Obesity Panacea

 Image by Randy Son of Robert.

I love simple physical activity interventions.  We all know that physical activity is a good thing, and yet it can be really difficult for people to increase their physical activity levels, especially over the long-term.  So it’s exciting whenever any intervention is shown to be effective, but even more so when it is simple.  And an intervention that is both simple and inexpensive is pure gold.  I wrote about one such intervention a few weeks ago, when I described a British study that showed that simply painting lines on a school-yard playground resulted in a dramatic increase in physical activity levels during recess.  The intervention was simple, it was inexpensive and extremely easy to implement, and yet it had an impressive positive impact.  What more could you ask for?

Earlier this week I came across a similarly simple intervention published in the Journal of Physical Activity and Health, this time focused on adults.  In this new study, Megan Grimstvedt and colleagues placed signs near the elevators of 4 university buildings in San Antonio.  The sign said simply “Walking up stairs burns almost 5 times as many calories as riding an elevator” and included an arrow directing people to the nearest staircase, as well as a cartoon of the school mascot walking up a flight of stairs.  Two of the buildings had very visible staircases, while two of the buildings had staircases that were relatively hidden.  The buildings with hidden staircases had an additional sign on the staircase door to tell people that the stairs were accessible (e.g. no fire alarm would sound). The researchers then positioned themselves in “inconspicuous” locations for 2 hours per day, Monday-Thursday, and tallied the number of people using the staircase and elevator.

So, what did they find?  Not surprisingly, hidden staircases were used far less than visible staircases at all time points.  At baseline, only 13% of people used hidden staircases, while 43% of people used visible staircases.  Even more interesting is that overall stair use increased 34% as a result of the intervention, an increase which persisted 4 weeks after the signs had been removed.  The absolute increase was similar for both the hidden and visible staircases (roughly 12 percentage points), although the relative increase was far greater for the hidden staircases, which went from being used just 13% of the time at baseline to nearly 25% 4 weeks after the intervention.
 
Based on data from Grimstvedt et al, 2010.

I think this study is really interesting for a couple reasons.  First, it confirms common sense – people don’t use staircases that are hard to find.  But it also suggests that a simple poster can have a significant impact on peoples’ decision to take take the stairs rather than the elevator, and that this impact persists for at least one month once the signs are removed.  The authors point out that this might be due to the fact that the same people (students and faculty) would be using the buildings on a regular basis, so staircase use may have been adopted into part of their normal routine (they note that previous research in shopping centres, which would have a more transient population, have shown much less persistence once signs are taken down).

Now of course increased stair use alone is not going to fix our current epidemic of physical inactivity and chronic disease.  And even after the intervention, only about 50% of all individuals chose to use the stairs (the proportion was closer to 60% when the stairs were easily visible).  But this is an intervention that would cost almost nothing, and had a noticeable and persistent impact on physical activity levels – what more could you ask for?

It’s not often that I come across a study that is so applicable to the modern workplace, and I’d encourage you to try it out in the coming weeks.  Place a sign next to your workplace elevator with an arrow pointing to the nearest staircase and see what happens.  I’m hoping to try it out where I work, and I’m curious to hear how it goes for others.  Do co-workers get upset, like when Pam put up a sign asking co-workers to clean the microwave on The Office?  Or do they appreciate the reminder? I’d love to hear what you think!


Have a great weekend,

Travis

ResearchBlogging.orgMegan E. Grimstvedt, Jacqueline Kerr, Sara B. Oswal, Donovan L. Fogt, Tiffanye M. Vargas-Tonsing, & Zenong Yin (2010). Using Signage to Promote Stair Use on a University Campus
in Hidden and Visible Stairwells Journal of Physical Activity and Health, 232-238

Comments

  1. #1 becca
    April 9, 2010

    This study is horribly flawed. Everyone knows everyone gets laziest on Friday. THAT is when you want to study willpower failure. ;-)
    (seriously, I wanna see fast food consumption as a function of day of the week)

    Our elevators all have signs that say “for your health- walk up one, down two”. I *think* they may have had an effect when I first got here; I suspect I’m acclimated to them now. You know what *does* get me to climb the stairs? Remembering people who can’t.

  2. #2 Andreas Johansson
    April 9, 2010

    Know what makes me take the stairs? Slow smelly elevators.

    (I suspect a conspiracy of public-health-minded architects.)

  3. #3 Rogue Epidemiologist
    April 9, 2010

    I’ve always been really good about taking the stairs, but sometimes, I simply cannot be arsed. We have signs near our elevators, and they have stupid, cutesy slogans on them.

    I flip the bird at the cutesy and get on the lift. grr…

    Should the study continue, they should look into what kind of signs are best for motivation … and which ones just piss us off at 5:02PM when we just wanna GTFO.

  4. #4 Jojo
    April 9, 2010

    I take the stairs all the time at work. Many people have asked me why I don’t just take the elevator. I always respond that it seems silly to take the elevator at work and then go home and hop on an exercise bike that doesn’t go anywhere. Everyone agrees that taking the steps makes sense, and some of them even start doing it.

  5. #5 Kim
    April 9, 2010

    I’ve worked in a couple of buildings with hidden or otherwise difficult staircases and it just drives me up a wall. Buildings should’ve never been designed that way.

  6. #6 Andreas Johansson
    April 9, 2010

    I’ve worked in a couple of buildings with hidden or otherwise difficult staircases and it just drives me up a wall. Buildings should’ve never been designed that way.

    When I worked as a paperboy, I had the displeasure of delivering newspapers to an office building where I could use the (slow and smelly) elevator but didn’t have the security clearance to enter the stairs!

  7. #7 speedwell
    April 9, 2010

    In the parking garage where I work, the elevator door and the stairs door are right next to each other. After major surgery, once I was able to walk without a cane, I still was not able to take the stairs. But the peer pressure, though unspoken, was incredible. A lot of people just looked at me disapprovingly as I got on the elevator and they very pointedly took the stairs. Maybe this sort of shaming is operating where the stairways are highly visible.

  8. #8 Hilary PhD
    April 9, 2010

    I routinely use stairs when I can find them. But the signage issue isn’t just about signing the way to the stairs themselves. In large complicated buildings (my work takes me to a lot of hospitals), it’s also about having signs which are visible when arriving via the stairs. On reaching a floor, I often have to work out how to get back to the lift purely in order to see signs to the various different departments on that floor.

  9. #9 Smeddley
    April 9, 2010

    I think they missed the boat with the signs – they should have pictures of construction and tell some of the stories the ex-construction workers in my engineering classes told about workmanship… It’d scare people into taking the stairs!

    I was trapped between two elevator doors (yes, I know they’re supposed to spring back open, but they didn’t!) as a kid, so I’ve had a life-long aversion to elevators. I’ve walked up 26 flights of stairs to avoid an elevator…

  10. #10 Nora
    April 9, 2010

    I use the stairs a lot but not always. Sometimes I feel like a slug for walking up only two floors, so I will ride up two or thee extra floors and then walk down as some kind of penance. I hate to arrive at a meeting sweaty and/or winded. My campus has some signs and directions and has made some effort to provide directions so you don’t get lost. However in the secure areas, the stairwells are a trap. The doors will let you into the stairwell but once you are in you can only get out on the ground floor. Or by calling security on your cellphone if you can get a signal. There aren’t even badge reader access points on most floors. I think they will install them in locations where security spends too much time liberating stuck faculty, but that’s just a guess.

  11. #11 Alan
    April 10, 2010

    I’m a big fan of the stairs as exercise, and it gives me a kick taking them. So it gave me quite a shock when I started working at an NGO based in the admin block of a public hospital here in Cape Town, South Africa, to discover that my colleagues would wait up to five minutes for the elevator, the doors of which opened onto the stairwell which would take them to their floor after two very short flights.

    Many other people working in the building behaved the same way. I rather suspect that, despite the obviousness of the stairs, a culture existed that normalised taking the elevator for short flights – even at great inconvenience. There was a lot of obesity, and colleagues would often commiserate about the difficulty of exercise in ways that were totally alien to me – like the effort of getting into and out of a chair.

    I wonder whether an official looking sign wouldn’t have put some peer pressure – since they were immune to my example (I didn’t brag about it but just consistently took the stairs for 3 years and explained why if anyone asked).

    Unfortunately, the office has now moved to a building with only two stories. There’s no elevator – good for my colleagues – but no multi-story stair use either – not so hot for me.

  12. #12 Rachael
    April 10, 2010

    I lived in a dorm building in which the stairwells were locked. You had to use the elevator to go up, even if you lived on the second floor. Because apparently unlocking the doors to the stair wells was a security risk. Even though when the elevators broke down (2-3 times a quarter) they had to unlock the doors anyways. Many of us lamented the fact that we had to use the elevators rather than taking the 3-4 flights of stairs up.

    Additionally most people in my building would have loved to take the stairs because we were all scared that the inconsistent elevators were going to get stuck, or fall while we were riding them up two floors (which happened a few times, the panic of a free falling elevator was enough to make me take stairs whenever possible).

  13. #13 Chris
    April 10, 2010

    My office is only on the third floor, and I’d love to take the stairs, but the building has the stairwell doors locked.

  14. #14 Rachelle
    April 11, 2010

    When I was a little girl, my landlady was sexually assaulted and beaten in the staircase of our building, and I’ve been afraid of stairs ever since. The stairs in both my apartment building and office building are very isolated, and I don’t believe anyone would hear if I called out for help. It would be great if they could be well-lit, less soundproof, and full of other people!

  15. #15 Travis Saunders
    April 11, 2010

    I really like this blog.

    Stairwell design in commercial and residential buildings is primarily a safety response as a nonmechanical exit path for occupants (mechanized lift failure) and entry passage for emergency response personnel.

    I have worked in buildings that had stairwell access doors set to deploy fire alarms when opened. Majorly PO’ed management and firemen if you ignored the signs and mistakenly used the stairwell to speed your travels around the office.

    In some government buildings, for security reasons after 9/11 each floor’s access door was locked out from the inside of the stairwell, meaning one is headed on a one-way path down to the ground floor or second floor exits, which had doors that are locked out on the floor side to prevent unwanted street entry.

    These stairwells are not suitable for squeezing in extra bit of exercise obviously. Thankfully, they appear to be in the minority of commercial building stairwells.

    In several government agency and more than a few university research facilities I’ve worked in, we were thankful for ready access to stairwells because the lifts had chronic maintenance problems. These hazards frequently entrapped unlucky riders (resulting in adrenaline-rush yelling, pounding on doors and audible swearing) between floors or refused to stop at designated floors. One learned to read the symptoms by the number of times we heard emergency bells going off or prolong periods of inactivity. Eleven flights of stairs wasn’t a major deterrent if you feared being marooned for hours in the lifts.

    At one state university, the elevators would mysteriously respond to commands to move from one floor to another in the wee hours of the night in 5-story building, without visible occupant intervention…at least, not human. The building was chockablock with very large cockroaches not endemic to the US, most likely escapees from a long-ago research project.

  16. #16 Passerby
    April 11, 2010

    I really like this blog.

    Stairwell design in commercial and residential buildings is primarily a safety response as a nonmechanical exit path for occupants (mechanized lift failure) and entry passage for emergency response personnel.

    I have worked in buildings that had stairwell access doors set to deploy fire alarms when opened. Majorly PO’ed management and firemen if you ignored the signs and mistakenly used the stairwell to speed your travels around the office.

    In some government buildings, for security reasons after 9/11 each floor’s access door was locked out from the inside of the stairwell, meaning one is headed on a one-way path down to the ground floor or second floor exits, which had doors that are locked out on the floor side to prevent unwanted street entry.

    These stairwells are not suitable for squeezing in extra bit of exercise obviously. Thankfully, they appear to be in the minority of commercial building stairwells.

    In several government agency and more than a few university research facilities I’ve worked in, we were thankful for ready access to stairwells because the lifts had chronic maintenance problems. These hazards frequently entrapped unlucky riders (resulting in adrenaline-rush yelling, pounding on doors and audible swearing) between floors or refused to stop at designated floors. One learned to read the symptoms by the number of times we heard emergency bells going off or prolong periods of inactivity. Eleven flights of stairs wasn’t a major deterrent if you feared being marooned for hours in the lifts.

    At one state university, the elevators would mysteriously respond to commands to move from one floor to another in the wee hours of the night in 5-story building, without visible occupant intervention…at least, not human. The building was chockablock with very large cockroaches not endemic to the US, most likely escapees from a long-ago research project.

  17. #17 Chris W.
    April 11, 2010

    I used to work in a 7-story office building where you could only use the stairway if you requested a key for it from the building management. I knew someone who had done so and he said they were pretty nice about it, so I requested one too when I was working on the 4th floor. (Actually the 5th, as the building had a Mezzanine level between the first and second floors.)

    Later we moved to another building for 5 years, and then came back to that building, but we were on the 7th floor now so I didn’t request a key again. (I had turned in the key when we moved to a different building.) Five flights of stairs had been hard enough to go up, so I didn’t feel up to three more.

  18. #18 Frank Timis
    April 12, 2010

    felt guilty, took the lift downstairs today(2nd office floor), but I made it up after lunch and took the stairs, will avoid lift and make more “cigarette” brakes (i dont smoke) just to have one or two climbs more a day

  19. #19 monado
    April 12, 2010

    Combine this with piano stairs in the subway, which play notes when you step on them, and people will be using even more calories.

    Other interventions: workplace consciousness. At one place where I worked, there was a small but growing group who ate lunch quickly, then climbed up and down the stairs in the building, keeping track of how many flights they climbed and improvements.

  20. #20 bananacat
    April 13, 2010

    I prefer to take the stairs at work because it’s usually just faster. However, the stairwells are not heated in the winter and they are never cleaned, and I end up taking the elevator more often than I would otherwise because of this.

    I would suggest intentionally making elevators slow or inconvenient, but that’s not really fair to people who really need to use them. I can fully support making staircases more appealing though.

  21. #21 Sue
    April 13, 2010

    To make stairwells more appealing, they could play only “good” music in them, while the elevator just has a loop of “Raindrops Keep Fallin’ On My Head”.

  22. #22 Alexander Rose
    April 19, 2010

    At my work the staircase is hidden around the side of the building, whilst the elevator is at the main reception. In my experience not many people at all use the stairs. I personally do as it is a great way to stress your body on a daily basis. Bringing attention to the location of the stairs is a great idea though.

  23. #23 hoary puccoon
    April 27, 2010

    I’m a little late on the comments, but please, if you’re going to push for stair climbing as exercise, also push for non-skid treads and adequate handrails. I have hemiplegic cerebral palsy, and stair climbing is exactly the kind of exercise that’s right for me– noncompetitive and not requiring much coordination. But I sometimes end up taking the elevator because there’s nothing to hold onto going downstairs.

  24. #24 Carlie
    April 27, 2010

    Definitely the design of the stairwell has a lot to do with it. I’ve been in some dark, scary stairwells, I’ve been in some where you don’t realize until you’re in it that the doors are locked from the other side (so the only option is all the way downstairs to exit the building), I’ve spent up to 10 minutes searching on a small floor just to find the stairwell. More often than not I’ve given up and taken the elevator even a single floor simply because it was so difficult to find and use the stairs.

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