ArticlePDF Available

Abstract and Figures

Objectives Cultivating healthy workplaces is a critical aspect of comprehensive worksite health promotion. The influence of healthy workplace exposures on employee health outcomes warrants research attention. To date, it is unknown if nature contact in the workplace is related to employee stress and health. This study was designed to examine the effects of nature contact experienced at work on employee stress and health. Methods Office staff at a southeastern university ( n=503, 30% response rate) participated in the cross-sectional study. We used a 16-item workplace environment questionnaire, the Nature Contact Questionnaire, to comprehensively measure, for the first time, nature contact at work. The Perceived Stress Questionnaire and 13 established health and behavioral items assessed the dependent variables, general perceived stress, stress-related health behaviors, and stress-related health outcomes. Results There was a significant, negative association between nature contact and stress and nature contact and general health complaints. The results indicate that as workday nature contact increased, perceived stress and generalized health complaints decreased. Conclusions The findings suggest that nature contact is a healthy workplace exposure. Increasing nature contact at work may offer a simple population-based approach to enhance workplace health promotion efforts. Future researchers should test the efficacy of nature-contact workplace stress interventions.
Content may be subject to copyright.
R A
124 P H R / 2011 S 1 / V 126
Healthy Workplaces: The Effects
of Nature Contact at Work
on Employee Stress and Health
E L-W, PDa
W. W C, PD, CHESb
V D, PD, MPHb
R W, PD, MPHb
aUniversity of North Florida, Brooks College of Health, Department of Public Health, Jacksonville, FL
bUniversity of Florida, College of Health and Human Performance, Department of Health Education and Behavior, Gainesville, FL
Address correspondence to: Erin Largo-Wight, PhD, University of North Florida, Brooks College of Health, Department of Public Health,
1 UNF Drive, Jacksonville, FL 32224; tel. 904-620-2037; fax 904-620-1035; e-mail <>.
©2011 Association of Schools of Public Health
Objectives. Cultivating healthy workplaces is a critical aspect of comprehensive
worksite health promotion. The influence of healthy workplace exposures on
employee health outcomes warrants research attention. To date, it is unknown
if nature contact in the workplace is related to employee stress and health. This
study was designed to examine the effects of nature contact experienced at
work on employee stress and health.
Methods. Office staff at a southeastern university (n5503, 30% response
rate) participated in the cross-sectional study. We used a 16-item workplace
environment questionnaire, the Nature Contact Questionnaire, to comprehen-
sively measure, for the first time, nature contact at work. The Perceived Stress
Questionnaire and 13 established health and behavioral items assessed the
dependent variables, general perceived stress, stress-related health behaviors,
and stress-related health outcomes.
Results. There was a significant, negative association between nature contact
and stress and nature contact and general health complaints. The results
indicate that as workday nature contact increased, perceived stress and gener-
alized health complaints decreased.
Conclusions. The findings suggest that nature contact is a healthy workplace
exposure. Increasing nature contact at work may offer a simple population-
based approach to enhance workplace health promotion efforts. Future
researchers should test the efficacy of nature-contact workplace stress
E  N C  E S  H 125
P H R / 2011 S 1 / V 126
The work environment contributes to employee health.
A sick environment can threaten health through
biological and psychological pathways. Biologically,
indoor air pollutants and toxins may cause illness,
such as the Sick Building Syndrome.1 Psychologically,
ofce environments typied with crowding and noise
contribute to chronic stress.2,3 Conversely, ofce envi-
ronments can be created to enhance employee health.
Healthy exposures include the following: availability of
healthy behavioral options (e.g., healthy food choices),
enhanced and optimized safety, environmental sustain-
ability and stewardship, and the opportunity for nature
contact at work.4–8 The healthy workplace consists of
these healthful exposures and is free of the negative
Effective, comprehensive worksite health promo-
tion programs (WHPPs) aim to foster a healthy work-
place. It is now widely believed that worksite health
promotion should go beyond education and focus on
individual behavior change and also include environ-
mental modications. Environmental modications
are physical changes or interventions to the workplace
environment. Engbers et al. conducted a systematic
review of 13 randomized controlled trials (RCTs) with
environmental interventions at work entitled “Work-
site Health Promotion Programs with Environmental
Changes.”4 The Working Healthy Project, for example,
was a study of more than 2,000 employees that showed
how environmental modications, such as food label-
ing on vending machines and at restaurants and a
red-line route to promote lunchtime walking, resulted
in a signicant increase in fruit and vegetable con-
sumption and physical activity at 2.5 years follow-up.9
Environmental modications are especially important
components of WHPPs because they support and
enable health and behavioral outcomes.
One way that the workplace may be modied to
promote health is through the purposeful use of
nature contact.10 Nature contact is a component of all
healthy places and the focus of this workplace study.
Everyday nature contact is exposure to the outdoors or
outdoor-like elements in the places people live, work,
and play.5 At work, nature contact may be achieved by
adding an indoor ofce plant or taking a work break
outdoors. To date, a handful of workplace studies have
suggested that nature contact experienced at work
or in an ofce setting may be health promoting. For
example, previous work or ofce ndings suggest that
relaxing outdoors,11 indoor ofce plants,12 and ofce
window views7 were related to less stress. Although
these ndings support the notion that nature contact
is a component of a healthy workplace, studies are
few and limited.
There are important nature-contact and health nd-
ings in other populations and other settings. These
ndings, although not directly related to work, may
inform future worksite studies and practice. These nd-
ings help point to possible forms of nature contact that
may represent healthy exposures at work and warrant
future research. For example, a nature-contact inter-
vention of gardening reduced stress in a study of breast
cancer patients.13 Other less active forms of outdoor
exposure, such as spending passive time in an urban
park, have also been associated with less stress among
random samples of city dwellers.14 Indoor exposure to
plants, natural lighting, sh tanks, and a view from the
window have been previously associated with less stress
among many populations.15–19 In addition, exposure to
abstract representations of nature experienced indoors,
such as recorded nature sounds or photographed
images, has been associated with decreased stress and
stress-related outcomes.20 A study demonstrated that a
“nature therapy” intervention consisting of two forms of
nature contact—a nature mural printed on a hospital
bedside curtain and a nature CD playing—resulted
in signicantly less perceived pain and stress during
a bronchoscopy procedure.21 In summary, these stud-
ies suggest that the following forms of nature contact
were health-promoting among a variety of populations
and settings: window view, natural light, sh tanks,
live or articial plants, listening to recorded nature
sounds on a CD, nature photography or art, and out-
door breaks or lunch.5 These nature-contact ndings
may inform future work studies by pointing to these
forms of nature contact that may be healthful in the
workplace as well.
The theoretical question “How does nature contact
promote health?” has previously been explored. In
a nutshell, nature contact reduces stress. Biological
researchers point to an evolutionary explanation for
this phenomenon. The biophilia hypothesis contends
that natural elements are calming for people today
because of the linkage to survival in the past (just as
common fears—such as snakes, spiders, and heights—
are rooted in the past and related to survival):22,23
“Throughout human existence, human biology has
been embedded in the natural environment. Those
who could smell the water, nd the plants, follow the
animals, and recognize the safe havens must have
enjoyed survival advantages.”23 Psychological research-
ers have studied the brain and stress response after
exposure to nature contact. This work has led to two
potential mechanisms to explain how natural ele-
ments reduce stress in people today. Environments
with natural elements either (1) restore stress-fatigued
cognitive resources to enhance coping abilities24 or (2)
126 R A
P H R / 2011 S 1 / V 126
stimulate underutilized portions of the “old” brain,
which balance the concentrated stimulation and relieve
exhausted portions of the brain25 to reduce stress.
Stress-reducing work environments represent an impor-
tant focus of research and practice. Stress not only inu-
ences mental health and quality of life, it also increases
the likelihood of chronic diseases, such as heart disease
and cancer.26–28 Stress and related health consequences
are more prevalent in the U.S. today than in the past,
and work is attributed as a major cause.29 According
to the demand-control model and previous ndings,
occupational positions with low decision latitude and
high psychological demands, such as ofce staff, suffer
most from stress.30,31 In addition to having high-stress
jobs, ofce staff are a priority public health population
because they represent 70% of the U.S. workforce.32
In this study, we examine workplace environments and
stress among ofce staff.
This study was designed to (1) describe the inu-
ence of nature contact at work on perceived stress and
stress-related health and behavioral outcomes and (2)
inform public health promotion. Although there is
evidence that nature contact is health-promoting in
many populations and varied settings, there are few
ndings on nature contact at work and health among
ofce staff, a priority public health population.7 To
date, it is unknown if regular contact with nature in
the workplace is associated with perceived stress levels
of ofce staff. Understanding and designing healthy
workplaces is important and offers a promising and
population-based approach to reduce stress and related
health outcomes among working Americans.5,7
We invited a census of ofce staff at a southeastern
university (n51,622) to participate in the study. The
group included 13 job codes of full-time, mostly desk-
bound ofce staff, such as secretaries and ofce clerks.
Electronic informed consent was obtained from all par-
ticipants; participation was anonymous and voluntary.
We used a cross-sectional, Web-based survey design to
collect data. We sent an e-mail invitation along with
the Web link to access the online survey to the census.
The participants took approximately 10–15 minutes to
complete the online survey. We utilized a Web-based
survey because it was cost-efcient, environmentally
sound, practical, and had the potential to reach the
study’s population.33 Five previously identied strate-
gies34 were used to minimize potential disadvantages
of Web-based surveys, such as non-response error and
low response rate: (1) e-mails were personalized by
addressing each participant by name; (2) informed
consent to participate in the study was obtained by
clicking “next” on the online survey; (3) personal
questions about income, age, and marital status were
located at the end of the survey; (4) two follow-up,
reminder e-mails were sent three and ve days after
the initial e-mail invitation to ofce staff who had not
yet participated; and (5) participants in the study were
eligible for a nominal incentive.
We measured nature contact at work using a 16-item
scale, the Nature Contact Questionnaire (NCQ). We
measured total score and three subscales—outdoor,
indoor, and indirect nature contact. The outdoor-na-
ture-contact subscale measured the employees’ outdoor
exposure at work—for example, “the weekly frequency
of work breaks outdoors.” The indoor-nature-contact
subscale measured employees’ exposure to natural
elements within the ofce space, such as view from a
window, natural light, and live plants. An example was
“the number of live plants in the ofce.” The indirect-
nature-contact subscale measured employees’ exposure
to abstract representations of natural elements in the
ofce, such as photographs of natural landscapes and
recorded nature sounds. An example was “percentage
of time per week listening to recorded nature sounds
on CD.” The range of possible total scores was 16
to 96. We used a continuous Likert scale to quantify
the response options and included percentage of
time exposed to the item (0%, 1%–20%, 21%–40%,
41%–60%, 61%–80%, and 81%–100%), frequency of
contact with the item (N/A, 0, 1, 2, 3, 4, and 5 or more),
and number of contact items (0, 1, 2, 3, 4, and 5 or
more). We established content validity (expert panel),
construct validity (Kaiser-Meyer-Olkin 5 0.68), internal
consistency (alpha 5 0.63), and test-retest reliability
(r50.84). The NCQ and psychometric properties were
reported in detail elsewhere.35
We measured stress using the Perceived Stress Ques-
tionnaire (PSQ). The PSQ consists of 30 items, such
as “you have too many things to do,” “you feel lonely
or isolated,” and “you nd yourself in situations of
conict.” The range of possible total scores was 30 to
120. The reported test-retest reliability of the PSQ was
r50.82 and the internal reliability was alpha 5 0.92.
The PSQ psychometric properties also were reported
in detail elsewhere.36
E  N C  E S  H 127
P H R / 2011 S 1 / V 126
We measured health and health behaviors using 13
items drawn from the Behavioral Risk Factor Surveil-
lance System (BRFSS),37 National Quality Institute,38
Centers for Disease Control and Prevention,39 and
previous studies.40,41 We measured self-reported health,
the number of days in the past month inuenced by
poor health, and behavioral items—including ciga-
rette smoking and preventive behaviors—using BRFSS
historical questions.37 Alcohol and coffee consump-
tion were measured with items similar to the BRFSS
historical questions but modied based on previous
research.40 We measured frequency of moderate and
vigorous physical activity using items from a national
healthy workplace questionnaire.38 Lastly, we measured
diet with two items related to fruit and vegetable con-
sumption based on previous research41 and dened a
serving using governmental guidelines from the 5 A
Day for Better Health Program.39
Data analysis
We used SPSS® version 1642 to analyze the data. All sur-
vey responses were numerically coded, and totals and
subtotals were calculated for both survey instruments
(PSQ and NCQ). We used multiple regression analysis
to determine which of the health and behavioral items
were stress related. To explore the relationship between
nature contact and health and the relationships among
forms of nature contact, we conducted bivariate cor-
relation analyses and independent t-test analyses.
The majority of the participants were women (92.9%)
and white (82.5%). The mean age of the participants
was 42 years, with a standard deviation of 12 years.
Approximately half of the participants attended some
college or technical school (47.5%), reported earn-
ing $25,001–$35,000 per year (49.5%), and reported
being married (54.4%). The response rate was about
30% (n5503).
Nature contact at work and employee health
First, we determined which of the health and behav-
ioral survey items were stress related. To determine
the stress-related variables, we employed a multiple
regression analysis with the PSQ stress total as the
dependent variable and the 13 health and behavior
survey items as independent variables. Data analysis
revealed that “general health” self-rating (poor to
excellent) and “number of days in the past 30 days
that health prevented from doing usual activities” were
signicant predictors of stress and, thus, represented
the stress-related variables in this study. None of the
health behavior items, such as smoking and physical
activity, was a statistically signicant predictor of stress.
As a result, we included the PSQ stress total and the two
stress-related health variables as dependent variables
in remaining analyses.
We used Pearson product bivariate correlations
to examine the relationship between nature contact
at work and the three study variables (stress, general
health, and number of days health prevented activi-
ties). Higher nature-contact scores represented more
nature contact at work, and lower perceived stress and
health scores represented less stress and fewer health
concerns (Table 1). The correlations were interpreted
based on the strength of the association.
We conducted t-test analyses to further examine
the patterns of association between nature contact
and health. High and low nature-contact scores were
dummy-coded as 1 and 2, respectively. The high-
nature-contact group was one standard deviation above
the mean and the low-nature-contact group was one
standard deviation below the mean. We ran analyses
to compare the highest and lowest nature-contact
groups. The high-total-nature-contact group and the
high-outdoor-nature-contact group had signicantly
less stress and better general health than the related
low groups. There was no statistically signicant dif-
ference between high and low nature contact for the
number of days one missed normal activities over the
last month for any measure of nature contact. Table 2
Table 1. Relationships between nature contact at
work and stress, general health, and number of days
health prevented activities among office staff
Independent variables Dependent variables r
Nature contact total Stress total 20.14a
General health 20.14a
Days health poor 0.01
Outdoor nature contact
Stress total
General health
Days health poor 0.04
Indoor nature contact
Stress total
General health
Days health poor 20.03
Indirect nature contact
Stress total
General health
Days health poor 20.01
bp,0.001 (two-tailed)
128 R A
P H R / 2011 S 1 / V 126
provides a summary of the inuence of high vs. low
nature contact on total stress score.
The purpose of this study was to examine the inuence
of nature contact at work on stress and health among
ofce staff, a priority public health population that
has not been well studied.11 The ndings from this
study were consistent with previous ndings in other
settings and the primary theoretical explanations.5,24–25
Employees with more nature contact at work reported
signicantly less perceived stress and stress-related
health complaints. These ndings suggest that nature
contact at work may constitute a healthy workplace
It is important to understand healthy workplace
exposures. It is now widely believed that cultivating
healthy workplaces is an important component of
comprehensive WHPPs.4 This study’s main ndings
suggest that nature contact at work, as in other settings,
is associated with stress reduction among employees.
These ndings, in the context of the larger body of
literature, suggest that the purposeful use of nature
contact at work may reduce employee stress.5 Creating,
enhancing, or promoting the use of outdoor break
areas, for example, may be one way for health promo-
tion practitioners to cultivate a healthy workplace with
nature-contact exposures.10 Future research should
build off of these cross-sectional ndings and assess if
environmental (nature-contact) interventions at work
result in stress reduction among employees.
Although the effect size was small to moderate, the
ndings were statistically signicant and important. The
ndings are particularly important because increasing
nature-contact exposure at work may be an inexpensive
and practical way to enhance worksite health promo-
Table 2. Relationships between perceived stress and high vs. low nature contact at work among office staff
Independent variables NM SD t-score
Low nature contact—total 41 67.3 16.2 2.1a
High nature contact—total 60 60.5 16.2
Low nature contact—outdoor subscale 85 68.0 17.8 3.1b
High nature contact—outdoor subscale 58 59.2 15.7
Low nature contact—indoor subscale 131 65.4 16.1 0.8
High nature contact—indoor subscale 52 63.1 17.1
Low nature contact—indirect subscale 84 66.1 16.5 2.1a
High nature contact—indirect subscale 46 60.1 16.6
M 5 mean
SD 5 standard deviation
bp,0.01 (two-tailed)
tion efforts. In contrast to other factors that inuence
perceived stress, such as social support, job demands,
and relaxation skills,28 enhancing nature contact at
work is a relatively simple approach. Adding indoor
plants, opening blinds, or going outside for a work
break instead of to the break room, for example, are
straightforward ways to increase healthy exposures at
work to combat stress and promote health. Enhancing
coping or social support, on the other hand, likely
involves more time, effort, and resources. Maller et al.
and others recognized that “contact with nature may
provide an effective population-wide strategy.”43
These ndings are also important because this
was the rst known study to measure nature contact
comprehensively at work or in any setting. Other
studies have examined the inuence of one form of
nature contact (e.g., the number of indoor plants) on
stress or health. Researchers have previously pointed
to three forms of nature contact important for child
development that were similar to the forms measured
and analyzed in this study,44 but this is the rst known
study to measure all known health-promoting forms
of nature contact. The ndings from this study also
allowed the rst-ever quantitative comparisons between
forms of nature contact. Kuo emphasized the need to
study nature contact comprehensively to determine
“which forms or doses of nature enhance effectiveness
and which do not.”45
In this study, ndings suggest that the forms of
nature contact may matter. The most direct nature
contact—outdoor nature contact—had the strongest
association with stress reduction and health. The
frequency of employees’ outdoor exposure at work
had the strongest negative correlation to stress and
health complaints, whereas the least direct form of
nature contact—indirect nature contact—resulted
in the least health benets. Employees’ exposure to
E  N C  E S  H 129
P H R / 2011 S 1 / V 126
nature photography or nature sounds in the ofce,
for example, had the weakest negative correlation to
stress and health complaints. These novel ndings will
help health promotion practitioners begin to prioritize
efforts. These ndings are important for shaping work-
place stress interventions and may suggest that taking
an outdoor “booster break,”46 for example, would be
more important than displaying nature photography
or a live plant in the ofce. Future research should
build off of these cross-sectional ndings and compare
environmental (nature-contact) interventions at work
to best inform practice.
Although the ndings from our study and other studies
suggest that nature contact may be helpful to reduce
employee stress, future research should be conducted.
An important limitation of our study was that partici-
pants consisted of ofce staff from one university. This
limits generalizability to larger populations. Future
research should examine other working populations.
Another limitation of our study was the lack of
causal relationships. Like all cross-sectional studies,
the ndings from this study cannot infer causation.
Nature contact did not cause stress reduction in this
study. Future studies should examine the efcacy of
workplace nature-contact interventions, such as the
outdoor booster break, on employee stress among vary-
ing populations of employees. Intervention research
could also be employed to better compare the forms
(outdoor, indoor, and indirect) of nature contact on
stress. Ideally, future intervention research should
employ a RCT design in an applied workplace setting
with several follow-ups to best inform recommenda-
tions for practice.
Creating environments with natural elements to reduce
stress is both intuitive and scientic. Ofce windows,
vacation destinations, and real-estate costs worldwide
suggest that people everywhere value nature contact
(and will pay more for it).5,17,47–50 This phenomenon
has also been well studied. The main theoretical per-
spectives suggest that natural elements are calming
for people today because of the linkage to survival in
the past.5,24,25
A recent review entitled “Cultivating Healthy Places
and Communities: Evidenced-Based Nature Contact
Recommendations”10 summarized the nature-contact
literature as it related to human health. The article
points to 12 research-based health promotion recom-
mendations, with the assumption that “environments
can be protected, created, recongured, or regulated
to prevent, eliminate, or mitigate [stress].”51 The rec-
ommendations include the following: advocate for the
preservation of pristine wilderness; incorporate wooded
parks/green space in community design; maintain
healing gardens; cultivate and landscape grounds for
outdoor viewing; welcome animals inside; provide a
plethora of indoor potted plants within view; light
rooms with bright, natural sunlight; provide a clear
view of nature outside; allow outside air and sounds
in; display nature photography and realistic nature art;
watch nature on TV or videos; and listen to recorded
nature sounds.10
Our study’s ndings support the notion that many
of these recommendations may also apply to the
workplace environment. These ndings, together
with the previous studies and the evidenced-based
recommendations, suggest that nature contact may
be fostered through environmental modications to
reduce employee stress. The concept of “wellness by
design”15 in the workplace may be achieved, in part,
through the purposeful use of nature contact.
This study was supported by the Society for Public Health Educa-
tion (SOPHE)/Agency for Toxic Substances and Disease Registry
(ATSDR) student fellowship in environmental health promotion.
The contents of this article are solely the responsibility of the
authors and do not necessarily represent the ofcial views of
1. Samet JM, Spengler JD. Indoor environments and health: moving
into the 21st century. Am J Public Health 2003;93:1489-93.
2. Brennan A, Chugh JS, Kline T. Traditional versus open ofce design:
a longitudinal eld study. Environ Behav 2002;34:279-99.
3. Raffaello M, Maass A. Chronic exposure to noise in industry: the
effects on satisfaction, stress symptoms, and company attachment.
Environ Behav 2002;34:651-71.
4. Engbers LH, van Poppel MN, Chin A Paw MJ, van Mechelen W.
Worksite health promotion programs with environmental changes:
a systematic review. Am J Prev Med 2005;29:61-70.
5. Frumkin H. Beyond toxicity: human health and the natural envi-
ronment. Am J Prev Med 2001;20:234-40.
6. Frumkin H, McMichael AJ. Climate change and public health:
thinking, communicating, acting. Am J Prev Med 2008;35:403-10.
7. Kaplan R. The role of nature in the context of the workplace.
Landscape Urban Plan 1993;26:193-201.
8. Srinivasan S, O’Fallon LR, Dearry A. Creating healthy communi-
ties, healthy homes, healthy people: initiating a research agenda
on the built environment and public health. Am J Public Health
9. Emmons KM, Linnan JA, Shadel WG, Marcus B, Abrams DB. The
Working Healthy Project: a worksite health-promotion trial target-
ing physical activity, diet, and smoking. J Occup Environ Med
10. Largo-Wight E. Cultivating healthy places and communities:
evidenced-based nature contact recommendations. Int J Environ
Health Res 2011;21:41-61.
11. Trenberth L, Dewe P, Walkey F. Leisure and its role as a strategy
for coping with work stress. Int J Stress Manag 1999;6:89-103.
12. Larson L, Adams J, Deal B, Kweon BS, Tyler E. Plants in the
workplace: the effects of plant density on productivity, attitudes,
and perceptions. Environ Behav 1998;30:261-81.
130 R A
P H R / 2011 S 1 / V 126
13. Cimprich B. Development of an intervention to restore attention
in cancer patients. Cancer Nurs 1993;16:83-92.
14. Grahn P, Stigsdotter UA. Landscape planning and stress. Urban
For Urban Green 2003;2:1-18.
15. Ulrich RS. Wellness by design: psychologically supportive patient
surroundings. Group Pract J 1991;40:10-9.
16. Dijkstra K, Pieterse ME, Pruyn A. Stress-reducing effects of indoor
plants in the built healthcare environment: the mediating role of
perceived attractiveness. Prev Med 2008;47:279-83.
17. Kaplan R. The nature of the view from home: psychological benets.
Environ Behav 2001;33:507-42.
18. Leather P, Beale D, Santos A, Watts J, Lee L. Outcomes of environ-
mental appraisal of different hospital waiting areas. Environ Behav
19. Shibata S, Suzuki N. Effects of the foliage plant on task performance
and mood. J Environ Psychol 2002;22:265-72.
20. Felsten G. Where to take a study break on the college campus:
an attention restoration theory perspective. J Environ Psychol
21. Diette GB, Lechtzin N, Haponik E, Devrotes A, Rubin HR. Distrac-
tion therapy with nature sights and sounds reduces pain during
exible bronchoscopy: a complementary approach to routine
analgesia. Chest 2003;123:941-8.
22. Buss DM. Evolutionary psychology: a new paradigm for psychologi-
cal science. Psychol Inq 1995;6:1-30.
23. Wilson EO. Biophilia: the human bond with other species. Cam-
bridge (MA): Harvard University Press; 1984.
24. Kaplan S. The restorative benets of nature: toward an integrative
framework. J Environ Psychol 1995;15:169-82.
25. Ulrich RS, Simons RF, Losito BD, Fiorito E. Stress recovery during
exposure to natural and urban environments. J Environ Psychol
26. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York:
Springer; 1984.
27. Cohen S, Frank E, Doye WJ, Dkoner DP, Rabin BS, Gwaltney JM Jr.
Types of stressors that increase susceptibility to the common cold
in healthy adults. Health Psychol 1998;17:214-23.
28. Karren KJ, Hafen BQ, Smith NL, Frandsen KJ. Mind/body health:
the effects of attitudes, emotions and relationships. 2nd ed. San
Francisco: Benjamin Cummings; 2002.
29. Horan AP. An effective workplace stress management interven-
tion: Chicken Soup for the Soul at Work Employee Groups. Work
30. Mausner-Dorsch H, Eaton WW. Psychological work environment
and depression: epidemiologic assessment of the demand-control
model. Am J Public Health 2000;9:1765-70.
31. Melchior M, Krieger N, Kawachi I, Berkman LF, Niedhammer I,
Goldberg M. Work factors and occupational class disparities in sick-
ness absence: ndings from the GAZEL cohort study. Am J Public
Health 2005;95:1206-12.
32. Mendell MJ, Fisk WJ, Kreiss K, Levin H, Alexander D, Cain WS, et
al. Improving the health of workers in indoor environments: priority
research needs for a national occupational research agenda. Am J
Public Health 2002;92:1430-40.
33. Daley EM, McDermott RJ, McCormack Brown KR, Kittleson MJ.
Conducting web-based survey research: a lesson in Internet designs.
Am J Health Behav 2003;27:116-24.
34. Dillman DA. Mail and Internet surveys: the tailored design method.
2nd ed. New York: John Wiley & Sons, Inc.; 2000.
35. Largo-Wight E, Chen W, Dodd V, Weiler R. The Nature Contact
Questionnaire: a measure of healthy workplace exposure. Work.
In press 2011.
36. Levenstein S, Prantera C, Varvo V, Scribano ML, Berto E, Luzi C,
et al. Development of the Perceived Stress Questionnaire: a new
tool for psychosomatic research. J Psychosom Res 1993;37:19-32.
37. Centers for Disease Control and Prevention (US). Behavioral Risk
Factor Surveillance System—historical questions [cited 2010 Dec
13]. Available from: URL:
38. National Quality Institute. Health in the workplace employee ques-
tionnaire. Investing in comprehensive workplace health promotion.
Toronto: National Quality Institute; 2001.
39. Centers for Disease Control and Prevention (US), National Fruit
and Vegetable Program. What counts as a cup? [cited 2010 Dec
13]. Available from: URL:
40. Conway TL, Vickers RR Jr, Ward HW, Rahe RH. Occupational
stress and variation in cigarette, coffee, and alcohol consumption.
J Health Soc Behav 1981;22:155-65.
41. Berrigan D, Dodd K, Troiano RP, Krebs-Smith SM, Barbash RB. Pat-
terns of health behavior in U.S. adults. Prev Med 2003;36:615-23.
42. SPSS, Inc. SPSS®: Version 16. Chicago: SPSS, Inc.; 2001.
43. Maller C, Townsend M, Pryor A, Brown P, St Leger L. Healthy
nature healthy people: “contact with nature” as an upstream
health promotion intervention for populations. Health Promot
Int 2006;21:45-54.
44. Kellert SR. Experiencing nature: affective, cognitive, and evalua-
tive development in children. In: Kahn PH Jr, Kellert SR, editors.
Children and nature: psychological, sociocultural, and evolutionary
investigations. Cambridge (MA): The MIT Press; 2002. p. 117-51.
45. Kuo FE. Coping with poverty: impacts of environment and attention
in the inner city. Environ Behav 2001;33:5-34.
46. Taylor WC. Transforming work breaks to promote health. Am J
Prev Med 2005;29:461-5.
47. Ulrich RS, Simons RF, Miles MA. Effects of environmental simu-
lations and television on blood donor stress. J Archit Plan Res
48. Northridge ME, Sclar ED, Biswas P. Sorting out the connections
between the built environment and health: a conceptual framework
for navigating pathways and planning healthy cities. J Urban Health
49. Regan CL, Horn SA. To nature or not to nature: associations between
environmental preferences, mood states and demographic factors.
J Environ Psychol 2005;25:57-66.
50. Parsons R. The potential inuences of environmental perception
on human health. J Environ Psychol 1991;11:1-23.
51. Hartig T. Guest editor’s introduction. Environ Behav 2001;33:475-9.
... Existing literature has discussed different types of natural settings in the urban space as an essential index of living quality (Arnberger and Eder 2015;Hansen et al. 2017). Urban public places such as parks, vertical greenery, and street trees could provide a certain degree of restoration, yielding health effects that lower the risk of depression and negative emotion (Beute and de Kort 2018;Bressane et al. 2022), stress level (Hunter et al. 2019;Largo-Wight et al. 2011), and the overall well-being of the population regardless of gender, culture, or community (Hedblom et al. 2019;Lee and Maheswaran 2011;Liu et al. 2021;Mennis et al. 2018;Richardson and Mitchell 2010;Wolch et al. 2014). Urban residents participating in nearby outdoor recreation also report higher well-being and psychological resilience (Buchecker and Degenhardt 2015). ...
Accessible urban greenery allows short breaks and leisure activities while experiencing nature. Studies have shown that contact with nature elicits psychological and physical health benefits. However, the immediate impact and influence of exposure to artificial versus rural ecological nature have yet to be examined. This study investigates their psychophysiological restorative effects onsite, specifically when individuals view a ubiquitous urban public greenery space or a more indigenous ecological forest-like nature area, to compare levels of restorativeness and relaxation. Participants were asked to sit and view a scene onsite for 6 min while their facial muscle tension was recorded. The data were used to evaluate the degree of facial relaxation for both scenes. In addition, participant self-reports measured perceived restorativeness after the 6-min period. The self-reported data showed that the ecological farm scene was rated significantly higher for perceived restorativeness (t [49.136] = 9.094, p < .001) after 6 min of viewing. The muscle tension analysis showed that facial tension significantly declined when participants viewed the farm scene compared to the urban greenery space. These results, especially those on the farm, show that nature with more forest-like and rural elements elicited more powerful restorative effects and significantly lowered facial muscle tension (t [65] = − 2.785, p < .05), thus verifying that a more ecological nature landscape provides immediate, significant health benefits through attention recovery and reduced facial muscle stress.
... For example, previous research finds that taking a break outdoors, provision of indoor plants, and providing green views from office windows is related to lower levels of stress (Frumkin, 2001;Larson et al., 1998;Trenberth et al., 1999). A range of studies of office workers in the US (Largo-Wight et al., 2011), Norway (Bjornstad et al., 2016, Finland (Korpela et al., 2015(Korpela et al., , 2017, and the UK (Colley et al., 2016;Hähn et al., 2020) have found that workplace nature contact lowers stress levels. ...
... Reported participation rates range from 3% to 100%, with over half of all studies reporting the average (or in some cases the overall) participation rate of less than 50% (20 studies). Two studies reported participation rates of less than 10% [20,30], five studies reported participation rates from 20% to 30% [31][32][33][34][35], five studies reported participation rates between 30% and 40% [21,29,[36][37][38], and eight studies reported participation rates between 40% and 50% [22][23][24][39][40][41][42][43]. Four studies reported participation rates between 50% and 60% [25,[44][45][46], five studies reported participation rates between 60% and 70% [47][48][49][50][51], four studies reported participation rates between 70% and 80% [26,27,52,53], two reported participation rates between 80% and 90% [12,54], and finally one study reported a participation rate between 90% and 100% [55]. ...
Full-text available
Workplace health promotion programmes (WHPPs) are among the most important measures to improve the health and motivation of the ageing workforce. However, they are accompanied with certain challenges, such as low participation rates and higher participation levels of the more health-conscious workers, often failing to engage those who need such interventions the most. Following the PRISMA guidelines, this scoping review examined participation rates reported in articles on WHPPs to identify potential knowledge gaps. The results are worrying: participation rates are not only infrequently reported, but also low. Of the 58 articles, 37 report participation rates, with the majority (20) reporting an average participation rate of less than 50%. Reported participation rates refer either to different target groups, the type of intervention, or to single points in time, which makes it difficult to establish consistent criteria for comparison. We argue that despite the importance of WHPP efficacy, research focus should shift to the determinants of participation, as well as the issue of standardising the reporting of participation rates, alongside the potential problem of reporting bias.
... The literature provides a range of studies discussing biophilic design's positive effects on workers' cognitive performance, health, and well-being [120]. More specifically, research shows that nature contact can actively help office workers recover from work stress [122]. ...
... More and more buildings are now beginning to use green walls as a key element in the trend for biophilic design [1,2,8]. Studies [9][10][11][12][13] report that the use of green elements such as green walls result in measurable improvements to the human condition in terms of health, productivity and well-being. Wilkins [14] argues that the human visual system evolved in a natural environment and the modern urban environment increases the amount of neural computation necessary to process the images received. ...
Full-text available
This study demonstrates the possibility of growing green walls in normal commercial building environments with lighting designed primarily for aesthetic reasons, rather than the promotion of plant growth. Lighting is a key resource required for the growth and maintenance of robust green walls within interior environments. The study evaluated the appearance and growth of green walls with electric lighting used primarily for aesthetic reasons. Three identical green walls with six different plants were illuminated using three different white LED light sources for a period of five months. Plant health was monitored and documented in terms of growth patterns. One hundred and six subjects appraised the appearance of the walls using questionnaires. Findings of this study indicate that it is indeed possible to grow and maintain green walls in normal commercial building environments with lighting designed for aesthetic reasons. Further, it was observed that the selection of the correct plant species for the green walls is important to ensure plant health.
... This, combined with the mobilisation of the parasympathetic nervous system, leads to higher levels of positive feelings, reduced negatively-toned feelings and a maintenance or restoration of attention and energy, which are adaptive to survival [28,29]. Evidence for SRT following nature exposure is supported by the positive effects on various physiological and emotional parameters associated with stress recovery [30,31]. These outcomes have been particularly highlighted in the forest-bathing (or 'shinrin-yoku' in Japanese) literature [32]. ...
Full-text available
This systematic review aimed to identify mechanisms of psychological change following exposure to nature within an adolescent population. Keyword searches within Scopus, PsychINFO and Web of Science were carried out to include articles published by 14 September, 2021. Records were reviewed in line with inclusion criteria: samples with an average age of 24 and under, exposure to nature vs. control using an experimental or quasi-experimental design and outcomes of mental health and psychological status. The review resulted in 27 papers that were assessed for methodological quality and manually searched for mediation analyses. A range of psychological outcomes were identified and grouped into 10 categories: Mood and Affect, Mental Health, Wellbeing, Perceived Restoration, Stress, Energy, Cognitive Functioning, Resilience, Self-Concept and Pro-Social Behaviour. Only one formal mediation analysis was reported, highlighting a mediating role of belonging in increases in resilience. Limitations include the majority use of university student samples and over half of the papers being of low methodological quality. No firm conclusions on key mechanisms in an adolescent population were made due to insufficient evidence of mediating variables. The development of methodologically rigorous experimental studies with the inclusion of statistical pathway modelling is needed to test and specify plausible mechanisms.
Hızla büyüyen, kalabalıklaşan, karmaşıklaşan ve daha gürültülü hale gelen kentlerde yaşam kalitesi giderek düşmekte ve kentte yaşayan insanlar sessiz/sakin bir ortamda dinlenme, rahatlama ve rehabilite olma ihtiyacı hissetmektedir. Bu anlamda kentsel bölgelerdeki park, bahçe, avlu vb. açık alanlar sessiz/sakin alan olarak, bu ihtiyacın karşılanması için kullanılabilecek öneme sahip mekanlardır. Bu tür yerlere örnek bir alan olarak Eskişehir Kurşunlu Camii ve Külliyesi bahçesi bu çalışmada konu edilmiştir. Eskişehir Odunpazarı Kentsel Sit Alanı içerisinde bulunan ve bir Osmanlı Dönemi yapı grubu olan külliye, tarihi değeri ve turistik kullanımı ile ön plana çıksa da külliyeyi oluşturan binaların arasında kalan yeşil alan, çevresine göre sessiz/sakin bir yer olma potansiyeline sahiptir. Bu bağlamda bahçe, alana sessizlik/sakinlik niteliği kazandıran özellikleri açısından işitsel peyzaj yaklaşımıyla alan çalışması üzerinden incelenerek sessiz/sakin alan olma potansiyeli değerlendirilmiş, sessizlik/sakinlik algısını etkileyen faktörler (akustik özellikler, mekânsal özelikler, işlev) belirlenmiştir. Alan çalışmasında akustik ölçüm ve anket yapılmıştır. Akustik ölçüm sonuçlarına göre alandaki ses basınç düzeyi (LAeq) kabul edilebilir düzeyin (55 dB’in) altındadır. Anket sonuçlarına göre ise beklenene paralel olarak alan, çoğunluk tarafından sessiz/sakin olarak değerlendirilmiştir. Alanda sessizlik/sakinlik algısını etkileyen faktörler alan özelliklerine göre; alanda su sesinin, kuş seslerinin ve dini seslerin duyulması; ses kaynağı sayısının ve çeşidinin az olması; yetişkin ağaçların bulunması, alanın tarihi ve kültürel değere sahip olması şeklinde ifade edilmiştir. Sonuç olarak Kurşunlu Camii ve Külliyesi bahçesinin sessiz/sakin alan olarak kullanılabileceği ve dolayısıyla farklı kentsel bölgelerde bu alan ile benzer özelliklere sahip açık alanların da ergonomik kent koşullarının oluşturulmasına katkı sağlayan alanlar olarak değerlendirilebileceği ortaya konulmuştur
Despite the awareness that employees spend at least half of their awake time at work, knowledge about how the physical office work environment (POWE) shapes employee wellbeing remains fragmented, inconsistent and scattered across disciplines. We provide a narrative review of the empirical literature to summarise the current state of the science and lay the groundwork for advancing a more holistic and nuanced theoretical understanding of the mediating mechanisms underlying the POWE‐wellbeing relationship. To do so, we propose an updated taxonomy of POWE features, incorporating a new dimension – exposure to nature, and use this extended taxonomy to examine the evidence base on the relationship between POWE features and five dimensions of wellbeing: affective, physical, social, cognitive and professional. Based on our findings, we extend a meta‐theoretical model which identifies three distinct theoretically‐driven mediating pathways – relatedness, energy and functional discomfort – through which POWE features differentially influence wellbeing dimensions. In doing so, we integrate the organizational behaviour theory of Job Demands‐Resources and the environmental psychology framework of POWE functions to argue that POWE functions can be both demands and resources‐generating, and can, therefore, have simultaneous positive and negative consequences for employee wellbeing. We conclude with a critical examination of theoretical, methodological and practical implications for future research.
Full-text available
Background The effect of a forest therapy in a natural environment noted that the forest therapy induced a state of relaxation among workers, thereby decreasing cortisol levels and work-related stress. Objective The primary objective of this study is to determine the effects of the forest therapy for employees in the manufacturing industry on psychological stress responds, stress hormone and heart rate variability (HRV). The secondary objective is to determine the effects of the forest therapy for employees in the manufacturing industry on cytotoxic activity of natural killer (NK) cells, health-related quality of life and mood states compare to urban untreated and remained in urban environment. Methods Forty-two employees were recruited from a single workplace located in Incheon city, Republic of Korea. Participants were allocated to either an experimental group (n= 21), wherein they participated in the forest therapy and or a control group (n= 21), wherein they were given no treatment. Participants were assigned to these groups on a randomized, open-label basis. Pre and post-test measures of natural killer (NK) cell activity, salivary cortisol, heart rate variability (HRV), health-related quality of life, stress response, and mood states were taken for both groups. Results The results showed that participants who took part in the forest therapy showed greater physiological improvement when compared to those in the control group, as indicated by a significant increase in some HRV measures. The forest therapy also contributed to a significantly greater decrease in work-related stress symptoms and a significantly greater improvement in health-related quality of life and mood states compared to participants in the control group. Conclusions These results may suggest that the forest therapy could be an effective means of relaxation technique, reducing stress and leads to an increase in positive mood for employees in the manufacturing industry.
Full-text available
This study used an experimental design and multiple measures to ascertain whether stress in healthcare consumers undergoing a procedure known to be stressful - blood donation - would be affected by modest changes in a clinic environment. Four different environmental conditions were presented to 872 blood donors (68% males; 32% females; mean age = 40.4 years) using wall-mounted television monitors: a videotape of nature settings (Nature); a tape of urban environments (Urban); daytime television (Television); or a blank monitor (No Television). Findings from physiological measures (blood pressure, pulse rate) provided a pattern of evidence that the environmental conditions had significantly different effects on donor stress. Consistent with arousal/stimulation theory, the blood-pressure and pulse-rate findings converged to indicate that stress was lower during No Television than Television, and during Low Stimulation (No Television + Nature) than High Stimulation (Television + Urban). In line with evolutionary theory, pulse rates were markedly lower during Nature than Urban. An important clinical implication of the findings is that the common practice of playing uncontrollable daytime television in healthcare waiting areas where stress is a problem may actually have stressful. not stress-reducing, influences on many patients/consumers. Healthcare environments should tend to be more restorative and supportive for stressed outpatients when Nature is prominently present, and environmental stimulation levels are low rather than high and intrusive.
Full-text available
This experiment measures the effects of indoor plants on participants' productivity, attitude toward the workplace, and overall mood in the office environment. In an office randomly altered to include no plants, a moderate number of plants, and a high number of plants, paid participants (N = 81) performed timed productivity tasks and completed a survey questionnaire. Surprisingly, the results of the productivity task showed an inverse linear relationship to the number of plants in the office, but self-reported perceptions of performance increased relative to the number of plants in the office. Consistent with expectations, participants reported higher levels of mood, perceived office attractiveness, and (in some cases) perceived comfort when plants were present than when they were not present. Decreased productivity scores are linked to the influence of positive and negative affect on decision making and cognitive processing.
Full-text available
Depending on what is in the view, looking out the window may provide numerous opportunities for restoration. Unlike other restorative opportunities, however, window viewing is more frequent and for brief moments at a time. The setting is also experienced from afar rather than while being in it. A study conducted at six low-rise apartment communities, using a survey with both verbal and visual material, provides considerable support for the premise that having natural elements or settings in the view from the window contributes substantially to residents’ satisfaction with their neighborhood and with diverse aspects of their sense of well-being. Views of built elements, by contrast, affected satisfaction but not well-being. Views of the sky and weather did not have a substantial effect on either outcome. The potential of nature content in the view from home to contribute so significantly to satisfaction and well-being suggests clear action mandates.
Research and teaching in environmental health have centered on the hazardous effects of various environmental exposures, such as toxic chemicals, radiation, and biological and physical agents. However, some kinds of environmental exposures may have positive health effects. According to E.O. Wilson’s “biophilia” hypothesis, humans are innately attracted to other living organisms. Later authors have expanded this concept to suggest that humans have an innate bond with nature more generally. This implies that certain kinds of contact with the natural world may benefit health. Evidence supporting this hypothesis is presented from four aspects of the natural world: animals, plants, landscapes, and wilderness. Finally, the implications of this hypothesis for a broader agenda for environmental health, encompassing not only toxic outcomes but also salutary ones, are discussed. This agenda implies research on a range of potentially healthful environmental exposures, collaboration among professionals in a range of disciplines from public health to landscape architecture to city planning, and interventions based on research outcomes.
This article evaluates the intuitively informed interior design changes made to a United Kingdom neurology outpatient waiting area following relocation to an alternative building. This nouveau environment is compared with the more traditional waiting area used before the relocation. The two waiting areas are compared in terms of their effects on the environmental appraisals, self-reported stress and arousal, satisfaction ratings, and pulse readings of 145 outpatients. The equivalence of the outpatient samples attending each clinic is demonstrated in terms of their common demographic characteristics and their similar health profiles. The results provide convergent evidence that the nouveau waiting area is associated with more positive environmental appraisals, improved mood, altered physiological state, and greater reported satisfaction. These findings provide support for the concept of a therapeutic hospital environment.
A field study (N = 62) is reported comparing two industries that had comparably high noise levels during the pretest phase; one of the two factories was subsequently moved to a new site with strongly reduced noise levels, whereas the control industry remained in the same building as during pretesting. The main prediction was that the reduction of noise in the experimental organization would lead to greater environmental satisfaction, greater job satisfaction, reduced stress symptoms, reduced difficulty of communication, a more positive company image, and greater attachment to the company. No changes from pretest to posttest were expected in the control industry for any of these variables. The hypotheses were fully confirmed, suggesting that environmental conditions reliably affect not only the worker’s physical and psychological well-being but also organizationally relevant variables such as image of and attachment to the company, which have largely been ignored by previous research.
Research in open office design has shown that it is negatively related to workers’ satisfaction with their physical environment and perceived productivity. A longitudinal study was conducted within a large private organization to investigatethe effects of relocating employees from traditional offices to open offices. A measure was constructed that assessed employees’satisfaction with the physical environment, physical stress, coworker relations, perceived job performance, and the use of open office protocols. The sample consisted of 21 employees who completed the surveys at all three measurement intervals: prior to the move, 4 weeks after the move, and 6 months after the move. Results indicated decreased employee satisfaction with all of the dependent measures following the relocation. Moreover, the employees’dissatisfaction did not abate, even after an adjustment period. Reasons for these findings are discussed and recommendations are presented.