title: Associations between building design, point-of-decision stair prompts, and stair use in urban worksites.
abstract: OBJECTIVE
  Incidental forms of physical activity such as stair use offer frequent opportunities for energy expenditure and may contribute to the prevention and control of chronic diseases. This study analyzes the associations between building characteristics, stair prompts, and stair use in large urban worksites.
  
  
  METHODS
  Bootstrapped generalized mixed models were used to analyze self-reported stair use, using data from 1348 surveys of city employees and fourteen building assessments conducted in New York City in 2012.
  
  
  RESULTS
  57% of respondents reported climbing ≥1 flights of stairs daily at the workplace. Model results show that stair prompts were associated with a 3.21 increased likelihood of stair use. Naturally lit stairwells and stairwell visibility were also positively associated. Higher floor residency and BMI were negatively related, as were gender, stairwell distance from lobby entrances, the total number of floors in each building, and building averages for BMI and gender. Residual heterogeneity measured by adjusted median odds ratios indicates that buildings can have a moderate effect on the likelihood of stair use beyond those of individual characteristics.
  
  
  CONCLUSIONS
  Specific building features and stair prompts may potentially be leveraged to positively influence rates of incidental physical activity and contribute to improvements in population health.
authors.affiliation: Bureau of Chronic Disease Prevention & Tobacco Control, New York City Department of Health and Mental Hygiene, 42-09 28th Street, Queens, NY, 11101-4132, USA. Electronic address: rruff@health.nyc.gov.
authors.forename: Ryan R
authors.initials: RR
authors.lastname: Ruff
authors.affiliation: Bureau of Chronic Disease Prevention & Tobacco Control, New York City Department of Health and Mental Hygiene, 42-09 28th Street, Queens, NY, 11101-4132, USA.
authors.forename: Randi
authors.initials: R
authors.lastname: Rosenblum
authors.affiliation: Bureau of Chronic Disease Prevention & Tobacco Control, New York City Department of Health and Mental Hygiene, 42-09 28th Street, Queens, NY, 11101-4132, USA.
authors.forename: Sean
authors.initials: S
authors.lastname: Fischer
authors.affiliation: Bureau of Chronic Disease Prevention & Tobacco Control, New York City Department of Health and Mental Hygiene, 42-09 28th Street, Queens, NY, 11101-4132, USA.
authors.forename: Hamidah
authors.initials: H
authors.lastname: Meghani
authors.affiliation: Bureau of Chronic Disease Prevention & Tobacco Control, New York City Department of Health and Mental Hygiene, 42-09 28th Street, Queens, NY, 11101-4132, USA.
authors.forename: John
authors.initials: J
authors.lastname: Adamic
authors.affiliation: Bureau of Chronic Disease Prevention & Tobacco Control, New York City Department of Health and Mental Hygiene, 42-09 28th Street, Queens, NY, 11101-4132, USA.
authors.forename: Karen K
authors.initials: KK
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D001107:Architectural Accessibility; D015992:Body Mass Index; D016022:Case-Control Studies; D003657:Decision Making; D015444:Exercise; D005160:Facility Design and Construction; D005260:Female; D005430:Floors and Floorcoverings; D006293:Health Promotion / Q000379:methods; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009519:New York City; D009786:Occupational Health Services; D017063:Outcome Assessment, Health Care; D015397:Program Evaluation; D057566:Self Report; D011795:Surveys and Questionnaires; D014505:Urban Population; D016138:Walking / Q000523:psychology*; D017132:Workplace; D055815:Young Adult
keywords: Environment; Exercise; Hierarchical analysis; Motor activity; Public health