As our cities grow, it is important to develop policies and streetscape designs that provide pedestrians with safe comfortable walking conditions and acknowledge the challenges involved in making urban places feel liveable and safe while understanding the critical role of streets around busy destinations. To understand these challenges at a nuanced, human level, new methods of citizen engagement are needed. This paper outlines the development and application of a new citizen perception collection method, using immersive virtual environments (IVE), coupled with an interactive emoji affective activation-pleasure grid and digital slider elements, embedded within an online e-participation survey to quantify, and rank the impact of individual (single-variable) urban design elements and safe system treatments on pedestrians’ perceptions of safety and place. The results demonstrate the effectiveness of this method for providing detailed, interrogable, scalable citizen perception data of a variety of urban street design elements and safe system treatments, which allows a statistical analysis of responses and prioritization of the most effective pedestrian-oriented interventions for maintaining or enhancing street vibrancy and liveability. Our IVE e-participation approach is an important contribution to forming a better understanding of streetscapes and provides a valuable method for urban designers and transport planners to prioritise different streetscape place and safety approaches.

Changing the physical environment of healthcare facilities can positively impact patient outcomes. Virtual reality (VR) offers the potential to understand how healthcare environment design impacts users’ perception, particularly among those with brain injuries like stroke, an area with limited research. In this study, our objective was to forge a new pathway in healthcare environment research by developing a comprehensive, six-module ‘user-centered’ design decision support approach, utilizing VR technology. This innovative method integrated patient engagement, architectural design principles, BIM prototyping, and a sophisticated VR user interface to produce realistic and immersive healthcare scenarios. Forty-four stroke survivors participated, experiencing 32 VR scenarios of in-patient bedrooms, followed by interactive in-VR questions and semi-structured interviews. The results of the approach proved to be comparatively efficient and feasible, provided a high level of immersion and presence for the participants, and effectively elicited extremely rich quantifiable response data, which revealed distinct environmental preferences. Our novel approach to understanding end-user responses to stroke rehabilitation architecture demonstrates potential to inform user-centered evidence-based design decisions in healthcare, to improve user experiences and health outcomes in other healthcare populations and environments.

BACKGROUND: Stroke inpatient rehabilitation is a complex process involving stroke survivors, staff, and family utilizing a common space for a shared purpose: to optimize recovery. This complex pathway is rarely fully described. Stroke care is ideally guided by Clinical Practice Guidelines, and the rehabilitation built environment should serve to optimize care delivery, patient and staff experience. We aimed to articulate the inpatient stroke rehabilitation process of care in a series of process maps, and to understand the degree to which current stroke clinical and building construction (ie, design) guidelines align to support inpatient stroke rehabilitation. METHODS: We used the Value-Focused Process Engineering methodology to create maps describing the events and activities that typically occur in the current stroke inpatient rehabilitation service model. These maps were completed through individual and group session consultations with stroke survivors, architects, policy makers, and clinical experts. We then determined which sections of the Australian Stroke Rehabilitation Guidelines and the Australasian Health Facility Design Guidelines could be aligned and applied to the process maps. RESULTS: We present a summary process map for stroke inpatient rehabilitation, alongside detailed process maps for 4 different phases of rehabilitation (admission, a normal weekday, a weekend day, and discharge) using Value-Focused Process Engineering notation. The integration of design and clinical guidelines with care pathway maps revealed where guidelines lack detail to be readily linked to current stroke inpatient care practice, providing an opportunity to design stroke inpatient rehabilitation spaces based on the activities occurring within them. CONCLUSIONS: Our findings highlight gaps where clinical and design experts should work together to use guidelines to their full potential; and to improve the process of planning for future stroke rehabilitation units.

Main streets and traffic thoroughfares are difficult public spaces to “humanize” as they are home to intense multisensory interactions between traffic, people, and place. In current practice, urban designers assess people’s feelings of safety and amenability of streetscapes either in situ or using paper-based methods to present alternatives. This study demonstrates the role HCI methods can play in increasing flexibility, accessibility, and inclusivity in evaluating alternative urban streetscape elements using virtual environments and remote evaluation. Using HCI methods, we can measure user experience in the virtual environment while gathering perceptions on safety and amenity of different urban elements. Using an interactive 360-degree video embedded in an online survey, we collected data on usability, user experience, and affective responses to alternative streetscape designs. Our findings show that the online survey generated useful data on perceptions of pedestrian-oriented streetscape interventions. We argue that in validating the positive user experience of the virtual environment, we increase urban designer confidence in the quality of responses toward informing design of real-world safe and amenable streets. Our contribution demonstrates that HCI methods can be used to help create a new, flexible, far-reaching, and effective approach for gathering community feedback on future urban designs.

BACKGROUND: The hospital’s physical environment can impact health and well-being. Patients spend most of their time in their hospital rooms. However, little experimental evidence supports specific physical design variables in these rooms, particularly for people poststroke. The study aimed to explore the influence of patient room design variables modeled in virtual reality using a controlled experimental design. METHODS: Adults within 3 years of stroke who had spent >2 nights in hospital for stroke and were able to consent were included (Melbourne, Australia). Using a factorial design, we immersed participants in 16 different virtual hospital patient rooms in both daytime and nighttime conditions, systematically varying design attributes: patient room occupancy, social connectivity, room size (spaciousness), noise (nighttime), greenery outlook (daytime). While immersed, participants rated their affect (Pick-A-Mood Scale) and preference. Mixed-effect regression analyses were used to explore participant responses to design variables in both daytime and nighttime conditions. Feasibility and safety were monitored throughout. Australian New Zealand Clinical Trials Registry, Trial ID: ACTRN12620000375954. RESULTS: Forty-four adults (median age, 67 [interquartile range, 57.3–73.8] years, 61.4% male, and a third with stroke in the prior 3–6 months) completed the study in 2019–2020. We recorded and analyzed 701 observations of affective responses (Pick-A-Mood Scale) in the daytime (686 at night) and 698 observations of preference responses in the daytime (685 nighttime) while continuously immersed in the virtual reality scenarios. Although single rooms were most preferred overall (daytime and nighttime), the relationship between affective responses differed in response to different combinations of nighttime noise, social connectivity, and greenery outlook (daytime). The virtual reality scenario intervention was feasible and safe for stroke participants. CONCLUSIONS: Immediate affective responses can be influenced by exposure to physical design variables other than room occupancy alone. Virtual reality testing of how the physical environment influences patient responses and, ultimately, outcomes could inform how we design new interventions for people recovering after stroke. REGISTRATION: URL: https://anzctr.org.au ; Unique identifier: ACTRN12620000375954.