Promoting stair climbing in public-access settings: an audit of intervention opportunities in England

Objective: Introducing message prompts at the ‘point-of-choice’ (POC) between stairs and escalators increases stair choice in ‘public-access’ settings (e.g. malls). For nationwide campaigns, plentiful POCs appear needed. We audited the availability of POCs in public-access settings across England. Methods: Boundaries for 25 urban areas (population=6,829,874) were verified using Ordinance Survey maps, which showed all airports and train/tram stations. Malls and bus stations were identified from commercial listings and local authority web-pages. From September 2010-March 2011 two investigators visually inspected all venues (N=410), counting ‘true’ POCs and ‘quasi’ POCs (i.e. instances where stairs were visible from, but not adjacent to, escalators). Results: 5% of venues had ≥1 true POC (quasi POC=3%). Aggregating across areas, there was a true and quasi POC for every 243,924 and 379,437 people, respectively. There were regional variations; one area had 10 true/quasi POCs, whilst 10/24 remaining areas had none. POCs were more common in airports (4/6 venues) than malls (11/85) and train stations (4/215). Conclusion: Although public-access POCs reach sizeable audiences, their availability in England is sporadic, precluding nationwide campaigns. Interventions should be considered locally, based on available POCs. Work/community venues (e.g. offices, hospitals), where pedestrians choose between stairs and elevators, may provide greater intervention opportunities.