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Dr. Lina Engelen

'Health for all' promoter | 

I believe this world has so much potential, we just need to use some imagination, courage and kindness to fully reach this potential.

Evaluation Lead - School Infrastructure NSW

Founder and Principal Consultant - Active Spaces Consulting

Fitwel ambassador


Affiliate Senior Research Fellow at the University of Sydney


Founder of Active Spaces network

How does the modern physical environment influence our health, wellbeing and performance?

How can we create environments that support our activities for play, learning, work and ageing?

These are questions I ask myself and try to find an answer to.



Image by krakenimages

Activity Based Working (ABW)

The evidence base is growing

In a systematic review of the research on the impacts of ABW on people’s health, performance and perceptions we summarise the best current evidence.

The positives

The review found positive effects on collaboration, communication, work performance, the sense of control (when and where work is done) and the functionality of the workspace.  ABW work style can support employees to work more collaboratively, with efficient and effective communication methods, through increased opportunities for formal and informal knowledge exchange and networking.

The negatives

The negatives were around privacy, storage and difficulties to concentrate due to increased interruptions and distractions, such as high noise levels (particularly in comparison to cell offices. However, the ABW environments often perform better than standard open-plan offices. Workplaces that provide sufficient and well-designed workspaces for quiet/concentrated work seem to perform better.

We did not find clear evidence for mental and physical health related outcomes. 

Recommendations made based on the evidence in the systematic review include:

a.    tailor the design to each organisation and their staff, with their needs in mind. Work can vary from high concentration to high interactions. 

b.       The design needs to be flexible and easily respond to changing needs of an organisation.

c.       Appropriate management style, modelling and support is vital for successful implementation of ABW

Design for healthy ageing

Although we tend to live longer, we can’t guarantee well-being and quality of life (QoL). The built environment is known to influence health outcomes across the lifespans. In a narrative review we took a cross-disciplinary approach to understand the evidence of the relationship between design, healthy ageing and QoL.

From the sixty-five papers we reviewed it was we found clear evidence that access to biophilia and good indoor environmental quality have impacts on healthy ageing.  

The evidence for the effect of technology, wayfinding, and opportunities for social interactions is emerging.

To date more research is needed to understand how safety/security and adaptability/fit affects healthy ageing.

One significant consideration for healthy ageing was older adults maintaining agency in their lives, including the ability to exert control over their environment in order to support healthy ageing. Design decisions have a significant impact on the health and well-being of older adults, but these decisions are often made in the absence of strong scientific evidence. This review sets out to assist decision-makers to consider design principles that support healthy ageing.

Beyond posters - promoting stair climbing

Stair climbing is a great way to get moving; it is considered vigorous physical activity and as such has a range of benefits for health. 

Stair climbing is often promoted through posters, however the effects are limited.

We performed a study that had a 1-month multi-component intervention including gaming, followed by 6 months with just point-of-choice prompts (posters and directional signs) in a six-story university building. We measured all floors climbed and lifts ascended by infrared people counters. Regular building occupants were invited to participate in the Stairtember Challenge intervention component.

We found that stair climbing increased by 15% during the intervention. Stair to lift ratios increased from 0.46 to 0.56.

As these effects are larger than previously found for traditional signage-based interventions, future interventions should go beyond posters for larger effects on population health.

Engelen et al 2019, JOEM

Active Design

With many adults spending most of their waking hours at work, the workplace is a logical setting for health interventions. Active design is a new concept that includes levels of environmental design, workplace culture and policy. It addresses features of the built environment that can support daily physical activity. When new office and research buildings are designed, they often include central staircases, light and attractive walkways, communal areas and toilets adjacent to central areas that can increase incidental physical activity.


We studied groups of people moving from older style buildings to new active design buildings to assess if moving to a health-promoting building changed workplace physical activity, sitting, workplace perceptions and productivity.


Moving to an active design building appeared to have physical health-promoting effects on occupants; such as increased standing and less lower back pain. Occupants reported looking forward to going to work more than before, but their perceptions about the new work environment varied; where the new work environment was perceived as more motivating and they were positive about the light and ventilation, but less so about the noise level and storage space. The results from these studies can inform future interventions and building design.



Engelen et al. 2016 Occ Med    Engelen et al. 2017 WORK

In-the-moment measurement

When evaluating health initiatives it is important to gauge participants' perceptions as well as their mood and interactions. 

Ecological momentary assessment (EMA) involves repeated sampling of current behaviours and experiences in real-time at random intervals. EMA is an innovative measurement method for program evaluation, using mobile technology to collect contextual data with good compliance. This study examined the feasibility of using EMA for measuring workplace health outcomes


The results show that In-the-moment methods using readily available mobile technology to assess participants' perceptions, mood and activity is a promising way to evaluate future health promotion programs. It can provide rich information with minimal participant burden.

Engelen et al, 2017 Health Promotion Journal of Australia

Engelen and Held, 2019 Buildings 


Schoolgirls Playing

Size does matter

Physical activity is important for the health and well-being of children and young people, but only a small proportion meet the daily recommended levels. Children spend a large part of their day at school, hence the school environment is likely to have a major impact on children’s physical activity levels.

In a recent study based on data from 5238 students, aged 5 to 12 years in NSW, Australia, we found that the amount of school playground space is positively associated with children’s physical activity outcomes. We observed better physical activity outcomes with increasing playground space up to 25 m2 per student, and access to loose equipment was also important.

These results show that school playground space guidelines need to incorporate sufficient space for students to support children’s physical activity.

Grunseit et al, 2020 BMJ Open

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