title: An uphill struggle: effects of a point-of-choice stair climbing intervention in a non-English speaking population.
abstract: BACKGROUND
  Increases in lifestyle physical activity are a current public health target. Interventions that encourage pedestrians to choose the stairs rather than the escalator are uniformly successful in English speaking populations. Here we report the first test of a similar intervention in a non-English speaking sample, namely the Hong Kong Chinese.
  
  
  METHODS
  Travellers on the Mid-Levels escalator system in Hong Kong were encouraged to take the stairs for their health by a point-of-choice prompt with text in Chinese positioned at the junction between the stairs and the travelator. Gender, age, ethnic origin, and walking on the travelator were coded by observers. A 2 week intervention period followed 2 weeks of baseline monitoring with 57 801 choices coded. Specificity of the intervention was determined by contrasting effects in Asian and non-Asian travellers.
  
  
  RESULTS
  There was no effect of the intervention on stair climbing and baseline rates (0.4%) were much lower than previous studies in Western populations (5.4%). Nonetheless, a modest increase in walking up the travelator, confined to the Asian population (OR = 1.12), confirmed that the intervention materials could change behaviour.
  
  
  CONCLUSIONS
  It would be unwise to assume that lifestyle physical activity interventions have universal application. The contexts in which the behaviours occur, e.g. climate, may act as a barrier to successful behaviour change.
authors.affiliation: School of Sport and Exercise Sciences, University of Birmingham, UK. F.F.Eves@bham.ac.uk
authors.forename: Frank F
authors.initials: FF
authors.lastname: Eves
authors.forename: Rich S W
authors.initials: RS
authors.lastname: Masters
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000523:psychology; D002755:Choice Behavior; D004607:Elevators and Escalators; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006293:Health Promotion / Q000379:methods*; D006723:Hong Kong; D006801:Humans; D006813:Humidity; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D005082:Physical Exertion; D013696:Temperature