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August 2001, Vol 91, No. 8 | American Journal of Public Health 1192-1193
© 2001 American Public Health Association

RESEARCH

Encouraging Stair Use: Stair-Riser Banners Are Better Than Posters

Jacqueline Kerr, PhD, Frank Eves, PhD and Douglas Carroll, PhD

At the time of the study Jacqueline Kerr was, and Frank Eves and Douglas Carroll are, with the School of Sport and Exercise Sciences, University of Birmingham, Birmingham, England.

Correspondence: Requests for reprints should be sent to Frank Eves, PhD, School of Sport and Exercise Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom (e-mail: f.f.eves{at}bham.ac.uk).


   INTRODUCTION
TOP
 INTRODUCTION
References
 
Increasing physical activity levels among a largely sedentary public is a health priority.1 Lifestyle exercise, such as walking or stair climbing, has been recommended because it provides substantial health benefits and fits easily into daily routines.2 Opportunities for stair climbing in workplaces, public buildings, and the home are frequently available to most population groups.

Studies conducted in both the United States and the United Kingdom have shown that posters at the "point of choice" between escalators and stairs can increase stair use.3–6 As a result, physical activity promoters have championed the use of such posters.

In a recent study, however, messages placed as banners on alternate stair risers were associated with a greater increase in shoppers' stair use than that typically observed with posters.7 To confirm the superiority of these banners in promoting stair climbing, we systematically compared the use of poster prompts and stair-riser banners.

The study was conducted at 2 shopping malls; both sites had 28-step staircases with adjacent escalators. Following a coding system,3 an observer recorded the number of people using the escalators and stairs on alternate days at each location. Observations were made between 11 AM and 1 PM to include day and lunchtime shoppers.

At the control site, a 2-week baseline period was followed by 4 weeks during which a poster that read "Stay healthy, use the stairs" was displayed. Use of this poster had been found to be effective in previous research.3 At the experimental site, 2 weeks of baseline observation and 2 weeks of the poster intervention were followed by 2 weeks during which banners, containing mulitple messages, were placed on the stair risers, as in our earlier study.7

Logistic regression analyses were conducted with escalator–stair use as the dichotomous outcome variable. Overall pedestrian traffic volume, a potential confounding variable,3 was calculated as the total number of people using the escalators and stairs during each half-hour period. Traffic volume was entered into the logistic regression models as a continuous variable. Sex, age, and ethnicity were also added to the models, in that previous research had demonstrated their importance.3–6

Figure 1Go illustrates the effects of the poster and banner conditions in the 2 shopping malls. At the control site (n = 12 018), the rate of stair use increased from 2.2% at baseline to 4.8% during the first 2 weeks of the poster exposure but fell slightly to 4.1% during the second 2 weeks. At the experimental site (n = 11 961), stair use increased from 2.4% at baseline to 4.0% when the poster was in place and rose to 6.7% when the banners were displayed on the stair risers.



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  		FIGURE 1—— Stair use at baseline in poster and banner conditions in the control and experimental shopping malls.

 
Logistic regression analyses revealed that stair use increased at both sites during the first 2 weeks in which the poster was displayed (odds ratio [OR] = 2.18, 95% confidence interval [CI] = 1.69, 2.80), with no significant differences between the sites. During the second intervention period, there was an interaction between the sites (OR = 2.06, 95% CI = 1.48, 2.87) such that rates of stair use were higher with the banners at the experimental site than with the poster at the control site.

There are several reasons why the banners were more effective than the poster in encouraging stair use. First, the banners were highly visible. In our earlier studies, 76% of interviewees reported seeing these banners,7 whereas only a third reported noticing the poster used.8 Second, while the poster included only one health-related message, the banners contained multiple messages, such as "Keep fit," "Be active," and "Free exercise." As such, they are likely to appeal to a broader population range.9

Regular stair climbing has been associated with discernible health gains.10 Accordingly, if large population groups are regularly exposed to motivating stair banners instead of the posters currently used by health promoters, the public health dividends could be considerable.


   Footnotes
 
J. Kerr organized the study, collected and analyzed the data, and wrote the paper. F. Eves and D. Carroll assisted with the study design, supervised data analysis, and contributed to the writing of the paper.

Peer Reviewed

Accepted for publication January 10, 2001.


   References
TOP
 INTRODUCTION
 References
 
1. Physical Activity and Health: A Report of the Surgeon General. Atlanta, Ga: Centers for Disease Control and Prevention; 1996.

2. Dunn AL, Andersen RE, Jakicic JM. Lifestyle physical activity interventions: history, short- and long-term effects, and recommendations. Am J Prev Med.1998;15:398–412.[Medline]

3. Kerr J, Eves FF, Carroll D. The influence of poster prompts on stair use: the effects of setting, poster size and content. Br J Health Psychol. In press.

4. Andersen RE, Franckowiak SC, Snyder J, et al. Can inexpensive signs encourage the use of stairs? Results from a community intervention. Ann Intern Med.1998;129:363–369.[Abstract/Free Full Text]

5. Blamey A, Mutrie N, Aitchison T. Promoting active living: a step in the right direction. J Institute Health Educ.1996;34:5–9.

6. Brownell KD, Stunkard AJ, Albaum JM. Evaluation and modification of exercise patterns in the natural environment. Am J Psychiatry.1980;137:1540–1545.[Abstract/Free Full Text]

7. Kerr J, Eves FF, Carroll D. Getting more people on the stairs: the impact of a new message format. J Health Psychol. In press.

8. Kerr J, Eves FF, Carroll D. Posters can prompt less active individuals to use stairs. J Epidemiol Community Health. 2000;54:942–943.[Free Full Text]

9. Kreuter MW, Strecher VJ, Glassman MAT. One size does not fit all: the case for tailoring print materials. Ann Behav Med.1999;21:276–283.[Medline]

10. Boreham CAG, Wallace WFM, Nevill A. Training effects of accumulated daily stair-climbing exercise in previously sedentary young women. Prev Med.2000;30:277–281.[Medline]




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