still gathering evidence...

Building Health 

a practical framework to create 

typologies for the continuum of care 

Defining the Continuum of Care

The Design and Building Sciences Department at TU-Berlin is proposing a practical framework and a collaboration platform to improve the health of all communities and people at different environments, settings, and workplaces beyond hospital buildings. 

The framework takes in the knowledge and experience invested in the development of buildings and landscapes for care delivery around the globe. Highlighted, are those proven to meet the health needs and requirements of citizens considering their specific spatial, socio-economic, and cultural contexts.

A web-based version of the framework depicts three areas in the ‘continuum of care’ (1) at three built environment scales. The latest health and design case studies are showcased at each scale, for the general audience to read, or for technical partners and other stakeholders to review and edit.

The case studies we support must have an evidence-based design approach that: compiles information on site specific social and health problems; describes methods and instruments; analyzes building characteristics; and verifies health-related outcomes are reached. Summaries are then fashioned to invite for collaboration or strengthen partnerships towards making projects that gather further evidence.

Building Health

The collaboration platform supports the framework with communication tools and a co-working interface. Efforts to structure an E-bD case are streamlined across multiple sectors, institutes, experts, and professionals in health and/or building design.

Communications across stakeholders and partners will be possible through online and in-person lectures, courses, conferences, and transdisciplinary workshops using case structuring and problem-solving techniques.
A co-working environment, following an evidence-based design research methodology, will integrate inputs from stakeholders including end users.

Methods and results from cases are invaluable contributions in developing guidelines, standards, procedures, and policies. Reason why we strongly encourage its dissemination through our partner the Cities & Health Journal.

Public health Research...

Workshops ...

Case Structuring and Problem Solving with

Evidence-based Design Research

whether or not scientific methods are being used to develop physical environments and measure its health-related outcomes. 

Most healing architecture and E-bD practitioners tend to apply findings from environmental health and environmental psychology studies directly into their projects (interventions). The most common applications derive from studies relating levels of light, noise, smell, and temperature to our overall sense of wellbeing and health. This bold practice is what Kirk Hamilton calls first level practitioners in his 4 level evidence-based practice model (2). 

Evidence-based Design Research

E-bD Research is a practical framework that takes in health research and building design together with a transdisciplinary approach. Scientific methods and tools are employed at different project phases to ensure that spatial arrangements and design qualities effectively improve health-related outcomes, especially of vulnerable groups such as children, the elderly, people with disabilities, and patients.

A collaboration platform to build E-bD research tools

to develop HEALTH PROMOTION, DISEASE PREVENTION, and CLINICAL CARE solutions at 3 urban scales: City; Neighborhood; and Building.

The Design and Building Sciences Department at Berlin University of Technology (TU-Berlin) is steering collaborative efforts to adapt, develop, and publish tools for this framework.
Several institutes and entities across Europe have joined the department to make available their knowledge and expertise in applying scientific research in building and landscape design processes. 

For general guidance on joining and contributing to this platform please contact Alvaro Valera Sosa.

He will be available to offer more information on Building Health, E-bD research, and the publication process with our publishing partner the Cities & Health Journal.

environments to build health

Health promotion is the process of enabling people to increase control over, and to improve their health (3). WHO website info here!


Regenerative Landscapes


Active living


Smart Living

Disease prevention

settings to target disease

Disease prevention is a procedure through which individuals, particularly those with risk factors for a disease, are treated in order to prevent a disease from occurring. Treatment normally begins either before signs and symptoms of the disease occur, or shortly thereafter (4).


Rehabilitation / therapeutic centres


Community health centres


Assisted Living

Clinical care

workplaces to cure disease

Clinical care teams physicians, nurses, physician assistants, clinical pharmacists, social workers, and other health professionals team to establish lines of collaboration, communication, and cooperation that better serve patients’ needs (5).





patient centred medical homes



Home care


Project development

Webpage development

BHL Building Health Lab
Alvaro Valera Sosa: Original draft, Writing-reviewing, Editing, Design, Administration.
Netra Naik: Software, Data curation.
Julia Reißinger: Software, Data curation.

Links and sources

1. Evashwick C. Creating the continuum of care. Health Matrix. 1989 Spring;7(1):30-9. PMID: 10293297.

2. Hamilton, D.. (2007). Four Levels of Evidence-Based Practice. 3.

3. Health promotion. (2019, November 15). WHO | World Health Organization. https://www.who.int/health-topics/health-promotion#tab=tab_1

4. (n.d.). Nature. https://www.nature.com/subjects/disease-prevention

5. Doherty, R. B. (2013). Principles supporting dynamic clinical care teams: An American College of Physicians position paper. Annals of Internal Medicine159(9), 620. https://doi.org/10.7326/0003-4819-159-9-201311050-00710