Nudging interventions on stair use: a scoping review

Nudging interventions on stair use: a scoping review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review Nudging interventions on stair use: a scoping review Alexandros Tzikas, George Koulierakis, Konstantinos Athanasakis, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4008053/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 15 Jun, 2024 Read the published version in Journal of Prevention → Version 1 posted You are reading this latest preprint version Abstract Stair use is a physical activity that can be incorporated into the daily lifestyle of a majority of the population, resulting in several health benefits. Nudges are increasingly used in public health interventions to encourage healthy behaviours such as physical activity in a cost-effective manner. This scoping review aimed to investigate the effect and the characteristics of nudges used on interventions to promote stair use. We reviewed the relevant literature published in PubMed, Cochrane Library, Mendeley & Google Scholar, from January 2009 to May 2022. Eligibility criteria included original studies of any type of design, written in English, targeting healthy adults, reporting nudging interventions, using elevator or escalator as comparators and defining a baseline for comparisons. Initially, 118 publications were identified, and after applying exclusion criteria, 27 articles were included in the analysis. Results showed that most of the nudging interventions had significant positive effect on stair use in several settings. The evidence from this review suggests that incorporating nudges into public health interventions can effectively promote physical activity through increased stair usage. Emphasizing prevention measures in public health interventions may contribute to better health outcomes. Public health Physical activity Stair use Health behaviour Nudging interventions Figures Figure 1 1. Introduction The increase of physical activity (PA) of population is a challenging public health issue (WHO, 2009). Globally, 25% of the adult population does not meet the recommended physical activity levels (WHO, 2018). This is estimated to cause more than 3 million premature deaths in an annual basis around the world and has a considerable economic burden for the healthcare systems (Müller-Riemenschneider et al., 2008 , Lee et al., 2012 ). Regular PA is beneficial for individual health status and has protective effects on various chronic diseases and their risk factors, such as cardiovascular disease, obesity, type 2 diabetes, stroke, cancer (Nocon et al., 2008 ; Rhodes et al., 2017 ), as well as depression (Strawbridge et al., 2002 ). People can easily adopt simple activities in their daily routines to increase PA level. Stair use (either ascent or descent) is a PA that can be part of their daily lifestyle (Smith et al., 2014 ). Stair use and specifically stair climbing is a vigorous physical activity and is associated with lower blood pressure, weight loss and improved fitness (Andersen, 2013; Meyer, 2010). Regular stair use is related to lower risk of death (Lee & Paffenbarger, 2000 ; Rey-Lopez et al., 2019 ). Just 7 minutes of stair climbing per day can reduce the possibility of dying from coronary heart disease by 62% (Yu et al., 2003 ). Using the stairs, instead of elevators or escalators, is a freely accessible way to become more active, it is readily available and has ample opportunities to be practiced. It can be done by the most of population groups in a variety of settings, such as train stations, worksites, universities, public buildings, malls and other such places (Bellettiere et al., 2017; Bellicha et al., 2016; Boen et al., 2010; Lewis et al., 2012; Moloughney et al., 2018). Motivating people to increase their physical activity level is a public health priority and am major prevention issue, yet the main question is how to facilitate this behaviour change, so that it is incorporated in people’s daily routine. Nudges can influence health behaviours of targeted groups of population via simple and cost-effective interventions to the environment in which people make decisions (Benartzi et al., 2017 ). The core idea of the Nudge theory is that small and insignificant details can affect human’s behaviour (Madrian, 2014 ). According to Thaler and Sustein (2021, p.8), a nudge is “any aspect of the choice architecture that alters people’s behaviour in a predictable way without forbidding any options or significantly changing their economic incentives”. This approach has been used in a various fields such as food choice (Bauer and Reisch, 2019 ), hand hygiene (Tzikas and Koulierakis, 2023 ), energy use (Rasul and Hollywood, 2012 ), finance (Cai, 2019) and physical activity (Forberger et al., 2019 ). This study addresses a critical gap left by prior reviews by focusing on nudging interventions aimed at promoting stair use over elevators or escalators in various settings. Unlike previous reviews that either concentrated on increasing stair usage without exploring nudging interventions (Bellicha et al., 2010; Jennings et al., 2017 ) or reported limited evidence on physical activity (Laiou et al., 2021 ), this review aims to offer an updated overview of the effectiveness and characteristics of nudges in encouraging physical activity through stair utilization, categorizing the nudging interventions according to the MINDSPACE framework. 2. Method Α scoping review methodology was adopted following the relevant guidelines and recommendations (Arksey & O’Malley, 2005 ; Daudt et al., 2013 ). The review was conducted in five steps: (1) identifying the research question; (2) identifying relevant studies; (3) selecting the studies; (4) charting the data; and (5) collating, summarizing, and reporting results. The study procedures are explained in the following sections and visualized in Fig. 1 . This scoping review is reported according to PRISMA-ScR guidelines (Tricco et al. 2018 ) (See appendix Prisma ScR checklist). 2.1 Search Strategy A systematic search of the international literature on nudging interventions targeting stair use, in four electronic databases (PubMed, Cochrane Library, Mendeley & Google Scholar) was conducted between January 1, 2009 (one year after the publication year of Thaler and Sunstein’s seminal book on nudging) and May 07, 2022. We performed our search based on the PICO framework (see appendix : Table 2 ). Population and Comparison were manually checked during the selection process of the studies. In terms of Intervention , our initial search included the terms “nudg*” and “behavioral economic*”, but we revised our search with additional terms of nudge subcategories as we missed some eligible studies that used relevant nudge subcategory terms. More specifically, we added the terms of the MINDSPACE framework (Messenger, Incentives, Norms, Defaults, Salience, Priming, Affect, Commitment & Ego), as it is considered one of the most popular nudge toolkits and it is widely used in nudge literature (Dolan et al., 2011 ). Outcome included terms indicating the primary outcome of the intervention, that is the changes of stairs use rates (including ascending or descending). Moreover, reference lists of the included studies were manually searched in order to identify additional studies. Following a snowball method, we first used backward search and then we conducted a forward search (citation search) (Wohlin 2014 ). The identified studies were explored based on the inclusion and exclusion criteria of our search. 2.2 Inclusion and Exclusion Criteria The identified studies were eligible to be included in the analysis if they met the following inclusion criteria: (1) they should have been published from January 1, 2009 to May 07, 2022, (2) they should have been original studies, (3) participants should be healthy adults (over 18 years old), (4) nudging interventions should be used with primary aim to increase stair use (either ascent and/or descent), (5) elevator or escalator should have been used as a comparison, (6) outcomes of intervention stages should be compared with a baseline level, (7) studies should have applied all study designs (8) they should have been written in English. On the other hand, the identified studies were not eligible if they met the following exclusion criteria: (1) being published before 2009 and after May 07, 2022, (2) being other than original studies, (3) participants were not healthy adults (e.g. people with injuries, physical incapacity or other disorders) or belonged to any preventive health program (e.g. weight management), (4) interventions did not apply the concept of nudges, (5) intervention outcomes were not compared with baseline levels (6) studies were not published in English, (7) studies were described as theory papers, abstracts, opinions or conference presentations. 2.3 Studies selection process The collected studies were merged in order to identify and delete duplicates. After the removing duplicates process, the first two authors (AT and GK) independently screened for eligibility criteria the titles and abstracts. In case reviewers were unable to access the full text, the first author (AT) requested it from the corresponding author of the study via personal email or ResearchGate platform. Then, their full texts were further studied and checked that the entry criteria that mentioned above were satisfied. Disagreements about the inclusion or exclusion of an article were discussed before the final selection. 2.3 Synthesis Process During the synthesis process, the MINDSPACE was used as framework for understanding and categorizing the different characteristics of nudging interventions and evaluating their effectiveness. The first author (AT) synthesised the extracted data in corroboration with the second author (GK) and presented it in a table, mapping the collected studies against the following categories (see Table 1 ): authors and year of publication, study design, main purpose of study, country and place of interventions, target group, duration of study, nudge intervention technique, MINDSPACE factor, method of data collection and effectiveness of interventions. A narrative synthesis approach was adopted to present the results. 3. Results Initially, 118 articles were identified. After excluding duplicates (n = 61), 57 articles were assessed and 26 of them were removed as non-relevant, after the reading of the titles and the abstracts. 31 full-text articles were assessed against the inclusion criteria and 4 of them were excluded. A total of 27 articles were included in this review (see Fig. 1 ). 3.1 Characteristics of the included studies Table 1 summarizes the general characteristics of the included studies in this review. 3.1.1 Country & Publication Year Studies were published between 2009 and 2022 in 13 different countries. Most of them (n = 16) were published in the first half of the selected period (until 2016) and the rest (n = 11), until 2022. No studies, published in 2015 and 2022 (until 7th of May) were identified. The majority (n = 6) were conducted in UK, followed by USA (n = 4), Belgium and Germany (n = 3 each), Australia, Japan and the Netherlands (n = 2 each), France, Spain, Norway, Canada, South Africa, and Singapore (n = 1 each). One study took place in two countries, Spain and UK. 3.1.2 Study design Twenty studies used quasi-experimental designs, while six studies relied on observational methods. Additionally, three studies opted for experimental designs. Notably, two studies stood out for using two different designs to conduct separate experiments. 3.1.3 Place and duration of interventions The duration of the interventions varied considerably and ranged from 1 day to 37 months. Most of the studies (n = 21) lasted up to 8 weeks. Eleven of them lasted up to 4 weeks and the rest (n = 10) studies lasted from 5 to 8 weeks. The majority of studies were conducted in train stations (n = 9). The rest studies took place in office buildings (n = 8), universities buildings (n = 7), shopping mall, airport, medical center and health-fitness facilities (n = 1 each). 3.1.4 Data collection methods The majority of the studies (n = 18) (Andersen et al., 2012; Bellettiere et al., 2017; Boen et al., 2010; Eves et al., 2009; Krisam et al., 2020; Krull et al., 2021; Lewis et al., 2012a; Lewis et al., 2012b; Müller-Riemenschneider et al., 2010; Nomura et al., 2009; Nomura et al., 2014; Olander et al., 2011; Pillay et al., 2009; Ryan et al., 2011; Sloan et al., 2013; Suri et al., 2014; Van der Meiden et al., 2019; Van Hoecke et al., 2017) used solely direct observation as the method for their data collection. Most of the studies recorded the number of individuals who ascended the stairs or they moved via escalator or elevator. Three studies (Crozier, 2019; Engelen et al., 2017; Moloughney et al., 2018) combined electronic movement counters and direct observation to measure the number of individuals ascending and descending the stairs or using the elevator. The data of five studies was collected solely remotely. Four of them (Åvitsland et al., 2017; Bellicha et al., 2016; Puig-Ribera et al., 2019; Van Calster et al., 2017) used automatic movement sensors that monitored only stair climbing or both the ascent from and descent to the ground floor by either elevators or stairs. In one study (Van Nieuw-Amerongen et al., 2011) stair ascending and elevator use were observed using video cameras. 3.1.5 Nudging Interventions The nudging intervention techniques employed in the included studies are reported in Table 1 and they are further categorized according to the MINDSPACE framework. This framework provides a structured approach to understanding the various behavioural influences utilized within the interventions, encompassing factors such as Messenger, Incentives, Norms, Defaults, Salience, Priming, Affect, Commitment, and Ego. The two most commonly used MINDSPACE factors were “priming” and “salience”. “Priming” involves prompts like motivational messages about energy savings, caloric consumption or health benefits on posters near stairs, along with directional cues like footprints or arrows. “Salience”, which emphasizes the enhanced visibility of staircases through eye-catching signage or vibrant visual cues strategically placed in prominent locations, plays a crucial role in capturing attention and encouraging individuals to opt for stairs. The majority of the studies (n = 26) combined at least these two factors to promote stair use (Andersen et al., 2012; Åvitsland et al., 2017; Bellettiere et al., 2017; Bellicha et al., 2016; Boen et al., 2010; Cohen, 2013; Crozier, 2019; Engelen et al., 2017; Eves et al., 2009; Krull et al., 2021; Lewis et al., 2012a; Lewis et al., 2012b; Moloughney et al., 2018; Müller-Riemenschneider et al., 2010; Nomura et al., 2009; Nomura et al., 2014; Olander et al., 2011; Pillay et al., 2009; Puig-Ribera et al., 2019; Ryan et al., 2011; Sloan et al., 2013; Suri et al., 2014; Van Calster et al., 2017; Van der Meiden et al., 2019; Van Hoecke et al., 2017; Van Nieuw-Amerongen et al., 2011). Five studies employed “norms” to influence participants to choose stairs over the elevators or escalators. They achieved this by employing stair-climbing role models (Krisam et al., 2020; Van Calster et al., 2017), using stick figures walking up the stairs accompanied by social prompt messages (Crozier, 2019; Engelen et al., 2017) or by congratulating employees for their increased stair use (Van Hoecke et al., 2017). Four studies employed the “messenger” factor to nudge participants, primarily employees, towards increased stair use. They achieved this by encouraging stair use through corporate emails (Cohen, 2013; Moloughney et al., 2018; Van Calster et al., 2017) or by providing congratulatory messages via personal letters (Van Hoecke et al., 2017). One study introduced “incentives” to reward participants who taking the stairs with a small money prize (Cohen, 2013). Additionally, one study employed “affect” by triggering emotional associations through positive feedback messages containing smiley faces. This technique aimed to influence employees to choose the stairs over the elevator (Åvitsland et al., 2017). “Commitment”, “defaults” and “ego” were not identified in the included articles. 3.1.6 Effects of interventions Table 1 summarizes the key results of the included articles. Twenty-two of the twenty-seven articles showed that nudging interventions had a positive effect on stair use and reported at least one significant effect (Bellettiere et al., 2017; Bellicha et al., 2016; Boen et al., 2010; Crozier, 2019; Engelen et al., 2017; Eves et al., 2009; Lewis et al., 2012a; Lewis et al., 2012b; Moloughney et al., 2018; Müller-Riemenschneider et al., 2010; Nomura et al., 2009; Nomura et al., 2014; Olander et al., 2011; Pillay et al., 2009; Puig-Ribera et al., 2019; Ryan et al., 2011; Sloan et al., 2013; Suri et al., 2014; Van Calster et al., 2017; Van der Meiden et al., 2019; Van Hoecke et al., 2017; Van Nieuw-Amerongen et al., 2011) that was mainly reported with a p- value < 0.05 or lower. Nine of them identified mixed results from the nudging interventions (Crozier, 2019; Engelen et al., 2017; Eves et al., 2009; Lewis et al., 2012a; Müller-Riemenschneider et al., 2010; Olander et al., 2011; Puig-Ribera et al., 2019; Van der Meiden et al., 2019; Van Hoecke et al., 2017). The remaining five out of twenty-seven articles did not demonstrate any significant positive effects (Andersen et al., 2012; Cohen, 2013; Krisam et al., 2020; Krull et al., 2021;) or yielded negative effects on stair use (Åvitsland et al., 2017). 4. Discussion This scoping review aimed at investigating the effect and the characteristics of nudging interventions on stair use, instead of elevator or escalator in different everyday life settings, such as worksites, universities, public buildings, train stations, medical centers, fitness facilities, airports & malls. The findings indicate that nudging interventions can be effective in influencing people to use the stairs instead of elevators or escalators. This review identified twenty-seven studies, the vast majority of which (twenty-two) showed that nudging interventions had a positive effect on stair use and reported at least one significant effect. The current findings are consistent with previous relevant systematic reviews. Bellicha et al (2010) found an increase in stair use in both worksites and public settings. Additionally, the findings of Jennings et al (2017) and Landais et al (2020) demonstrated that the majority of interventions promoting stair use were effective. In our review, some included studies estimate both stair ascent and descent into a measure of stair use when they estimated intervention effects. However, efficacy can be achieved only by stair climbing, as associated with various health benefits such as reduced cardiovascular disease risk, lower blood pressure, improved fitness and weight loss (Boreham et al., 2005; Meyer, 2010). To the best of our knowledge, there are not specific data indicating that stair descent has similar health benefits. Stair descent has the half exercise intensity (4.8 METs) compared to stair climbing (9.6 METs) (Teh & Aziz, 2002). Stair climbing is clearly a more preferred physical activity than stair descending and future studies should analyze both activities separately. However, any kind of activity, even those with light intensity are associated with beneficial effects (Healy et al., 2015). Most of the interventions (twenty-three) took place in EU countries, North America countries (USA & Canada) and Australia. This possibly reflects the politically liberal conditions in those countries. The liberal traditions in the USA, Canada, Australia and European countries tend to favor nudging interventions in health policy (Jones et al., 2014). In the USA, President Barack Obama nominated Cass Sunstein to be Administrator of the Office of Information and Regulatory Affairs in 2009. One year later, UK Prime Minister David Cameron supported set up the Behavioural Insight Team (BIT) in the Cabinet Office in order to influence population to behave in a more socially integrated way (Jones et al., 2014). The primary nudging strategy involved using messages and posters. These message-based interventions predominantly featured health, fitness, and caloric expenditure messages aimed at promoting stair climbing. Notably, most posters included a human figure ascending stair, often accompanied by stair banners. The majority of studies incorporating positively framed messages reported significant effects. However, the only study utilizing a health risk-oriented message did not observe a notable positive impact on stair use. Rothman and Salovey (1997) reported that health messages can emphasize gains or losses associated with behaviors, with gain-framed messages being more influential for prevention behaviors and loss-framed messages for detection behaviors. Gallagher and Updegraff’s (2012) meta-analysis supported the idea that positively framed messages significantly influence preventive health behaviors. Overall, these findings align with existing literature on message framing and its impact on behaviour change. Another nudging intervention based on the enhancement of stairwell aesthetics and its visibility reported in four studies. Because of the small number of studies, it was not possible to generalize its positive effects. However, the results are promising and can be taken into consideration by architects and civil engineers when they design or renovate a structure and especially stairs and elevators. Elevators often attract people because of their central locations, well designs and amenities such as music, mirrors, automated doors. On the other hand, stairs are located in not easily accessible and visible locations without any attractiveness. Thus, architectural design modifications and policy changes may have a positive impact on stair use (McGann et al., 2013). The place of interventions may influence the amount of exposure. The population of specific locations such as airports and shopping malls likely do not return from one day to the following day compared to other places such as worksites, universities, fitness facilities, hospitals and train stations in where populations may return day after day and are possibly exposed to repeated nudging interventions. Nevertheless, none of the included studies measured the effect of the repeated exposure to nudges on stair use. Studies should investigate the lasting effects of nudges, particularly in settings like worksites where it's more feasible to follow the same population throughout the study (Eves et al., 2012). From this review, there is limited evidence suggesting that nudging interventions resulted in sustained behavioural changes related to stair use. The inclusion of follow-up periods shorter than 12 weeks in many studies constrained the evaluation of the long-term effectiveness of nudging interventions (Weerd & Degens, 2019). Future research should focus on exploring the lasting effects of nudges on stair use. Sustaining habitual behaviour poses a significant challenge. In behavioural science, it's crucial to distinguish between initiating behaviour change and maintaining that change over time (Kwasnicka et al., 2016). It would also be beneficial for future studies to expand on the critical analysis of this review's findings, particularly concerning their implications for physical activity public health policies and the ethical complexities associated with nudging. Nudging has been criticised for its reliance on individualized, behaviour-centric approaches, potentially sidelining the broader social determinants of health and disparities in resources. This criticism highlights the need for future research to delve deeper into the ethical considerations and limitations of nudges as they pertain to public health interventions (Mulderrig, 2019; Wilkins, 2013). This scoping review presents strengths and weaknesses. A strength is that it included studies that used nudges in different target groups and settings, from different countries covering a wide range of population everyday life such as worksites, universities, public buildings, train stations, medical centers, fitness facilities, airports & malls. Furthermore, this review included both stairs climbing and stair descent under the general term “stair use”. Finally, it considered studies that used nudge principles in terms of a theoretical framework such as MINDSPACE. This review has also weak points. Many of the included studies did not directly use nudges or even refer to any concept of behavioural economics and a challenging issue of our search was to develop a search approach that could identify any relevant articles. Due to the heterogeneity of studies, in regard to study design, nudging intervention characteristics and the outcome measures, it was not possible to compare the effect sizes across studies. Moreover, the studies showing significant results are more likely to be published. This may reflect a publication bias (Hopewell et al., 2009). The use of specific databases (PubMed, Cochrane Library, Mendeley & Google Scholar) and the exclusion of studies published in other than English language is possibly a selection bias, thus the results may not be generalizable. Conclusion The majority of studies identified in this scoping review reported significant positive results in stair use in several settings. Nudging interventions can be a simple and cost-effective policy and prevention tool as it may produce immediate behavioral changes. Nudges can be used as additional public health tool to improve the levels of physical activity, via stair use, covering a wide range of population everyday life that would have a cumulative positive effect on population health. Declarations Conflict of Interest The authors declare that they have no conflict of interest Funding The present study was funded by the Special Account for Research Grants (ELKE) of the University of West Attica (21-29/06/2023). References * The references included in this review are marked with an asterisk *Andersen, L., Bungum, T., & Moonie, S. (2012). The effects of environmental prompts on stair usage. Nevada Journal of Public Health, 9 (1), 7-12. https://digitalscholarship.unlv.edu/njph/vol9/iss1/2 Andersen, L. L., Sundstrup, E., Boysen, M., Jakobsen, M. D., Mortensen, O. S., & Persson, R. (2013). 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Characteristics of the included studies Αuthor( s), Year Purpose Country Study design Place of intervention Target group Duration of study Data collection Nudg ing interventions MINDSPACE factors Intervention findings Effect Andersen et al., 2012 To assess the effects of selected signage prompts on stair usage. USA QE, Pretest - Posttest University buildings Students, staff & visitors 7 weeks Direct observations Signage prompts using messages Salience & Priming Stair usage was not increased. (-) Interventions had no significant effect on stair use (p > 0.05). Åvitsland et al., 2017 To examine workplace stair climbing, assessing the impact of single and combined interventions. Norway QE, Time Series Office buildings Employees 14 weeks Infrared sensors Footprints & stair-riser banners Salience, Priming & Affect Stair climbing decreased. (-) Stair climbing decreased significantly during the intervention periods (p < 0.001). Bellettiere et al., 2017 To evaluate sign prompts and participant factors, including past physical activity, on airport stair ascent. USA QE, Interrupted Time Series International Airport Passengers 22 days Direct observations Sign prompts Salience & Priming Stair climbing increased. (+) Significant effect of sing prompts on stair ascent (p<0.001). Bellicha et al., 2016 To evaluate a worksite stair-climbing intervention's short- and long-term effectiveness. France QE, Controlled before - after Corporate buildings Employees 1 year Automatic counters Motivational - directional signs & enhancement of stairwell aesthetics Salience & Priming Stair climbing increased. (+) Significant effect of sings on stair climbing. (p<0.001). Boen et al., 2010 To investigate the impact of a health sign in three community settings. Belgium QE, Pretest - Posttest Shopping mall & 2 Train stations Shoppers Commuters 4 days 4 days & 5 days Direct observations Health Sign using a message Salience & Priming Stair climbing increased. (+) Significant effect of sings on stair Climbing (p < 0.001). Cohen, 2013 To examine the impact of a health promotion intervention on stair use. USA QE, Pretest - Posttest Medical Center Staff members 6 weeks Electronic counters Prompts signs & education Messenger, Incentives, Salience & Priming Stair usage was not increased. (-) No significant effect of interventions on stair usage (p > 0.05). Crozier, 2019 To examine the influence of social and non-social stair prompts on stair use. Australia OS, Cross Sectional & E, Time Series University campus building Students & staff 4 weeks Direct observations & infrared sensors Social prompts using signs Norms, Salience & Priming Mixed results. (+/-) Significant effect of norm perceptions and social prompts on stair use. (p0.05). Engelen et al., 2017 To investigate if promoting stair-use signage changed stair-to-elevator proportion Australia QE, Pretest - Posttest University campus buildings Students & staff 4 weeks Direct observations & Infrared counters Motivational and directional posters using messages. Norms, Salience & Priming Mixed results. (+/-), Interventions in multiple buildings yielded significant effects: two increased & one decreased (p < 0.05). Eves et al., 2009 To study how environment layout impacts intervention responsiveness. UK QE, Pretest - Posttest Train station Commuters 7 weeks Direct observations Stair riser banners using messages Salience & Priming Mixed results. (+/-) Significant effect of the largest isovist on stair climbing. (OR = 1.30, 95% CI = 1.09 – 1.56; p = .004). No effect for the smaller isovist. Krisam et al., 2020 To investigate the effect of role model on stair and escalator use. Germany QE, Repeated Measures Train station Commuters 1 day Direct observations Social Norms: role model Norms Stair use was not increased. (-) Role model had no significant effect on stair use (p>0.01). Krull et al., 2021 To examine how health message interventions motivate behaviour change. Germany QE, Pretest - Posttest University campus buildings Students & employees 36 & 20 days Direct observations Round & precise health messages Salience & Priming Stair use was not increased. (-) Interventions had no significant effect on stair use (p > 0.05). Lewis at al., 2012a To investigate the effectiveness of stair-climbing intervention components: volitional and motivational aspects. UK QE, Interrupted Time Series University building Students & staff 18 days Direct observations Posters & Arrow Salience & Priming Mixed results. (+/-) Significant effect of volitional component on stair climbing (OR = 1.23, 95% CI, 1.14–1.32, p < .001). No significant effect when positioned alone in the lift (OR = 0.93, 95% CI, 0.85–1.02, p = .123). Lewis at al., 2012b To test the effects of two messages with varying complexity. UK QE, Interrupted Time Series Train Station Commuters 5 weeks Direct observations Posters using messages Salience & Priming Stair climbing increased. (+) Significant effect of both messages: complex (OR = 1.10, CI, 1.02–1.18, P = .01) and simple (OR = 1.07, CI = 1.01–1.13, P = .02) on stair climbing. Αuthor( s), Year Purpose Country Study design Place of intervention Target group Duration of study Data collection Nudg ing interventions MINDSPACE factors Intervention findings Effect Moloughney et al., 2018 To examine the impact of environmental stairwell enhancements on stair use, alongside prompts. Canada QE, Longitudinal Municipal administrative buildings Employees & visitors 37 months Direct observations & Infrared counters Prompts & environmental enhancements Messenger, Salience & Priming Stair climbing increased. (+) Significant effects of prompts (OR =1.36; 95% CI: 1.31-1.41) & environmental enhancements (OR= 1.31; 95% CI: 1.25-1.37). Müller-Riemenschneider et al., 2010 To test the feasibility and effectiveness of using posters as decision prompts. Germany OS, Pre -Post Train stations Commuters 10 weeks Direct observations Prompts: posters using motivational message Salience & Priming Mixed results. (+/-) Stair use increased significantly in women (p 0.05). Nomura et al., 2009 To study motivational signs' effectiveness in promoting stair use over escalators. Japan OS, Cross Sectional Train station Commuters 8 weeks Direct observations Posters and banners with motivational messages Salience & Priming Stair use increased. (+) Significant effects of posters & banners on stair use for both intervention periods: I1: (OR= 1.39, 95% CI, 1.22–1.59) and I2: (OR 1.56, 95% CI 1.36–1.77). Nomura et al., 2014 To study the effects of a stair climbing campaign over a long-term period at a worksite. Japan OS, Pretest-Posttest Local prefectural offices Office workers 18 months Direct observations Prompts using message banners Salience & Priming Stair use increased. (+) Significant effect of message banners on stair use for both genders, women (OR = 4.25, 95% CI 3.20−5.64) & men (OR = 4.65 95% CI 3.72−5.83). Olander et al., 2011 To compare information-based and environmental interventions for workplace stair climbing promotion. UK QE, Interrupted Time Series University campus buildings Employees 15 days Direct observations Floor stand providing health information Vs Signage prompts using posters Salience & Priming Mixed results. (+/-) Significant effect of posters (OR = 1.20; 95% CI, 1.06-1.37; p < .01) but no significant increase of health information intervention on stair climbing (OR = 1.45; 95% CI, 1.25-1.68; p = 0.83). Pillay et al., 2009 To assess the effectiveness of a signed intervention for stairs in a fitness facility. South Africa OS, Time Series Health and fitness facility Students, staff, tenants, visitors & patients 3 weeks Direct observations Motivational signs: coloured signs using messages & footprints Salience & Priming Stair use increased. (+) Significant effect of signs on stair use (OR 1.45, 95% CI 1.25–1.68 p<.0001). Puig-Ribera et al., 2019 To investigated the effects of signage on stair use. UK & Spain QE, Pretest - Posttest Office buildings Employees 4 weeks Automatic counters Posters with messages Salience & Priming Mixed Results. (+/-) Significant effect on stair descent (OR =1.10, 95% CI = 1.07, 1.13) but not effect on stair ascent (OR = 0.99, 95% CI= 0.97, 1.01). Ryan et al., 2011 To compare stair climbing rates in high and low socioeconomic areas and evaluate interventions' efficacy in both. UK QE, Pretest - Posttest Train Stations Commuters 7 weeks Direct observations Posters with messages Salience & Priming Stair climbing increased. (+) Significant effects of posters on stair climbing posters in high and low socioeconomic areas (OR = 1.24, 95% CI= 1.11 - 1.39). Sloan et al., 2013 To investigate point-of-decision prompts effectiveness in promoting stair use over escalators. Singapore QE, Pretest - Posttest Train Station Commuters 8 weeks Direct observations Stair-riser banners & floor stickers with physical activity messages Salience & Priming Stair climbing increased. (+) Significant effect of stair-riser banners (OR= 1.49, 95% CI 1.34–1.64). Suri et al., 2014 To test if signs promoting heuristic processing are most effective at the point of choice, while those promoting systematic processing work best at a distance. USA QE, Pretest – Posttest & E, Factorial Train Station Commuters 1 week Direct observations Signs using messages Salience & Priming Stair climbing increased. (+) Significant effect of both signs conditions on stair use ( p < .001). Van Calster et al., 2017 To examine the impact of enhanced stairwell visibility and a stair climbing model video on stair use. Belgium QE, Interrupted time series Office buildings Employees 4 weeks Infrared sensors Visibility via pictograms Email & TV phase Messenger, Norms, Salience & Priming Stair climbing increased. (+) Significant effect of all interventions on stair use (p<0.001). Van der Maiden et al., 2019 To examine the effectiveness and reasons behind nudging interventions stimulating employee stair use in an office setting. The Netherlands E, Pretest – Posttest Office building Employees 5 weeks Direct observations Footprints & posters with health messages Salience & Priming Mixed Results. (+/-) Significant effect of footprints on stair use (p 0.15). Αuthor( s), Year Purpose Country Study design Place of intervention Target group Duration of study Data collection Nudg ing interventions MINDSPACE factors Intervention findings Effect Van Hoecke et al., 2017 To evaluate the impact of footprints on stair climbing in a worksite & public setting. Belgium QE, Interrupted Time Series Office building & shopping mall Employees & visitors of the mall 11 & 18 weeks Direct observations Prompts: footprints, health message referring to footprints & congratulating participants Messenger, Norms, Salience & Priming Mixed Results. (+/-) Significant effect of health message in both worksite and public settings (p<0.001). Footprints had significant effect on worksite and not in public settings, while congratulating people had no effect on stair use in any setting. Van Nieuw-Amerongen et al., 2011 To investigated the impact of an environmental intervention to increase stair use. The Netherlands OS, Pretest- Posttest University faculties Students & employees 7 weeks Video cameras Prompts, Visibility, Accessibility & Aesthetics of stairwell Salience & Priming Stair climbing increased. (+) Significant effect of interventions on stair use ( p < .001). Abbreviations: E: Experimental design, QE: Quasi-Experimental design, OS: Observational design. OR: odds ratio, CI: confidence interval. (+) indicates a significant effect of the main intervention, (+/-) indicates both significant and not significant effects, (-) indicates not significant or negative effect. Additional Declarations The authors declare no competing interests. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4008053","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":276029988,"identity":"9f65adf1-65dd-456f-847f-88dd5e54edb0","order_by":0,"name":"Alexandros Tzikas","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3klEQVRIie3OsQrCMBCA4ZNCXCJZDwr2FS4URFDxVSqCk4KjkxQEV1cn38DV+SBQl0LXgktddHVyKqh1FVq7ieSHy3QfFwCb7Rdrvl8kAIcB6BvivIbfRAS1SLErv9oHUCsncm9511eb+O7O58YDtc9KCRoxJpbYwXR2cLdkdIjXinNG6owR+5C2Dq6kUyPEqFx4Rt2YCfteEl8KMqwkZGQj4wA7xFNRkFGo1uVEG+FTzOjrdOL3JD3GaxTlpH1cXXCRL/UuMeeTzCeDjar42GcCg7oEFNcmNpvN9t89AQOUQeiyLbuDAAAAAElFTkSuQmCC","orcid":"https://orcid.org/0009-0001-5972-1238","institution":"Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece","correspondingAuthor":true,"prefix":"","firstName":"Alexandros","middleName":"","lastName":"Tzikas","suffix":""},{"id":276030129,"identity":"3839c726-9e01-423e-b7be-b89e6db2b18d","order_by":1,"name":"George Koulierakis","email":"","orcid":"https://orcid.org/0000-0003-3705-1007","institution":"Laboratory of Epidemiology, Health Determinants and Well-Being, Division of Epidemiology, Prevention and Quality of Life, Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece","correspondingAuthor":false,"prefix":"","firstName":"George","middleName":"","lastName":"Koulierakis","suffix":""},{"id":276030290,"identity":"be4579b5-56d3-4ed3-9a15-96894d7bd2d9","order_by":2,"name":"Konstantinos Athanasakis","email":"","orcid":"https://orcid.org/0000-0002-1024-3802","institution":"Laboratory for Health Technology Assessment, Division of Health Systems and Policy. Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece","correspondingAuthor":false,"prefix":"","firstName":"Konstantinos","middleName":"","lastName":"Athanasakis","suffix":""},{"id":276030291,"identity":"6e593e78-7dba-4a3e-b644-97ec687c2d19","order_by":3,"name":"Kyriakoula Merakou","email":"","orcid":"https://orcid.org/0000-0001-7690-1348","institution":"Laboratory of Epidemiology, Health Determinants and Well-Being, Division of Epidemiology, Prevention and Quality of Life, Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece","correspondingAuthor":false,"prefix":"","firstName":"Kyriakoula","middleName":"","lastName":"Merakou","suffix":""}],"badges":[],"createdAt":"2024-03-03 09:06:49","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-4008053/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4008053/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s10935-024-00790-2","type":"published","date":"2024-06-15T15:16:43+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":51936334,"identity":"08692eca-832c-45c3-87e2-c830e997afeb","added_by":"auto","created_at":"2024-03-04 07:45:46","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":43032,"visible":true,"origin":"","legend":"\u003cp\u003ePRISMA - ScR flow diagram (Tricco et al., 2018).\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4008053/v1/80f42233d975ec1706bcd4ef.png"},{"id":58823034,"identity":"cd4a62ac-2079-47b9-aeaf-7db1f76d984a","added_by":"auto","created_at":"2024-06-21 16:51:17","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":750820,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4008053/v1/07ab718f-270f-4488-b41c-8c2149cf8b7a.pdf"},{"id":51936331,"identity":"587daaa7-4217-4c2c-9435-6a8f5837bdd3","added_by":"auto","created_at":"2024-03-04 07:45:46","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":24300,"visible":true,"origin":"","legend":"","description":"","filename":"CheckList.docx","url":"https://assets-eu.researchsquare.com/files/rs-4008053/v1/55202a706a37b394bae37411.docx"},{"id":51936376,"identity":"5f4a21e9-3d2d-4895-b4ab-54c09d744fce","added_by":"auto","created_at":"2024-03-04 07:45:48","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":17749,"visible":true,"origin":"","legend":"","description":"","filename":"Appendix.docx","url":"https://assets-eu.researchsquare.com/files/rs-4008053/v1/c73cdbf07574af5bc4267447.docx"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eNudging interventions on stair use: a scoping review\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eThe increase of physical activity (PA) of population is a challenging public health issue (WHO, 2009). Globally, 25% of the adult population does not meet the recommended physical activity levels (WHO, 2018). This is estimated to cause more than 3\u0026nbsp;million premature deaths in an annual basis around the world and has a considerable economic burden for the healthcare systems (M\u0026uuml;ller-Riemenschneider et al., \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2008\u003c/span\u003e, Lee et al., \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2012\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRegular PA is beneficial for individual health status and has protective effects on various chronic diseases and their risk factors, such as cardiovascular disease, obesity, type 2 diabetes, stroke, cancer (Nocon et al., \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2008\u003c/span\u003e; Rhodes et al., \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), as well as depression (Strawbridge et al., \u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e2002\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePeople can easily adopt simple activities in their daily routines to increase PA level. Stair use (either ascent or descent) is a PA that can be part of their daily lifestyle (Smith et al., \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Stair use and specifically stair climbing is a vigorous physical activity and is associated with lower blood pressure, weight loss and improved fitness (Andersen, 2013; Meyer, 2010). Regular stair use is related to lower risk of death (Lee \u0026amp; Paffenbarger, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2000\u003c/span\u003e; Rey-Lopez et al., \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Just 7 minutes of stair climbing per day can reduce the possibility of dying from coronary heart disease by 62% (Yu et al., \u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e2003\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eUsing the stairs, instead of elevators or escalators, is a freely accessible way to become more active, it is readily available and has ample opportunities to be practiced. It can be done by the most of population groups in a variety of settings, such as train stations, worksites, universities, public buildings, malls and other such places (Bellettiere et al., 2017; Bellicha et al., 2016; Boen et al., 2010; Lewis et al., 2012; Moloughney et al., 2018).\u003c/p\u003e \u003cp\u003eMotivating people to increase their physical activity level is a public health priority and am major prevention issue, yet the main question is how to facilitate this behaviour change, so that it is incorporated in people\u0026rsquo;s daily routine. Nudges can influence health behaviours of targeted groups of population via simple and cost-effective interventions to the environment in which people make decisions (Benartzi et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). The core idea of the Nudge theory is that small and insignificant details can affect human\u0026rsquo;s behaviour (Madrian, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). According to Thaler and Sustein (2021, p.8), a nudge is \u0026ldquo;any aspect of the choice architecture that alters people\u0026rsquo;s behaviour in a predictable way without forbidding any options or significantly changing their economic incentives\u0026rdquo;. This approach has been used in a various fields such as food choice (Bauer and Reisch, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), hand hygiene (Tzikas and Koulierakis, \u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e2023\u003c/span\u003e), energy use (Rasul and Hollywood, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e2012\u003c/span\u003e), finance (Cai, 2019) and physical activity (Forberger et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis study addresses a critical gap left by prior reviews by focusing on nudging interventions aimed at promoting stair use over elevators or escalators in various settings. Unlike previous reviews that either concentrated on increasing stair usage without exploring nudging interventions (Bellicha et al., 2010; Jennings et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) or reported limited evidence on physical activity (Laiou et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), this review aims to offer an updated overview of the effectiveness and characteristics of nudges in encouraging physical activity through stair utilization, categorizing the nudging interventions according to the MINDSPACE framework.\u003c/p\u003e"},{"header":"2. Method","content":"\u003cp\u003eΑ scoping review methodology was adopted following the relevant guidelines and recommendations (Arksey \u0026amp; O\u0026rsquo;Malley, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2005\u003c/span\u003e; Daudt et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). The review was conducted in five steps: (1) identifying the research question; (2) identifying relevant studies; (3) selecting the studies; (4) charting the data; and (5) collating, summarizing, and reporting results. The study procedures are explained in the following sections and visualized in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. This scoping review is reported according to PRISMA-ScR guidelines (Tricco et al. \u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) (See \u003cspan refid=\"Sec16\" class=\"InternalRef\"\u003eappendix\u003c/span\u003e Prisma ScR checklist).\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Search Strategy\u003c/h2\u003e \u003cp\u003eA systematic search of the international literature on nudging interventions targeting stair use, in four electronic databases (PubMed, Cochrane Library, Mendeley \u0026amp; Google Scholar) was conducted between January 1, 2009 (one year after the publication year of Thaler and Sunstein\u0026rsquo;s seminal book on nudging) and May 07, 2022. We performed our search based on the PICO framework (see \u003cspan refid=\"Sec16\" class=\"InternalRef\"\u003eappendix\u003c/span\u003e: Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e2\u003c/span\u003e). \u003cem\u003ePopulation\u003c/em\u003e and \u003cem\u003eComparison\u003c/em\u003e were manually checked during the selection process of the studies. In terms of \u003cem\u003eIntervention\u003c/em\u003e, our initial search included the terms \u0026ldquo;nudg*\u0026rdquo; and \u0026ldquo;behavioral economic*\u0026rdquo;, but we revised our search with additional terms of nudge subcategories as we missed some eligible studies that used relevant nudge subcategory terms. More specifically, we added the terms of the MINDSPACE framework (Messenger, Incentives, Norms, Defaults, Salience, Priming, Affect, Commitment \u0026amp; Ego), as it is considered one of the most popular nudge toolkits and it is widely used in nudge literature (Dolan et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). \u003cem\u003eOutcome\u003c/em\u003e included terms indicating the primary outcome of the intervention, that is the changes of stairs use rates (including ascending or descending).\u003c/p\u003e \u003cp\u003eMoreover, reference lists of the included studies were manually searched in order to identify additional studies. Following a snowball method, we first used backward search and then we conducted a forward search (citation search) (Wohlin \u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). The identified studies were explored based on the inclusion and exclusion criteria of our search.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Inclusion and Exclusion Criteria\u003c/h2\u003e \u003cp\u003eThe identified studies were eligible to be included in the analysis if they met the following inclusion criteria: (1) they should have been published from January 1, 2009 to May 07, 2022, (2) they should have been original studies, (3) participants should be healthy adults (over 18 years old), (4) nudging interventions should be used with primary aim to increase stair use (either ascent and/or descent), (5) elevator or escalator should have been used as a comparison, (6) outcomes of intervention stages should be compared with a baseline level, (7) studies should have applied all study designs (8) they should have been written in English.\u003c/p\u003e \u003cp\u003eOn the other hand, the identified studies were not eligible if they met the following exclusion criteria: (1) being published before 2009 and after May 07, 2022, (2) being other than original studies, (3) participants were not healthy adults (e.g. people with injuries, physical incapacity or other disorders) or belonged to any preventive health program (e.g. weight management), (4) interventions did not apply the concept of nudges, (5) intervention outcomes were not compared with baseline levels (6) studies were not published in English, (7) studies were described as theory papers, abstracts, opinions or conference presentations.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Studies selection process\u003c/h2\u003e \u003cp\u003eThe collected studies were merged in order to identify and delete duplicates. After the removing duplicates process, the first two authors (AT and GK) independently screened for eligibility criteria the titles and abstracts. In case reviewers were unable to access the full text, the first author (AT) requested it from the corresponding author of the study via personal email or ResearchGate platform. Then, their full texts were further studied and checked that the entry criteria that mentioned above were satisfied. Disagreements about the inclusion or exclusion of an article were discussed before the final selection.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Synthesis Process\u003c/h2\u003e \u003cp\u003eDuring the synthesis process, the MINDSPACE was used as framework for understanding and categorizing the different characteristics of nudging interventions and evaluating their effectiveness. The first author (AT) synthesised the extracted data in corroboration with the second author (GK) and presented it in a table, mapping the collected studies against the following categories (see Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e): authors and year of publication, study design, main purpose of study, country and place of interventions, target group, duration of study, nudge intervention technique, MINDSPACE factor, method of data collection and effectiveness of interventions. A narrative synthesis approach was adopted to present the results.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003eInitially, 118 articles were identified. After excluding duplicates (n\u0026thinsp;=\u0026thinsp;61), 57 articles were assessed and 26 of them were removed as non-relevant, after the reading of the titles and the abstracts. 31 full-text articles were assessed against the inclusion criteria and 4 of them were excluded. A total of 27 articles were included in this review (see Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Characteristics of the included studies\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e summarizes the general characteristics of the included studies in this review.\u003c/p\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003e3.1.1 Country \u0026amp; Publication Year\u003c/h2\u003e \u003cp\u003eStudies were published between 2009 and 2022 in 13 different countries. Most of them (n\u0026thinsp;=\u0026thinsp;16) were published in the first half of the selected period (until 2016) and the rest (n\u0026thinsp;=\u0026thinsp;11), until 2022. No studies, published in 2015 and 2022 (until 7th of May) were identified. The majority (n\u0026thinsp;=\u0026thinsp;6) were conducted in UK, followed by USA (n\u0026thinsp;=\u0026thinsp;4), Belgium and Germany (n\u0026thinsp;=\u0026thinsp;3 each), Australia, Japan and the Netherlands (n\u0026thinsp;=\u0026thinsp;2 each), France, Spain, Norway, Canada, South Africa, and Singapore (n\u0026thinsp;=\u0026thinsp;1 each). One study took place in two countries, Spain and UK.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section3\"\u003e \u003ch2\u003e3.1.2 Study design\u003c/h2\u003e \u003cp\u003eTwenty studies used quasi-experimental designs, while six studies relied on observational methods. Additionally, three studies opted for experimental designs. Notably, two studies stood out for using two different designs to conduct separate experiments.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section3\"\u003e \u003ch2\u003e3.1.3 Place and duration of interventions\u003c/h2\u003e \u003cp\u003eThe duration of the interventions varied considerably and ranged from 1 day to 37 months. Most of the studies (n\u0026thinsp;=\u0026thinsp;21) lasted up to 8 weeks. Eleven of them lasted up to 4 weeks and the rest (n\u0026thinsp;=\u0026thinsp;10) studies lasted from 5 to 8 weeks. The majority of studies were conducted in train stations (n\u0026thinsp;=\u0026thinsp;9). The rest studies took place in office buildings (n\u0026thinsp;=\u0026thinsp;8), universities buildings (n\u0026thinsp;=\u0026thinsp;7), shopping mall, airport, medical center and health-fitness facilities (n\u0026thinsp;=\u0026thinsp;1 each).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section3\"\u003e \u003ch2\u003e3.1.4 Data collection methods\u003c/h2\u003e \u003cp\u003eThe majority of the studies (n\u0026thinsp;=\u0026thinsp;18) (Andersen et al., 2012; Bellettiere et al., 2017; Boen et al., 2010; Eves et al., 2009; Krisam et al., 2020; Krull et al., 2021; Lewis et al., 2012a; Lewis et al., 2012b; M\u0026uuml;ller-Riemenschneider et al., 2010; Nomura et al., 2009; Nomura et al., 2014; Olander et al., 2011; Pillay et al., 2009; Ryan et al., 2011; Sloan et al., 2013; Suri et al., 2014; Van der Meiden et al., 2019; Van Hoecke et al., 2017) used solely direct observation as the method for their data collection. Most of the studies recorded the number of individuals who ascended the stairs or they moved via escalator or elevator.\u003c/p\u003e \u003cp\u003eThree studies (Crozier, 2019; Engelen et al., 2017; Moloughney et al., 2018) combined electronic movement counters and direct observation to measure the number of individuals ascending and descending the stairs or using the elevator.\u003c/p\u003e \u003cp\u003eThe data of five studies was collected solely remotely. Four of them (\u0026Aring;vitsland et al., 2017; Bellicha et al., 2016; Puig-Ribera et al., 2019; Van Calster et al., 2017) used automatic movement sensors that monitored only stair climbing or both the ascent from and descent to the ground floor by either elevators or stairs. In one study (Van Nieuw-Amerongen et al., 2011) stair ascending and elevator use were observed using video cameras.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section3\"\u003e \u003ch2\u003e3.1.5 Nudging Interventions\u003c/h2\u003e \u003cp\u003eThe nudging intervention techniques employed in the included studies are reported in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e and they are further categorized according to the MINDSPACE framework. This framework provides a structured approach to understanding the various behavioural influences utilized within the interventions, encompassing factors such as Messenger, Incentives, Norms, Defaults, Salience, Priming, Affect, Commitment, and Ego. The two most commonly used MINDSPACE factors were \u0026ldquo;priming\u0026rdquo; and \u0026ldquo;salience\u0026rdquo;. \u0026ldquo;Priming\u0026rdquo; involves prompts like motivational messages about energy savings, caloric consumption or health benefits on posters near stairs, along with directional cues like footprints or arrows. \u0026ldquo;Salience\u0026rdquo;, which emphasizes the enhanced visibility of staircases through eye-catching signage or vibrant visual cues strategically placed in prominent locations, plays a crucial role in capturing attention and encouraging individuals to opt for stairs.\u003c/p\u003e \u003cp\u003eThe majority of the studies (n\u0026thinsp;=\u0026thinsp;26) combined at least these two factors to promote stair use (Andersen et al., 2012; \u0026Aring;vitsland et al., 2017; Bellettiere et al., 2017; Bellicha et al., 2016; Boen et al., 2010; Cohen, 2013; Crozier, 2019; Engelen et al., 2017; Eves et al., 2009; Krull et al., 2021; Lewis et al., 2012a; Lewis et al., 2012b; Moloughney et al., 2018; M\u0026uuml;ller-Riemenschneider et al., 2010; Nomura et al., 2009; Nomura et al., 2014; Olander et al., 2011; Pillay et al., 2009; Puig-Ribera et al., 2019; Ryan et al., 2011; Sloan et al., 2013; Suri et al., 2014; Van Calster et al., 2017; Van der Meiden et al., 2019; Van Hoecke et al., 2017; Van Nieuw-Amerongen et al., 2011).\u003c/p\u003e \u003cp\u003eFive studies employed \u0026ldquo;norms\u0026rdquo; to influence participants to choose stairs over the elevators or escalators. They achieved this by employing stair-climbing role models (Krisam et al., 2020; Van Calster et al., 2017), using stick figures walking up the stairs accompanied by social prompt messages (Crozier, 2019; Engelen et al., 2017) or by congratulating employees for their increased stair use (Van Hoecke et al., 2017).\u003c/p\u003e \u003cp\u003eFour studies employed the \u0026ldquo;messenger\u0026rdquo; factor to nudge participants, primarily employees, towards increased stair use. They achieved this by encouraging stair use through corporate emails (Cohen, 2013; Moloughney et al., 2018; Van Calster et al., 2017) or by providing congratulatory messages via personal letters (Van Hoecke et al., 2017).\u003c/p\u003e \u003cp\u003eOne study introduced \u0026ldquo;incentives\u0026rdquo; to reward participants who taking the stairs with a small money prize (Cohen, 2013). Additionally, one study employed \u0026ldquo;affect\u0026rdquo; by triggering emotional associations through positive feedback messages containing smiley faces. This technique aimed to influence employees to choose the stairs over the elevator (\u0026Aring;vitsland et al., 2017). \u0026ldquo;Commitment\u0026rdquo;, \u0026ldquo;defaults\u0026rdquo; and \u0026ldquo;ego\u0026rdquo; were not identified in the included articles.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section3\"\u003e \u003ch2\u003e3.1.6 Effects of interventions\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e summarizes the key results of the included articles. Twenty-two of the twenty-seven articles showed that nudging interventions had a positive effect on stair use and reported at least one significant effect (Bellettiere et al., 2017; Bellicha et al., 2016; Boen et al., 2010; Crozier, 2019; Engelen et al., 2017; Eves et al., 2009; Lewis et al., 2012a; Lewis et al., 2012b; Moloughney et al., 2018; M\u0026uuml;ller-Riemenschneider et al., 2010; Nomura et al., 2009; Nomura et al., 2014; Olander et al., 2011; Pillay et al., 2009; Puig-Ribera et al., 2019; Ryan et al., 2011; Sloan et al., 2013; Suri et al., 2014; Van Calster et al., 2017; Van der Meiden et al., 2019; Van Hoecke et al., 2017; Van Nieuw-Amerongen et al., 2011) that was mainly reported with a p- value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 or lower. Nine of them identified mixed results from the nudging interventions (Crozier, 2019; Engelen et al., 2017; Eves et al., 2009; Lewis et al., 2012a; M\u0026uuml;ller-Riemenschneider et al., 2010; Olander et al., 2011; Puig-Ribera et al., 2019; Van der Meiden et al., 2019; Van Hoecke et al., 2017). The remaining five out of twenty-seven articles did not demonstrate any significant positive effects (Andersen et al., 2012; Cohen, 2013; Krisam et al., 2020; Krull et al., 2021;) or yielded negative effects on stair use (\u0026Aring;vitsland et al., 2017).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThis scoping review\u0026nbsp;aimed at investigating the effect and the characteristics of nudging interventions on stair use,\u0026nbsp;instead of elevator or escalator in different everyday life settings,\u0026nbsp;such as worksites, universities, public buildings, train stations, medical centers, fitness facilities, airports \u0026amp; malls. The findings indicate that nudging interventions can be effective in influencing people to use the stairs instead of elevators or escalators.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis review identified twenty-seven studies, the vast majority of which (twenty-two) showed that nudging interventions had a positive effect on stair use and reported at least one significant effect. The current findings are consistent with previous relevant systematic reviews. Bellicha et al (2010) found an increase in stair use in both worksites and public settings.\u0026nbsp;Additionally, the findings of Jennings et al (2017)\u0026nbsp;and\u0026nbsp;Landais et al (2020) demonstrated that the majority of interventions promoting stair use were effective. In our review, some included studies estimate both stair ascent and descent into a measure of stair use when they estimated intervention effects. However, efficacy can be achieved only by stair climbing, as associated with various health benefits such as reduced cardiovascular disease risk, lower blood pressure, improved fitness and weight loss\u0026nbsp;(Boreham et al., 2005; Meyer, 2010). To the best of our knowledge, there are not specific data indicating that stair descent has similar health benefits. Stair descent has the half exercise intensity (4.8 METs) compared to stair climbing (9.6 METs) (Teh \u0026amp; Aziz, 2002). Stair climbing is clearly a more preferred physical activity than stair descending and future studies should analyze both activities separately. However, any kind of activity, even those with light intensity are associated with beneficial effects (Healy et al., 2015).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMost of the interventions (twenty-three) took place in EU countries, North America countries (USA \u0026amp; Canada) and Australia.\u0026nbsp;This possibly reflects the politically liberal conditions in those countries. The liberal traditions in the USA, Canada, Australia and European countries tend to favor nudging interventions in health policy\u0026nbsp;(Jones et al., 2014). In the USA, President Barack Obama nominated Cass Sunstein to be Administrator of the Office of Information and Regulatory Affairs in 2009. One year later, UK Prime Minister David Cameron supported set up the Behavioural Insight Team (BIT) in the Cabinet Office in order to influence population to behave in a more socially integrated way (Jones et al., 2014).\u003c/p\u003e\n\u003cp\u003eThe primary nudging strategy involved using messages and posters. These message-based interventions predominantly featured health, fitness, and caloric expenditure messages aimed at promoting stair climbing. Notably, most posters included a human figure ascending stair, often accompanied by stair banners. The majority of studies incorporating positively framed messages reported significant effects. However, the only study utilizing a health risk-oriented message did not observe a notable positive impact on stair use. Rothman and Salovey (1997) reported that health messages can emphasize gains or losses associated with behaviors, with gain-framed messages being more influential for prevention behaviors and loss-framed messages for detection behaviors. Gallagher and Updegraff\u0026rsquo;s (2012) meta-analysis supported the idea that positively framed messages significantly influence preventive health behaviors. Overall, these findings align with existing literature on message framing and its impact on behaviour change.\u003c/p\u003e\n\u003cp\u003eAnother nudging intervention based on the enhancement of stairwell aesthetics and its visibility reported in four studies. Because of the small number of studies, it was not possible to generalize its positive effects. However, the results are promising and can be taken into consideration by architects and civil engineers when they design or renovate a structure and especially stairs and elevators. Elevators often attract people because of their central locations, well designs and amenities such as music, mirrors, automated doors. On the other hand, stairs are located in not easily accessible and visible locations without any attractiveness. Thus, architectural design modifications and policy changes may have a positive impact on stair use (McGann et al., 2013).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe place of interventions may influence the amount of exposure. The population of specific locations such as airports and shopping malls likely do not return from one day to the following day compared to other places such as worksites, universities, fitness facilities, hospitals and train stations in where populations may return day after day and are possibly exposed to repeated nudging interventions. Nevertheless, none of the included studies measured the effect of the repeated exposure to nudges on stair use.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eStudies should investigate the lasting effects of nudges, particularly in settings like worksites where it\u0026apos;s more feasible to follow the same population throughout the study (Eves et al., 2012). From this review, there is limited evidence suggesting that nudging interventions resulted in sustained behavioural changes related to stair use. The inclusion of follow-up periods shorter than 12 weeks in many studies constrained the evaluation of the long-term effectiveness of nudging interventions (Weerd \u0026amp; Degens, 2019).\u003c/p\u003e\n\u003cp\u003eFuture research should focus on exploring the lasting effects of nudges on stair use. Sustaining habitual behaviour poses a significant challenge. In behavioural science, it\u0026apos;s crucial to distinguish between initiating behaviour change and maintaining that change over time (Kwasnicka et al., 2016).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIt would also be beneficial for future studies to expand on the critical analysis of this review\u0026apos;s findings, particularly concerning their implications for physical activity public health policies and the ethical complexities associated with nudging. Nudging has been criticised for its reliance on individualized, behaviour-centric approaches, potentially sidelining the broader social determinants of health and disparities in resources. This criticism highlights the need for future research to delve deeper into the ethical considerations and limitations of nudges as they pertain to public health interventions\u0026nbsp;(Mulderrig, 2019; Wilkins, 2013).\u003c/p\u003e\n\u003cp\u003eThis scoping review presents strengths and weaknesses. A strength is that it included studies that used nudges in different target groups and settings, from different countries covering a wide range of population\u0026nbsp;everyday life such as worksites, universities, public buildings, train stations, medical centers, fitness facilities, airports \u0026amp; malls.\u0026nbsp;Furthermore, this review included both stairs climbing and stair descent under the general term \u0026ldquo;stair use\u0026rdquo;. Finally, it considered studies that used nudge principles in\u0026nbsp;terms of a theoretical framework such as MINDSPACE.\u003c/p\u003e\n\u003cp\u003eThis review has also weak points. Many of the included studies did not directly use nudges or even refer to any concept of behavioural economics and a challenging issue of our search was to develop a search approach that could identify any relevant articles. Due to the heterogeneity of studies, in regard to study design, nudging intervention characteristics and the outcome measures, it was not possible to compare the effect sizes across studies. Moreover, the studies showing significant results are more likely to be published. This may reflect a publication bias (Hopewell et al., 2009). The use of specific databases (PubMed, Cochrane Library, Mendeley \u0026amp; Google Scholar) and the exclusion of studies published in other than English language is possibly a selection bias, thus the results may not be generalizable.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe majority of studies identified in this scoping review reported significant positive results in stair use in several settings. Nudging interventions can be a simple and cost-effective policy and prevention tool as it may produce immediate behavioral changes. Nudges can be used as additional public health tool to improve the levels of physical activity, via stair use, covering a wide range of population everyday life that would have a cumulative positive effect on population health.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflict of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflict of interest\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe present study was funded by the Special Account for Research Grants (ELKE) of the University of West Attica (21-29/06/2023).\u003c/p\u003e"},{"header":"References","content":"\u003cp\u003e* The references included in this review are marked with an asterisk\u003c/p\u003e\n\u003col\u003e\n\u003cli\u003e*Andersen, L., Bungum, T., \u0026amp; Moonie, S. (2012). The effects of environmental prompts on stair usage. \u003cem\u003eNevada Journal of Public Health, 9\u003c/em\u003e(1), 7-12. https://digitalscholarship.unlv.edu/njph/vol9/iss1/2\u003c/li\u003e\n\u003cli\u003eAndersen, L. L., Sundstrup, E., Boysen, M., Jakobsen, M. D., Mortensen, O. S., \u0026amp; Persson, R. (2013). Cardiovascular health effects of internet-based encouragements to do daily workplace stair-walks: Randomized controlled trial. \u003cem\u003eJournal of Medical Internet Research, 15\u003c/em\u003e(6), e2340. https://doi.org/10.2196/jmir.2340\u003c/li\u003e\n\u003cli\u003eArksey, H., \u0026amp; O\u0026rsquo;Malley, L. (2005). Scoping studies: Towards a methodological framework. \u003cem\u003eInternational Journal of Social Research Methodology\u003c/em\u003e, \u003cem\u003e8\u003c/em\u003e(1), 19\u0026ndash;32. https://doi.org/10.1080/1364557032000119616\u003c/li\u003e\n\u003cli\u003e*\u0026Aring;vitsland, A., Solbraa, A. K., \u0026amp; Riiser, A. (2017). Promoting workplace stair climbing: Sometimes, not interfering is the best. \u003cem\u003eArchives of Public Health, 75\u003c/em\u003e(1), 1-9. https://doi.org/10.1186/s13690-016-0170-8\u003c/li\u003e\n\u003cli\u003eBauer, J. M., \u0026amp; Reisch, L. A. (2019). Behavioural insights and (un)healthy dietary choices: A review of current evidence. \u003cem\u003eJournal of Consumer Policy, 42\u003c/em\u003e(1), 3-45. https://doi.org/10.4337/9781788116060.00013\u003c/li\u003e\n\u003cli\u003e*Bellettiere, J., Liles, S., BenPorat, Y., Bliss, N., Hughes, S. C., Bishop, B., \u0026amp; Hovell, M. F. (2017). And she\u0026rsquo;s buying a stairway to health: Signs and participant actors influencing stair ascent at a public airport. \u003cem\u003eThe Journal of Primary Prevention, 38\u003c/em\u003e(6), 597-611. https://doi.org/10.1007/s10935-017-0491-6\u003c/li\u003e\n\u003cli\u003eBellicha, A., Kieusseian, A., Fontvieille, A. M., Tataranni, A., Charreire, H., \u0026amp; Oppert, J. M. (2015). Stair-use interventions in worksites and public settings\u0026mdash;A systematic review of effectiveness and external validity. \u003cem\u003ePreventive Medicine\u003c/em\u003e, \u003cem\u003e70\u003c/em\u003e, 3-13. https://doi.org/10.1016/j.ypmed.2014.11.001\u003c/li\u003e\n\u003cli\u003e*Bellicha, A., Kieusseian, A., Fontvieille, A. M., Tataranni, A., Copin, N., Charreire, H., \u0026amp; Oppert, J. M. (2016). A multistage controlled intervention to increase stair climbing at work: Effectiveness and process evaluation. \u003cem\u003eInternational Journal of Behavioral Nutrition and Physical Activity\u003c/em\u003e, \u003cem\u003e13\u003c/em\u003e(1), 1-9. \u003cbr\u003e https://doi.org/10.1186/s12966-016-0371-0\u003c/li\u003e\n\u003cli\u003eBenartzi, S., Beshears, J., Milkman, K. L., Sunstein, C. R., Thaler, R. H., Shankar, M., Tucker-Ray, W., Congdon, W. J., \u0026amp; Galing, S. (2017). 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Prompt before the choice is made: Effects of a stair‐climbing intervention in university buildings. \u003cem\u003eBritish Journal of Health Psychology\u003c/em\u003e, \u003cem\u003e17\u003c/em\u003e(3), 631-643. https://doi.org/10.1111/j.2044-8287.2011.02060.x\u003c/li\u003e\n\u003cli\u003e*Lewis, A. L., \u0026amp; Eves, F. F. (2012b). Prompts to increase stair climbing in stations: The effect of message complexity. \u003cem\u003eJournal of Physical Activity and Health\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e(7), 954-961. https://doi.org/10.1123/jpah.9.7.954 \u003c/li\u003e\n\u003cli\u003eLiberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., G\u0026oslash;tzsche, P. C., Ioannidis, J. P. A., ... Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. \u003cem\u003eJournal of Clinical Epidemiology, 62\u003c/em\u003e, 1\u0026ndash;34. https://doi.org/10.1016/j.jclinepi.2009.06.006\u0026Alpha;\u0026rho;\u0026chi;ή \u0026phi;ό\u0026rho;\u0026mu;\u0026alpha;\u0026sigmaf;\u003c/li\u003e\n\u003cli\u003eMadrian, B. C. (2014). Applying insights from behavioral economics to policy design. New York: National Bureau of Economic Research. https://doi.org/10.3386/w20318\u003c/li\u003e\n\u003cli\u003eMcGann, S., Jancey, J., \u0026amp; Tye, M. (2013). Taking the stairs instead: The impact of workplace design standards on health promotion strategies. \u003cem\u003eThe Australasian Medical Journal\u003c/em\u003e, \u003cem\u003e6\u003c/em\u003e(1), 23. http//dx.doi.org/10.4066/AMJ.2013.1584\u003c/li\u003e\n\u003cli\u003eMeyer, P., Kayser, B., Kossovsky, M. P., Sigaud, P., Carballo, D., Keller, P.-F., Martin, X. E., Farpour-Lambert, N., Pichard, C., \u0026amp; Mach, F. (2010). Stairs instead of elevators at workplace: Cardioprotective effects of a pragmatic intervention. \u003cem\u003eEuropean Journal of Cardiovascular Prevention \u0026amp; Rehabilitation, 17\u003c/em\u003e(5), 569\u0026ndash;575. https://doi.org/10.1097/HJR.0b013e328338a4dd\u003c/li\u003e\n\u003cli\u003e*Moloughney, B. W., Bursey, G. E., Fortin, R. B., Morais, M. G., \u0026amp; Dang, K. T. (2019). A multicomponent intervention to encourage stair use in municipal buildings. \u003cem\u003eAmerican Journal of Health Promotion\u003c/em\u003e, \u003cem\u003e33\u003c/em\u003e(1), 57-69. https://doi.org/10.1177/0890117118776893\u003c/li\u003e\n\u003cli\u003eMulderrig, J. (2019). The language of \u0026ldquo;nudge\u0026rdquo; in health policy: Preempting working class obesity through biopedagogy. Critical Policy Studies, 13(1), 101\u0026ndash;121. https:// doi.org/10.1080/19460 171.2017.1398672\u003c/li\u003e\n\u003cli\u003eM\u0026uuml;ller-Riemenschneider, F., Reinhold, T., Bergh\u0026ouml;fer, A., \u0026amp; Willich, S. N. (2008). Health-economic burden of obesity in Europe. \u003cem\u003eEuropean Journal of Epidemiology, 23\u003c/em\u003e(8), 499\u0026ndash;509. https://doi.org/10.1007/s10654-008-9239-1\u003c/li\u003e\n\u003cli\u003e*M\u0026uuml;ller-Riemenschneider, F., Nocon, M., Reinhold, T., \u0026amp; Willich, S. N. (2010). Promotion of physical activity using point-of-decision prompts in Berlin underground stations. \u003cem\u003eInternational Journal of Environmental Research and Public Health, 7\u003c/em\u003e(8), 3063\u0026ndash;3070. https://doi.org/10.3390/ijerph7083063\u003c/li\u003e\n\u003cli\u003eNocon, M., Hiemann, T., M\u0026uuml;ller-Riemenschneider, F., Thalau, F., Roll, S., \u0026amp; Willich, S. N. (2008). Association of physical activity with all-cause and cardiovascular mortality: A systematic review and meta-analysis. \u003cem\u003eEuropean Journal of Preventive Cardiology\u003c/em\u003e, \u003cem\u003e15\u003c/em\u003e(3), 239-246. https://doi.org/10.1097/HJR.0b013e3282f55e09\u003c/li\u003e\n\u003cli\u003e*Nomura, T., Katayama, K., Kashiwa, T., Akezaki, Y., \u0026amp; Sato, A. (2014). Maintenance of the rate of stair use over a long-term period using a stair climbing campaign. \u003cem\u003eJournal of Occupational Health, 56\u003c/em\u003e(1), 52\u0026ndash;59. https://doi.org/10.1539/joh.13-0223-FS\u003c/li\u003e\n\u003cli\u003e*Nomura, T., Yoshimoto, Y., Akezaki, Y., \u0026amp; Sato, A. (2009). Changing behavioral patterns to promote physical activity with motivational signs. \u003cem\u003eEnvironmental Health and Preventive Medicine, 14\u003c/em\u003e(1), 20\u0026ndash;25. https://doi.org/10.1007/s12199-008-0053-x\u003c/li\u003e\n\u003cli\u003e*Olander, E. K., \u0026amp; Eves, F. F. (2011). Effectiveness and cost of two stair-climbing interventions\u0026mdash;Less is more. \u003cem\u003eAmerican Journal of Health Promotion\u003c/em\u003e, \u003cem\u003e25\u003c/em\u003e(4), 231-236. https://doi.org/10.4278/ajhp.090325-QUAN-119\u003c/li\u003e\n\u003cli\u003e*Pillay, J. D., Kolbe-Alexander, T., Achmat, M., Carstene, M., \u0026amp; Lambert, E. V. (2009). Are point-of-decision prompts in a sports science and medicine centre effective in changing the prevalence of stair usage? A preliminary study. \u003cem\u003eSouth African Journal of Sports Medicine\u003c/em\u003e, \u003cem\u003e21\u003c/em\u003e(2). https://doi.org/10.17159/2078-516X/2009/v21i2a299\u003c/li\u003e\n\u003cli\u003e*Puig-Ribera, A., Se\u0026ntilde;\u0026eacute;-Mir, A. M., Taylor-Covill, G. A., De Lara, N., Carroll, D., Daley, A., \u0026amp; Eves, F. F. (2019). Signage interventions for stair climbing at work: More than 700,000 reasons for caution. \u003cem\u003eInternational Journal of Environmental Research and Public Health, 16\u003c/em\u003e(19), 3782. https://doi.org/10.3390/ijerph16193782\u003c/li\u003e\n\u003cli\u003eRasul, I., \u0026amp; Hollywood, D. (2012). Behavior change and energy use: Is a \u0026lsquo;nudge\u0026rsquo; enough? \u003cem\u003eCarbon Management\u003c/em\u003e, \u003cem\u003e3\u003c/em\u003e(4), 349-351. https://doi.org/10.4155/cmt.12.32\u003c/li\u003e\n\u003cli\u003eRey-Lopez, J. P., Stamatakis, E., Mackey, M., Sesso, H. D., \u0026amp; Lee, I. M. (2019). Associations of self-reported stair climbing with all-cause and cardiovascular mortality: The Harvard Alumni Health Study. \u003cem\u003ePreventive Medicine Reports\u003c/em\u003e, \u003cem\u003e15\u003c/em\u003e, 100938. https://doi.org/10.1016/j.pmedr.2019.100938\u003c/li\u003e\n\u003cli\u003eRhodes, R. E., Janssen, I., Bredin, S. S., Warburton, D. E., \u0026amp; Bauman, A. (2017). Physical activity: Health impact, prevalence, correlates and interventions. \u003cem\u003ePsychology \u0026amp; Health, 32\u003c/em\u003e(8), 942\u0026ndash;975. https://doi.org/10.1080/08870446.2017.1325486\u003c/li\u003e\n\u003cli\u003eRothman, A. J., \u0026amp; Salovey, P. (1997). Shaping perceptions to motivate healthy behavior: The role of message framing. \u003cem\u003ePsychological Bulletin, 121\u003c/em\u003e(1), 3-19. https://doi.org/10.1037/0033-2909.121.1.3\u003c/li\u003e\n\u003cli\u003e*Ryan, J., Lyon, K., Webb, O. J., Eves, F. F., \u0026amp; Ryan, C. G. (2011). Promoting physical activity in a low socioeconomic area: Results from an intervention targeting stair climbing. \u003cem\u003ePreventive Medicine\u003c/em\u003e, \u003cem\u003e52\u003c/em\u003e(5), 352-354. https://doi.org/10.1016/j.ypmed.2011.03.004\u003c/li\u003e\n\u003cli\u003e*Sloan, R. A., Haaland, B. A., Leung, C., \u0026amp; M\u0026uuml;ller-Riemenschneider, F. (2013). The use of point-of-decision prompts to increase stair climbing in Singapore. \u003cem\u003eInternational Journal of Environmental Research and Public Health\u003c/em\u003e, \u003cem\u003e10\u003c/em\u003e(1), 210-218. https://doi.org/10.3390/ijerph10010210\u003c/li\u003e\n\u003cli\u003eSmith, L. P., Ng, S. W., \u0026amp; Popkin, B. M. (2014). No time for the gym? Housework and other non-labor market time use patterns are associated with meeting physical activity recommendations among adults in full-time, sedentary jobs. \u003cem\u003eSocial Science \u0026amp; Medicine\u003c/em\u003e, \u003cem\u003e120\u003c/em\u003e, 126-134. https://doi.org/10.1016/j.socscimed.2014.09.010\u003c/li\u003e\n\u003cli\u003eStrawbridge, W. J., Deleger, S., Roberts, R. E., \u0026amp; Kaplan, G. A. (2002). Physical activity reduces the risk of subsequent depression for older adults. \u003cem\u003eAmerican Journal of Epidemiology\u003c/em\u003e, \u003cem\u003e156\u003c/em\u003e(4), 328-334. https://doi.org/10.1093/aje/kwf047\u003c/li\u003e\n\u003cli\u003e*Suri, G., Sheppes, G., Leslie, S., \u0026amp; Gross, J. J. (2014). Stairs or escalator? Using theories of persuasion and motivation to facilitate healthy decision making. \u003cem\u003eJournal of Experimental Psychology: Applied\u003c/em\u003e, \u003cem\u003e20\u003c/em\u003e(4), 295. http://dx.doi.org/10.1037/xap0000026\u003c/li\u003e\n\u003cli\u003eTeh, K. C., \u0026amp; Aziz, A. R. (2002). Heart rate, oxygen uptake, and energy cost of ascending and descending the stairs. \u003cem\u003eMedicine and Science in Sports and Exercise\u003c/em\u003e, \u003cem\u003e34\u003c/em\u003e(4), 695-699. https://doi.org/10.1097/00005768-200204000-00021\u003c/li\u003e\n\u003cli\u003eThaler, R.,\u003cstrong\u003e \u0026amp; \u003c/strong\u003eSunstein, C. (2021). Nudge: The Final Edition. London: Allen Lane, Penguin Press.\u003c/li\u003e\n\u003cli\u003eTricco, A. C., Lillie, E., Zarin, W., O\u0026apos;Brien, K. K., Colquhoun, H., Levac, D., ... \u0026amp; Straus, S. E. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. \u003cem\u003eAnnals of Internal Medicine, 169\u003c/em\u003e(7), 467\u0026ndash;473. https://doi.org/10.7326/M18-0850\u003c/li\u003e\n\u003cli\u003eTzikas, A., \u0026amp; Koulierakis, G. (2023). A systematic review of nudges on hand hygiene against the spread of COVID-19. \u003cem\u003eJournal of Behavioral and Experimental Economics, 102046.\u003c/em\u003e https://doi.org/10.1016/j.socec.2023.102046\u003c/li\u003e\n\u003cli\u003e*Van Calster, L., Van Hoecke, A. S., Octaef, A., \u0026amp; Boen, F. (2017). Does a video displaying a stair climbing model increase stair use in a worksite setting? \u003cem\u003ePublic Health\u003c/em\u003e, \u003cem\u003e149\u003c/em\u003e, 11-20. https://doi.org/10.1016/j.puhe.2017.04.007\u003c/li\u003e\n\u003cli\u003e*Van der Meiden, I., Kok, H., \u0026amp; Van der Velde, G. (2019). Nudging physical activity in offices. \u003cem\u003eJournal of Facilities Management\u003c/em\u003e. https://doi.org/10.1108/JFM-10-2018-0063\u003c/li\u003e\n\u003cli\u003e*Van Hoecke, A. S., Seghers, J., \u0026amp; Boen, F. (2018). 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(\u0026lrm;2018)\u0026lrm;. \u003cem\u003eGlobal action plan on physical activity 2018\u0026ndash;2030: More active people for a healthier world\u003c/em\u003e\u003cem\u003e.\u003c/em\u003e Geneva, Switzerland.\u003c/li\u003e\n\u003cli\u003eYu, S., Yarnell, J. W. G., Sweetnam, P. M., \u0026amp; Murray, L. (2003). What level of physical activity protects against premature cardiovascular death? The Caerphilly study. \u003cem\u003eHeart\u003c/em\u003e, \u003cem\u003e89\u003c/em\u003e(5), 502-506. http://dx.doi.org/10.1136/heart.89.5.502\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1. \u003c/strong\u003eCharacteristics of the included studies\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"1297\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026Alpha;uthor(\u003c/strong\u003e\u003cstrong\u003es),\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eYear\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePurpose\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCountry\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudy\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003edesign\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of intervention\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTarget group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003estudy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eData collection\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\"\u003e\n \u003cp\u003e\u003cstrong\u003eNudg\u003c/strong\u003e\u003cstrong\u003eing interventions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMINDSPACE\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003efactors\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntervention findings\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffect\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eAndersen et al., 2012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo assess the effects of selected signage prompts on stair usage.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eQE, Pretest - Posttest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eUniversity buildings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStudents, staff \u0026amp; visitors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e7\u0026nbsp;weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003eSignage prompts using messages\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eSalience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStair usage was not increased.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(-) Interventions had no significant effect\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;on stair use (p \u0026gt; 0.05).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026Aring;vitsland et al., 2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo examine workplace stair climbing, assessing the impact of single and combined interventions.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eNorway\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eQE, Time Series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eOffice buildings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eEmployees\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e14 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eInfrared sensors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003eFootprints \u0026amp; stair-riser banners\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eSalience, Priming \u0026amp; Affect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStair climbing decreased.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(-) Stair climbing decreased significantly\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eduring the intervention periods (p \u0026lt; 0.001).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eBellettiere et al., 2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo evaluate sign prompts and participant factors, including past physical activity, on airport stair ascent.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eQE, Interrupted Time Series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eInternational Airport\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003ePassengers\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e22 days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003eSign prompts\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eSalience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStair climbing increased.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+) Significant effect of sing prompts\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eon stair ascent (p\u0026lt;0.001).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eBellicha et al., 2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo evaluate a worksite stair-climbing intervention\u0026apos;s short- and long-term effectiveness.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eFrance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eQE, Controlled before - after\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eCorporate buildings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eEmployees\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e1 year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eAutomatic counters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003eMotivational - directional signs \u0026amp; enhancement of stairwell aesthetics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eSalience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStair climbing increased.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+) Significant effect of sings on\u003c/p\u003e\n \u003cp\u003estair climbing. (p\u0026lt;0.001).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eBoen et al., 2010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo investigate the impact of a health sign in three community settings.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eBelgium\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eQE, Pretest - Posttest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eShopping mall \u0026amp; 2 Train stations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eShoppers\u003c/p\u003e\n \u003cp\u003eCommuters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e4 days\u003c/p\u003e\n \u003cp\u003e4 days \u0026amp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;5 days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003eHealth Sign using a message\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eSalience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStair climbing increased.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+) Significant effect of sings on stair\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eClimbing\u0026nbsp;(p \u0026lt; 0.001).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eCohen, 2013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo examine the impact of a health promotion intervention on stair use.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eQE, Pretest - Posttest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eMedical Center\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStaff members\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e6 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eElectronic counters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003ePrompts signs \u0026amp; education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eMessenger, Incentives, Salience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStair usage was not increased.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(-) No significant effect of interventions\u003c/p\u003e\n \u003cp\u003eon stair usage (p \u0026gt; 0.05).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eCrozier, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo examine the influence of social and non-social stair prompts on stair use.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eAustralia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eOS, Cross Sectional \u0026amp; E, Time Series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eUniversity campus building\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStudents \u0026amp; staff\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e4 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations \u0026amp; infrared sensors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003eSocial prompts using signs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eNorms, Salience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eMixed results.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+/-) Significant effect of norm perceptions\u003c/p\u003e\n \u003cp\u003eand social prompts on stair use. (p\u0026lt; 0.001)\u003c/p\u003e\n \u003cp\u003ebut non \u0026ndash;social prompts did not affect stair\u003c/p\u003e\n \u003cp\u003euse\u0026nbsp;(p\u0026gt;0.05).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eEngelen et al., 2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo investigate if promoting stair-use signage changed stair-to-elevator proportion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eAustralia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eQE, Pretest - Posttest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eUniversity campus buildings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStudents \u0026amp; staff\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e4 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u0026nbsp;\u0026amp; Infrared counters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003eMotivational and directional posters using messages.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eNorms, Salience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eMixed results.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+/-), Interventions in multiple buildings\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eyielded significant effects: two increased \u0026amp;\u003c/p\u003e\n \u003cp\u003eone decreased (p \u0026lt; 0.05).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eEves et al.,\u0026nbsp;2009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo study how environment layout impacts intervention responsiveness.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eUK\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eQE, Pretest - Posttest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eTrain station\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eCommuters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e7 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003eStair riser banners using messages\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eSalience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eMixed results.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+/-) Significant effect of the largest isovist\u003c/p\u003e\n \u003cp\u003eon stair climbing. (OR = 1.30, 95% CI = 1.09\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u0026ndash; 1.56; p = .004). No effect for the smaller\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;isovist.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eKrisam et al., 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo investigate the effect of role model on stair and escalator use.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eGermany\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eQE, Repeated Measures\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eTrain station\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eCommuters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e1 day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003eSocial Norms: role model\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eNorms\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStair use was not increased.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(-) Role model had no significant effect on\u0026nbsp;\u003c/p\u003e\n \u003cp\u003estair use (p\u0026gt;0.01).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eKrull et al., 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo examine how health message interventions motivate behaviour change.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eGermany\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eQE, Pretest - Posttest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eUniversity campus buildings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStudents \u0026amp; employees\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e36 \u0026amp; 20 days\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003eRound \u0026amp; precise health messages\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eSalience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStair use was not increased.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(-) Interventions had no significant effect on\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;stair use (p \u0026gt; 0.05).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eLewis at al., 2012a\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo investigate the effectiveness of stair-climbing intervention components: volitional and motivational aspects.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eUK\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eQE, Interrupted Time Series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eUniversity building\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStudents \u0026amp; staff\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e18\u0026nbsp;days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003ePosters \u0026amp; Arrow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eSalience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eMixed results.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+/-) Significant effect of volitional\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ecomponent on stair climbing (OR = 1.23,\u003c/p\u003e\n \u003cp\u003e95% CI, 1.14\u0026ndash;1.32, p \u0026lt; .001). No significant\u003c/p\u003e\n \u003cp\u003eeffect when positioned alone in the lift\u003c/p\u003e\n \u003cp\u003e(OR = 0.93, 95% CI, 0.85\u0026ndash;1.02, p = .123).\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eLewis at al., 2012b\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo test the effects of two messages with varying complexity.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eUK\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eQE, Interrupted Time Series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eTrain Station\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eCommuters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e5 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003ePosters using messages\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eSalience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStair climbing increased.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+) Significant effect of both messages:\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ecomplex (OR = 1.10, CI, 1.02\u0026ndash;1.18, P = .01)\u003c/p\u003e\n \u003cp\u003eand simple (OR = 1.07, CI = 1.01\u0026ndash;1.13,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eP = .02) on stair climbing.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026Alpha;uthor(\u003c/strong\u003e\u003cstrong\u003es),\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eYear\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePurpose\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCountry\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudy\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003edesign\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of intervention\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTarget group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003estudy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eData collection\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\"\u003e\n \u003cp\u003e\u003cstrong\u003eNudg\u003c/strong\u003e\u003cstrong\u003eing interventions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMINDSPACE\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003efactors\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntervention findings\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffect\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eMoloughney et al., 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo examine the impact of environmental stairwell enhancements on stair use, alongside prompts.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eCanada\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eQE, Longitudinal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eMunicipal administrative buildings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eEmployees \u0026amp; visitors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e37 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u0026nbsp;\u0026amp;\u0026nbsp;Infrared counters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003ePrompts \u0026amp; environmental enhancements\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eMessenger, Salience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStair climbing increased.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+) Significant effects of prompts (OR =1.36;\u003c/p\u003e\n \u003cp\u003e95% CI: 1.31-1.41) \u0026amp; environmental\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eenhancements (OR= 1.31; 95% CI: 1.25-1.37).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eM\u0026uuml;ller-Riemenschneider\u0026nbsp;et al., 2010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo test the feasibility and effectiveness of using posters as decision prompts.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eGermany\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eOS, Pre -Post\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eTrain stations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eCommuters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e10 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003ePrompts: posters using motivational message\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eSalience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eMixed results.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+/-) Stair use increased significantly in women\u003c/p\u003e\n \u003cp\u003e(p\u0026lt;0.05), but not in men (p \u0026gt; 0.05).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eNomura et al., 2009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo study motivational signs\u0026apos; effectiveness in promoting stair use over escalators.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eJapan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eOS, Cross Sectional\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eTrain station\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eCommuters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e8 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003ePosters and banners with motivational messages\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eSalience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStair use increased.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+) Significant effects of posters \u0026amp; banners on\u003c/p\u003e\n \u003cp\u003estair use for both intervention periods: I1:\u003c/p\u003e\n \u003cp\u003e(OR= 1.39, 95% CI, 1.22\u0026ndash;1.59)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eand I2: (OR 1.56, 95% CI 1.36\u0026ndash;1.77).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eNomura et al., 2014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo study the effects of a stair climbing campaign over a long-term period at a worksite.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eJapan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eOS, Pretest-Posttest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eLocal prefectural offices\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eOffice workers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e18 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003ePrompts using message banners\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eSalience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStair use increased.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+) Significant effect of message banners on stair\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;use for both genders, women (OR = 4.25, 95%\u003c/p\u003e\n \u003cp\u003eCI 3.20\u0026minus;5.64) \u0026amp; men (OR = 4.65 95%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;CI 3.72\u0026minus;5.83).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eOlander et al., 2011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo compare information-based and environmental interventions for workplace stair climbing promotion.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eUK\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eQE, Interrupted Time Series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eUniversity campus buildings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eEmployees\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e15 days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003eFloor stand providing health information Vs Signage prompts using posters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eSalience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eMixed results.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+/-) Significant effect of posters (OR = 1.20;\u003c/p\u003e\n \u003cp\u003e95% CI, 1.06-1.37; p \u0026lt; .01) but no significant\u003c/p\u003e\n \u003cp\u003eincrease of health information intervention on\u003c/p\u003e\n \u003cp\u003estair climbing (OR = 1.45; 95% CI, 1.25-1.68;\u003c/p\u003e\n \u003cp\u003ep = 0.83).\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003ePillay et al., 2009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo assess the effectiveness of a signed intervention for stairs in a fitness facility.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eSouth Africa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eOS, Time Series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eHealth and fitness facility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStudents, staff, tenants, visitors \u0026amp; patients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e3 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003eMotivational signs: coloured signs using messages \u0026amp; footprints\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eSalience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStair use increased.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+) Significant effect of signs on stair use\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;(OR 1.45, 95% CI 1.25\u0026ndash;1.68 p\u0026lt;.0001).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003ePuig-Ribera et al., 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo investigated the effects of signage on stair use.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eUK \u0026amp; Spain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eQE, Pretest - Posttest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eOffice buildings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eEmployees\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e4 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eAutomatic counters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003ePosters with messages\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eSalience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eMixed Results.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+/-) Significant effect on stair descent (OR =1.10,\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;95% CI = 1.07, 1.13) but not effect on stair\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eascent (OR = 0.99, 95% CI= 0.97, 1.01).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eRyan et al., 2011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo compare stair climbing rates in high and low socioeconomic areas and evaluate interventions\u0026apos; efficacy in both.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eUK\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eQE, Pretest - Posttest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eTrain Stations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eCommuters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e7 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003ePosters with messages\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eSalience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStair climbing increased.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+) Significant effects of posters on stair\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eclimbing posters in high and low socioeconomic\u003c/p\u003e\n \u003cp\u003eareas (OR = 1.24, 95% CI= 1.11 - 1.39).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eSloan et al., 2013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo investigate point-of-decision prompts effectiveness in promoting stair use over escalators.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eSingapore\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eQE, Pretest - Posttest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eTrain Station\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eCommuters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e8 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003eStair-riser banners \u0026amp; floor stickers with physical activity messages\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eSalience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStair climbing increased.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+) Significant effect of stair-riser banners\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(OR= 1.49, 95% CI 1.34\u0026ndash;1.64).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eSuri et al., 2014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo test if signs promoting heuristic processing are most effective at the point of choice, while those promoting systematic processing work best at a distance.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eQE, Pretest \u0026ndash; Posttest \u0026amp; E, Factorial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eTrain Station\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eCommuters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e1 week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003eSigns using messages\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eSalience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStair climbing increased.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+) Significant effect of both signs conditions on\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;stair use (\u003cem\u003ep\u003c/em\u003e\u0026lt; .001).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eVan Calster et al., 2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo examine the impact of enhanced stairwell visibility and a stair climbing model video on stair use.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eBelgium\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eQE, Interrupted time series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eOffice buildings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eEmployees\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e4 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eInfrared sensors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003eVisibility via pictograms Email \u0026amp; TV phase\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eMessenger, Norms, Salience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eStair climbing increased.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+) Significant effect of all interventions on stair\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;use (p\u0026lt;0.001).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.707787201233616%\" valign=\"top\"\u003e\n \u003cp\u003eVan der Maiden et al., 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.94834232845027%\" valign=\"top\"\u003e\n \u003cp\u003eTo examine the effectiveness and reasons behind nudging interventions stimulating employee stair use in an office setting.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.548959136468774%\" valign=\"top\"\u003e\n \u003cp\u003eThe\u0026nbsp;Netherlands\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.705474171164225%\" valign=\"top\"\u003e\n \u003cp\u003eE, Pretest \u0026ndash; Posttest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eOffice building\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eEmployees\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.394757131842714%\" valign=\"top\"\u003e\n \u003cp\u003e5 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.859676175790285%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.247494217424826%\" valign=\"top\"\u003e\n \u003cp\u003eFootprints \u0026amp; posters with health messages\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.553585196607556%\" valign=\"top\"\u003e\n \u003cp\u003eSalience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.088666152659985%\" valign=\"top\"\u003e\n \u003cp\u003eMixed Results.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.99691595990748%\" valign=\"top\"\u003e\n \u003cp\u003e(+/-) Significant effect of footprints on stair use\u003c/p\u003e\n \u003cp\u003e(p \u0026lt;0.15). Posters did not impact significantly\u003c/p\u003e\n \u003cp\u003e(p \u0026gt;0.15).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"1221\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.388206388206388%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026Alpha;uthor(\u003c/strong\u003e\u003cstrong\u003es),\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eYear\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.81081081081081%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePurpose\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.487305487305488%\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eCountry\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.405405405405405%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudy\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003edesign\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.224406224406224%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of intervention\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.405405405405405%\"\u003e\n \u003cp\u003e\u003cstrong\u003eTarget group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.6683046683046685%\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003estudy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.224406224406224%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eData collection\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.254709254709255%\"\u003e\n \u003cp\u003e\u003cstrong\u003eNudg\u003c/strong\u003e\u003cstrong\u003eing interventions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.961506961506961%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMINDSPACE\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003efactors\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.142506142506143%\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntervention findings\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.027027027027028%\"\u003e\n \u003cp\u003e\u003cstrong\u003eEffect\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.39344262295082%\" valign=\"top\"\u003e\n \u003cp\u003eVan Hoecke et al., 2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.819672131147541%\" valign=\"top\"\u003e\n \u003cp\u003eTo evaluate the impact of footprints on stair climbing in a worksite \u0026amp; public setting.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.409836065573771%\" valign=\"top\"\u003e\n \u003cp\u003eBelgium\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.409836065573771%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eQE, Interrupted Time Series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.229508196721311%\" valign=\"top\"\u003e\n \u003cp\u003eOffice building \u0026amp; shopping mall\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.409836065573771%\" valign=\"top\"\u003e\n \u003cp\u003eEmployees \u0026amp; visitors of the mall\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.672131147540983%\" valign=\"top\"\u003e\n \u003cp\u003e11 \u0026amp; 18 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.229508196721311%\" valign=\"top\"\u003e\n \u003cp\u003eDirect observations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.262295081967213%\" valign=\"top\"\u003e\n \u003cp\u003ePrompts: footprints, health message referring to footprints \u0026amp; congratulating participants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.967213114754099%\" valign=\"top\"\u003e\n \u003cp\u003eMessenger, Norms, Salience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.147540983606557%\" valign=\"top\"\u003e\n \u003cp\u003eMixed Results.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.049180327868854%\" valign=\"top\"\u003e\n \u003cp\u003e(+/-) Significant effect of health message in\u003c/p\u003e\n \u003cp\u003eboth worksite and public settings (p\u0026lt;0.001).\u003c/p\u003e\n \u003cp\u003eFootprints had significant effect on worksite\u003c/p\u003e\n \u003cp\u003eand not in public settings, while\u0026nbsp;\u003c/p\u003e\n \u003cp\u003econgratulating people had no effect on stair\u0026nbsp;\u003c/p\u003e\n \u003cp\u003euse in any setting.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.39344262295082%\" valign=\"top\"\u003e\n \u003cp\u003eVan Nieuw-Amerongen et al., 2011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.819672131147541%\" valign=\"top\"\u003e\n \u003cp\u003eTo investigated the impact of an environmental intervention to increase stair use.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.409836065573771%\" valign=\"top\"\u003e\n \u003cp\u003eThe Netherlands\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.409836065573771%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eOS, Pretest- Posttest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.229508196721311%\" valign=\"top\"\u003e\n \u003cp\u003eUniversity faculties\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.409836065573771%\" valign=\"top\"\u003e\n \u003cp\u003eStudents \u0026amp; employees\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"4.672131147540983%\" valign=\"top\"\u003e\n \u003cp\u003e7 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.229508196721311%\" valign=\"top\"\u003e\n \u003cp\u003eVideo cameras\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.262295081967213%\" valign=\"top\"\u003e\n \u003cp\u003ePrompts, Visibility, Accessibility \u0026amp; Aesthetics of stairwell\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.967213114754099%\" valign=\"top\"\u003e\n \u003cp\u003eSalience \u0026amp; Priming\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.147540983606557%\" valign=\"top\"\u003e\n \u003cp\u003eStair climbing increased.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.049180327868854%\" valign=\"top\"\u003e\n \u003cp\u003e(+) Significant effect of interventions on stair\u0026nbsp;\u003c/p\u003e\n \u003cp\u003euse (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; .001).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations: E: Experimental design, QE: Quasi-Experimental design, OS: Observational design. OR: odds ratio, CI: confidence interval. (+) indicates a significant effect of the main intervention, (+/-) indicates both significant and not significant effects, (-) indicates not significant or negative effect.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Public health, Physical activity, Stair use, Health behaviour, Nudging interventions","lastPublishedDoi":"10.21203/rs.3.rs-4008053/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4008053/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eStair use is a physical activity that can be incorporated into the daily lifestyle of a majority of the population, resulting in several health benefits. Nudges are increasingly used in public health interventions to encourage healthy behaviours such as physical activity in a cost-effective manner. This scoping review aimed to investigate the effect and the characteristics of nudges used on interventions to promote stair use. We reviewed the relevant literature published in PubMed, Cochrane Library, Mendeley \u0026amp; Google Scholar, from January 2009 to May 2022. Eligibility criteria included original studies of any type of design, written in English, targeting healthy adults, reporting nudging interventions, using elevator or escalator as comparators and defining a baseline for comparisons. Initially, 118 publications were identified, and after applying exclusion criteria, 27 articles were included in the analysis. Results showed that most of the nudging interventions had significant positive effect on stair use in several settings. The evidence from this review suggests that incorporating nudges into public health interventions can effectively promote physical activity through increased stair usage. Emphasizing prevention measures in public health interventions may contribute to better health outcomes.\u003c/p\u003e","manuscriptTitle":"Nudging interventions on stair use: a scoping review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-04 07:45:38","doi":"10.21203/rs.3.rs-4008053/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c08966de-a233-42f9-9821-2208bc61e386","owner":[],"postedDate":"March 4th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-06-21T15:16:43+00:00","versionOfRecord":{"articleIdentity":"rs-4008053","link":"https://doi.org/10.1007/s10935-024-00790-2","journal":{"identity":"the-journal-of-primary-prevention","isVorOnly":false,"title":"Journal of Prevention"},"publishedOn":"2024-06-15 15:16:43","publishedOnDateReadable":"June 15th, 2024"},"versionCreatedAt":"2024-03-04 07:45:38","video":"","vorDoi":"10.1007/s10935-024-00790-2","vorDoiUrl":"https://doi.org/10.1007/s10935-024-00790-2","workflowStages":[]},"version":"v1","identity":"rs-4008053","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4008053","identity":"rs-4008053","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}