The research centre for inclusive access to outdoor environments

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• The research centre for inclusive access to
  outdoor environments
• Edinburgh College of Art/Heriot-Watt University

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• 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.

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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?

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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?

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Can nature affect clinical outcomes?
Comparing recovery records of gall bladder
surgery patients with different bedside views
(Ulrich, 1984)

• 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)

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Contributory Factors to General Well-being

• Mental Health
• Physical Health
• Spiritual Health
• Social Well Being

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Stress Recovery Experiment R.Ulrich, 1991
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 traffic pedestrian mall nature
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From Ulrich 1991 Change in skin conductance
during stress and recovery
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From Ulrich 1991 Change in pulse transit time
during stress and recovery
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From Ulrich 1991 Change in muscle tension during
stress and recovery
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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

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Results - NHS Journal, 2000

• Patients on newer wards rated the environment,
  their treatment and the staff more positively

• 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

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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)

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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

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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

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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

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Why might you want to collaborate with us?

• We have experience in eliciting peoples
  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

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