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ItemGentrification or Health-promoting Resource? Long-term Residents' Perceptions and Use of the Atlanta BeltLine(Georgia Institute of Technology, 2021-01-27) Matic, ZoranaInvestments in green infrastructure such as multi-use urban greenways are made with the goal to improve the residents' health by creating space for physical activity, recreation, and social interactions, providing opportunities for active transportation, and increasing exposure to nature's healing effects. Despite the host of benefits, regreening initiatives in lower-income neighborhoods can also catalyze 'green' or 'environmental' gentrification. There is growing empirical evidence that gentrification affects the residents' health and well-being, both positively and adversely. The previous scholarship mostly focused on greenway users and has mainly adopted quantitative methods (such as observation and intercept surveys) to measure green infrastructure use, activity patterns, and users' satisfaction. However, the research on the incumbent residents living adjacent to a newly developed greenway is limited. It is still not fully understood whether incumbent residents have a positive perception of newly installed greenways, the extent to which they take advantage of these new resources, and whether the new greenways mostly attract new and habitually active residents. This research seeks to fill this gap by exploring the interrelationships between green infrastructure, green gentrification, and long-term residents' health and healthy behaviors in Atlanta, which that has recently invested into and developed a number of green infrastructure projects. This dissertation has two studies. Capitalizing on free and readily available U.S. census data, the first study proposes a replicable quantitative approach for developing a composite socioeconomic index as a tool for identifying and measuring gentrification. In the second study, this research closely looks at two historically African American neighborhoods in the early stages of gentrification and adjacent to the new BeltLine recreational trail. By interviewing long-term residents, this research seeks to develop a deeper understanding of green gentrification from their vantage point and to examine their responses to new greenway and opportunities for adopting health-promoting behaviors. The quantitative analysis indicated that nearly half of eligible census tracts in Atlanta are gentrifying, while two-thirds will soon be in various stages of gentrification. The census tracts within one-half mile of the BeltLine proposed path are gentrifying at a slightly faster pace. The Atlanta's gentrification patterns echo the previous findings on the proximity of the BeltLine and growing gentrification pressures in the trail-adjacent neighborhoods. Additionally, the results suggest the association between gentrification and residents' better self-rated health. The analysis found a consistent pattern of decreasing rates of residents who report low physical activity and poor self-rated health (both mental and physical) with increasing levels of gentrification. The interviews revealed much more nuanced responses to the trail construction and green gentrification. Most interviewees perceived and used the new trail as a health-promoting resource; while it enabled the habitual exercisers to maintain active lifestyles, it prompted some new trail users to be physically active. However, concerns regarding gentrification and feeling that new amenities cater to the 'gentrifiers' and not the existing community, in some cases acted as barriers to trail usage and regular physical activity. The findings suggest that perceptions of social environment entwine inextricably with perceptions of the physical environment and the extent to which groups or individuals take advantage of health-promoting resources. This study has important implications for future research and design of effective greening infrastructure to increase trail usage among long-term residents, particularly those who are not habitually active.
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ItemThe Role of Positive Distraction in the Patient’s Experience in Healthcare Setting: A Literature Review of the Impacts of Representation of Nature, Sound, Visual Art, and Light(Georgia Institute of Technology, 2020-12-08) Dabrowska, Maria AnnaBackground One of the key strategies to help patients reduce stress and anxiety in healthcare settings is positive distraction defined as “an environmental feature that elicits positive feelings and holds attention without taxing or stressing the individual, thereby blocking worrisome thoughts” (Ulrich, 1991, p. 102). While several studies found the impact of positive distraction on health-related outcomes, few studies have categorized the distractors and collected the evidence from experiments. Despite the common use in design and broadly accepted assumption that positive distraction brings psychophysiological benefits, there has not been a comprehensive evaluation of research on positive distraction. Methods The present literature review examined 40 peer-reviewed articles from the last 20 years on nature, artwork, music, and light to describe the phenomenon of positive distraction, review the evidence on the impact of interventions on outcomes, and investigate the quality of the research. This paper explored historic background, definitions, and organized the key information from articles into a table. Based on the similarities of themes, I categorized and described the interventions. This paper presents a framework that links the categories to healthcare settings, outcomes, and measures which were used to assess each outcome. Finally, I marked the number of studies in each category that indicated the beneficial influence of interventions for each outcome. The significance of this study lies in collecting and analyzing the studies, describing the crucial aspects that need to be considered when designing positive distractions, and pointing out the directions for future research. Results I organized interventions into the following seven categories: Real and artificial nature, Visual representation of nature, Music and Sound, Light, Illuminated projection, Audiovisual, and Audiovisual with light. The most common interventions were plants placed in a patient room as well as Illuminated projection and Audiovisual interventions with light in diagnostic imaging rooms. Pain and anxiety were the most studied outcomes. While 16 out of 22 studies found a statistically significant improvement in perceived pain, only 10 out of 24 articles found this effect for anxiety. More than 60% of studies that measured the impact of interventions on pain, satisfaction, environmental satisfaction, reduction in restlessness and calm behavior, and perceived attractiveness found statistically significant positive results. Although the positive distraction was initially recognized for its potential to reduce stress, only eight articles investigated stress and distress, but more than half of those studies found a beneficial effect. Interventions in Real and Artificial Nature, and Music and Sound, and Audiovisual with Light showed a beneficial impact on more than six outcomes and emerged as the most promising. Conclusions Despite the 40-years tradition, the field of positive distraction is still in an exploratory phase. This analysis confirmed that there is a positive correlation between positive distraction and outcomes and strong evidence that positive distraction helps reduce perceived pain. Future work should consider the division of the term positive distraction into more precise sub-terms to account for different characteristics of interventions categorized as a positive distraction as well as focus on defining the beneficial features of the distractors, explaining the underlying mechanisms, determining the effect size of interventions, and improving both aesthetics of interventions and the methodological quality of studies.
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ItemAGENT-BASED SIMULATION FOR EVALUATING THE IMPACTS OF DESIGN ON NURSES’ SPATIOTEMPORAL EXPERIENCE(Georgia Institute of Technology, 2020-01-14) Hadi, KhaterehStudying dynamics of care providers’ spatial experience based on their space occupancy and activity patterns allows us to better understand the impacts of design on care providers’ outcomes. During the early stages of design, computer simulation models can be used to evaluate design options for optimizing care providers’ spatiotemporal experience. Current simulation platforms offer advanced capabilities for modeling workflows and activities but have limitations in spatial analytics. This study focuses on developing an agent-based simulation model for evaluating the spatiotemporal experience of care providers based on layout attributes. The proposed model integrates spatial analytic methods into a simulation platform in order to investigate impacts of the layout on care providers’ encounters as an example of spatiotemporal events. Observational data collected from a pediatric cardiac intensive care unit is used to inform the simulation. The model records the care provider agents’ encounters measures defined by unobstructed lines of sight between agents within a defined field of view and distance threshold, including agents’ encounter durations (CCEt) and encounter counts (CCEn). Bivariate analyses of the simulation encounter output and layout attributes show that changes in “compactness” and “betweenness” levels of bedside nurse agents’ locations are associated with changes in CCEt and CCEn measures. These associations are in alignment with records of interactions collected through on-site observations of similar locations and confirm assumptions of the present study. Enhancing simulation platforms through the integration of spatial analysis methods can provide further insights into understanding the impacts of design on building occupants’ spatiotemporal experience.