Environmental and Policy Approaches to Increase Physical Activity: Point-of-Decision Prompts to Encourage Use of Stairs

Task Force Finding*

Point-of-decision prompts (PODPs) are motivational signs placed on or near stairwells or at the base of elevators and escalators to encourage individuals to increase stair use. These signs inform individuals about a health or weight-loss benefit from taking the stairs and remind individuals already predisposed to becoming more active, for health or other reasons, about an opportunity at hand to do so.

The use of PODPs may be combined with other environmental changes such as the placement of footprints as a pathway from the POPD poster to the stairwell. For the PODP review, this type of environmental change was considered a secondary prompt (and thus not a separate intervention) that may serve to enhance the sign used in the intervention, and thus it was not examined separately.

The Task Force identified 13 studies qualifying for the primary review of PODP. The Task Force recommends the use of PODP on the basis of strong evidence of its effectiveness in moderately increasing levels of physical activity, as measured by an increase in the percentage of people choosing to take the stairs rather than an elevator or escalator.

This intervention has been shown to be effective in a range of settings and a variety of population subgroups. Findings from several of the studies included in this review suggested that tailoring the prompts either by specifying the benefits of stair use or by customizing the sign to appeal to specific populations may increase intervention effectiveness. No notable harms or other potential benefits were reported, and no qualifying economic information was identified from the literature.

The PODP review also examined the effectiveness of studies of additional interventions (e.g., modifying and enhancing stairwells through painting walls, laying carpet, adding artwork, or playing music, or some combination of these) that may increase the effectiveness of PODPs by making stair use a more appealing option. The Task Force identified two qualifying studies for the secondary review of stairwell enhancements when combined with PODPs. Due to the small number of studies, there was insufficient evidence to determine the effectiveness of this intervention.

*From the following publication:

Task Force on Community Preventive Services. Recommendation for use of point-of-decision prompts to increase stair use in communities. [PDF - 44KB] Am J Prev Med 2010;38(2S):290-291.

Review completed: June 2005