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Eves FF. When weight is an encumbrance; avoidance of stairs by different demographic groups. PLoS One 2020; 15:e0228044. [PMID: 31978202 PMCID: PMC6980638 DOI: 10.1371/journal.pone.0228044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/06/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Locomotion is an energy costly behaviour, particularly when it entails raising weight against gravity. Minimization of locomotor costs appears a universal default. Avoidance of stair climbing helps humans minimise their energetic costs. In public access settings, demographic subgroups that raise more 'dead' weight than their comparison groups when climbing are more likely to avoid stairs by choosing the escalator. Individuals who minimise stair costs at work, however, can accumulate a deficit in energy expenditure in daily life with potential implications for weight gain. This paper tests the generality of avoidance of stairs in pedestrians encumbered by additional weight in three studies. METHODS Pedestrian choices for stairs or the alternative were audited by trained observers who coded weight status, presence of large bags and sex for each pedestrian. Sex-specific silhouettes for BMIs of 25 facilitated coding of weight status. Choices between stairs and a lift to ascend and descend were coded in seven buildings (n = 26,981) and at an outdoor city centre site with the same alternatives (n = 7,433). A further study audited choices to ascend when the alternative to stairs was a sloped ramp in two locations (n = 16,297). Analyses employed bootstrapped logistic regression (1000 samples). RESULTS At work and the city centre site, the overweight, those carrying a large bag and females avoided both stair climbing and descent more frequently than their comparison groups. The final study revealed greater avoidance of stairs in these demographic subgroups when the alternative means of ascent was a sloped ramp. DISCUSSION Minimization of the physiological costs of transport-related walking biases behaviour towards avoidance of stair usage when an alternative is available. Weight carried is an encumbrance that can deter stair usage during daily life. This minimization of physical activity costs runs counter to public health initiatives to increase activity to improve population health.
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Affiliation(s)
- Frank F. Eves
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, England, United Kingdom
- * E-mail:
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Puig-Ribera A, Señé-Mir AM, Taylor-Covill GAH, De Lara N, Carroll D, Daley A, Holder R, Thomas E, Milà R, Eves FF. Signage Interventions for Stair Climbing at Work: More than 700,000 Reasons for Caution. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193782. [PMID: 31597383 PMCID: PMC6801962 DOI: 10.3390/ijerph16193782] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/01/2019] [Accepted: 10/02/2019] [Indexed: 12/04/2022]
Abstract
Increased stair climbing reduces cardiovascular disease risk. While signage interventions for workplace stair climbing offer a low-cost tool to improve population health, inconsistent effects of intervention occur. Pedestrian movement within the built environment has major effects on stair use, independent of any health initiative. This paper used pooled data from UK and Spanish workplaces to test the effects of signage interventions when pedestrian movement was controlled for in analyses. Automated counters measured stair and elevator usage at the ground floor throughout the working day. Signage interventions employed previously successful campaigns. In the UK, minute-by-minute stair/elevator choices measured effects of momentary pedestrian traffic at the choice-point (n = 426,605). In Spain, aggregated pedestrian traffic every 30 min measured effects for ‘busyness’ of the building (n = 293,300). Intervention effects on stair descent (3 of 4 analyses) were more frequent than effects on stair climbing, the behavior with proven health benefits (1 of 4 analyses). Any intervention effects were of small magnitude relative to the influence of pedestrian movement. Failure to control for pedestrian movement compromises any estimate for signage effectiveness. These pooled data provide limited evidence that signage interventions for stair climbing at work will enhance population health.
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Affiliation(s)
- Anna Puig-Ribera
- Departament de Ciències de l´Activitat Física, Centre d´Estudis Sanitaris i Socials, Universitat de Vic-Universitat Central de Catalunya, Barcelona, 08500 Vic, Spain
| | - Anna M Señé-Mir
- Departament de Ciències de l´Activitat Física, Centre d´Estudis Sanitaris i Socials, Universitat de Vic-Universitat Central de Catalunya, Barcelona, 08500 Vic, Spain
| | - Guy A H Taylor-Covill
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Núria De Lara
- Agència de Salut Pública de Catalunya, 08023 Barcelona, Spain
| | - Douglas Carroll
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Amanda Daley
- Department of General Practice, University of Birmingham, Birmingham, B15 2TT, UK
| | - Roger Holder
- Department of General Practice, University of Birmingham, Birmingham, B15 2TT, UK
| | - Erica Thomas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Raimon Milà
- Departament de Salut i Acció Social, Universitat de Vic-Universitat Central de Catalunya, Barcelona, 08500 Vic, Spain
| | - Frank F Eves
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
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Grover E, Hossain MK, Uddin S, Venkatesh M, Ram PK, Dreibelbis R. Comparing the behavioural impact of a nudge-based handwashing intervention to high-intensity hygiene education: a cluster-randomised trial in rural Bangladesh. Trop Med Int Health 2017; 23:10-25. [PMID: 29124826 DOI: 10.1111/tmi.12999] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the impact of environmental nudges on handwashing behaviours among primary school children as compared to a high-intensity hygiene education intervention. METHODS In a cluster-randomised trial (CRT), we compared the rates of handwashing with soap (HWWS) after a toileting event among primary school students in rural Bangladesh. Eligible schools (government run, on-site sanitation and water, no hygiene interventions in last year, fewer than 450 students) were identified, and 20 schools were randomly selected and allocated without blinding to one of four interventions, five schools per group: simultaneous handwashing infrastructure and nudge construction, sequential infrastructure then nudge construction, simultaneous infrastructure and high-intensity hygiene education (HE) and sequential handwashing infrastructure and HE. The primary outcome, incidence of HWWS after a toileting event, was compared between the intervention groups at different data collection points with robust-Poisson regression analysis with generalised estimating equations, adjusting for school-level clustering of outcomes. RESULTS The nudge intervention and the HE intervention were found to be equally effective at sustained impact over 5 months post-intervention (adjusted IRR 0.81, 95% CI 0.61-1.09). When comparing intervention delivery timing, the simultaneous delivery of the HE intervention significantly outperformed the sequential HE delivery (adjusted IRR 1.58 CI 1.20-2.08), whereas no significant difference was observed between sequential and simultaneous nudge intervention delivery (adjusted IRR 0.75, 95% CI 0.48-1.17). CONCLUSION Our trial demonstrates sustained improved handwashing behaviour 5 months after the nudge intervention. The nudge intervention's comparable performance to a high-intensity hygiene education intervention is encouraging.
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Affiliation(s)
- Elise Grover
- Department of Civil Engineering and Environmental Science/Center for Applied Social Research, University of Oklahoma, Norman, OK, USA
| | | | - Saker Uddin
- Save the Children, Bangladesh, Dhaka, Bangladesh
| | | | - Pavani K Ram
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | - Robert Dreibelbis
- Department of Civil Engineering and Environmental Science/Center for Applied Social Research, University of Oklahoma, Norman, OK, USA.,Faculty of Infectious and Tropical Disease, Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK
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Lazi MKAM, Mustafa M, Rahman ZA, kaman NB. Assessing Pedestrian Behavior and Walking Speed on Staircase: A Review. INCIEC 2015 2016:1019-1029. [DOI: 10.1007/978-981-10-0155-0_85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Zacharias J, Tang B. Choosing between stairs and escalators in China: The impact of location, height and pedestrian volume. Prev Med Rep 2015; 2:529-32. [PMID: 26844113 PMCID: PMC4721357 DOI: 10.1016/j.pmedr.2015.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This research examines whether Beijing residents are more or less likely than Montréal residents to avoid stair climbing, by replicating a study in Montréal, Canada that measured the impacts of distance between stairs and escalator, height between floors and pedestrian volume on stair climbing rate. METHOD 15 stairways, 14 up-escalators and 13 down-escalators were selected in 13 publicly accessible settings in Beijing. Distance between the bottom or top of nearest stair and escalator combinations varied from 2.1 m to 114.1 m with height between floors varying from 3.3 m to 21.7 m. Simultaneous counts were conducted on stair and escalator pairs, for a total of 37,081 counted individuals. RESULTS In the ascent model, pedestrian volume accounted for 16.3% of variance in stair climbing, 16.4% when height was added and 45.1% when distance was added. In the descent model, 40.9% of variance was explained by pedestrian volume, 41.5% when height was added and 45.5% when distance was added. CONCLUSION Separating stairs and escalator is effective in increasing stair climbing in Beijing, accounting for 29% of the variance in stair climbing, compared with 43% in Montreal. As in the Montreal case, distance has less effect on stair use rate when descending. Overall, 25.4% of Beijingers opted for stairs when ascending compared with 20.3% of Montrealers, and for descending 32.8% and 31.1% respectively.
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Affiliation(s)
- John Zacharias
- College of Architecture and Landscape, Peking University, Beijing 100080, China
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Abstract
Perception of hill slant is exaggerated in explicit awareness. Proffitt (Perspectives on Psychological Science 1:110–122, 2006) argued that explicit perception of the slant of a climb allows individuals to plan locomotion in keeping with their available locomotor resources, yet no behavioral evidence supports this contention. Pedestrians in a built environment can often avoid climbing stairs, the man-made equivalent of steep hills, by choosing an adjacent escalator. Stair climbing is avoided more by women, the old, and the overweight than by their comparators. Two studies tested perceived steepness of the stairs as a cue that promotes this avoidance. In the first study, participants estimated the steepness of a staircase in a train station (n = 269). Sex, age, height, and weight were recorded. Women, older individuals, and those who were heavier and shorter reported the staircase as steeper than did their comparison groups. In a follow-up study in a shopping mall, pedestrians were recruited from those who chose the stairs and those who avoided them, with the samples stratified for sex, age, and weight status. Participants (n = 229) estimated the steepness of a life-sized image of the stairs they had just encountered, presented on the wall of a vacant shop in the mall. Pedestrians who avoided stair climbing by choosing the escalator reported the stairs as steeper even when demographic differences were controlled. Perceived steepness may to be a contextual cue that pedestrians use to avoid stair climbing when an alternative is available.
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Is there any Proffitt in stair climbing? A headcount of studies testing for demographic differences in choice of stairs. Psychon Bull Rev 2014; 21:71-7. [PMID: 23775216 PMCID: PMC3901940 DOI: 10.3758/s13423-013-0463-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The apparent slope of a hill, termed geographical slant perception, is overestimated in explicit awareness. Proffitt (2006) argued that overestimation allows individuals to manage their locomotor resources. Increasing age, fatigue, and wearing a heavy back pack will reduce the available resources and result in steeper reports for a particular hill. In contrast, Durgin and colleagues have proposed an alternative explanation for these effects based on experimental design—particularly, the potential effects of experimental demand. Proffitt’s resource-based model would predict that pedestrians with reduced resources should avoid climbing a hill that would further deplete their resources if the opportunity arose. Within the built environment, stairs are the man-made equivalent of relatively steep hills (20°–30°). In many public access settings, pedestrians can avoid climbing the stairs by opting for an adjacent escalator. Observations of pedestrian behavior in shopping malls reveal that 94.5 % do so. This article summarizes the effects of demographic grouping on avoidance of stairs in public health research. Observations in shopping malls (n = 355,069) and travel contexts (n = 711,867) provide data consistent with Proffitt’s resource model. Women, the old, and those carrying excess body weight or large bags avoid the stairs more than do their comparison groups. Discussion focuses on differences in physiology that may underlie avoidance of stair climbing in order to highlight the pedestrian behavior that psychology needs to explain.
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Eves FF, Webb OJ, Griffin C, Chambers J. A multi-component stair climbing promotional campaign targeting calorific expenditure for worksites; a quasi-experimental study testing effects on behaviour, attitude and intention. BMC Public Health 2012; 12:423. [PMID: 22686243 PMCID: PMC3490976 DOI: 10.1186/1471-2458-12-423] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 05/18/2012] [Indexed: 12/04/2022] Open
Abstract
Background Accumulation of lifestyle physical activity is a current aim of health promotion, with increased stair climbing one public health target. While the workplace provides an opportunity for regular stair climbing, evidence for effectiveness of point-of-choice interventions is equivocal. This paper reports a new approach to worksite interventions, aimed at changing attitudes and, hence, behaviour. Methods Pre-testing of calorific expenditure messages used structured interviews with members of the public (n = 300). Effects of multi-component campaigns on stair climbing were tested with quasi-experimental, interrupted time-series designs. In one worksite, a main campaign poster outlining the amount of calorific expenditure obtainable from stair climbing and a conventional point-of-choice prompt were used (Poster alone site). In a second worksite, additional messages in the stairwell about calorific expenditure reinforced the main campaign (Poster + Stairwell messages site). The outcome variables were automated observations of stair and lift ascent (28,854) and descent (29,352) at baseline and for three weeks after the intervention was installed. Post-intervention questionnaires for employees at the worksites assessed responses to the campaign (n = 253). Analyses employed Analysis of Variance with follow-up Bonferroni t-tests (message pre-testing), logistic regression of stair ascent and descent (campaign testing), and Bonferroni t-tests and multiple regression (follow-up questionnaire). Results Pre-testing of messages based on calorific expenditure suggested they could motivate stair climbing if believed. The new campaign increased stair climbing, with greater effects at the Poster + Stairwell messages site (OR = 1.52, 95% CI = 1.40-1.66) than Posters alone (OR = 1.24, 95% CI = 1.15-1.34). Follow-up revealed higher agreement with two statements about calorific outcomes of stair climbing in the site where they were installed in the stairwell, suggesting more positive attitudes resulted from the intervention. Future intentions for stair use were predicted by motivation by the campaign and beliefs that stair climbing would help weight control. Conclusions Multi-component campaigns that target attitudes and intentions may substantially increase stair climbing at work.
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Affiliation(s)
- Frank F Eves
- School of Sport and Exercise Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
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Lewis A, Eves F. Prompt before the choice is made: Effects of a stair-climbing intervention in university buildings. Br J Health Psychol 2012; 17:631-43. [DOI: 10.1111/j.2044-8287.2011.02060.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Specific Effects of a Calorie-Based Intervention on Stair Climbing in Overweight Commuters. Ann Behav Med 2011; 42:257-61. [DOI: 10.1007/s12160-011-9283-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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Webb OJ, Eves FF, Smith L. Investigating behavioural mimicry in the context of stair/escalator choice. Br J Health Psychol 2011; 16:373-85. [PMID: 21489063 DOI: 10.1348/135910710x510395] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES We investigated whether individuals mimic the stair/escalator choices of preceding pedestrians. Our methodology sought to separate cases where the 'model' and 'follower' were acquaintances or strangers. DESIGN Natural experiment. METHODS Infrared monitors provided a second-by-second log of when pedestrians ascended adjacent stairs/escalators in a mall. Manual timings established that stair climbers spent ≥ 7 s on ascent, during which time they could act as models to following pedestrians. Thus, individuals who mounted the stairs/escalator ≤ 7 s after the previous stair climber were assigned to a 'stair model' condition. A 'no stair model' condition comprised individuals with a gap to the previous stair climber of ≥ 60 s. The stair model condition was subdivided, depending if the gap between model and follower was 1-2 s or 3-7 s. It was hypothesized that the former cohort may know the model. RESULTS Percentage stair climbing was significantly higher in the 'stair model' versus 'no stair model' condition (odds ratio [OR]= 2.08). Subgroup analyses showed greater effects in the '1-2 s' cohort (OR = 3.33) than the '3-7 s' cohort (OR = 1.39). CONCLUSIONS Individuals appear to mimic the stair/escalator choices of fellow pedestrians, with more modest effects between strangers. People exposed to message prompts at stair/escalator sites are known to take the stairs unprompted in subsequent situations. Our results suggest that these individuals could recruit a second generation of stair climbers via mimicry. Additionally, some of the immediate behavioural effects observed in interventions may be a product of mimicry, rather than a direct effect of the messages themselves.
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Affiliation(s)
- Oliver J Webb
- School of Sport, Exercise and Health Sciences, Loughborough University, Ashby Road, Loughborough, Leicestershire, UK.
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Point-of-decision prompts to increase stair use. Am J Prev Med 2010; 38:573-4. [PMID: 20409507 DOI: 10.1016/j.amepre.2010.02.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Revised: 01/29/2010] [Accepted: 02/11/2010] [Indexed: 11/21/2022]
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Workplace intervention to promote stair‐use in an NHS setting. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2008. [DOI: 10.1108/17538350810926525] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Berrigan D, McKinnon RA. Built environment and health. Prev Med 2008; 47:239-40. [PMID: 18694780 PMCID: PMC2707753 DOI: 10.1016/j.ypmed.2008.07.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Revised: 07/07/2008] [Accepted: 07/08/2008] [Indexed: 11/25/2022]
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