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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 8: Physical Activity

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Strategy. Prompts to Encourage Physical Activity

Approach. Use signage or other prompts located at points where people make decisions about being active to increase physical activity.

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Overview. Research indicates that posters, signs, or media placed at elevators or escalators are associated with more people choosing an active option, such as taking the stairs. These low-cost strategies can be part of a larger campaign that includes additional programmatic, policy, and environmental interventions.1, 2

Evidence. Scientifically Rigorous. Research shows that point-of-decision prompts are effective in moderately increasing levels of physical activity. This strategy has been tested more than once and results trend positive overall. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings). Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Community.

Outcome. Increase in overall physical activity in children and adolescents. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the “Intervention Results” for each study.

Examples from the Field. Access descriptions of current ESMs that use this strategy directly or intervention components that aligns with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Use signage or other prompts located at points where people make decisions about being active to increase physical activity,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of posters, signs, or media placed at elevators or escalators to encourage people to use active options, such as stairs.
  • Number of wayfinding signs placed at strategic points in walkable places to direct community members to nearby parks, recreation facilities, and other attractions.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of community sites with point-of decision prompts to encourage physical activity.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of families who are aware of prompts to encourage physical activity.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of families who report increased physical activity due to signage or other prompts in community spaces.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


References:

1 Soler RE, Leeks KD, Ramsey Buchanan L, et al. Point-of-decision prompts to increase stair use: a systematic review update. Am J Prev Med 2010;38(2S):292-300.

2 Task Force on Community Preventive Services. Recommendation for use of point-of-decision prompts to increase stair use in communities. Am J Prev Med 2010;38(2S):290-291.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.