Health Promotion and the Built Environment – Views From Swedish Healthcare Organisations

Objective – The study examined the role and integration of the built environment in health promotion as perceived and described by representatives of Swedish health promotive healthcare organisations (HPHs). Background – A majority of Swedish healthcare organisations have implemented health promotion strategies in their plans and actions. These HPHs engage in an ongoing reorientation from a disease focus to a health focus, which includes a person-centred approach that considers people as active participants controlling their own health and care. Swedish HPHs are supported by the Swedish HPH network in introducing health promotion. The HPH network aims are guided by health promotion standards, which indicate the importance of creating health-promoting environments. These aims are confirmed in a letter of intent and membership contract. The aims are also expected to have implications for the planning of healthcare buildings. However, knowledge of the relationship between HPH strategies and the built environment is limited. Additionally, health promotion, when used by building designers, often seems to be reduced to a focus on the enhancement of health. To continue developing health promotion and fulfilling the intentions of the letter of intent as a driver for HPHs, it is important to understand and actively include the built environment in analysis, planning and design. Research question – How do Swedish HPH representatives perceive and describe the relationship between HPHs and the built environment? Methods – An explorative study including both qualitative and quantitative data was carried out. First, data were collected through a survey with county representatives of Swedish HPHs (n=17). Then, qualitative data were obtained from interviews with the Swedish HPH network committee members. The combined data were analysed through descriptive statistics and content analysis. Results – The results showed varied and limited perspectives on the relationship between the built environment and health promotion and diverse HPH intentions related to health equity, health, empowerment, population health, and preventive measures. The results indicated that the documentation meant to support HPHs was not used or well known. Surprisingly, representatives who worked on healthcare building projects did not necessarily consider the built environment to be related to design strategies or characteristics or to their health promotion work within the framework of their HPHs. Conclusion – The results indicate the need to recognise the diverse dimensions and interpretations of health promotion to be able to integrate the built environment in HPHs.publishedVersio

Future-proofing in healthcare building design

Objective - The objective of the study is to explore how future-proofing (FP) in healthcare building design is approached by Swedish architects. Background - Buildings are changing due to physical, economical, functional, technological, social and legal drivers. These changing circumstances results in new requirements on the buildings and drive change in healthcare building design projects. This results in a need to consider future-proofing (FP) approaches to manage this situation. Previous research on FP approaches has mostly focused on the importance of FP as such. There has been little attention on how the architectural practice actually worked with healthcare buildings related to FP, or their interpretations of related concepts to FP, such as flexibility. Research question - How do Swedish architects approach and address FP and what design strategies have they applied in healthcare projects? Methods - The paper is an explorative, qualitative, multi-case study of planned and/or built Swedish healthcare buildings. Data has been collected from presentations of healthcare building design projects encompassing FP approaches and through semi-structured interviews with architects designing healthcare buildings. The interviews were transcribed and analysed through content analysis focussing on the architects view and interpretation of FP in their projects. Results - Sixteen different types of building design strategies addressing future changes were identified in the projects that were studied. The differences in the design strategies related to dissimilar contexts, budgets, stakeholders and design processes. Conclusion - The view among the architects, that were included in the study, on FP approaches is found to be based on a narrow scope and include a vague terminology. While it is difficult, even impossible, to predict all future changes in a healthcare building design project, there is a need to develop design strategies that can address FP. However, and herein lies the challenge, an FP approach needs to be broad enough to allow for variations and defined enough to be justifiable from a project cost and delivery perspective as well as enabling a design supporting the healthcare activities.publishedVersio

Nordic campus retrofitting concepts - Scalable practices

AbstractMultidisciplinary collaboration and transformations in learning processes can be supported by activity-based campus retrofitting. The aim of this paper is to analyse the ongoing campus retrofitting processes at the three university campuses and to identify the elements of activity-based retrofitting. We answer the questions “What kind of examples of retrofitting are there at Nordic Campuses?” and “What kind of elements are typical for activity-based retrofitting concepts?”The 3-level framework of campus retrofitting processes was employed when conducting the three case studies. The cases were about the new ways of researching, collaborating and learning with the concepts of Living lab, Creative community for innovation and entrepreneurship and Network of learning hubs. The cases provided the first insights on retrofitting based on users’ changing needs and the requirements of more sustainable solutions at campuses. Notably, a technical and spatial solution covers only part of retrofitting processes. The activity-based retrofitting consists on multidisciplinary collaboration and learning processes where diverse users have diverse roles during retrofitting processes. A process and a product are equally important for a viable retrofitting concept

Reported food intake and distribution of body fat: a repeated cross-sectional study

BACKGROUND: Body mass, as well as distribution of body fat, are predictors of both diabetes and cardiovascular disease. In Northern Sweden, despite a marked increase in average body mass, prevalence of diabetes was stagnant and myocardial infarctions decreased. A more favourable distribution of body fat is a possible contributing factor. This study investigates the relative importance of individual food items for time trends in waist circumference (WC) and hip circumference (HC) on a population level. METHODS: Independent cross-sectional surveys conducted in 1986, 1990, 1994 and 1999 in the two northernmost counties of Sweden with a common population of 250000. Randomly selected age stratified samples, altogether 2982 men and 3087 women aged 25–64 years. Questionnaires were completed and anthropometric measurements taken. For each food item, associations between frequency of consumption and waist and hip circumferences were estimated. Partial regression coefficients for every level of reported intake were multiplied with differences in proportion of the population reporting the corresponding levels of intake in 1986 and 1999. The sum of these product terms for every food item was the respective estimated impact on mean circumference. RESULTS: Time trends in reported food consumption associated with the more favourable gynoid distribution of adipose tissue were increased use of vegetable oil, pasta and 1.5% fat milk. Trends associated with abdominal obesity were increased consumption of beer in men and higher intake of hamburgers and French fried potatoes in women. CONCLUSION: Food trends as markers of time trends in body fat distribution have been identified. The method is a complement to conventional approaches to establish associations between food intake and disease risk on a population level

ARCH 14 - International Conference on Research on Health Care Architecture - November 19-21, 2014, Espoo, Finland - Conference Proceedings

Healthcare Architecture has grown rapidly in recent years. However, there are still many questions remaining. The commission, therefore, is to share the existing research knowledge and latest results and to carry out research projects focusing more specifically on the health care situation in a variety of contexts. The ARCH14 conference was the third conference in the series of ARCH conferences on Research on Health Care Architecture initiated by Chalmers University. It was realized in collaboration with the Nordic Research Network for Healthcare Architecture .It was a joint event between Aalto University, Finnish Institute of Occupational Health (FIOH) and National Institute of Health and Welfare (THL International).The conference gathered together more than 70 researchers and practitioners from across disciplines and countries to discuss the current themes