Theoretical frameworks used in built environment research – a scoping review

Theore&cal frameworks in Healthcare Built

Environment research

– a scoping review

Michelle Shannon(1), Susanna Nordin (2), Anna Anaker (2),

Julie Bernhardt (1) Marie Elf (2);

1. The Florey Institute of Neuroscience & Mental Health, CRE Stroke Rehabilitation

Objectives

•  Background to our study •  Why consider theories/frameworks in Health Design research? •  What theories/ frameworks are there? •  How are they used?

What is the built environment of healthcare? “……a holis&c place of healing where physical domains of the built environment and interac&ons between people within that environment intersect..” (van Hoof and Verkerk, 2013).

Background to our study

- what is the built

environment of healthcare?

•  Architectural and/ or non-permanent (ambient) features •  Exterior view/ outdoors •  Indoor physical environment

What is the problem?

What theories do health design researchers use….?

Theories & Evidence-Based Design

Design decisions of the built environment based on

informa&on from credible evidence

(Brown & Ecoff, 2011; Diaz Moore & Geboy, 2010; Pa&, 2011; Viets, 2009).

“…. Not just research results but the frameworks

used to structure the research process and the

ecological context in which research is

generated…”

(Becker 2011)

Theories & Evidence-Based Design

•  Process to describe how events/factors may have a rela&onship with each other •  Can be tested in cause-effect way •  Can be be tested for associa&on •  Permits deeper understanding of interplay of factors

What was our study objective?

Our Overall Aim •  (i) to iden&fy theories & frameworks used in research of the built environment of healthcare •  (ii) to describe core constructs & assump&ons •  (iii) to assess scien&fic applicability.

What were our methods?

•  Scoping Review process (Arksey & O’Malley,2005) •  Iden&fy key Search terms •  Iden&fy studies to broadly summarize within the health design field •  Synthesize the scien&fic u&lity •  Disseminate

What were our methods?

•  3-4 inter-disciplinary reviewers •  7 Databases searched April 2015-August 2016 •  Search strategy developed itera&vely •  Boolean Operators and Free Text terms

Main Findings: 3 main clusters…. Agen&on-Restora&on Theory; Therapeu&c Landscapes; Prospect-Refuge Theory; The Biophilia Hypothesis; Visual Affordances; Salutogenics; Place Theory Inclusive or Universal Design; ICF-ICIDH; The Inclusive & Integrated Health Facili&es Design Model Person-Environment Fit Theory; Stress-Reduc&on Theory; Proxemics; PCC Enriched Environments Sensory exposure, Percep&on; Evalua&ve Stress exposure; Autonomy _Contextual; User involvement in design Cogni&ve, social, physical ac&vity & learning

Main Findings- the challenges….. The Biophilia Hypothesis example

Safety & Security Self-Report Sensory s&muli- physiological; Cogni&ve-Perceptual Cogni&ve-Evalua&ve Affinity for Nature Evolu&onary Expert ra&ng Brain Imaging Theore&cal

Construct Opera&onal _Construct

Physiological

Study popula&on-age, disease type,

Summary & Conclusions

• 

_{Complete the second stage of Scoping Review}

• 

_{Collate studies across health built}

environments

• 

_{Synthesize the Theories that have shown}

applicability in What health built environment

contexts

Acknowledgements

Prof J Bernhardt, The Florey Prof A Pert, Melbourne University Prof J Olver, Monash University A/Prof M Elf, Dalarna University Dr Liam Johnson, The Florey

Dr. Karen Borschmann Dr. Janice Collier

Ms Sharon Kramer, PhD Candidate

Ms Ruby Lipson-Smith, PhD Candidate Ms Jan Chamberlain