A simple health sign increases stair use in a shopping mall and two train stations in Flanders, Belgium.

The aim of this study was to test the impact of a simple health-promotion sign on stair use in three community settings in Flanders, Belgium. A health sign was placed at the junction between the stairs and an escalator in a shopping mall and two train stations. Observations took place on four days: baseline, first intervention, post-intervention and second intervention. In the second station, a second post-intervention phase was added. In total, 1437 choices of shoppers were registered in the mall, while 2869 and 2025 choices of commuters were recorded in the two stations, respectively. Despite the different baselines of stair use, the introduction of the health sign in the first intervention phase resulted in a significant increase in all three settings: 10.0% increase in the mall, 8.6% in the first station and 18.0% in the second station. In the second station, the increase during the second intervention exceeded that of the first intervention. Moreover, in this station stair use in the second post-intervention phase was significantly higher than at baseline. An inexpensive health-promoting sign has a substantial effect on the proportion of stair users among shoppers and commuters. Preliminary evidence was found that repeated exposure to a health sign might have a longer term effect on stair use.