The Use of Point-of-Decision Prompts to Increase Stair Climbing in Singapore

Robert Sloan,Falk Müller-Riemenschneider,Carol Leung,Benjamin Haaland

doi:10.3390/ijerph10010210

Abstract

Physical inactivity is a significant contributor to worldwide mortality and morbidity associated with non-communicable diseases. An excellent avenue to incorporate lifestyle physical activity into regular routine is to encourage the use of stairs during daily commutes. We evaluated the effectiveness of point-of-decision prompts (PODPs) in promoting the use of stairs instead of the escalators in a Singapore Mass Rapid Transit (MRT) station. We measured the number of stair climbers before the PODPs were put up, during the 4 weeks that they were in use, and 2 weeks after they were removed. Measurements at a no intervention control site were additionally taken. The use of stair-riser banners was associated with an increase in the number of people using the stairs by a factor of 1.49 (95% CI 1.34–1.64). After the banners were removed, the number of stair climbers at the experimental station dropped to slightly below baseline levels. The Singapore MRT serves a diverse multi-ethnic population with an average daily ridership of over 2 million and 88 stations island-wide. An increase of physical activity among these MRT commuters would have a large impact at the population level. Our findings can be translated into part of the national strategy to encourage an active lifestyle in Singaporeans.

Highlights

The World Health Organization reports that approximately 65% of all worldwide deaths are associated with non-communicable diseases (NCDs) and the rate is expected to climb another 15% in less than 20 years [1]
More people used the stairs of male gender, during point-of-decision prompts (PODPs) intervention, and during periods with more trains
One-at-a-time backwards removal of variables having p-values ≥0.05 resulted in a multivariate model containing the variables gender, PODP intervention, post-PODP, and number of trains

Summary

Introduction

The World Health Organization reports that approximately 65% of all worldwide deaths are associated with non-communicable diseases (NCDs) and the rate is expected to climb another 15% in less than 20 years [1]. More sophisticated and sustainable public health approaches to increasing physical activity and reducing sedentary behavior are needed in order to help reduce the fiscal and social costs associated with poor health related quality of life, non-communicable diseases, and premature mortality. Concepts such as active living [3] and zero point thinking, where some activity is better than none [4], together provide the underpinning that transitory and well-spaced increments of physical activity can mitigate incidence of NCDs and likely improve adherence to higher volumes of activity [4]. The Singapore Mass Rapid Transit (MRT) system serves a diverse multi-ethnic population, composed of approximately 75% Chinese, 15% Malays, 8% Indians, and 2% others, and has an average daily ridership of over 2 million, with 88 stations across the country [5] providing a potential strategic environment to induce more physical activity and increase energy expenditure

Methods

Results

Conclusion