Is there sufficient evidence regarding signage-based stair use interventions?:A sequential meta-analysis

Bauman, Adrian, Milton, Karen, Kariuki, Maina, Fedel, Karla and Lewicka, Mary (2017) Is there sufficient evidence regarding signage-based stair use interventions?:A sequential meta-analysis. BMJ Open, 7 (11). ISSN 2044-6055

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Objective: The proliferation of studies using motivational signs to promote stair use continues unabated, with their oft-cited potential for increasing population-level physical activity participation. This study examined all stair use promotional signage studies since 1980, calculating pre-estimates and post-estimates of stair use. The aim of this project was to conduct a sequential meta-analysis to pool intervention effects, in order to determine when the evidence base was sufficient for population-wide dissemination. Design: Using comparable data from 50 stair-promoting studies (57 unique estimates) we pooled data to assess the effect sizes of such interventions. Results: At baseline, median stair usage across interventions was 8.1%, with an absolute median increase of 2.2% in stair use following signage-based interventions. The overall pooled OR indicated that participants were 52% more likely to use stairs after exposure to promotional signs (adjusted OR 1.52, 95% CI 1.37 to 1.70). Incremental (sequential) meta-analyses using z-score methods identified that sufficient evidence for stair use interventions has existed since 2006, with recent studies providing no further evidence on the effect sizes of such interventions. Conclusions: This analysis has important policy and practice implications. Researchers continue to publish stair use interventions without connection to policymakers' needs, and few stair use interventions are implemented at a population level. Researchers should move away from repeating short-term, small-scale, stair sign interventions, to investigating their scalability, adoption and fidelity. Only such research translation efforts will provide sufficient evidence of external validity to inform their scaling up to influence population physical activity.

Item Type: Article
Additional Information: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Pure Connector
Date Deposited: 25 Jan 2018 16:30
Last Modified: 21 Oct 2022 17:34
DOI: 10.1136/bmjopen-2016-012459

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