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      A multistage controlled intervention to increase stair climbing at work: effectiveness and process evaluation

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          Abstract

          Background

          Stair climbing helps to accumulate short bouts of physical activity throughout the day as a strategy for attaining recommended physical activity levels. There exists a need for effective long-term stair-climbing interventions that can be transferred to various worksite settings. The aims of this study were: 1) to evaluate short- and long-term effectiveness of a worksite stair-climbing intervention using an objective measurement of stair climbing and a controlled design; and 2) to perform a process evaluation of the intervention.

          Methods

          We performed a controlled before-and-after study. The study was conducted in two corporate buildings of the same company located in Paris (France), between September, 2013 and September, 2014. The status of either “intervention site” or “control site” was assigned by the investigators. Participants were on-site employees (intervention site: n = 783; control site: n = 545 at baseline). Two one-month intervention phases using signs (intervention phase 1) and enhancement of stairwell aesthetics (intervention phase 2) were performed. The main outcome was the change in stair climbing, measured with automatic counters and expressed in absolute counts/day/100 employees and percent change compared to baseline. Qualitative outcomes were used to describe the intervention process.

          Results

          Stair climbing significantly increased at the intervention site (+18.7 %) but decreased at the control site (-13.3 %) during the second intervention phase (difference between sites: +4.6 counts/day/100 employees, p < 0.001). After the intervention and over the long term, stair climbing returned to baseline levels at the intervention site, but a significant difference between sites was found (intervention site vs. control site: +2.9 counts/day/100 employees, p < 0.05). Some important facets of the intervention were implemented as intended but other aspects had to be adapted. The main difficulty reported by the company’s staff members lay in matching the internal communications rules with critical intervention criteria. The program was maintained at the setting level after the end of the study.

          Conclusions

          This study shows a successful stair-climbing intervention at the worksite. The main barriers to adoption and implementation were related to location and visibility of posters. Process evaluation was useful in identifying these barriers throughout the study, and in finding appropriate solutions.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12966-016-0371-0) contains supplementary material, which is available to authorized users.

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          Most cited references28

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          Global health risks: mortality and burden of disease attributable to selected major risks

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            Point-of-decision prompts to increase stair use. A systematic review update.

            In 2000, the Guide to Community Preventive Services (Community Guide) completed a systematic review of the effectiveness of various approaches to increasing physical activity including informational, behavioral and social, and environmental and policy approaches. Among these approaches was the use of signs placed by elevators and escalators to encourage stair use. This approach was found to be effective based on sufficient evidence. Over the past 5 years the body of evidence of this intervention has increased substantially, warranting an updated review. This update was conducted on 16 peer-reviewed studies (including the six studies in the previous systematic review), which met specified quality criteria and included evaluation outcomes of interest. These studies evaluated two interventions: point-of-decision prompts to increase stair use and enhancements to stairs or stairwells (e.g., painting walls, laying carpet, adding artwork, playing music) when combined with point-of-decision prompts to increase stair use. This latter intervention was not included in the original systematic review. According to the Community Guide rules of evidence, there is strong evidence that point-of-decision prompts are effective in increasing the use of stairs. There is insufficient evidence, due to an inadequate number of studies, to determine whether or not enhancements to stairs or stairwells are an effective addition to point-of-decision prompts. This article describes the rationale for these systematic reviews, along with information about the review process and the resulting conclusions. Additional information about applicability, other effects, and barriers to implementation is also provided. Published by Elsevier Inc.
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              Public health strategies for preventing and controlling overweight and obesity in school and worksite settings: a report on recommendations of the Task Force on Community Preventive Services.

              Reducing morbidity and mortality related to overweight and obesity is a public health priority. Various interventions in school and worksite settings aim to maintain or achieve healthy weight. To identify effective strategies for weight control that can be implemented in these settings, the Task Force on Community Preventive Services (Task Force) has conducted systematic reviews of the evidence on nutrition, physical activity, combinations of these interventions, and other behavioral interventions (e.g., cognitive techniques such as self-awareness and cue recognition). Task Force recommendations are based on evidence of effectiveness, which is defined in this report as achieving a mean weight loss of > or =4 pounds, measured > or =6 months after initiation of the intervention program. The Task Force recommends multicomponent interventions that include nutrition and physical activity (including strategies such as providing nutrition education or dietary prescription, physical activity prescription or group activity, and behavioral skills development and training) to control overweight and obesity among adults in worksite settings. The Task Force determined that insufficient evidence existed to determine the effectiveness of combination nutrition and physical activity interventions to prevent or reduce overweight and obesity in school settings because of the limited number of qualifying studies reporting noncomparable outcomes. This report describes the methods used in these systematic reviews; provides additional information regarding these recommendations; and cites sources for full reviews containing details regarding applicability, other benefits and harms, barriers to implementation, research gaps, and economic data (when available) regarding interventions.
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                Author and article information

                Contributors
                alicebellicha@gmail.com
                akieusseian@yahoo.fr
                anne-marie.fontvieille@sanofi.com
                antonio.tataranni@sanofi.com
                nanecopin@yahoo.co.uk
                helene.charreire@u-pec.fr
                jean-michel.oppert@aphp.fr
                Journal
                Int J Behav Nutr Phys Act
                Int J Behav Nutr Phys Act
                The International Journal of Behavioral Nutrition and Physical Activity
                BioMed Central (London )
                1479-5868
                11 April 2016
                11 April 2016
                2016
                : 13
                : 47
                Affiliations
                [ ]Institute of Cardiometabolism and Nutrition (ICAN), University Pierre et Marie Curie-Paris 6, Paris, France
                [ ]Sanofi, 54 rue La Boetie, Paris, 75008 France
                [ ]Department of Geography, Lab-Urba, Urbanism Institute of Paris, University Paris-Est, Creteil, France
                [ ]Department of Nutrition, Pitie-Salpetriere University Hospital (AP-HP) University Pierre et Marie Curie-Paris 6, Center for Research on Human Nutrition Ile-de-France (CRNH IdF), Paris, France
                Article
                371
                10.1186/s12966-016-0371-0
                4827230
                27067670
                af343753-700e-4e03-9826-fa345541af96
                © Bellicha et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 10 November 2015
                : 4 April 2016
                Funding
                Funded by: ICAN - Institute of cardiometabolism and nutrition, Paris, France
                Award ID: Translational Research Programme
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2016

                Nutrition & Dietetics
                Nutrition & Dietetics

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