Which population-level interventions promote physical activity equitably across socioeconomic groups? A rapid systematic review

Introduction: Promoting physical activity among disadvantaged groups is a major policy goal in many high-income countries. We aimed to summarise evidence on the effectiveness of population-level interventions to promote physical activity among socioeconomically disadvantaged groups. Methods: A rapid systematic review was undertaken. Searches were conducted in four bibliographic databases in April 2025 (2015-2025) and grey literature, with additional forward citation searching and checking reference lists of relevant reviews. Studies were included if they: evaluated population-level approaches to promoting physical activity in adult populations; compared effectiveness between socioeconomic groups and were published in English from any country. Studies were quality assessed and a narrative synthesis applied. Results: 12 studies (13 publications) were included. Studies were rated moderate (n=3) and low (n=9) in quality. A programme of free access to gym and swim facilities with supplementary health promotion (UK) and a community-wide health promotion programme targeting older adults (Japan) were successful in promoting physical activity among disadvantaged groups while posing a low risk of widening health inequalities. Other interventions identified either did not increase physical activity in disadvantaged groups or posed a high risk of widening health inequalities. Conclusion: Some population-level approaches are promising, but ongoing monitoring of how these approaches work across different contexts is crucial. Hidden costs must be mitigated against to maximise the benefits of population approaches for the most disadvantaged. There has been modest progress in incorporating equity considerations into evaluations of population-level interventions to promote physical activity. PROSPERO registration number: CRD420251032624.