Prompting Increases in Stair Climbing at Work to Target Weight Control
Lead Research Organisation:
University of Birmingham
Department Name: Sport, Exercise & Rehabilitation Science
Abstract
Obesity is a major problem facing society, with increased exercise on approach to the issue. In the UK, only 40% of men and 28% of women meet the minimum amount of exercise suggested by the Chief Medical Officer. One simple answer to this problem may be increased stair climbing at work. Few people think of stair climbing as exercise but it actually burns more calories per minute than jogging. Increased stair climbing can reduce both the risks of heart disease and weight. Most adults spend half their waking life at work and regular stair climbing could help combat the rise in obesity.
Recent research by the team has produced a 50% increase in stair climbing in one workplace, a major advance as the previous best was a 5% increase. Instead of simply encouraging people to stay healthy, we converted the science behind stair climbing into lay terms. For example, an average man going upstairs in his house an extra ten times every day for a year expends energy equivalent to three pounds of fat. We place signs at the choice point between stairs and lifts outlining the benefits that stair climbing brings. Two recent studies by the team have produced greater increases in stair climbing in overweight individuals. This project will explore the best way to promote stair climbing. First, we will compare the merits of different types of messages. For this, we will interview people at their place of work and then test the different messages in workplaces. Second we will investigate new ways of delivering this message so that people continue to respond to it. Typically people get used to health advice and the messages lose their impact. The project will test whether changing the message regularly can reverse any decline in response. All the studies set out to encourage working people to be more active.
Recent estimates put the annual cost of obesity in England at about #4.2 billion to the NHS and weight problems at around #16 billion to the overall economy. Obesity is bad for our health and the nation?s wealth. When rolled out nationally, the cost of stair climbing campaigns for a five storey workplace would be about #25, which equates to 5p an employee for a workforce of 500. This cost-effective approach to exercise promotion could make a significant difference to rising levels of obesity and its associated health problems.
Recent research by the team has produced a 50% increase in stair climbing in one workplace, a major advance as the previous best was a 5% increase. Instead of simply encouraging people to stay healthy, we converted the science behind stair climbing into lay terms. For example, an average man going upstairs in his house an extra ten times every day for a year expends energy equivalent to three pounds of fat. We place signs at the choice point between stairs and lifts outlining the benefits that stair climbing brings. Two recent studies by the team have produced greater increases in stair climbing in overweight individuals. This project will explore the best way to promote stair climbing. First, we will compare the merits of different types of messages. For this, we will interview people at their place of work and then test the different messages in workplaces. Second we will investigate new ways of delivering this message so that people continue to respond to it. Typically people get used to health advice and the messages lose their impact. The project will test whether changing the message regularly can reverse any decline in response. All the studies set out to encourage working people to be more active.
Recent estimates put the annual cost of obesity in England at about #4.2 billion to the NHS and weight problems at around #16 billion to the overall economy. Obesity is bad for our health and the nation?s wealth. When rolled out nationally, the cost of stair climbing campaigns for a five storey workplace would be about #25, which equates to 5p an employee for a workforce of 500. This cost-effective approach to exercise promotion could make a significant difference to rising levels of obesity and its associated health problems.
Technical Summary
The seminal Harvard Alumni study demonstrated dose-response effects of stair climbing on health, observations subsequently supported by experimental work. Increased stair climbing at work can reduce both cardiovascular risk and weight. To increase stair climbing, messages are positioned at the point-of-choice between the stairs and lift, outlining the health benefits. These prompts function by interrupting habitual behaviour at the point of occurrence allowing its replacement with a health enhancing alternative. Two recently completed interventions recast the science behind stair climbing in lay terms. For the first time, the messages specified the amount of stair climbing required to achieve the benefits. Further, the main campaign message was reinforced by additional messages in the stairwell. This approach produced greater effects in overweight individuals, a finding recently confirmed in a metro station. Stair climbing may be a particularly attractive method of exercise to overweight individuals.
The project will improve further the effectiveness of these simple interventions. Optimal message content will be explored with focus groups followed by product testing in field interviews. For the intervention phase, quasi-experimental interrupted time series designs will be used. For example, a 3-week baseline is followed by an intervention, with a step change at the point of interruption in the time series providing strong evidence of effectiveness. Matched comparison sites can test the relative merits of different interventions whereas workforce details allow estimates of threats to generalisation. Stair and lift use will be monitored with automated counters. For the main messages, a balanced design will compare three different messages in six workplaces. Two further studies of message delivery will assess the effects of changing the message on adaptation of its effects. In the first study, simultaneous presentation of three main messages for 12 weeks will be compared with a matched worksite where a single main message is changed every four weeks. The second study on message delivery will compare simultaneous presentation of six additional stairwell messages with a single stairwell message that changes each week.
Rolled out regionally, these interventions are cheap ? 5p per employee for a 500-strong workforce. Links with Directors of Public Health in Birmingham ensures dissemination to practitioners at a regional and national level. A reciprocal arrangement to share materials with NHS Health Scotland, ongoing consultation with DoH, Catalunya and the PIs membership of the working group on worksite health promotion for the Health Enhancing Physical Activity network (HEPA Europe) ensure wider dissemination.
The project will improve further the effectiveness of these simple interventions. Optimal message content will be explored with focus groups followed by product testing in field interviews. For the intervention phase, quasi-experimental interrupted time series designs will be used. For example, a 3-week baseline is followed by an intervention, with a step change at the point of interruption in the time series providing strong evidence of effectiveness. Matched comparison sites can test the relative merits of different interventions whereas workforce details allow estimates of threats to generalisation. Stair and lift use will be monitored with automated counters. For the main messages, a balanced design will compare three different messages in six workplaces. Two further studies of message delivery will assess the effects of changing the message on adaptation of its effects. In the first study, simultaneous presentation of three main messages for 12 weeks will be compared with a matched worksite where a single main message is changed every four weeks. The second study on message delivery will compare simultaneous presentation of six additional stairwell messages with a single stairwell message that changes each week.
Rolled out regionally, these interventions are cheap ? 5p per employee for a 500-strong workforce. Links with Directors of Public Health in Birmingham ensures dissemination to practitioners at a regional and national level. A reciprocal arrangement to share materials with NHS Health Scotland, ongoing consultation with DoH, Catalunya and the PIs membership of the working group on worksite health promotion for the Health Enhancing Physical Activity network (HEPA Europe) ensure wider dissemination.