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      Signage Interventions for Stair Climbing at Work: More than 700,000 Reasons for Caution

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          Abstract

          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.

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          Most cited references38

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          Economic analysis of physical activity interventions.

          Numerous interventions have been shown to increase physical activity but have not been ranked by effectiveness or cost. This study provides a systematic review of physical activity interventions and calculates their cost-effectiveness ratios. A systematic literature review was conducted (5579 articles) and 91 effective interventions promoting physical activity were identified, with enough information to translate effects into MET-hours gained. Cost-effectiveness ratios were then calculated as cost per MET-hour gained per day per individual reached. Physical activity benefits were compared to U.S. guideline-recommended levels (1.5 MET-hours per day for adults and 3.0 MET-hours per day for children, equivalent to walking 30 and 60 minutes, respectively). The most cost-effective strategies were for point-of-decision prompts (e.g., signs to prompt stair use), with a median cost of $0.07/MET-hour/day/person; these strategies had tiny effects, adding only 0.2% of minimum recommended physical activity levels. School-based physical activity interventions targeting children and adolescents ranked well with a median of $0.42/MET-hour/day/person, generating an average of 16% of recommended physical activity. Although there were few interventions in the categories of "creation or enhanced access to places for physical activity" and "community campaigns," several were cost effective. The least cost-effective categories were the high-intensity "individually adapted behavior change" and "social support" programs, with median cost-effectiveness ratios of $0.84 and $1.16 per MET-hour/day/person. However, they also had the largest effect sizes, adding 35%-43% of recommended physical activity, respectively. Study quality was variable, with many relying on self-reported outcomes. The cost effectiveness, effect size, and study quality should all be considered when choosing physical activity interventions. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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            Training effects of short bouts of stair climbing on cardiorespiratory fitness, blood lipids, and homocysteine in sedentary young women.

            To study the training effects of eight weeks of stair climbing on Vo2max, blood lipids, and homocysteine in sedentary, but otherwise healthy young women. Fifteen women (mean (SD) age 18.8 (0.7) years) were randomly assigned to control (n = 7) or stair climbing (n = 8) groups. Stair climbing was progressively increased from one ascent a day in week 1 to five ascents a day in weeks 7 and 8. Training took place five days a week on a public access staircase (199 steps), at a stepping rate of 90 steps a minute. Each ascent took about two minutes to complete. Subjects agreed not to change their diet or lifestyle over the experimental period. Relative to controls, the stair climbing group displayed a 17.1% increase in Vo2max and a 7.7% reduction in low density lipoprotein cholesterol (p < 0.05) over the training period. No change occurred in total cholesterol, high density lipoprotein cholesterol, triglycerides, or homocysteine. The study confirms that accumulating short bouts of stair climbing activity throughout the day can favourably alter important cardiovascular risk factors in previously sedentary young women. Such exercise may be easily incorporated into the working day and therefore should be promoted by public health guidelines.
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              Heart rate, oxygen uptake, and energy cost of ascending and descending the stairs.

              This study describes the heart rate and oxygen uptake responses during, and the intensity and caloric cost of, ascending and descending a public-access staircase. Subjects were initially assessed for their maximum oxygen uptake and heart rate on a treadmill in the laboratory. For field measurements, subjects ascended (N = 103) and descended (N = 49) 11 stories of 180 steps, each step of 15 cm in height, for a total vertical displacement of 27.0 m. The mean oxygen uptake and heart rate during the last 30 s of ascending were 33.5 +/- 4.8 mL.kg(-1).min(-1) and 159 +/- 15 beats.min(-1), respectively. During the descent, oxygen uptake and heart rate during the last 30 s of the climb were 17.0 +/- 3.8 mL.kg(-1).min(-1) and 107 +/- 18 beats.min(-1), respectively. The estimated gross energy expended during ascending and descending were 19.7 and 9.0 kcal, or equivalent to an intensity of 9.6 and 4.9 metabolic equivalents (METs), respectively (or 10.2 and 5.2 kcal.min(-1), respectively). The caloric cost of stepping up and down a step was calculated to be 0.11 and 0.05 kcal, respectively. Stair-climbing exercise using a local public-access staircase met the minimum requirements for cardiorespiratory benefits and can therefore be considered a viable exercise for most people and suitable for promotion of physical activity.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                08 October 2019
                October 2019
                : 16
                : 19
                : 3782
                Affiliations
                [1 ]Departament de Ciències de l’Activitat Física, Centre d’Estudis Sanitaris i Socials, Universitat de Vic-Universitat Central de Catalunya, 08500 Barcelona, Vic, Spain
                [2 ]School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
                [3 ]Agència de Salut Pública de Catalunya, 08023 Barcelona, Spain
                [4 ]Department of General Practice, University of Birmingham, Birmingham B15 2TT, UK
                [5 ]Departament de Salut i Acció Social, Universitat de Vic-Universitat Central de Catalunya, 08500 Barcelona, Vic, Spain
                Author notes
                [* ]Correspondence: evesff@ 123456bham.ac.uk
                Author information
                https://orcid.org/0000-0002-4921-7169
                Article
                ijerph-16-03782
                10.3390/ijerph16193782
                6801962
                31597383
                80084653-b205-4733-a26e-9eb9ae6da9b4
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 12 September 2019
                : 02 October 2019
                Categories
                Article

                Public health
                stair climbing,stair descent,point-of-choice prompts,workplace,pedestrian movement,lifestyle physical activity

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