title: Stair-use interventions in worksites and public settings - a systematic review of effectiveness and external validity.
abstract: OBJECTIVE
  We performed a literature review with the main aims to propose an updated overview of the effectiveness of stair-use interventions and to determine the most effective type of intervention.
  
  
  METHODS
  We systematically searched stair-use interventions performed in worksites or public settings, published up to mid 2013. We used a harvest plot approach to visualize the findings in addition to a quantitative synthesis. We also assessed external validity using the Reach, Efficacy, Adoption, Implementation, Maintenance (RE-AIM) framework.
  
  
  RESULTS
  Of 8571 articles identified, 50 were included. In worksites (25 studies) and public settings (35 studies), an increase in stair climbing was found during the intervention period in 64% and 76% of studies, respectively. Combining motivational and directional signs in worksites or conducting a second intervention phase in public settings increased stair climbing in 83% and 86% of studies, respectively. Elements of external validity were overall largely under-reported.
  
  
  CONCLUSIONS
  There is evidence that stair-use interventions are effective to increase stair climbing in public settings, but evidence of such effect is limited in worksites. Issues regarding the best sequencing of interventions or the potential importance of environmental interventions should be addressed in future studies. Process evaluation should be an integral part of interventions.
authors.affiliation: Institute of Cardiometabolism and Nutrition (ICAN), University Pierre et Marie Curie - Paris 6, Paris, France.
authors.forename: Alice
authors.initials: A
authors.lastname: Bellicha
authors.affiliation: Institute of Cardiometabolism and Nutrition (ICAN), University Pierre et Marie Curie - Paris 6, Paris, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Kieusseian
authors.affiliation: Sanofi, 54 rue La Boetie, 75008 Paris, France.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Fontvieille
authors.affiliation: Sanofi, 54 rue La Boetie, 75008 Paris, France.
authors.forename: Antonio
authors.initials: A
authors.lastname: Tataranni
authors.affiliation: Department of Geography, Lab-Urba, Urbanism Institute of Paris, University Paris-Est, Créteil, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Charreire
authors.affiliation: Institute of Cardiometabolism and Nutrition (ICAN), University Pierre et Marie Curie - Paris 6, Paris, France; Department of Nutrition, Pitie-Salpetriere University Hospital (AP-HP), University Pierre et Marie Curie - Paris 6, Center for Research on Human Nutrition Ile-de-France (CRNH IdF), Paris, France. Electronic address: jean-michel.oppert@psl.aphp.fr.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Oppert
mesh_terms: D016206:Databases, Bibliographic; D003657:Decision Making; D004607:Elevators and Escalators / Q000706:statistics & numerical data; D004779:Environment Design; D006801:Humans; D008123:Location Directories and Signs / Q000706:statistics & numerical data*; D009042:Motivation; D011633:Public Facilities; D016138:Walking / Q000502:physiology* / Q000523:psychology / Q000706:statistics & numerical data; D017132:Workplace
keywords: Physical activity; Point-of-decision prompts; Public settings; Stair-use interventions; Systematic review; Worksites