Is There Sufficient Evidence Regarding Signage-based Stair-use Intervention Studies ? A Sequential Meta-Analysis

Abstract

PURPOSE: The proliferation of stair-use promotion studies continues unabated, with their oft-cited potential for ‘increasing population level physical activity participation’. This study examined all stair use promotional studies since 1980, where pre- and post-promotional sign estimates of stair use are provided. The aim of this project was to conduct a sequential meta-analysis [using Stata 11] to pool the results to determine when the ‘evidence base’ was sufficient for population-wide dissemination. METHODS: Using comparable data from 52 stair-promoting studies [57 unique estimates] we combined data to assess the pooled effect size across time of such interventions. RESULTS: At baseline, median stair usage across interventions was 8.1%, with an absolute median increase of 2.2% in stair use following interventions. The overall pooled odds ratio indicated that participants were 52% more likely to use stairs after exposure to promotional signs (adj OR 1.52, 95% CI 1.37-1.70); however, incremental [sequential] meta-analyses using z-score methods identified that no further evidence on the effect size of such studies accumulated beyond research published in 2005. CONCLUSIONS: The study has important policy and practice implications, as researchers increasingly publish stair use interventions, without connection to policy makers or the public health system to test and trial scaling-up and replicating promotional signs in wider community settings. Without substantial efforts at dissemination, these stair-use promotional programs will not impact on population levels of active living or physical activity.