Sustainable Health Design Based on Ecological Dynamics:Construction and Evaluation of a Dynamic Health Behavior Environment

Abstract

Sedentary lifestyles and unhealthy behavioral patterns are placing an increasing strain on public health by accelerating the prevalence of chronic non-communicable diseases. Yet many health-oriented built-environment interventions remain largely static, offering fixed facilities that fail to adapt to people’s changing needs, abilities, and motivations. Grounded in ecological dynamics, this study advances a sustainable health design approach that operationalizes person–environment coupling through a Dynamic Affordance Model, a multi-dimensional Health Behavior Environment Evaluation Framework, and five core design principles: Adaptability, Interactivity, Inclusivity, Motivation, and Ecological Integrity. To examine its real-world effectiveness, we implemented a dynamically adjustable health behavior environment in a community setting and conducted a six-month quasi-experimental study with 120 adult residents, randomly assigned to an intervention group (n = 60) or a control group (n = 60). A total of 112 participants completed the study. To enhance feasibility and reproducibility under typical community conditions, data collection relied primarily on low-cost, widely accessible tools, including participants’ own smartphones (built-in step and activity records), brief on-site health checks, mobile questionnaires, and semi-structured interviews, supplemented by simple facility-use logs and structured behavioral observations. Repeated-measures analyses revealed a significant time-by-group interaction for physical activity outcomes. Average daily steps in the intervention group increased from 6,250 to 8,960 (a 43.4% increase), while the control group showed no meaningful change; moderate-to-vigorous physical activity followed a similar pattern. Social interaction frequency rose from 3.5 to 6.8 times per week, accompanied by greater co-presence and longer dwell times in public spaces. Both physiological and psychological indicators improved, including reduced resting heart rate and higher self-efficacy scores (from 3.2 to 4.2). Further regression-based mediation analyses indicated that dynamic affordances influence health behavior not only directly but also indirectly by enhancing perceived environmental attractiveness and individual self-efficacy. Overall, the findings demonstrate that translating ecological dynamics into dynamically adjustable environmental affordances can generate measurable and sustainable improvements in community health behaviors and well-being, offering a practical and scalable pathway for health-oriented environmental design.