Equity in Physical Activity Interventions to Promote Health: A Scoping Review of Trials

Physical activity (PA) improves health and well-being, and helps prevent long-term conditions. Yet opportunities to be active are not evenly distributed, with social, economic, and environmental disadvantages constraining access to PA among populations who may benefit most. Since the extent to which PA interventions incorporate equity considerations remains insufficiently characterised, risking exacerbation of health inequity, this scoping review aims to synthesise trial evidence on interventions of PA to improve health outcomes in populations at risk of health inequity as defined by the PROGRESS-Plus and CORE20PLUS5 frameworks. PubMed, Web of Science, and Scopus were searched for randomised controlled trials of PA interventions with at-risk populations published between 2020 and 2025. Study characteristics, intervention design, and equity-relevant factors were extracted. Two reviewers independently screened and synthesised findings narratively. Results indicate that of 2,480 articles identified, 23 trials met eligibility criteria. Most reported positive effect of PA on health outcomes amongst at-risk populations, including weight loss, improved motor skills and gait speed, reduced anxiety and PTSD, and fewer fractures or hospital visits. Interventions commonly included strength and balance training, group exercise, stretching, and aerobic fitness. UK-based studies and subgroup analyses by e.g. sex or age were largely absent, and many populations at risk of health inequity were underrepresented. Explicit equity considerations throughout design, implementation, or evaluation were rare across trials and few assessed differential effects between social or economic groups. Integrating equity frameworks and engaging with at-risk populations is recommended in future physical activity interventions to mitigate exacerbation of health inequity.