7. Gidlow, C, Johnston, LH, Crone, D, James, D. Attendance of exercise referral schemes in the UK: A systematic review. Health Educ J. 2005;64:168186.
8. Stiggelbout, M, Hopman-Rock, M, Crone, M, Lechner, L, van Mechelen, W. Predicting older adults' maintenance in exercise participation using an integrated social psychological model. Health Educ Res. 2006;21:114.
9. Wing, RR, Jeffery, RW. Benefits of recruiting participants with friends and increasing social support for weight loss and maintenance. J Consult Clin Psychol. 1999;67:132138.
10. Campbell, F, Holmes, M, Everson-Hock, E, et al. A systematic review and economic evaluation of exercise referral schemes in primary care: A short report. Health Technol Assess. 2015;19:1110.
11. Farrance, C, Tsofliou, F, Clark, CJ. Evaluating the views of participants and adherence rates of community based group exercise interventions: A mixed methods systematic review. Physiotherapy. 2015;101 (Suppl 1):e374–e375.
12. De Moor, D. Walking for health. London: The Ramblers Association; 2013.
13. Lee, IM, Buchner, DM. The importance of walking to public health. Med Sci Sports Exerc. 2008;40 (Suppl):S512–S518
14. Milton, K, Grix, J. Public health policy and walking in England – Analysis of the 2008 ‘policy window’. BMC Public Health. 2015;15: 614.
15. Anon. Before, during and after: Making the most of the London 2012 Games. London: UK Government Department for Culture, Media and Sport; 2008. (accessed October 13, 2016).
16. U.S. Department of Health and Human Services. Surgeon Active living. (accessed September 22, 2016).
17. U.S. Department of Health and Human Services. Step it up! The Surgeon General's call to action to promote walking and walkable communities. Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General; 2015
18. U.S. Department of Health and Human Services. Surgeon National Prevention Strategy. Priorities (accessed September 22, 2016).
19. Hanson, S, Jones, A. Is there evidence that walking groups have health benefits? A systematic review and meta-analysis. Br J Sports Med. 2015;49:710715
20. Kassavou, A, Turner, A, French, DP. Do physical interventions to promote walking in groups increase physical activity? A meta-analysis. Int J Behav Nutr Phys Act. 2013;10:18
21. Blank, L, Jones, R, Buckley Woods, H, Payne, N. Systematic review and narrative synthesis of the effectiveness of local interventions to promote cycling and walking for recreational and travel purposes. Sheffield: University of Sheffield, School of Health and Related Research; 2012.
22. Higgins, JPT, Green, S, eds. Cochrane handbook for systematic reviews of interventions, Version 5.1.0 [updated March 2011]. London: The Cochrane Collaboration; 2011
23. Avila, P, Hovell, MF. Physical activity training for weight loss in Latinas: A controlled trial. Int J Obes Relat Metab Disord. 1994;18:476482 (referenced in Blank L, Jones R, Woods HB, Payne N. Systematic review and narrative review of the effectiveness of local interventions to promote cycling and walking for recreational and travel purposes. Sheffield: ScHARR University of Sheffield; 2012. (accessed August 24, 2016).
24. Fisher, KJ, Li, F. A community-based walking trial to improve neighbourhood quality of life in older adults: A multilevel analysis. Ann Behav Med. 2004;28:186194.
25. Gusi, N, Reyes, MC, Gonzalez-Guerrero, JL, Herrera, E, Garcia, JM. Cost-utility of a walking programme for moderately depressed, obese or overweight elderly women in primary care: A randomised controlled trial. BMC Public Health. 2008;8:110.
26. Hamdorf, PA, Penhall, RK. Walking with its training effects on the fitness and activity patterns of 79–91 year old females. Aust N Z J Med. 1999;29:2228
27. Isaacs, AJ, Critchley, JA, See Tai, S, et al. Exercise evaluation randomised trial (EXERT): A randomised trial comparing GP referral for leisure centre-based exercise, community based walking and advice only. Health Technol Assess. 2007;11:10.
28. Jancey, JM, Lee, AH, Howat, PA, Clarke, A, Wang, K, Shilton, T. The effectiveness of a physical activity intervention for seniors. Am J Health Promot. 2008;22:318321.
29. Krieger, J, Rabkin, J, Sharify, D, Song, L. High point walking for health: Creating built and social environments that support walking in a public housing community. Am J Public Health. 2009;99 (Supp 3): S593–S599.
30. Kriska, AM, Bayles, C, Cauley, JA, et al. A randomised exercise trial in older women: Increased activity over two years and the factors associated with compliance. Med Sci Sports Exerc. 1986;18:557562.
31. Lamb, SE, Bartlett, HP, Ashley, A, Bird, W. Can lay-led walking programmes increase physical activity in middle aged adults? A randomised controlled trial. J Epidemiol Community Health. 2002;56:246252.
32. Maki, Y, Ura, C, Yamaguchi, T, et al. Effects of intervention using a community-based walking programme for prevention of mental decline: A randomised controlled trial. J Am Geriatr Soc. 2012;60:505510.
33. Moore-Harrison, TL, Speer, EM, Johnson, FT, Cress, E. The effects of aerobic training and nutrition education on functional performance in low socioeconomic older adults. J Geriatr Phys Ther. 2008;31:1823.
34. Palmer, LK. Effects of a walking program on attributional style, depression and self-esteem in women. Percept Mot Skills. 1995;81:891898.
35. Resnick, B. Testing the effect of the WALC intervention on exercise adherence in older adults. J Gerontol Nurs. 2002;28:4049.
36. Takahashi, M, Miyashita, M, Kawanishi, N, et al. Low volume exercise training attenuates oxidative stress and neutrophils activation in older adults. Eur J Appl Physiol. 2013;113:11171126.
37. Cox, KL, Burke, V, Beilin, LJ, et al. Short and long-term adherence to swimming and walking programs in older women – The sedentary women exercise adherence trial (SWEAT-2). Prev Med. 2008;46: 511517.
38. Lee, CY, Lee, H, Jeon, KM, Hong, YM, Park, SH. Self-management program for obesity control among middle-aged women in Korea: A pilot study. Jpn J Nurs Sci. 2011;8:6675.
39. Nguyen, M-N, Gauvin, L, Martineau, I, Grignon, R. Promoting physical activity at the community level: Insights into health promotion practice from the Laval Walking club's perspective. Health Promot Pract. 2002;3:485496.
40. Thomas, GN, MacFarlane, DJ, Guo, B, et al. Health promotion in older Chinese: A 12-month cluster randomized controlled trial of pedometry and “peer support”. Med Sci Sport Exerc. 2012;44:11571166.
41. Pereira, MA, Kriska, AM, Day, RD, et al. A randomised walking trial in postmenopausal women. Effects on physical activity and health 10 years later. Arch Intern Med. 1998;158:16951701
42. NHS Choices. Physical activity guidelines for adults. (accessed September 26, 2016).
43. Coleman, RJ, Kokolakakis, T. Ramchandani, G. Walking for Health Attendance Study. Natural England Commissioned Reports, Number 098. Sheffield: Sports Industries Research Centre (SIRC); 2011.
44. Waters, L, Reeves, M, Fjeldsoe, B, Eakin, E. Control group improvements in physical activity intervention trials and possible explanatory factors: A systematic review. J Phys Act Health. 2012;9:884895.
45. Caspersen, CJ, Powell, KE, Christenson, GM. Physical activity, exercise, and physical fitness: Definitions and distinctions for health-related research. Public Health Rep. 1985;100:126131.
46. Ekelund, U, Steene-Johannessen, J, Brown, WJ, et al. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet. 2016;388:13021310.
47. Ding, D, Lawson, KD, Kolbe-Alexander, TL, et al. The economic burden of physical inactivity: A global analysis of major non-communicable diseases. Lancet. 2016;388:13111324.
48. Williamson, P, Clarke, M. The COMET (Core Outcome Measures in Effectiveness Trials) Initiative: Its role in improving Cochrane reviews. Cochrane Database Syst Rev. 2012;5:ED000041.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Journal of Technology Assessment in Health Care
  • ISSN: 0266-4623
  • EISSN: 1471-6348
  • URL: /core/journals/international-journal-of-technology-assessment-in-health-care
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Type Description Title
Supplementary materials

Meads and Exley supplementary material
Tables S1-S4 and Figures S1-S3

 Word (66 KB)
66 KB


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed