Promoting workplace stair climbing: sometimes, not interfering is the best

Nudging Interventions on Stair Use: A Scoping Review

Stair use is a physical activity that can be incorporated into the daily lifestyle of a majority of the population, resulting in several health benefits. Nudges are increasingly used in public health interventions to encourage healthy behaviours such as physical activity in a cost-effective manner. This scoping review aimed to investigate the effect and the characteristics of nudges used on interventions to promote stair use. We reviewed the relevant literature published in PubMed, Cochrane Library, Mendeley and Google Scholar, from January 2009 to May 2022. Eligibility criteria included original studies of any type of design, written in English, targeting healthy adults, reporting nudging interventions, using elevator or escalator as comparators and defining a baseline for comparisons. Initially, 118 publications were identified, and after applying exclusion criteria, 27 articles were included in the analysis. Results showed that most of the nudging interventions had significant positive effect on stair use in several settings. The evidence from this review suggests that incorporating nudges into public health interventions can effectively promote physical activity through increased stair usage. Emphasizing prevention measures in public health interventions may contribute to better health outcomes.

How do different interventions impact stair climbing? A systematic review and meta-analysis

OBJECTIVES

This study aimed to analyze the effect of interventions to increase stair use.

STUDY DESIGN

Systematic review and meta-analysis.

METHODS

An online search was conducted in January 2021 in five databases (Web of Science, SPORTDiscus, MedLine/PubMed, PsycINFO, and CINAHL). Experimental studies (randomized and non-randomized) conducted in adults, which provided stair use measures with pre- and post-intervention periods were included. A random-effect meta-analysis, as well as subgroup analyses were conducted to evaluate the quantitative effect of interventions on stair use.

RESULTS

Overall, 34 studies were included in qualitative analyses, and 15 in the meta-analysis. Most of the studies were conducted in Europe and private settings (e.g., office buildings). Overall, interventions increased stair use in adults (odds ratio (OR) 1.48; 95% confidence intervals (CI) 1.38-1.58; I2 = 99.6%). Subgroup analyses showed that interventions increased stair use regardless of the continent and observer type (manual or electronic). However, different settings (shopping malls and office buildings), as well as studies (time of intervention) and intervention characteristics (sign size and location, message characters) were associated with increased stair use.

CONCLUSIONS

Different interventions can increase stair use in several continents and settings. Sign and message characteristics should be considered when designing interventions or policies to promote physical activity by increasing stair use.

Activity space, office space: Measuring the spatial movement of office workers

A key to the development of more effective interventions to promote movement and reduce physical inactivity in office workplaces may be to measure and locate individual's spatial movement. Using an activity space estimation method, high resolution location data collected from 15 office workers over 12 days were used to estimate and analyse the location and extent of their daily spatial movement whilst in an office work-based setting. The results indicated that the method, kernel density estimation, combined with location data offers significant opportunities to not only measure and compare spatial movement behaviours but also simultaneously identify the locations where the behaviours occur. Combined with other data streams, this method will allow researchers to further investigate the influence of different environmental characteristics on these behaviours, potentially leading the development of more effective, longer lasting interventions to promote movement and reduce stationary behaviour, ultimately improving the health of office workers.

Identifying interior design strategies for healthy workplaces – a literature review

Purpose

It is widely recognized that interior office space can affect health in several ways. Strategic and evidence-based design, including explicit design objectives, well-chosen design solutions and evaluation of results, aid realization of desired health effects. Therefore, this paper aims to identify possibly effective interior design strategies and accompanying design solutions and to provide examples of effectiveness measures.

Design/methodology/approach

A literature sample of 59 peer-reviewed papers published across disciplines was used to collect examples of workplace design features that have positively influenced workers’ well-being. The papers were grouped by their health objective and design scope successively and their theoretical assumptions, measures and findings were analyzed.

Findings

Four main workplace design strategies were identified. Design for comfort aims at reducing or preventing health complaints, discomfort and stress, following a pathogenic approach. It has the longest tradition and is the most frequently addressed in the included papers. The other three take a salutogenic approach, promoting health by increasing resources for coping with demands through positive design. Design for restoration supports physical and mental recovery through connections with nature. Design for social well-being facilitates social cohesion and feelings of belonging. Design for healthy behavior aims at nudging physical activity in the workplace.

Originality/value

By drawing complementary perspectives and offering examples of design solutions and effectiveness measures, this paper encourages workplace designers, managers and researchers to take a transdisciplinary and evidence-based approach to healthy workplaces. It also serves as a starting point for future empirical research.

Influence of COVID-19 Building Restrictions on Physical Activity Promotion Through Increased Stair Use and Limited Elevator Access: A Quasi-Experimental Study-Sport and Physical Activity Group Active Campus Project

BACKGROUND

The aim of this study was to determine the effectiveness of UK government COVID-19 safe offices policy to increase stair use in a higher education setting during the COVID-19 pandemic.

METHODS

Automated counts at 3 ground floor staircases and the elevator entrances were used to estimate stair to elevator use ratio for ascent and descent from/to the ground floor of a university building at baseline (January to March 2020), first and second intervention months (October 2020, November 2020, respectively). Stair promoting signage and a 1-way system was implemented, in line with government policy.

RESULTS

At baseline, stair to elevator use ratio for ascent from and descent to the ground floor was 1.36 (0.02) and 1.88 (0.02) people, respectively. The ratio significantly increased in the first intervention month to 2.64 (0.09) and 3.96 (0.22) people for ascent and descent, respectively. However, the ratio decreased between the first and second intervention months to 1.63 (0.06) and 3.05 (0.52) people for ascent and descent, respectively.

CONCLUSION

The UK government COVID-19 policy was effective at increasing stair use in a higher education setting.

The Power and Peril of Precise vs. Round Health Message Interventions to Increase Stair Use

Taking the stairs vs. an elevator generate benefits for the individual by increasing overall physical activity, health, and wellbeing. In the present paper, we report two pre-registered field intervention studies that examine how health message interventions can motivate individuals to change their behavior. We empirically contrasted opposing predictions from the literature as to whether numerically round (60.00%) or precise (61.87%) health messages are more effective in causing people to use the stairs over taking the elevator. Both interventions were compared to a control condition (no-health message). Contrary to our hypotheses and extant findings, both intervention studies did not produce a significant positive effect of the interventions relative to the control condition. In recent years such null findings have received increasingly more appreciation, particularly in the light of evident downsides of file-drawered studies. We discuss a number of moderating factors that may determine when and why nudging interventions are (in-) effective (e.g., a priori behavioral prevalence, pre-established habits, ceiling effects, and building infrastructure), as well as limitations and avenues for future research.

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.

Overstepping the boundaries of free choice: Folk beliefs on free will and determinism in real world contexts

We know little about the commonality of folk beliefs around applications of psychological research on the unconscious control of behaviours. To address this, in Experiment 1 (N = 399) participants volunteered examples of where research on the unconscious has been applied to influence their behaviours. A subset of these were presented in Experiment 2 (N = 198) and Experiment 3 (N = 100). Participants rated the extent to which the behaviour being influenced in these contexts was: (1) via the unconscious, (2) free, (3) the result of prior conscious intentions, (4) under conscious control. Relative to judgements about the extent to which behaviour was influenced via the unconscious, the remaining judgements regarding conscious control of behaviours were either higher (e.g., political contexts) or lower (e.g., therapy). This study is the first to show, using ecologically valid examples, the folk beliefs people share on psychological constructs concerning free will and determinism.

Nudging physical activity in offices

Purpose

This paper aims to investigate whether and why nudging interventions in an office environment are effective to stimulate stair use of employees.

Design/methodology/approach

This paper is based on a pre-test/post-test case study design at the headquarters of a Dutch online retailer. Observations were conducted to test the impact of two nudge interventions, being footprints and posters, on employees’ stair use in two consecutive pre-test/post-test weeks. An online survey questionnaire was used to assess employees’ overall experience with the nudging interventions after the fifth and again neutral week.

Findings

A total of 14,357 observations were recorded during five weeks. This research shows that footprints as nudging intervention significantly increase stair use of employees, and after removal, significantly decrease stair use again. Moreover, footprints were more effective than posters, of which the latter did not impact stair use significantly. Results from the survey questionnaire, completed by 46.2 per cent of the employees, showed that, in terms of degree of perception, footprints (91.4 per cent) were more noticeable than posters (46.3 per cent).

Originality/value

This paper contributes to the non-conclusive research regarding the effectiveness of nudging interventions on stair use in office environments. It clearly shows that perceptibility in combination with a positive attitude towards the nudge leads to a higher degree of initial behavioural change, yet not to a change of mind.