Increased stair climbing reduces cardiovascular disease risk. While signage interventions for workplace stair climbing offer a low-cost tool to improve population health, inconsistent effects of intervention occur. Pedestrian movement within the built environment has major effects on stair use, independent of any health initiative. This paper used pooled data from UK and Spanish workplaces to test the effects of signage interventions when pedestrian movement was controlled for in analyses. Automated counters measured stair and elevator usage at the ground floor throughout the working day. Signage interventions employed previously successful campaigns. In the UK, minute-by-minute stair/elevator choices measured effects of momentary pedestrian traffic at the choice-point (n = 426,605). In Spain, aggregated pedestrian traffic every 30 min measured effects for ‘busyness’ of the building (n = 293,300). Intervention effects on stair descent (3 of 4 analyses) were more frequent than effects on stair climbing, the behavior with proven health benefits (1 of 4 analyses). Any intervention effects were of small magnitude relative to the influence of pedestrian movement. Failure to control for pedestrian movement compromises any estimate for signage effectiveness. These pooled data provide limited evidence that signage interventions for stair climbing at work will enhance population health.

Efficacy of classical manual material handling (MMH) training interventions on back pain prevention at the workplace has been called into question. The way that observation (self-observation or hetero-observation) is used in other areas to create feedback addressed to modify motor activities can justify innovative components for these interventions. However, their implementation and evaluation cannot be done without tackling the methodological challenge of developing a reliable observational instrument to measure manual handling practice during the training process. The aims of this study were: (1) justify and develop an hetero-observation (H-O) instrument to assess changes in the worker behavioral patterns with a level of analysis convenient to derive a parallel version for the systematic self-observation (S-O) during training on MMH; (2) provide evidence on the inter-rater reliability of the H-O instrument; (3) provide evidence on the usability of the S-O instrument and its perceived usefulness; and (4) provide evidence on the benefits that can be derived with the use of the H-O instrument to create feedback based on T-pattern and polar coordinate analysis. A mixed method approach mainly grounded on systematic observation was used. A convenience sample composed by blue-collar workers participated in the study. Based on literature review and expert opinion, the H-O instrument proposed was composed by six dimensions (feet, knee joints, back, elbow joints, load position, and interaction between back tilt and displacement) plus a structural dimension which defined MMH phases. The inter-rater reliability of this instrument was almost perfect for all dimensions using a tolerance level of 2 s (the range of time-unit kappa was from 0.93 to 0.97 and the range of event-based kappa was from 0.82 to 0.9). The usability and usefulness of the S-O instrument was highly valued by workers. Regarding the way to use hetero-observations to create feedback, the paper shows the great potential of T-pattern and polar coordinate analysis. The observational instruments developed combined with these techniques make it possible to characterize the body positions adopted during manual handling performance, and this is crucial to create feedback on performance instead of only feedback on results.

This study aimed to assess the effect of systematic self-observation, hetero-observational feedback, and feedforward and intrinsic feedback (SsObserWork components) on workers’ knowledge and behaviour of a manual material handling (MMH) technique in the industrial sector. Blue-collar workers recruited from a food processing company in Catalonia (Spain) were randomized into SsObserWork (N = 31) and control (N = 30) groups. SsObserWork group members participated individually in two sessions and a three-week follow-up between sessions where they received the SsObserWork components. The control group participated individually in two sessions where they received a standard MMH training. An ad hoc instrumentcalled the MMH-SsObserWork instrument was used to assess the MMH behaviour, and an adaption of the instrument was done to assess the workers’ knowledge. Significant differences were found between groups for the identification of recommended back positions in the first session and also on comparing both sessions. However, no differences were found for the rest of the criteria. There also were significant differences between groups in the score changes of the back, knee joints, elbow joints, and interaction criterion, indicating that the SsObserWork group improved the MMH performance in these criteria (behaviour). SsObserWork intervention showed a positive effect on improving the knowledge and behaviour of the MMH technique, specifically on back posture.