The Journal of Primary Prevention

, Volume 38, Issue 6, pp 597–611 | Cite as

And She’s Buying a Stairway to Health: Signs and Participant Factors Influencing Stair Ascent at a Public Airport

  • John Bellettiere
  • Sandy LilesEmail author
  • Yael BenPorat
  • Natasha Bliss
  • Suzanne C. Hughes
  • Brent Bishop
  • Kristi Robusto
  • Melbourne F. Hovell
Original Paper


Several studies have demonstrated that point-of-choice prompts modestly increase stair use (i.e., incidental physical activity) in many public places, but evidence of effectiveness in airport settings is weak. Furthermore, evaluating the effects of past physical activity on stair use and on point-of-choice prompts to increase stair use is lacking. The purpose of this study was to evaluate the influence of sign prompts and participant factors including past physical activity on stair ascent in an airport setting. We used a quasi-experimental design, systematically introducing and removing sign prompts daily across 22 days at the San Diego International Airport. Intercept interviewers recruited stair and escalator ascenders (N = 1091; 33.0% interview refusal rate) of the only stairs/escalators providing access to Terminal 1 from the parking lot. A 13-item questionnaire about demographics, physical activity, health behavior, and contextual factors provided data not available in nearly all other stair use studies. We examined the effects of signs and self-reported covariates using multivariable logistic regression analyses, and tested whether physical activity and other covariates modified the intervention effect. Adjusting for all significant covariates, prompts increased the odds of stair use (odds ratio 3.67; p < .001). Past participation in vigorous physical activity increased the odds of stair use by 1.62 (p = 0.001). None of the covariates moderated the intervention effect. In conclusion, vigorous physical activity and correlates of physical activity were related to stair use in expected directions, but did not modify the effect of the intervention. This indicates that the effects of point-of-choice prompts are independent of past physical activity, making them effective interventions for active adults and the higher risk population of inactive adults. Signs can prompt stair use in an airport setting and might be employed at most public stairs to increase rates of incidental physical activity and contribute to overall improvements in population health.


Stairs Physical activity Point of decision prompts Point-of-choice prompts Obesity Built environment 



Dr. Hovell and other authors were supported in part by National Institutes of Health grant R01 CA138192-01A2 (Hovell)—Clinician Promotion of Healthy Diet and Activity to Reduce Obesity Among Adolescents (Project Healthy Smiles). We thank the San Diego Airport Administration that made this study possible as well as Vian Oraha and Elsie Campa for assistance with synthesis of the literature.

Compliance With Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Research Involving Human Participants and/or Animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. We obtained approval for all study procedures from airport authorities and the San Diego State University Institutional Review Board.

Informed Consent

Verbal consent was obtained from all individual participants included in the study. No personally identifying information was obtained.


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Center for Behavioral Epidemiology and Community Health, Graduate School of Public HealthSan Diego State UniversitySan DiegoUSA

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