The research centre for inclusive access to outdoor

environments

Edinburgh College of Art/Heriot-Watt University

OPENspace is concerned with access to the outdoor environment for everyone:

• for disabled people, • for people from ethnic

minorities, • for children and their

carers, • for older people and • for economically or

socially disadvantaged groups.

2

Health and Outdoor Environments

Some fundamental questions we are interested in exploring:

• Are there any measurable health benefits associated with 'natural' environments?

• If so, is looking at images of them (or even just thinking about them) as beneficial as looking at the real thing from a window or actually being in the natural environment?

• How much nature is 'enough' to get a benefit?

3

Health and Outdoor Environments

More fundamental questions we are interested in exploring:

• Are there any measurable health benefits to being (and doing things) outdoors rather than indoors?

• If so, what qualities of the outdoor environment are associated (best correlated) with health benefits?

4

Can ‘nature’ affect clinical outcomes?

Comparing recovery records of gall bladder surgery patients with different bedside views (Ulrich, 1984)

5

Bedside view of trees• Shorter hospital stays• Fewer minor post-op

complications • Fewer doses of strong

narcotic pain dugs needed

• More positive outlook (based on staff evaluation notes)

Bedside view of brick wall• Longer hospital stays• More minor complications

(e.g. persistent headaches, nausea)

• Needed more doses of narcotic pain drugs

• More negative outlook (based on staff evaluation notes)

Contributory Factors to General Well-being

• Mental Health

• Physical Health

• Spiritual Health

• Social Well Being

6

Phase 1

Subjects watched a 10-minute film on the prevention of workplace accidents, which showed distressing scenes of (simulated) injury.

Phase 2

Subjects were told to imagine they were relaxing while looking at the environment on a film of:

trafficpedestrian mallnature

Stress Recovery Experiment R.Ulrich, 1991

7

8

From Ulrich 1991: Change in skin conductance during stress and recovery

9

From Ulrich 1991: Change in pulse transit time during stress and recovery

10

From Ulrich 1991: Change in muscle tension during stress and recovery

Hospital Study-NHS Journal, 2000

Two groups of patients in a) orthopaedic and b) psychiatric wards moved to newly refurbished units

• Old wards compared with New wards• Same treatment regimes/ same staff• Questionnaires to patients leaving hospital• Focus groups with staff• Medication levels/length of stay

11

Results - NHS Journal, 2000Patients on newer wards rated the environment, their

treatment and the staff more positively

12

Orthopaedic Unit• surgery - same length

stay• non-surgery - shorter

stay in hospital• fewer analgesics - in

number and dosage for class A drugs (morphine)

• slight increase in lower level pain-killing drugs

Psychiatric Unit• Shorter Stays (14%

reduction)• Less time in intensive

care• Fewer threats/outbursts• Better progress -79% v

60% made good progress

Healthy Outdoor Exercise

Walking the way to Health Initiative (WHI) of British Heart Foundation and Countryside Agency (started 2000.

• 50% of people participating in an exercise gym scheme drop out after 6 months

• The reason cited by 80% of cardiovascular patients for staying with the pilot walk programme was “being in the countryside or a green space”

• “It could be argued that the natural environment has a competitive edge in exercise promotion as it leads to better adherence” (WHI Regional Case Officer, 2002)

13

Areas of potential interest 1

• Exercise, health and the environment– outdoor activity versus indoor activity– embodied experiences of exercising outdoors

• Stress and therapeutic environments– exercise– recreational activity– therapeutic environments

14

Areas of potential interest 2

• Patient recovery and the environment– rehabilitation treatment of mental health patients– convalescence of hospital based patients

• Prescriptive measures and well-being– exercise as an alternative to medication

/hospitalisation for specific health problems– exercise and outdoor activities as a preventative

measure to sustain good health

15

Does the environment matter?Environment

Quantitative• Air Quality• Ventilation/wind speed• Temperature• Sound levels• Illuminance

Qualitative• Light - sunshine/shade/cloud• Colour/Texture/Materials • Sounds (cars, birdsong)• Space/design• Nature - plant materials etc

Interactive• Privacy Control

People

Behaviour• Recovery rates• Number analgesics taken• Performance/actions/tasks

Psychological• Preferences• Perceptions• Moods• Satisfactions

Physiological• Heart rate/pulse rate/GSR

16

Why might you want to collaborate with us?We have experience in eliciting people’s responses to outdoor

environments in ways that take into account the multivariate nature of such places

We have experience of the processes involved in design, management and analysis of outdoor places

Why might we want to collaborate with you?We want to study subjects in different (well-defined) prior states

of health

We want assistance to identify and apply appropriate measures of health benefit associated with being in different environments

We want to produce a robust experimental design

17