ABSTRACT
<p><b>OBJECTIVES</b>We have evaluated the effectiveness of motivational signs in promoting stair use instead of escalators, in terms of gender and age, at a train station with a 37-step staircase. We also examined whether a newspaper article, or booster, had any effect on augmenting the impact of the signs.</p><p><b>METHODS</b>In a serial cross-sectional survey with prompted signs, the subjects were coded by gender and age (over 65 years, under 65 years), and students (13-18 years old and school uniforms). We used a 2-week baseline period, followed by a 4-week intervention in which a total of 45 posters and banners with motivational messages were used to encourage stair use. As a booster, we published a news release of this study on a web site and in a local newspaper during the intervention period.</p><p><b>RESULTS</b>A total of 43,241 escalator/stair-choice observations were made. Stair use increased significantly from 3.58 to 4.93% during the intervention period of 1-2 weeks for all subjects. In addition, stair use had a significantly high value of 5.80% during the intervention period of 3-4 weeks. Stair use also increased in subgroups during the intervention periods with the exception of women 65 and older. Attempts to publicize the study had no effect on the increase in stair use.</p><p><b>CONCLUSIONS</b>The use of signs was effective in changing behavior during the period of sign use, but this effectiveness was limited by gender, age, and the physical ability (e.g., muscle strength) and energy required to climb the stairs. The possible synergistic effects of publicity were inconclusive but are worthy of further investigation.</p>