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Service members of the US Department of Defense (DoD) have alarmingly high rates of depression, anxiety, probable stress disorders and suicidality, all of which are negative health conditions exacerbated by various external stressors. High-stress work conditions – to include shift work, hazardous territories, high-stakes mission sets and generally disconnected sites – require a work environment that facilitates, rather than inhibits, stress reduction and mental well-being. This paper aims to present “salutogenic design” as an innovative approach: Salutogenic design offers demonstrated architectural solutions that improve health and well-being.

This paper describes salutogenic design strategies beginning with the need for such an approach, the call to action to implement strategic and tactical solutions and the challenges and financial impacts of such a broad and innovative strategy to improve workplace health, well-being and performance in the DoD and beyond. Examples of these strategies, via biophilic design solutions, are presented in the central Table 1 as an easy-to-reference tool and supported by the voluminous literature as referenced, in part, through this research paper.

Salutogenic design strategies offer innovative, financially viable solutions to help mitigate stress and improve workforce well-being while maintaining the highest level of building security requirements in access-controlled spaces and disconnected sites, such as military installations and government compounds.

Issues of mental and physical health are complex and multi-faceted, and they require complex and multi-faceted solutions. Salutogenic design is presented as one facet of that solution: a tangible solution to an often-intangible issue. Further, as a novel approach to address a critical DoD issue, Table 1 bridges the common gap between high-concept design theory and practical construction-application solutions, with positive value to the health, performance, quality-of-life and well-being of service members.

To the best of the author’s knowledge, this paper is the first to approach the DoD’s imperative to reduce service members’ mental stress with “salutogenic design.”

This study aimed at the identification of perceptional environment properties in hospital public spaces that can affect salutogenic components and patients' overall satisfaction and suggested a conceptual framework.

A systematic review focused on specific steps to clarify the impact of public spaces' environmental quality on patients' satisfaction through the salutogenic approach. Searches were conducted in five databases and four scientific journals.

Five perceptional environment components of hospital public spaces: physical–psychological comfort, visibility, accessibility, legibility and relationability can be related to three indicators of salutogenic approach: manageability, perception and meaning and can be evaluated in patients' overall satisfaction: desire to use hospital again, to recommend the hospital to others, to prefer hospital to other healthcare environments and to trust in the hospital.

Despite studies on healthcare environments, there is a lack of research on the salutogenic approach in hospital public spaces. Therefore, this paper focuses on the environmental quality in public spaces as an influence on patients' satisfaction with the salutogenic perspective to create a health-promoting environment.

The purpose of this paper is to identify and discuss opportunities for health promotion through the workplace environment, adopting a “salutogenic” perspective of health which more explicitly focuses on factors that support human health and well-being, as opposed to factors which cause disease.

In the introduction, the salutogenic model of health and the Environmental Demands-Resources model are discussed, providing a conceptual framework to represent the workplace environment as a composite of pathogenic “demands” and salutogenic “resources”. Subsequently, a narrative review is performed to discuss the existing literature from the perspective of this novel framework, identifying environmental resources which might strengthen the three components of an employee’s “sense of coherence” (comprehensibility, manageability and meaningfulness), an individual orientation associated with more positive health outcomes.

Comprehensibility can be supported by effectively implementing a clear set of rules governing the use of the workplace. Manageability can be supported through biophilic design solutions, and through design which supports social cohesion and physical activity. Meaningfulness can be supported by recognising the importance of personal identity expression and through design which reinforces the employees’ sense of purpose.

The salutogenic perspective is a potentially valuable but relatively under-considered paradigm in workplace practice. The key contribution of this paper is to encourage researchers and practitioners to recognise the crucial role that an individual’s sense of coherence plays in supporting higher levels of physical and mental health, so that they increase their ability to provide truly “healthy” workplaces, capable of promoting health as well as minimising the risk of disease.

This paper aims to propose and provide an overview of a model analysis that considers the main spatial design attributes that influence and produce the most relevant salutogenic outcomes. These results are essential for a healthy work experience, especially in shared workspaces.

This study departs from the theoretical contributions of the salutogenic approach, principles from supportive design theory, psychosocial supportive design and the environmental demands and resources model. After a scoping literature review covering different fields of workspace design, environmental psychology and evidence-based design of health-care facilities, a conceptual analysis is done on a proposed understanding of work, health and environmental relations to overview spatial attributes that enhance specific salutogenic and well-being-promoting outcomes needed for a healthy work experience.

The model of analysis, as a theoretical element that helps create methodological tools, combined with the application of a post occupancy evaluation, is thought to assist architects, designers, workspace owners and stakeholders in their new designs or to evaluate existing ones.

Studies on defining spatial attributes and their intended salutogenic outcomes have been formally done in health-care facilities. However, applying this idea to shared workspaces is something new and is expected to contribute to their design and evaluation, especially if the notion of environmental demands and resources is complemented.

The purpose of the article is to present some preliminary findings and discussions points from a symposium on Public Outdoor Spaces and COVID-19 organised in Wageningen, The Netherlands, in June 2021.

The article argues for a salutogenic perspective on infrastructure planning and design, dealing with the interplay between the ideas and practices of infrastructure planning and design and the outcomes of those ideas and practices for health.

Within that perspective, the coronavirus (COVID-19) crisis is seen as an opportunity to revive the importance of infrastructure in promoting health and well-being.

The salutogenic approach adds a much-needed new perspective on infrastructure planning and design, and also involves challenges both in research and practice, for the application of holistic principles to the design of new environments.

This paper aims to look into the significance of architectural design in psychiatric care facilities. There is a strong correlation between perceptual dysfunction and psychiatric illness, and also between the patient and his environment. As such, even minor design choices can be of great consequence in a psychiatric facility. It is of critical importance, therefore, that a psychiatric milieu is sympathetic and does not exacerbate the psychosis.

This paper analyses the architectural elements that may influence mental health, using an architectural extrapolation of Antonovsky's salutogenic theory, which states that better health results from a state of mind which has a fortified sense of coherence. According to the theory, a sense of coherence is fostered by a patient's ability to comprehend the environment (comprehensibility), to be effective in his actions (manageability) and to find meaning (meaningfullness).

Salutogenic theory can be extrapolated in an architectural context to inform design choices when designing for a stress‐sensitive client base.

In the paper an architectural extrapolation of salutogenic theory is presented as a practical method for making design decisions (in praxis) when evidence is not available. As demonstrated, the results appear to reflect what evidence is available, but real evidence is always desirable over rationalist speculation. The method suggested here cannot prove the efficacy or appropriateness of design decisions and is not intended to do so.

The design of mental health facilities has long been dominated by unsubstantiated policy and normative opinions that do not always serve the client population. This method establishes a practical theoretical model for generating architectural design guidelines for mental health facilities.

The paper will prove to be helpful in several ways. First, salutogenic theory is a useful framework for improving health outcomes, but in the past the theory has never been applied in a methodological way. Second, there have been few insights into how the architecture itself can improve the functionality of a mental health facility other than improve the secondary functions of hospital services.

This study aims at identifying the key perceived environmental attributes that can influence patients’ sense of coherence (SOC) in hospital public spaces and can improve hospital quality to create a salutogenic environment.

In total, 205 patients from the two hospitals in Sari City, Iran, participated in a questionnaire survey. The data were analyzed through structural equation modeling using partial least squares to investigate the impact of environmental qualities of public spaces on patients’ SOC.

Results confirmed that public spaces’ quality is positively associated with patients’ SOC. Accessibility has the most effective role in patients’ SOC, closely followed by relationability and intelligibility indicators. Environmental comfort also influences patients’ SOC in hospital public spaces. In comparison, the quality of the visibility is less important to patients’ SOC.

Findings will help hospital managers and designers to identify influential factors to improve the quality of health-care environments. Furthermore, the study will provide a picture of patients’ views and SOC intentions regarding public spaces in health-care environments.

To the authors’ knowledge, there is a lack of studies on the relationship between hospital public spaces and users’ SOC. Thus, this study investigates the experiences and perceptions of patients toward the quality of public spaces in hospital environments in physical, social and psychological aspects to find out its effects on patients’ SOC.

Wellbeing at work inspires global interest (WHO, 1997, 2010) which shapes international wellbeing whilst ensuring national wellbeing initiatives are devolved. This study is set in Wales, UK; the findings, however, are of interest to the global community as they present ways in which health promotion practices that are essentially salutogenic in nature (Antonovsky, 1987; Mittlemark and Bauer, 2017), may be operationalised through leadership development. The study is contextualised during a time of perceived public service overwhelm, and the purpose of this paper is to explore how a salutogenic model (Gray, 2017) captures a leadership narrative shaped by workplace stress, informing what the authors know about the resilience and wellbeing of leaders.

The salutogenic model used in this exploratory study is based on the theories of Antonovsky (1979, 1987), and the conceptual work of De la Vega (2009). Participants were invited to take part in qualitative conversations, designed to explore leadership from a sense of coherence (SoC) perspective, and identify resilience and wellbeing descriptors across sectors. The data represented the lived experience of leader’s resilience and wellbeing within their work role. A purposeful sample of leaders (N=356) were invited to take part in the project, others were suggested as part of a snowball sampling approach (N=36). The overall participant numbers were N=68.

Using the SoC framework to explore resilience and wellbeing in terms of leadership, enabled participants to make sense of a stressful workplace environment, and share experiential knowledge that contributes to leadership development. The narrative that emerges is one in which leaders are feeling overwhelmed, and the broader influences of BREXIT, workforce and service user demographics, and organisational change are challenges to sustaining resilience. Participants suggest that leaders need to develop self-knowledge/awareness first, and role model the “resilient and well leader” to others.

The limitations of this study relate to the fact that given the potential for participation was nearer 400 leaders, the N=68 participants could not be deemed large enough to generalise the findings. However, this was a scoping study exercise, designed to explore resilience and wellbeing through SoC conversations and to surface descriptors that would add to what the authors know about contemporary leadership. The study could be improved in the future by the collection of more descriptors, and where practical segmentation of descriptors may provide further insight in terms of comparison between professions/sectors.

The authors know that leadership is linked to positive and negative outcomes for employees; it is, therefore, prudent to consider how the authors can support both current and future leaders, to incorporate their own and others’ resilience and wellbeing into their leadership repertoire. This may well be best facilitated through health leadership which is known to have a positive association in determining the psychological climate of the workplace. Leadership authenticity means leaders should be able to ask for help, if leaders are struggling with that, then the authors need to examine leadership from a cultural perspective. In practical terms, the generalised resistance resources (GRRs) put forward by the participants may also form local as well as national wellbeing action plans for the future.

Leadership is socially constructed within the organisational context, and the resilience and wellbeing of leaders is affected by the organisational health determinants in the working environment. If the authors are to consider how leaders are to develop an SoC for themselves and others, the authors need to attend to how the leader learns in the context. This is because their SoC is also shaped by the challenges they experience, and socio-constructed learning becomes neurologically embedded, so that ways of thinking, feeling and behaving are reinforced and exhibited over and over again.

This exploratory study demonstrates the efficacy of the salutogenic model to stimulate dialogue about a potentially sensitive subject. Many of the answers rest with the leaders themselves. The authors held conversations with leaders from the public services in Wales, identified “best self” and “peripheral” variables that leaders manifest across the various organisations they lead, and leaders produced a range of GRRs to support resilience and wellbeing across sectors in the future. There is a growing recognition that in terms of health leadership capability, there will be a premium on knowledge capital that pertains to improving the resilience and wellbeing of employees.

Guided by the salutogenic model of health and well-being, this study aims to use empirical measures of sense of coherence (SOC) and generalized resistance resources (GRRs) to gain a better understanding of the facilitators of successful transition and integration of refugees to Canada and relate these findings to current program development and delivery for the settlement of refugees.

Survey research and structural equation modeling.

The authors found that newcomers with a stronger SOC were more likely to report successful integration outcomes. GRRs were found to have both direct and indirect effects on the positive settlement of refugees, with the SOC acting as a strong mediator of indirect effects.

Owing in part, to the disruption caused by the global pandemic, the authors’ data collection period was protracted and the final sample size of 263 is smaller than the authors would have preferred. Another limitation of this study has to do with its cross-sectional design, which limits the articulation of cause-and-effect relationships among the variables.

In terms of program development and delivery for the settlement of refugees, the authors’ results provide further evidence that refugee participation in socially valued decision-making represents a key determinant of healthy resettlement.

Much research on refugee settlement originates within “a pathogenic paradigm” that focuses on the stressors and obstacles encountered by people who have been displaced. Taking its cue from Israeli health sociologist, Aaron Antonovsky’s salutogenic model of health and well-being, this study uses empirical measures of Antonovsky’s interrelated concepts of SOC and GRRs to gain a better understanding of the facilitators of successful transition and integration of refugees to a prairie province in Canada and relate these findings to current program development and delivery for the settlement of refugees.

The “Germanwings” air crash in 2015 in which 150 people were killed highlighted the challenges pilots working in the aviation industry face. Pilots regularly work for extensive periods in inhospitable and high-pressure operational conditions, exposing them to considerable work-related stress. This has raised calls for a more systemic cultural change across the aviation industry, championing a more holistic perspective of pilot health and well-being. The study aims to explore how peer coaching (PC) can promote an inclusive psychosocial safety climate enhancing pilot well-being and can mitigate hazardous attitudes and dysfunctional behaviours.

Adopting an interpretative phenomenological analysis (IPA), semi-structured interviews and questionnaires were conducted with military and civilian peer coach/coachee pilots and key industry stakeholders, totalling 39 participants. The research provided significant insights into the perceived value of PC in promoting both pilot health and mental well-being (MW) and flight safety across the aviation industry.

The study highlights four key PC superordinate themes, namely, coaching skills, significance of well-being, building of peer relationships and importance of confidentiality and autonomy. Such combined themes build reciprocal trust within peer conversations that can inspire engagement and effectively promote personal well-being. The contagious effect of such local interventions can help stimulate systemic cultural change and promote a positive psychosocial safety climate throughout an organisation and, in this case, across the aviation industry. This study provides a PC conceptual framework “Mutuality Equality Goals Autonomy Non-evaluative feedback, Skill Confidentiality Voluntary Supervisory (MEGANS CVS),” highlighting the salient features of PC in promoting MW.

The study highlights the salient features of PC and its role in promoting peer conversations that enable personal transition, openness and acceptance. This study also highlights how PC and well-being can be used to encourage inclusivity and engagement, thereby strengthening institutional resilience.

This study highlights how PC that can assist HRM/HRD professionals to embed a more inclusive and salutogenic approach to MW that can reshape organisational cultures. This study highlights the significance and link of workplace stress to hazardous attitudes and dysfunctional behaviours. It further notes that whilst the MEGANS CVS peer coaching framework has been applied to pilots, it can also be applied across all sectors and levels.

This study highlights the value of PC as an inexpensive means to engage at the grassroots level, which not only improves personal performance, safety and well-being but by building peer relationships can also act as a catalyst for positive and deep organisational cultural change.

This study offers the MEGANS CVS framework that exposes insights into PC practice that can assist HRM/HRD professionals embed a more inclusive and salutogenic approach to health and well-being that can reshape organisational cultures. This study highlights the significance and link of workplace stress to hazardous attitudes and dysfunctional behaviours, and whilst this framework has been applied to pilots, it can also have relevance across all sectors and levels. This study calls for a “salutogenic turn,” employing MW and PC to transform organisational capabilities to be more forward-thinking and solution-focused, promoting an inclusive “just culture” where leaders positively lead their people.