Sedentary practices and other lifestyle interventions have emphasized health education, counseling and other time limited and intensive training interventions. As such, they cannot keep up with the advancing epidemic of sedentary people, and their consequential morbidity. A public health approach is to understand the social and physical environment's role in the etiology of lifestyle practices. With such understanding it may be possible to design policies that change social systems, even cultures, and/or physical environments such as buildings or city systems to promote incidental physical activity and other healthy lifestyles. With both large scale epidemiological analyses of city designs and concurrent epidemiological analyses of more "molecular" processes, such as social influences at the time of incidental physical activity, it should be possible to identify modifiable features of the social and physical environments that might serve as interventions to promote physical activity.
Regular stair climbing is one such activity that can accumulate the health effects of moderate physical activity. Interventions that increase stair use include signs of varying sizes and messages, and improving the aesthetics of stairwells. Significant increases in stair use has been seen as a result of these stimuli, with comparable changes for promotion and deterrent type signs. To date, stair use interventions have not assessed behavioral modeling, and most have not assessed numerous other social and physical factors that might alter stair use.
Behavioral modeling is effective form of prompting health behaviors and is consistent with social learning theory and our Behavioral Ecological Model. This study attempts to increase stair use by presenting behavioral models in an Airport, and aims to explore the influence of demographic, individual characteristics, and social factors hypothesized by our Model to affect stair use.
A hybrid quasi-experimental time series design with alternating baseline (A) and experimental phases will be implemented to test two types of modeling interventions; one confederate model alone (B) and a combination of two confederate models with verbal prompts (C). Male and female models will be employed over the course of the study and presented on the stairs with and without luggage. Direct observation measures based on theoretical plausibility derived from the BEM and reports in previous literature will be used. They included demographics, dress, children luggage, speed, day/time, social group and behavioral modeling. Logistic regression models stratified by direction will be used to examine the influence of modeling on the odds of taking the stairs after concurrently controlling for these variables.
Small changes in stair use magnified over a population lead to a large amount of change. In addition to potentially influencing a large number of people, the amount of energy expended by would also increase. A previous study found caloric expenditure of descending and ascending was .05 and .11 kcal per step, respectively.
Principal Investigator: Mel Hovell, PhD, MPH
Co-Principal Investigator: Marc Adams, MPH
Source: CBEACH Intramural Support