Promoting routine stair use: Evaluating the impact of a stair prompt across buildings

Background: Although studies have demonstrated that stair prompts are associated with increased physical activity, many were conducted in low-rise buildings over a period of weeks and did not differentiate between stair climbing and descent. Purpose: This study evaluated the impact of a prompt across different building types, and on stair climbing versus descent over several months. Methods: In 20082009, stair and elevator trips were observed and analyzed at three buildings in New York City before and after the posting of a prompt stating "Burn Calories, Not Electricity" (total observations=18,462). Sites included a three-story health clinic (observations=4987); an eight-story academic building (observations=5151); and a ten-story affordable housing site (observations=8324). Stair and elevator trips up and down were recorded separately at the health clinic to isolate the impact on climbing and descent. Follow-up was conducted at the health clinic and affordable housing site to assess long-term impact. Results: Increased stair use was seen at all sites immediately after posting of the prompt (range=9.2%34.7% relative increase, p<0.001). Relative increases in stair climbing (20.2% increase, p<0.001) and descent (4.4% increase, p<0.05) were seen at the health clinic. At both sites with long-term follow-up, relative increases were maintained at 9 months after posting compared to baseline: 42.7% (p<0.001) increase in stair use at the affordable housing site and 20.3% (p<0.001) increase in stair climbing at the health clinic. Conclusions: Findings suggest that the prompt was effective in increasing physical activity in diverse settings, and increases were maintained at 9 months.