Influences of building design and site design on physical activity: research and intervention opportunities.

Americans spend much of their days in buildings, yet relatively little is known about how the design of buildings or their site influences physical activity. Although some evidence suggests that using specific features of buildings and their immediate surroundings such as stairs can have a meaningful impact on health, the influences of the physical environment on physical activity at the building and site scale are not yet clear. While there is some research suggesting that people will be more active in buildings that have visible, accessible, pleasing, and supportive features, such as motivational point-of-decision prompts and well-designed stairs, there is only limited evidence to support that assertion. This paper reviews the available evidence linking design and site decisions to physical activity, and suggests a framework for connecting research and implementation strategies for creating activity-friendly buildings. In consideration of the kinds of physical activities associated with buildings and their sites, it is proposed that the form of buildings and sites affect physical activity at several spatial scales: the selection and design of sites with respect to a building's location on its site and within its immediate community and the provision and layout of site amenities; building design such as the programming, layout, and form of the building; and building element design such as the design and layout of elements such as stairs or exercise rooms. The paper concludes with an overview of opportunities for research and intervention strategies within the building industry, focusing on public buildings, which provide numerous high-leverage opportunities for linking research and implementation.