And She’s Buying a Stairway to Health: Signs and Participant Factors Influencing Stair Ascent at a Public Airport

Abstract

Several studies have demonstrated that point-of-choice prompts modestly increase stair use (i.e., incidental physical activity) in many public places, but evidence of effectiveness in airport settings is weak. Furthermore, evaluating the effects of past physical activity on stair use and on point-of-choice prompts to increase stair use is lacking. The purpose of this study was to evaluate the influence of sign prompts and participant factors including past physical activity on stair ascent in an airport setting. We used a quasi-experimental design, systematically introducing and removing sign prompts daily across 22 days at the San Diego International Airport. Intercept interviewers recruited stair and escalator ascenders (N=1091; 33.0% interview refusal rate) of the only stairs/escalators providing access to Terminal 1 from the parking lot. A 13-item questionnaire about demographics, physical activity, health behavior, and contextual factors provided data not available in nearly all other stair use studies. We examined the effects of signs and self-reported covariates using multivariable logistic regression analyses, and tested whether physical activity and other covariates modified the intervention effect. Adjusting for all significant covariates, prompts increased the odds of stair use (odds ratio=3.67; p<.001). Past participation in vigorous physical activity increased the odds of stair use by 1.62 (p=0.001). None of the covariates moderated the intervention effect. In conclusion, vigorous physical activity and correlates of physical activity were related to stair use in expected directions, but did not modify the effect of the intervention. This indicates that the effects of point-of-choice prompts are independent of past physical activity, making them effective interventions for active adults and the higher risk population of inactive adults. Signs can prompt stair use in an airport setting and might be employed at most public stairs to increase rates of incidental physical activity and contribute to overall improvements in population health.

Prompts to increase physical activity at points-of-choice between stairs and escalators: what about escalator climbers?

“…In our study, when stair use was compared with escalator use, point-of-choice prompts increased stair use by 115 percent, confirming previous findings [4,12], including our own [13], that prompts are an effective means of changing stair-use behavior. However, to more accurately assess the impact on physical activity, we also compared active ascent (stair use or escalator climbing) with passive ascent (escalator standing) and found prompts increased active ascent by only 15 percent.…”

Nudging to move: a scoping review of the use of choice architecture interventions to promote physical activity in the general population

“…However, in the studies that reported data on the general population, children and persons with children, disabled persons, persons with luggage and, in online studies, persons under the age of 18 were excluded. Most studies were conducted in the UK [77, 81, 84–89, 92, 95, 105], followed by online studies mostly without geographical focus [101–104, 106–108], and studies from the USA [76, 78, 79, 97, 98, 109], and Hong Kong [75, 80]. There was one study each from Singapore [96], Japan [91], Denmark [83], Sweden [82], Germany [90], Belgium [100], France [99], South Africa [93], and Spain [94].…”

“…There was one study each from Singapore [96], Japan [91], Denmark [83], Sweden [82], Germany [90], Belgium [100], France [99], South Africa [93], and Spain [94]. Most studies were conducted in train stations/underground train stations [78, 79, 81–83, 89–92, 94, 96, 99, 100], followed by studies in malls/shopping malls [76–78, 84–88, 95, 100], airports [79, 97, 98, 109], pedestrian transit systems [80, 82], two public buildings [79, 93], and one bus station [78]. Eight studies were conducted online only [101–108].…”

“…Most of the studies used an observational study design [76–83, 85–90, 92, 95–97, 100, 109]. Experimental study [99, 101, 104, 107], post-test study [102], interrupted time-series, randomised controlled trial [75, 103, 105], interview study [84], quasi-experimental [94, 98, 108], and cross-sectional survey [91] designs were represented as well. All interventions targeted the micro level.…”

Establishing the Effectiveness of Public Health Interventions Using Sequential Meta-Analysis: Case Study Using Stair-Promotion Interventions

“…Numerous further typical small-scale studies on stair promotion signs have been published. These include stair signs in university settings (Crozier et al, 2019;Engelen 2017;Ly et al, 2019), metro stations (Allias et al, 2017), an airport (Bellettiere et al, 2017), and a city centre office building (Bennett et al, 2018). These studies have continued to reinforce that the magnitude of change in stair use following the installation of a sign is broadly consistent with what has been reported in previous studies.…”