A Multicomponent Intervention to Encourage Stair Use in Municipal Buildings

Evaluate the incremental impact of environmental stairwell enhancements on stair usage in addition to prompts.

Phased, nonrandomized, quasi-experimental intervention.

Two 6-story and one 8-story municipal government office buildings-each with 2 stairwells.

Approximately 2800 municipal employees and 1000 daily visitors.

All stairwells received door wraps and point-of-decision and wayfinding prompts. Environmental enhancements were installed in 1 stairwell in each of the 2 buildings: wall paint, upgraded stair treads and handrails, artwork, light-emitting diode (LED) lighting, fire-rated glass doors, and removal of security locks on at least the ground floor.

Staff surveys and focus groups, electronic and direct measures of stair and elevator use occurred at baseline and over 3 years of phased implementation and follow-up.

Change in the proportion of vertical movement by stairs using χ² analysis.

The prompts were associated with a significant increase in stair use (odds ratio [OR] = 1.36; 95% confidence interval [CI]: 1.31-1.41), with an average absolute increase of 3.2%. Environmental enhancements were associated with an additional significant increase in stair use (OR = 1.31; 95% CI: 1.25-1.37) beyond prompts alone with an average absolute increase of a further 3.5% that was sustained for 1 year. The initial increases in stair use with prompts alone were not sustained.

Implementing environmental stairwell enhancements in office buildings increased stair usage in a sustained manner beyond that achieved by prompts alone.