Workplace intervention to promote stair‐use in an NHS setting

Stair versus elevator use in a university residence hall setting

OBJECTIVE

Determine the temporal and spatial characteristics of stairs versus elevator use in a university residence hall to inform future physical activity promotion efforts.

PARTICIPANTS

All residents and visitors for a single, four-story residence hall dormitory building located on a college campus in Orange, CA.

METHODS

Smart mat systems capable of detecting pedestrian traffic were placed in front of the stairs and elevators on each floor plus a basement. Generalized additive mixed models (GAMMs) were used to compare stair versus elevator usage at different times of the day and on different floors.

RESULTS

Stair versus elevator use varied much more throughout the day on floors nearest to the ground floor, with stair use most common in the morning. Overall, the elevator was used more frequently on higher floors, with less variation throughout the day.

CONCLUSION

To be most effective, future stair promotion interventions should target residents on higher floors and in the morning.

Sport and physical activity participation in the workplace: the role of employees' self-perception

Purpose

Despite preventive efforts from some companies to offer some sport and physical activity (SPA) to their employees, French participation rates remain very low, which limit impacts in terms of health and economic benefits. The aim of this study was to better understand the factors influencing SPA participation in the workplace.

Design/methodology/approach

A cross-sectional study was conducted based on an electronic questionnaire survey disseminated to 24 companies based in France that offered SPA to their employees. An independent sample t-test was conducted to explore the differences between the most common facilitating and constraining factors, in relation to “being a sporty person” self-perception, leisure-time physical activity (LTPA) level and demographic information. Predictors of SPA in the workplace were determined using a binomial logistic regression.

Findings

A total of 1,318 employees completed the survey, of which 60% were women, mostly highly educated and white collar. “Being a sporty person,” self-perception has been a predictor of SPA participation in the workplace.

Practical implications

More multicomponent work-based interventions, including incidental physical activity, might be necessary to increase participation and overcome time constraint.

Originality/value

Although SPA participation in the workplace is considered to promote numerous positive organizational and individual consequences, this is the first study to assess the associations between facilitating and constraining factors of SPA participation in the workplace setting and physical self-perception.

Choice architecture interventions to change physical activity and sedentary behavior: a systematic review of effects on intention, behavior and health outcomes during and after intervention

BACKGROUND

Choice architecture interventions, which subtly change the environment in which individuals make decisions, can be used to promote behavior change. This systematic review aimed to summarize studies on micro-environmental choice architecture interventions that encouraged physical activity or discouraged sedentary behavior in adults, and to describe the effectiveness of those interventions on these behaviors - and on related intentions or health outcomes - in presence of the intervention and after removal of the intervention (i.e. post-intervention, regardless of the time elapsed).

METHODS

We systematically searched PubMed, Embase, PsycINFO and the Cochrane Library for (quasi) experimental studies published up to December 2019 that evaluated the effect of choice architecture interventions on physical activity and sedentary behavior, as well as on intentions and health outcomes related to physical activity/sedentary behavior. Studies that combined choice architecture techniques with other behavior change techniques were excluded. All studies were screened for eligibility, relevant data was extracted and two independent reviewers assessed the methodological quality using the QualSyst tool.

RESULTS

Of the 9609 records initially identified, 88 studies met our eligibility criteria. Most studies (n = 70) were of high methodologic quality. Eighty-six studies targeted physical activity, predominantly stair use, whereas two studies targeted sedentary behavior, and one targeted both behaviors. Intervention techniques identified were prompting (n = 53), message framing (n = 24), social comparison (n = 12), feedback (n = 8), default change (n = 1) and anchoring (n = 1). In presence of the intervention, 68% of the studies reported an effect of choice architecture on behavior, whereas after removal of the intervention only 47% of the studies reported a significant effect. For all choice architecture techniques identified, except for message framing, the majority of studies reported a significant effect on behavioral intentions or behavior in presence of the intervention.

CONCLUSIONS

The results suggest that prompting can effectively encourage stair use in adults, especially in presence of a prompt. The effectiveness of the choice architecture techniques social influence, feedback, default change and anchoring cannot be assessed based on this review. More (controlled) studies are needed to assess the (sustained) effectiveness of choice architecture interventions on sedentary behavior and other types of physical activity than stair use.

When weight is an encumbrance; avoidance of stairs by different demographic groups

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.

Signage Interventions for Stair Climbing at Work: More than 700,000 Reasons for Caution

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.

The Bioecological Model: applications in holistic workplace well-being management

Purpose

– The purpose of this paper is to exemplify how the bioecological model (BM) may be used as a systems approach framework to address workplace well-being in a holistic, meaningful and practical way.

Design/methodology/approach

– This conceptual paper is structured according to the design of Bronfenbrenner’s (1999) BM. As such, the different layers of the model are described and then examples from the recent international and interdisciplinary literature and current policy from Australia are provided to support the argument. These selected examples represent some key themes in the field of workplace health and well-being management.

Findings

– The BM is ideal in holistically analysing workplace health promotion and management. This finding supports future research using this model. The limitations of the model are that it can lend itself to research projects that are unfocused. It is suggested that determining the research aims and objectives and then using the model to respond to this agenda would use the model effectively.

Research limitations/implications

– This paper proposes the applicability of a specific model to a research agenda suggesting that interested parties could design a project around this model to investigate workplace health and well-being management.

Practical implications

– The model gives weight to the lived experiences of employees and suggests that business owners and policy makers hold power in controlling aspects that influence employee well-being. This model could be used to inform policy makers about the holistic nature of employee well-being urging inclusive policies that support positive well-being practices.

Originality/value

– This paper provides a unique contribution to the field by offering a topic-specific model useful to those concerned with workplace health and well-being management.

Systematic review of incidental physical activity community interventions

BACKGROUND

Increasing incidental physical activity (IPA) such as active transport has substantial public health potential.

OBJECTIVE

This systematic review describes community-based and community-wide IPA interventions and assesses their effectiveness.

METHOD

Data sources (Medline, Embase, PsycINFO and CINAHL) were searched along with the reference lists of identified systematic reviews and included articles. Eligibility criteria; 4+ weeks in duration; 20+ participants; community-based or community-wide; stated aim to increase IPA.

RESULTS

Forty three studies were identified from 42 original articles; more than half (60%) aimed to increase stair use compared to escalator and/or lift use; a quarter (23%) aimed to increase active transport; and, 16% to increase playground energy expenditure. More than two-thirds of studies reported a significant increase in IPA. Accurate comparisons between studies were not possible due to substantial heterogeneity in study design. Critical appraisal of studies revealed that the level of bias was moderate-high in most of the studies (77%).

CONCLUSION

Due to the heterogeneity and bias of included studies, only limited conclusions can be drawn about the effectiveness of IPA interventions. However, this systematic review provides a timely summary of current evidence that can be used to inform decision-makers in designing IPA interventions in the community.