Course description
Approximately 80% of the global burden of disease concerns non-communicable disease. The latter is function of human behaviour in the wider sense. One of the strongest predictors of all-cause morbidity and mortality is physical fitness. Physical fitness is determined in large part by daily physical activity levels. Habitual physical activity levels are in turn in part determined by the built environment but also by genes and memes. For example, the extensive cycling infrastructure in the Netherlands is one of the reasons for the better physical fitness of the Dutch in comparison with countries were mobility is generally more motorised. Modern architectural and urban design needs to integrate best principles to allow/induce physical activity levels because of public health needs. These principles should take into account the complexity of the determinants of spontaneous human behaviour, in specific with regard to physical activity patterns. The students will be made attentive about the power of design, the concept of nudging and the principles underlying behavioural health economics.

Learning outcomes
After discovering and studying basic principles of urban and architectural design aimed at promotion of physical activity levels the students will apply what they learned to practical examples from observations in the vicinity of Venice.
After the completion of this course the student:
•will be able to define principles of modern urban and architectural design commensurate with the human need for physical activity.
•will be able to describe interventions in the environment leading to increased levels of physical activity.
•will be able to imagine the outlines of interventions to increase spontaneous populational physical activity levels.
•will be able to write up and defend their design proposal in front of their class mates.

Teaching methods
Mix of lecture and class discussion (flipped classroom). Lectures are introductory to set the stage. Use of vignettes as starting points for class work. Class discussion in small groups and full class is then used to foster active critical thinking and participation. If possible a field trip will be made to a place near Venice to observe real examples of good and bad practice. Students write a final paper and present a case study in front of the class.

Evaluation methods
Active participation in class: 20%
Final paper: 50%
Final presentation in front of class: 30%

Bibliography
•Handy, S., Boarnet, M., Ewing, R., Killingsworth, R. (2002). How the built environment affects physical activity. American Journal of Preventive Medicine 23(2), 64-73. undefined(02)00475-0
•Smith, M., Hosking, J., Woodward, A., Witten, K., MacMillan, A., Field, A., Baas, P., Mackie, H. (2017). Systematic literature review of built environment effects on physical activity and active transport - an update and new findings on health equity. The international journal of behavioral nutrition and physical activity 14(1), 158. undefined
•Engelen, L., Dhillon, H., Chau, J., Hespe, D., Bauman, A. (2016). Do active design buildings change health behaviour and workplace perceptions? Occupational medicine (Oxford, England) 66(5), 408-11. undefined
•MacEwen, B., MacDonald, D., Burr, J. (2014). A systematic review of standing and treadmill desks in the workplace. Preventive medicine 70(J Phys Act Health 11 4 2014), 50-8. undefined

Important information for students enrolling in this course
Two weeks before starting the course the students are asked to install on their smart phones the FitBit® app (freely available for both Android and iPhones, no cost for basic counting of steps). The students are asked to record for at least one week but if possible for two weeks their daily steps with the help of the app before travelling to Venice, or before starting / starting the course online. Given the particular built environment of Venice (high walkability index) we will compare the effect of living and studying in Venice in comparison with living at home. The students following the course online from their homes are also encouraged to record their daily steps in order to have material for making links with the built environment around their home address. The data will be used in class when discussing built environment, walkability and population physical activity levels.

Course program details:
(all prior readings will be made available in Moodle)

Week 1 (Feb 22-26)
Introduction. Setting the stage: the global obesity and inactivity pandemics. Epidemiology. Historical perspective of spatial epidemiology. Public health and planning history.
Prior reading:
Link
Link

Week 2 (March 1-5)
Physical activity and health: trends and determinants. Financial cost of physical inactivity.
Prior reading:
Link
Link

Week 3 (March 8-12)
Interdisciplinary approaches. Studies and methodologies developed by sociologists, anthropologists, urban planners, sport scientists, epidemiologists and architects to evaluate the health impacts of the built environment.
Prior reading:
Link
Link

Week 4 (March 15-19)
Co-benefits of healthy environments in terms of sustainability and economy. Analysis of best practices.
Prior reading:
Link

Week 5 (March 22-26)
Designing the built environment for health. Tools and techniques available to connect urban planning and public health. Develop and implement new programs and policies that utilize built environment and design to promote public health.
Prior reading:
Link

Week 6 (March 29 - April 2)
Monitoring. Methods used to assess the built environment and its impact on health.
Assessing the populations needs.
Prior reading:
Link

Week 7 (April 12-16)
Communication. Describe the options available to promote healthy design decisions.
Present ideas linking evidence with policy guidance to local agency representatives.
Link

Week 8 (April 19-23)
Awareness. Raising awareness about health behavior of an individual’s everyday life.
Prior reading:
Link

Week 9 (April 26-30)
The economics of physical activity and health: the WHO Health Economic Assessment Tool (HEAT).
Prior reading:
Link

Week 10 (May 3-7)
Health economics and nudging. The stair example.
Prior reading:
Link

Week 11 (May 10-14)
Advocacy. WHO physical activity goals. The Lancet initiative. The global active city initiative.
Prior reading:
Link

Week 12 (May 17-21)
Wrap-up. Summary. Course evaluation. Preparation of the student presentations.