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behavior, design, wellness

Can architects nudge people into healthy action?

That's the question New York-based healthcare architect Avani Parikh posed on a poster she created for the International Design & Health Conference back in 2011.

Her goal was to present "a behavioral economics framework for preventative interventions and to provide a new way to think about the nexus between human behavior, architectural design, and wellness."

Avani realized that she needed more than just a poster as a platform for her theory. Some healthcare academics she knew encouraged her to write a book.

7 Years Later

"Choice Architecture:  A New Approach to Behavior, Design, and Wellness," was published by Routledge in 2018. Co-authored by Avani and her husband Prashant Parikh, a former research scholar at the University of Pennsylvania and Stanford University, this little book packs a lot of theory into its 130 pages.

It was a little too dense for me to fully read and digest, but those of you who are are into architectural theory will love it. Here's what is covered in each chapter:

  • Chapter 1:  Looks at how architecture surrounds us even if we don't always notice it and its effect on us.
  • Chapter 2:  Describes a new framework for choice architecture.
  • Chapter 3:  Explores ways in which people can be irrational within the context of behavioral economics.
  • Chapter 4:  Discusses the consequences of choice architecture, particularly as it relates to the Vitruvian triad of utility, firmness, and beauty -- and what that means for health and wellness.

Healthy Action by Design

I totally believe that architecture can nudge people into healthy action.

There are a number of examples of this in the book -- most not specific to healthcare settings, but most of which can be adapted for healthcare settings.  Things like:

  • Work environments that encourage social activity, walking, and provide access to natural light
  • Outdoor environments/streetscapes that encourage social activity and exercise
  • Clinics that have design elements that reduce the stress of waiting

Better Books for a Better World

The book is also the winner of a 2018 Nautilus Silver Medal Book Award, which celebrates and honors "books that support conscious living and green values, high-level wellness, positive social change and social justice, and spiritual growth."

Now that the book project is done, Avani is trying to build up her architectural practice again and do some speaking.

She's also one of 20 finalists for a grant from the New York State Council for the Arts.  Her proposal, "A Framework for Design-Enabled Care," applies her theory to four case studies for environments for seniors and people with disabilities.

More About Behavioral Economics

"What is Behavioral Economics?" Psychology Today, May 2017.

"An Introduction to Behavioral Economics," The Behavioral Economics Guide 2018.

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Leave a comment

Rada Doytcheva

5 years ago

Sara, your blog is as always very informative, and a real finding, since I met you last year at Neocon.
Will look into Avani's book ( actually I am getting it!).
Thanks for sharing your conviction that architecture can nudge people into action.
Can't agree more - and it is a fairly fundamental trait of well practiced profession.
There is room for change however. In the medical field - we see too much of "recalcitrant" architecture, catering to institutionalized, highly regulated, highly specialized profile, that does not allow for creativity, or bringing ideas from other building types or from a more heavily oriented design setting; The circle of "health care" architects is almost impenetrable. . .and the ideas there, although well marketed - are very often stale and dated. . .new ideas needed.
Clients (hospital administrators, etc) need to hear yours and Avani's message.
Hope to get my thoughts above - in a more organized way for our seminar at the Health Care Facilities Design and Expo in Boston in September, speaking with Randy Oostra of ProMedica on "Design and Social Determinants" in Health care. Looking forward to diving into the book you recommended! Best, Rada

Dr. Wayne Ruga

5 years ago

Thank you, Sara, for your sharing this book and its insights with your community. Avani did an incredibly good job of assimilating disparate strands of knowledge into a very practical approach for implementing a more health-focused design of our environment. I do hope Avani's book will become a required textbook for all design schools attempting to teach about designing for improved health and wellness.

Sara Marberry_013-Retouched-New copy

What's my story? I'm a healthcare and senior living design knowledge expert who writes and speaks frequently about trends and issues affecting these two industries. I'm also a strategic marketing consultant and content creator, working with companies and organizations who want to improve the quality of healthcare and senior living through the design of the physical environment. You can reach me at .

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