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Researching Environments that Magnify Health Everyday (REMEDHY)

Periodic Reporting for period 1 - REMEDHY (Researching Environments that Magnify Health Everyday (REMEDHY))

Reporting period: 2018-09-01 to 2020-08-31

The main problem being addressed is the lack of understanding about how perceptions of nature influence health and well-being. The ways in which the built environment is designed can affect residential communities in profound ways. A healthy design can shape how long people stay in their neighborhoods, how they move through their neighborhoods (e.g. walk, bike, public transit, personal automobile), and the ways in which people interact with neighbors and bond with where they live (place attachment). While street connectivity, mixed density, and land use are important factors in explaining some of these behaviors and perceptions, they do not go far enough in explaining the relationship between the built environment and health. What’s missing from this story is an understanding of the mediating factors that link aspects of the built environment to health outcomes. The overall objectives of the REMEDHY project are to examine the neighborhood qualities that shape people’s perceptions of place and, in turn, motivate them to engage with structures in the neighborhood, which promote health and to use this knowledge, together with citizen engagement, to design and pilot a multilevel, behaviorally-based intervention for young people in Barcelona.
We conducted a comprehensive statistical and spatial analysis of an international dataset on the natural environment and wellbeing. We developed a novel index of aesthetic ratings and developed multilevel statistical and spatial models to understand the factors that correlate with people's ratings of environmental aesthetics, that is, the factors that shape people’s perceptions of the natural and built environment and what features influence how people feel about the nature environment where they live. This is important because it shapes how people interact where they live and the types of behaviors in which they engage.

Our work showed the intermediate social, ecological, and psychological processes that link the structures that exist in a person’s environment and the health-promoting behaviors that lead to good health outcomes. Our research starts to shed light on why, for example, neighborhoods with parks or schools with patios or yards might encourage adults and children to walk or run or feel better. With this understanding, we have been able to inform local programs that seek to implement systems-level structural change that promote health and well-being. We used spatial statistics to understand the structural components of a neighborhood environment that shape people’s perceptions of their environment, such as whether they think a place is beautiful, safe, and supportive. We showed that places that are attractive (high-quality architecture and landscape design, views and vistas, street furniture, and other amenities) and walkable invite people to use, enjoy, and feel safe in them and contribute to health and wellbeing.

Building on this formative work, we worked with the Barcelona Department of Education to develop a school-based intervention to make playgrounds more climate friendly – adding green and blue amenities to cool the playgrounds and buffer the physiological and emotional stress of students and teachers during the warmer months and also during extremely cold weather episodes in the winter. We conducted listening sessions at a series of public schools to gain parent, teacher, student, and administrator insights about what was needed to support healthy school climates. Greening was selected as one of the main interventions of interest. As part of REMEDHY, we designed the intervention and the evaluation framework, drawing on the lessons of WP1. Additionally, we developed a new measurement tool to assess play behavior in the newly designed natural play settings. The tool is undergoing validation studies.

We have presented the results of work to local and international audiences in Barcelona, Melbourne, and online (during COVID-19 pandemic). We have published the work in international journals and participated in a webinar about the use of public open space during the COVID-19 times. Our work has appeared in the Vanguardia newspaper and in several policy statements about engaging with outdoor natural spaces during confinement and its importance for well-being.
We have been able to use the REMEDHY approach to inform the Climate Refuge Project in Schools and fundamentally change the approach to design and evaluate related school-based interventions. The data we analyzed and the community engagement processes we employed provided important information to facilitate community change within the school context by strengthening the evidence base around community interventions in schools and providing much-needed information to our community partners and local planners regarding the connections between community design and school design and health. We were also able to successfully incorporate emotional and social health mediators and processes into traditional climate-based environmental research protocol, strengthening school-based interventions to be behaviorally-based and multilevel, therefore extending the impact and reach of the interventions for student and community health.
Moreover, this work served to inform two new projects -- a Crown Institute project in the United States and a H2020 project on nature-based social prescribing in Europe, South America, and Australia. Both awards were selected for funding and will begin in 2021.
Finally, we were able to organize rapidly and inform real-time policy decisions about protecting public health in cities during the COVID-19 epidemic, advising the Spanish government on stay-at-home policies and specifically the use of public open space to support the health and wellness of populations across the lifespan. We prepared a manuscript, policy brief, and webinar accordingly.
Redesigning Urban School Yard through a Nature-Based Lens