Can international sports mega events be considered physical activity interventions? A systematic review and quality assessment of large-scale population studies

Amidst ongoing debate about the viability of physical activity (PA) legacies associated with hosting international sports mega events, this systematic review explores quantitative evidence from population studies that utilize repeated measures. This review is guided by the PRISMA protocol and includes article quality evaluation techniques from health intervention research. Structured Boolean searches were conducted across six databases and grey literature sources. In total, 12 studies were identified from the last two decades across four event typologies. Among these studies, 9 were evaluated as being of higher quality, but only 4 employed standard definitions or measures of PA. Among the higher quality studies, two-thirds found no evidence for statistically significantly PA legacies, although gaps and limitations precluded definitive assessment. Common concerns include limited evaluation of covariates, sweeping conclusions based on insufficient evidence, arbitrary conceptualization and operalization of PA, and lack of triangulation. Research recommendations for resolving the impasse are proposed.