Is there any Proffitt in stair climbing? A headcount of studies testing for demographic differences in choice of stairs

Developing habit-based health behaviour change interventions: twenty-one questions to guide future research

OBJECTIVE

Habitual behaviours are triggered automatically, with little conscious forethought. Theory suggests that making healthy behaviours habitual, and breaking the habits that underpin many ingrained unhealthy behaviours, promotes long-term behaviour change. This has prompted interest in incorporating habit formation and disruption strategies into behaviour change interventions. Yet, notable research gaps limit understanding of how to harness habit to change real-world behaviours.

METHODS

Discussions among health psychology researchers and practitioners, at the 2019 European Health Psychology Society 'Synergy Expert Meeting', generated pertinent questions to guide further research into habit and health behaviour.

RESULTS

In line with the four topics discussed at the meeting, 21 questions were identified, concerning: how habit manifests in health behaviour (3 questions); how to form healthy habits (5 questions); how to break unhealthy habits (4 questions); and how to develop and evaluate habit-based behaviour change interventions (9 questions).

CONCLUSIONS

While our questions transcend research contexts, accumulating knowledge across studies of specific health behaviours, settings, and populations will build a broader understanding of habit change principles and how they may be embedded into interventions. We encourage researchers and practitioners to prioritise these questions, to further theory and evidence around how to create long-lasting health behaviour change.

Interrupting Pedestrians in Indonesia; Effect of Climate on Perceived Steepness and Stair Climbing Behaviour

Increased activity during daily life is one public health initiative to reduce population inactivity. Increasing temperature and humidity influence walking for transport by reducing the blood supply available to exercising muscles. This study investigated effects of temperature and humidity on a perceptual cue, estimated stair slant, that can influence behaviour, and on subsequent speed of climbing. Participants (402 males, 423 females) estimated the slant of a 20.4° staircase at a university in Indonesia. Subsequently, the participants were timed covertly while climbing. As temperature and humidity increased, estimated stair slant became more exaggerated. Females estimated stair slant as steeper than males. For stair climbing, speed was reduced as temperature increased, and females climbed slower than males. Estimates of stair slant were not associated with speed of the subsequent climb. Climate influences estimates of stair slant that precede stair climbing and subsequent speed of the ascent. In this study, perception was unrelated to behaviour.

Psychological Aspects of Stair Use: A Systematic Review

Stair use, a common lifestyle activity, is a moderate-to-vigorous physical activity that, despite often being brief in duration, may contribute to psychological health. A systematic literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) method to summarize psychological aspects related to stair use. Included studies examined at least 1 psychological outcome in relation to either objective measures of stair use, such as time or stair height, or subjective measures of, or measures related to, stair use such as perceived difficulty using stairs. A total of 22 studies met the inclusion criteria; 12 used subjective stair use measures and 10 used objective stair use measures. The limited evidence from studies using self-reports supported that (1) perceived difficulty using stairs was positively associated with increased symptoms of anxiety and depression and (2) stair use was not associated with a reduced incidence of mental illnesses such as depression, suicide, or dementia. Studies using objective measures of stair use supported that (3) elevated symptoms of anxiety and depression are negatively associated with stair use performance. Given the widespread use of stairs, there is surprisingly little data about the extent to which, and for whom, stair use influences psychological health.

Daily stair climbing is associated with decreased risk for the metabolic syndrome

BACKGROUND

Stair climbing can be a vigorous lifestyle physical activity, and is associated with healthier lipoprotein profiles, lower body weight and blood pressure, as well as higher aerobic fitness. The present analysis of data from a cohort of late middle-aged men and women examined the association between daily stair climbing and the metabolic syndrome.

METHODS

Data from 782 (423 women) participants (mean (SD) age 58.3 (0.95) years in the Dutch Famine Birth Cohort Study (2002-2004) were used to examine the cross-sectional association between self-reported daily stair climbing and the metabolic syndrome. Stair climbing was assessed by the question 'Do you climb stairs daily?' and the metabolic syndrome was defined using the established five components relating to lipid fractions, blood glucose levels, blood pressure and abdominal obesity.

RESULTS

Not climbing stairs daily was associated with an increased incidence of the metabolic syndrome (OR = 1.90, 95% CI = 1.23, 2.92, p = 0.004) and a greater number of its components (F_1,780 = 8.48, p = 0.004): these associations were still evident after adjusting for a variety of potential confounders.

CONCLUSIONS

The most likely explanation for the current findings is that daily stair climbing may be protective against the metabolic syndrome. This result reinforces public health recommendations for increased stair climbing with evidence from physiological outcomes.

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.

Learnt effects of environmental cues on transport-related walking; disrupting habits with health promotion?

Background

In Ecological models, physical environments can be important determinants of transport-related walking. With repeated exposure to the same environment, learning of a linkage between the cues in the environment and walking should occur. Subsequent encounters with the cues can prompt the behaviour relatively automatically. No studies have experimentally tested the potential learning of this linkage between cues and behaviour. Choices between stairs and escalators in public access settings were employed to test this premise for transport-related walking.

Methods

Three studies investigated the effects of visual cues on stair/escalator choices (combined n = 115,062). In quasi-experimental, interrupted time-series designs, observers audited choices in public access settings. Design alone phases with art or coloured backgrounds were compared with design plus message phases in which verbal health promotion messages were superimposed on the visual cues. Analyses used bootstrapped logistic regression.

Results

In initial studies, the design alone phases had no effect whereas subsequent design plus message phases reduced escalator choice. In two further studies, a 5–6 week design plus message phase that reduced escalator choice preceded a design alone phase. The visual background behind the successful health promotion message was reintroduced four weeks after the intervention was removed. The visual cue of design alone reduced escalator choice after it had been paired with the verbal health promotion message. There were no differences between art and coloured backgrounds.

Conclusion

These studies demonstrate for the first time a learnt linkage between transport-related walking and environmental cues. Discussion focuses on the mechanisms that may underlie this learning and cues in the environment that are relevant to transport-related walking.

Social and Contextual Constraints on Embodied Perception

A number of papers have challenged research on physiological and psychological influences on perception by claiming to show that such findings can be explained by nonperceptual factors such as demand characteristics. Relatedly, calls for separating perception from judgment have been issued. However, such efforts fail to consider key processes known to shape judgment processes: people's inability to report accurately on their judgments, conversational dynamics of experimental research contexts, and misattribution and discounting processes. Indeed, the fact that initially observed effects of embodied influences disappear is predicted by an extensive amount of literature on judgments studied within social psychology. Thus, findings from such studies suggest that the initially presumed underlying processes are at work-namely, functional considerations that are informative in the context of preparing the body for action. In this article, I provide suggestions on how to conduct research on perception within the social constraints of experimental contexts.

The Relative Nature of Perception: A Response to Cañal-Bruland and van der Kamp (2015)

Cañal-Bruland and van der Kamp present an argument about the incommensurate relationship between affordance perception and spatial perception in a criticism of Proffitt and Linkenauger’s phenotypic approach to perception. Many of their criticisms are based on a difference in the interpretation of the core ideas underlying the phenotypic approach. The most important of these differences in interpretations concern fundamental assumptions about the nature of the perceptions of size and distance themselves. Extent perception must be relative to the organism; therefore, there can be no veridical perception of space. Also, we argue in the phenotypic approach that space perception is an emergent property of affordance perception; they are not different types of perceptions as Cañal-Bruland and van der Kamp presume. Third, affordance perception need not be perfectly accurate, just good enough. Additionally, affordance perception need not be dichotomous; this presumption likely originates in the methodology typically employed to study affordance perception. Finally, I agree with Cañal-Bruland and van der Kamp that joint research efforts will clarify and improve our understanding of these issues.

Mirror, Mirror by the Stairs: The Impact of Mirror Exposure on Stair versus Elevator Use in College Students

Previous research has indicated that self-awareness-inducing mirrors can successfully incite behaviors that align with one's personal values, such as helping others. Other research has found a large discrepancy between the high percentage of young adults who report valuing the healthfulness of physical activity (PA) and the low percentage who actually meet PA participation standards. However, few studies have examined how mirror exposure and both perceived and actual body size influence highly valued PA participation among college students. The present study assessed stair versus elevator use on a western college campus and hypothesized that mirror exposure would increase the more personally healthy transportation method of stair use. In accordance with previous research, it was also hypothesized that males and those with a lower body mass index (BMI) would be more likely to take the stairs, and that body size distorting mirrors would impact the stair-elevator decision. One hundred sixty-seven students (51% male) enrolled in an introductory psychology course were recruited to take a survey about their "transportation choices" at an indoor campus parking garage. Participants were individually exposed to either no mirror, a standard full-length mirror, or a full-length mirror manipulated to make the reflected body size appear either slightly thinner or slightly wider than normal before being asked to go to the fourth floor of the garage for a survey. Participants' choice of floor-climbing method (stairs or elevator) was recorded, and they were administered an Internet-based survey assessing demographic information, BMI, self-awareness, perceived body size, and other variables likely to be associated with stair use. Results from logistic regression analyses revealed that participants who were not exposed to a mirror [odds ratios (OR) = 0.37, 95% CI: 0.14-0.96], males (OR = 0.33, 95% CI: 0.13-0.85), those with lower BMI (OR = 0.84, 95% CI: 0.71-0.99), those with higher exercise participation (OR = 1.09, 95% CI: 1.02-1.18), and those engaging in more unhealthy weight-control behaviors (OR = 1.55, 95% CI: 1.14-2.11) showed increased odds of taking the stairs. Implications and future directions are discussed.

Does perceived steepness deter stair climbing when an alternative is available?

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.

Summarizing slant perception with words and hands; an empirical alternative to correlations in Shaffer, McManama, Swank, Williams & Durgin (2014)

The paper by Shaffer, McManama, Swank, Williams & Durgin (2014) uses correlations between palm-board and verbal estimates of geographical slant to argue against dissociation of the two measures. This paper reports the correlations between the verbal, visual and palm-board measures of geographical slant used by Proffitt and co-workers as a counterpoint to the analyses presented by Shaffer and colleagues. The data are for slant perception of staircases in a station (N=269), a shopping mall (N=229) and a civic square (N=109). In all three studies, modest correlations between the palm-board matches and the verbal reports were obtained. Multiple-regression analyses of potential contributors to verbal reports, however, indicated no unique association between verbal and palm-board measures. Data from three further studies (combined N=528) also show no evidence of any relationship. Shared method variance between visual and palm-board matches could account for the modest association between palm-boards and verbal reports.

The Unburdening Effects of Forgiveness

Research shows that in the aftermath of conflict, forgiveness improves victims’ well-being and the victim–offender relationship. Building on the research on embodied perception and economy of action, we demonstrate that forgiveness also has implications for victims’ perceptions and behavior in the physical domain. Metaphorically, unforgiveness is a burden that can be lightened by forgiveness; we show that people induced to feel forgiveness perceive hills to be less steep (Study 1) and jump higher in an ostensible fitness test (Study 2) than people who are induced to feel unforgiveness. These findings suggest that forgiveness may lighten the physical burden of unforgiveness, providing evidence that forgiveness can help victims overcome the negative effects of conflict.