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Media and social impact valuation of a living wall: The case study of the Sagrado Corazon hospital in Seville (Spain)
Urban Forestry & Urban Greening 24 (2017) 141–148
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Original article
Media and social impact valuation of a living wall: The case study of the Sagrado Corazon hospital in Seville (Spain)
MARK
⁎
Luis Pérez-Urrestarazua, , Ana Blasco-Romeroa, Rafael Fernández-Cañerob a
Urban Greening & Biosystems Engineering Research Group, Area of Agro-Forestry Engineering, Universidad de Sevilla, ETSIA Ctra, Utrera km. 1, 41013, Seville, Spain Urban Greening & Biosystems Engineering Research Group, Department of Agro-Forestry Sciences, Universidad de Sevilla, ETSIA Ctra, Utrera km. 1, 41013, Seville, Spain
b
A R T I C L E I N F O
A B S T R A C T
Keywords: Marketing Soft benefits Users’ perception Vertical garden Vertical greening systems
Vertical greening systems have increased in popularity during the last years due to their experienced added ecological and aesthetic value for current clients. The use of living walls is in line with a service sector focusing on environmental consciousness. Still, scientific evidence is lacking regarding the multiple benefits of LW. There is also a lingering fear of high installation and maintenance costs. Therefore, it is important to assess the intangible benefits that increase the value of living walls and, hence, of the place in which they are installed. The main objective of this work is the valuation of the returns obtained because of the publicity related to a living wall installed in the ‘Quirónsalud Sagrado Corazón’ Hospital in Seville (Spain) and the assessment of the public’s perception towards it. The investment that the hospital would have made in order to obtain a similar media impact has been estimated. The living wall proved to be very profitable in terms of publicity as the installation costs were recovered six times over. Also, the attitude towards the presence of such a greening system in the premises was assessed. To do so, 555 questionnaires were handed out face-to-face to patients, visitors and workers present at the hospital. Most participants concurred that the living wall induced positive reactions and improved their psychological well-being. Therefore, they completely agreed with the investment made by the hospital on such a vertical greening system.
1. Introduction Many cities are currently facing several problems related to a high construction density and lack of green spaces. For this reason, unconventional urban greening methods such as green roofs and vertical greening systems are being implemented. The use of living walls (LW) is becoming popular, even indoors, as a way of introducing plants into the built environment. However, in many cases, an LW is not installed because of the expenditure it involves, especially regarding installation and maintenance costs. For this reason, it is important to take into account the advantages of these technologies, several of which involve an economic gain that contributes to recovering the investment. In some cases, non-economic characteristics such as aesthetics and environmental protection are key motivators (Balram and Dragićević, 2005) which incentivise LW installations. In the service sector, users or clients are more environmentally conscious, so these systems can provide an added ecological value that is highly appreciated. Also, some authors point to an increase of the property value when there are green areas around (Bengochea Morancho, 2003; Czembrowski and Kronenberg, 2016; Netusil et al., 2014). In the case of an LW, these ⁎
increments have been estimated at between 2 and 5% (Perini and Rosasco, 2013). Of course, these figures are inconclusive as they depend on multiple variables (characteristics of the building, location, type and dimensions of the LW, etc.). Over the last years, the scientific community has been researching about the multiple ecological and environmental benefits associated with LWs, such as enriching urban biodiversity, improving air quality or enhancing building thermal performance (Pérez-Urrestarazu et al., 2015). Sometimes, the effect of an LW can be measured directly or determined using models. For example, noise attenuation or indoor temperature modulation due to an LW can be empirically tested. Therefore, there are some studies that quantify those benefits in terms of economic impact (e.g., energy savings). But in other cases, people benefit from an environmental amenity without consciously using it (Tomalty and Komorowski, 2010). This indirect use value is considered as a soft or intangible benefit, not directly tradable and quite difficult to quantify (e.g., users’ positive feelings towards a ‘greener’ space or marketing benefits related with the public’s interest in environmentally friendly products and sustainability). As an example, Tomalty and Komorowski (2010) quantified the economic value of different green
Corresponding author. E-mail addresses: [email protected] (L. Pérez-Urrestarazu), [email protected] (A. Blasco-Romero), [email protected] (R. Fernández-Cañero).
http://dx.doi.org/10.1016/j.ufug.2017.04.002 Received 21 November 2016; Received in revised form 6 March 2017; Accepted 4 April 2017 Available online 13 April 2017 1618-8667/ © 2017 Elsevier GmbH. All rights reserved.
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point of view concerning the presence of vegetation (specially the LW) were assessed by means of a survey in order to estimate the benefit obtained from it. The first working hypothesis is that the LW in the hospital had a monetary return in marketing making its installation worthwhile. The second involves the belief that the LW positively influenced the hospital personnel, visitors and patients, who agreed with the investment made by the medical centre.
roof case studies. For each benefit considered they used a different method to make the estimations. For instance, the value of the publicity gained as a direct consequence of green roof investments was assessed as a marketing benefit. The Noise Sensitivity Depreciation Index (NSDI) (Andersson et al., 2013) was used to estimate the financial gain due to sound attenuation. Stormwater retention was valued considering the cost of regular stormwater retention infrastructure required to have the same effect as the green roofs studied. Yang et al. (2008) calculated the economic benefit linked with the pollutant removal capacity of a green roof. Economic science has developed specific methods to estimate the value of environmental assets in monetary units (Bengochea Morancho, 2003; Tomalty and Komorowski, 2010). In ‘Stated preference’ techniques, such as contingent valuation, the economic value is attributed by asking people their Willingness To Pay (WTP) for certain services or benefits provided by green infrastructure (Bengochea Morancho, 2003; de Groot et al., 2002; Jim and Chen, 2006; Tomalty and Komorowski, 2010). This WTP can be related to how people perceive and interact with the green infrastructure, and their self-reported well-being and preferences (Dallimer et al., 2014; Mell et al., 2013). There are several studies using contingent valuation to establish the economic value of green infrastructure (Breffle et al., 1998; Dallimer et al., 2014; Jim and Chen, 2006; Mell et al., 2016, 2013). Most of them are related to conventional green infrastructures, mainly parks and open areas. There are some experiences with green roofs (Bianchini and Hewage, 2012; Clark et al., 2008; Claus and Rousseau, 2012; Tomalty and Komorowski, 2010), but an absence of them in LWs. Part of the value attributed to vegetated environments lies in their positive effect on health and well-being, providing relief from the pressures of high-density living. Even a passive involvement with nature, relying on the visual amenity, can bring about considerable psychological benefit (Özgüner and Kendle, 2006; Ulrich, 1984). Buildings with certain types of integrated vegetation seem to be more liked, aesthetically pleasing, and restorative than those without vegetation (White and Gatersleben, 2011). As viewing nature has been reported to relieve stress and pain, it makes it an ideal medium for use in healthcare settings (Vincent et al., 2010). Particularly, in the case of hospital confinement, some patients see their access to outdoor environments almost entirely limited to views through windows. Patients in hospital rooms with plants and flowers or even with access to a vegetated sight had significantly shorter hospitalisations, fewer intakes of analgesics, lower ratings of pain, anxiety and fatigue, more positive feelings and higher satisfaction (Bringslimark et al., 2009; Park et al., 2004; Park and Mattson, 2009, 2008; Ulrich, 1984). These findings emphasise the therapeutic value of plants in the hospital environment. Citizens generally have a positive attitude towards green infrastructure elements and these reactions are related with their support for them (Jungels et al., 2013). Environmental satisfaction is affected by many factors, such as gender or age, but also depends on the characteristics of the green spaces (type of vegetation, colours, smells) (Qin et al., 2013), so it is important to assess people’s response to their interaction with nature. Measuring individual stances towards urban green spaces has received sparse coverage in the environment and planning literature (Balram and Dragićević, 2005). Some studies are available involving positions regarding urban green spaces (Balram and Dragićević, 2005; Carrus et al., 2015; Jim and Chen, 2006; Mell et al., 2013), but few of them involve green roofs or green façades (Fernandez-Cañero et al., 2013; Jungels et al., 2013; Rahman et al., 2015; White and Gatersleben, 2011 Yuen and Nyuk Hien, 2005) and only Wong et al. (2010) referred to vertical greening systems in general. The main objective of this work is the valuation of the effect of an LW installed in a hospital in Seville (Spain) in terms of its impact in the media and on people. The media repercussion due to the LW was evaluated considering it as a marketing investment. On the other hand, the influence of the LW on the hospital personnel and users and their
2. Methods 2.1. The hospital and the living wall Quirónsalud Sagrado Corazón Hospital (QSCH) is part of Quirónsalud, a Spanish hospital group made up of several private hospitals. In 2015, QSCH received around 138,000 patients and had 575 workers. Apart from the main hospital building, QSCH has three medical centres in different locations in Seville (Spain). In 2012, the main building was remodelled and an LW was installed outdoors in August 2012 on an external façade facing the main hall of the hospital. The LW has an approximate area of 40 m2 (17 m long by 2.2 m high). In its design, inspired by Burle Marx’ “Suspended Garden”, around 1400 plants of 40 different species were used. For the LW installation, a felt system, composed of 1 × 1 modules with pockets in which the plant rootballs are inserted, was used. The LW can be viewed from the main hall through a large window (Fig. 1) and from some of the rooms for patients.
2.2. Media impact assessment All the QSCH media appearances due to the LW were identified from its installation until the end of 2015 in order to calculate the return on investment of the LW in terms of media impact. The comparable cost methodology (Tomalty and Komorowski, 2010) was used as a way of estimating the marketing benefits of green infrastructure by assessing the value of the free publicity received as a direct consequence of the LW’s presence. To do so, the real cost these media appearances would have entailed has been calculated. Those costs are broken down into the ad production charge (not taken into account in this study), plus the cost of running the advertisement. A slightly different process was adopted for each medium considering several factors. For radio and television, the aspects influencing the cost were the channel/radio station, duration of the interview/report (including only the minutes talking about the hospital’s LW), air time and audience. In the case of the written press, the process was more complex and the information on the estimated cost of each published article was provided by a specialised company (Acceso Group S.L.) which made an internal report for the hospital. Only the articles about the LW were taken into account. The variables involved to make the estimation were the newspaper in which the article was published, the total of copies distributed, section, number of pages, area covered by the article and% of the page occupied by it (page coverage), position on the page, the average number of readers and the author of the article. Finally, the advertising rates in each channel, station or newspaper were considered according to the factors previously described. For the digital press, the parameters usually employed are the number of visits and the CPM or cost per thousand impressions (Kumar and Sethi, 2009), where an impression can be defined as the display of an ad while a user is viewing a web page. However, the number of visits refers to the digital newspaper and not to a certain article, so the estimation using this number is not accurate. Therefore, the impact on the digital press was finally excluded from the study. Also, appearances in internet social networks, as well as in blogs, were not taken into account due to the difficulty of estimating the number of viewings or the value of a ‘like’ or a ‘share’. 142
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Fig. 1. View of the LW from the hall and participant filling out the questionnaire.
Well-Being Gain (Dallimer et al., 2014) and stances with respect to the LW. Lastly, ‘Contingent valuation’ questions were posed to identify the respondent’s WTP or how much they think the hospital should invest in the LW. Gathering WTP and self-reported well-being measures from the same individuals at the same time and place enables a direct comparison to be made between two radically different measures of value (Dallimer et al., 2014). In most questions, Likert scale options were used, though multiple-choice options were also employed. Question 18 used a Semantic Differential scale and required being in front of the LW to be answered. Therefore, it was not included in the form utilised at the QSCH-SE. A pilot test was conducted before implementing the fullscale survey. Prior to the statistical analysis, a data quality control was performed.
2.3. Survey methods and questionnaire design In studies about postures towards green infrastructure, the use of questionnaires is the most frequent resource to assess the population’s opinion about green infrastructure. The usual questionnaire approach to measure urban green spaces views is to include a range of semanticdifferential (with good/bad options for example) and Likert items (with agree/disagree options) to operationalise the attitude construct (Balram and Dragićević, 2005). In this work, a questionnaire was delivered in situ and face-to-face to 555 individuals present at the hospital (i.e., patients, visitors, workers) by a trained interviewer who gave explanations to respondents when necessary. Most of the surveys (453) were conducted from April to October 2015 at the QSCH main building where the respondents could view the LW. The rest of them (101) were performed from November 2015 to February 2016 at the Sagrado Corazón Quirónsalud Medical Centre Sevilla Este (QSCH-SE) in order to have responses from people visiting a medical centre of the same characteristics but with no LW. Prior to starting, each participant was given a brief description of the study, some instructions to complete the questionnaire and an assurance of anonymity. An informed consent was obtained verbally and participation was voluntary with no compensation. Table 1 shows the 26 pre-coded questions and the options for responses to each question can be seen in Annex B. The form had four different types of queries. The first one focused on the respondents’ personal data and descriptors, such as age, gender, occupation or the reason for being in the hospital. Then, general questions about attitude towards plants and green spaces were introduced in order to evaluate the respondents’ preference for plants, interest in gardening and previous knowledge about LWs. In the third type of questions, the survey’s respondents were asked about Self-Reported Psychological
2.4. Statistical analysis Survey responses were recorded and organised using Excel 2007 (Microsoft). Data were analysed applying SPSS 17 for Windows (IBM SPSS). Variables were assessed using the nonparametric Kruskal–Wallis one-way ANOVA test, as the data were not normally distributed. Dunnett’s C test was employed for multiple comparisons. Spearman’s rho correlation coefficient was also employed to investigate the association between categorical variables, since the data were not showing a normal distribution. The significance level was defined at p = 0.05.
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Table 1 Questions asked in the questionnaire. Question number
Question
A B C D 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22
Gender Age Occupation Type of job Why are you in the hospital? How often do you visit the hospital? Are you interested in gardening? Do you have plants at home? How many green areas are there close to your residence? How often do you visit parks or public gardens? How much would you be eager to pay monthly to increase/improve green areas close to your residence? Which of these emotions or reactions does being near plants inspire in you? How much do you value the presence of vegetation in your working environment? Are there any plants in your working environment? Did you ever hear about LWs before? LWs may favour a closer and more frequent contact between urban dwellers and green areas, improving their psychological well-being LWs have the same effects on those who perceive them as conventional gardens An LW may have a therapeutic effect contributing to improving the health of those who perceive it Would you like to view LWs in the building where you live or work? If you are in the hospital hall and look through the window, what would you like to see? In an LW, what most attracts your attention? (State your order of preference) When you look at the LW through the hall window, what reactions does it inspire in you? The investment made by the hospital for installing the LW in order to improve comfort and aesthetics through the presence of plants is appropriate How much should the hospital annually spend on LW and plants? Value from 0 to 5 the following alternatives to make the hospital more inviting If you had a choice between two hospitals with the same quality of care and services at the same price, would you choose the one with a greater presence of vegetation?
3. Results
questions in that line were posed. 39% were quite or very fond of gardening (where 61% were women, being 56.7% over 45 years old) while 26% had little or no interest at all. Nonetheless, nearly 80% claimed to have plants at home. Whereas 88% have green areas close to their residence, only 29% visit parks frequently (daily or several times a week). On the other hand, 34% rarely use green areas. Most participants (87.4%) value the presence of vegetation in their working environment, this being very important for 22% of them. On the other hand, 22% declare not having any plants in their workplace. When the participants were asked if they knew about LWs prior to this study, nearly 40% responded negatively. Previous knowledge about LWs significantly influenced (F = 30.715; p = 0.000) a higher desire of enjoying an LW where they live or work and the positive belief that LWs help to improve health (F = 17.802; p = 0.000) and psychological welfare (F = 26.121; p = 0.000). They also agreed more with the hospital investment in vegetation and had higher WTP quantities (F = 26.710; p = 0.001). Anyway, people generally think that these systems have a positive effect on those close to them. For instance, 81.5% of the respondents agreed that LWs may favour a closer contact with nature, improving their psychological well-being. A smaller number (51.4%) believed that an LW may have a therapeutic effect contributing to improving the health of those who perceive it. However, this seems not to be only related to LWs but with the presence of vegetation in general, as 50.6% of respondents think that LWs have the same effects as conventional gardens on those who perceive them. Only 6.5% of the participants would not like to have an LW at home or at their workplace, and 70% were quite or very attracted to that idea. 76.2% of the hospital workers surveyed thought that the LW helps to improve psychological wellbeing. In fact, 82% of them declared to feel happy and calm when viewing the LW. Notwithstanding, 40% of the hospital personnel respondents had little or no interest in it (taking into account the whole sample, the value was 26%). Yet, only 17% of workers did not value having plants at work. In order to determine if having the LW had a positive impact on people, the participants were asked how they felt about being close to vegetation. Different options were provided (several of which could be
3.1. Media impact assessment The media coverage due to QSCH’s LW included 30 appearances in 23 different newspapers, 2 radio interviews and 3 reports in a regional channel and 1 in national TV (accumulating more than 10 min talking about the LW). The total investment the hospital would have made to obtain the same repercussion is 198,945 €, as shown in Annex A for the different media considered. The printed press represented the highest amount: 107,705 €. Television appearances were valued at 87,149 €, while radio would only have cost 173 €. These figures have been compared with the investment made (26,162 €). To do so, only the installation cost has been taken into account as operation and maintenance costs are too variable. Therefore, the Return on Investment (ROI), defined as the difference between the gain and the cost of investment divided by the cost, is 660%. This means that more than 6 times the investment was recovered. Of course, when including operation (water and energy) and maintenance costs, ROI would decrease. As an example, considering maintenance costs in 2015 (approximately 4200 €, including pruning, disease control, cleaning of filters and tanks, adjusting irrigation times, plants replacements and SCADA system maintenance) being the same over a period of 15 years, ROI will still represent 122.4%.
3.2. Users’ perception and WTP A total of 555 people – 60.4% women and 39.6% men- were surveyed in both hospital locations. The age ranged between 18 and 86 years old, distributed as shown in Fig. 2. 69.3% of the respondents were employed and 9.3% unemployed, while 11.3% were students and 10.1% retired. It is interesting to note that less than 10% usually work outdoors. Around 19% were hospital workers who daily spend several hours inside the building. 26% were patients and 37.6% were visiting. 62.5% of those surveyed only visited the hospital sometimes. In order to take into account the possible influence of the respondents’ interest in gardening and plants on their answers, some 144
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Fig. 2. Distribution of male and female respondents: age group and type (1: worker; 2: patient; 3: visitor; 4: others).
Fig. 3. Semantic Differential scale chart showing respondents reactions when facing the LW.
response (53%). Also, they were asked to rate from 0 to 5 (5 being the most preferred) three different options to make the hospital more inviting. In this case, the most valued option was again introducing vegetation by means of planters and LWs (M = 4.06, SD = 1.17), compared to putting up a collection of paintings (M = 2.75, SD = 1.47) or installing TV monitors (M = 2.1, SD = 1.5). In order to estimate the economic value attributed to green infrastructure, the participants were asked how much they were WTP monthly to increase/improve green areas close to their residence. They were also asked about how much the hospital should annually spend on LW and plants. Table 2 shows the number of respondents answering certain amounts of money for each question. 22.4% declared to be WTP ‘nothing’ while most of them (59%) responded between 1 and 5 € and only 18.6% were WTP 10 € or more. On the other hand, 40.1% answered that the hospital should invest between 100 and 1000 €, 35.7% between 1000 and 10,000 € and 5.7% more than 10,000 €. Only 4.4% thought that the hospital ought not to spend any money on vegetation. A moderate positive correlation is observed between the responses to both questions (Spearman’s rho = 0.272; p < 0.02). Among those thinking that the hospital should not invest on plants, 87% were not WTP for green areas close to their residence. Those WTP more than 10 € represented 47% of the ones believing the hospital should spend more than 10,000 €. Conversely, 38% of respondents not WTP any money on green areas considered that the hospital should devote more than 1000 € to LWs and vegetation. In any case, 85.3% agree that the investment made by the hospital for installing the LW in order to improve comfort and aesthetics through the presence of plants is appropriate and only 2.8% disagree. Lastly, they were asked if they
selected at the same time), some of them considered positive (i.e., welfare, serenity, happiness), others negative (i.e., allergy, disgust) or no reaction at all. Most of them (87.7%) expressed feeling one or more positive emotions or reactions when being near plants. Around 60% experience serenity or welfare and 31% happiness. Though 30% of the respondents showed negative (mainly allergies) or no reactions, most of them felt positive ones at the same time. Therefore, only 12.3% of the respondents did not indicate any positive response at all. Further in the questionnaire, the participants (only the ones actually looking at the LW) were asked about the reactions the LW inspired in them. In this case, this aspect was approached associating these reactions with antagonist words using a Semantic Differential scale. ‘Calm’ and ‘happiness’ were the answers preferred (Fig. 3), followed by ‘pleasant’ and ‘stimulating’. Curiously, 6.2% of the respondents considered the LW more ‘Artificial’ than ‘Natural’. In any case, only 3.8% expressed indifference or negative feelings in all the items at that particular moment. With the purpose of evaluating people’s preferences concerning LWs, the participants were asked to rank different characteristics according to which one drew their attention more (1 being the first choice and 5 the last). The respondents prefer the mix of colours (M = 2.11, SD = 1.17) and a natural and wild aspect (M = 2.18, SD = 1.25) over order (M = 3.53, SD = 1.27) and uniformity in an LW (M = 4.05, SD = 1.16). Different textures are also appreciated (M = 2.92, SD = 1.21). When the hospital users were asked about what they would like to see through the windows of the hall, 93.4% of the answers involved some kind of vegetated landscape, though an LW was the favourite 145
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Table 2 Number of respondents WTP certain amount of money for green areas vs. quantities they think the hospital should annually spend on LWs and plants. How much should the hospital annually spend on LWs and plants
WTP monthly for green areas
a
Nothing 1€ 5€ 10 € > 10 € Totala
Nothing
1–100 €
100–1000 €
1000–10,000 €
> 10,000 €
Totala
20 1 2 0 0 23 (4.4%)
20 27 25 1 1 74 (14.1%)
33 60 81 27 10 211 (40.1%)
41 33 74 27 13 188 (35.7%)
4 3 4 5 14 30 (5.7%)
118 (22.4%) 124 (23.6%) 186 (35.4%) 60 (11.4%) 38 (7.2%)
Values in parentheses correspond to percentages referring to the 526 respondents who answered both questions.
Table 3 Interest in vegetation according to age groups. Age group
> 60
Interest in gardening Value vegetation at workplace Plants at home Would pay for green areas
3.91 4.20 4.09 2.36
± ± ± ±
46–60 0.133 0.123 0.135 0.161
a a a ab
3.56 3.90 3.66 2.77
± ± ± ±
36–45 0.083 0.082 0.097 0.096
a a a a
2.97 3.56 3.06 2.61
± ± ± ±
< 35 0.081 0.084 0.111 0.099
b b b ab
2.87 3.28 3.19 2.43
± ± ± ±
ANOVA 0.074 0.078 0.096 0.080
b b b b
F = 25.144; p = 0.000 F = 16.668; p = 0.000 F = 13.064; p = 0.000 F = 3.018; p = 0.029
Mean and SD values according to a Likert scale were 1: Highly disagree/None/Nothing; 5: Highly agree/Many/ > 10. Different letters within the same row denote significant differences following Dunnett’s C test.
systems can increase a building’s property value, visual interest and marketability. However, having proper maintenance is essential, as a poor state of the LW will cause exactly the opposite, undesired effect. Additionally, publicity or media dissemination can be favoured or incentivised. For example, launching a marketing campaign when an LW is installed can be a way of increasing its visibility and potentiating its positive effects. If done in a controlled manner, a small investment in marketing can produce a higher return. By employing this sort of initiatives, vertical greening systems will become more popular and be known by the population at large. Indeed, one of the reasons that may cause these systems not to be more widely used is the lack of knowledge about them. Many people are still unfamiliar with LWs (40% of the participants in this study did not know about them), which can even lead to prejudices and misconceptions. Yet, other non-ordinary urban greening technologies are becoming more known. For example, Jungels et al. (2013) found that most respondents (73%) in their study were aware of green roofs as a concept. This fact affected their perceptions or views in comparison to those people not familiar with green roofs. It appears that people in urbanised societies commonly believe that contact with nature provides them with recuperation from stress and fatigue and improves their health and well-being (van den Berg et al., 2007). In general, they think that vertical greenery systems will result in closer and more frequent contact with nature, therefore enhancing the psychological well-being of city dwellers, and that vertical greenery systems do have therapeutic effects by improving the health of their users (Wong et al., 2010). This is consistent with the findings of our study in which most people agreed with these assertions. Only a few expressed negative feelings, such as distress or disgust, when looking at the LW. There is also evidence in other studies of people recognising natural areas to be scary, disgusting and uncomfortable (Bixler and Floyd, 1997). But the most frequent reaction experienced was serenity or calmness, followed by welfare. This relaxing effect of vegetation has been also observed in experiences with green roofs (Rahman et al., 2015). Knowing what characteristic of the green infrastructure contributes the most to these feelings can be valuable. It seems that the mix of colours is one of the most important factors affecting the overall satisfaction of people with their vegetation environment, which is consistent with Qin et al.’s (2013) findings. Also the textures and wild aspect favour positive responses. This may be of importance for LW designers.
would choose a hospital with more presence of vegetation over another with the same quality of care and services and at the same price. In this case, 76.2% would choose the one with vegetation, while 19.3% do not really care. Lastly, the responses obtained were analysed according to the respondents’ characteristics (age, gender, occupation). The only significant difference in responses was found among the groups of age considered. Table 3 shows the attitude towards vegetation according to age groups. The respondents over 45 years old showed more interest in gardening and vegetation was more appreciated. Also, older respondents gave higher values in response to questions 13 (F = 4.947; p = 0.002), 14 (F = 7.405; p = 0.000), 15 (F = 5.552; p = 0.001), 19 (F = 6.642; p = 0.000) and 22 (F = 2.795; p = 0.04), the last one being less significant. 4. Discussion The results show that the investment the hospital should have made to obtain the same media coverage as that achieved due to the existence of the LW is close to 200,000 € This amount might be even higher, as only written press, radio and television appearances were considered, but the presence in social media (Facebook, YouTube, etc.) and online press was also extensive. A similar approach was used by Tomalty and Komorowski (2010), who estimated the returns in free publicity since the construction of a rooftop garden in a commercial building in Toronto (Canada) at $83,126. Still, it is difficult to assure that those values can be considered as an economic turnover both for the hospital or the commercial building as we do not know if the managers/owners would have made this marketing investment had the green infrastructure studied not existed. Moreover, in the QSCH the media coverage has been unusually broad due to the novelty of installing such a green infrastructure in a hospital. Therefore, it is improbable that other installations would have a similar impact. The marketing benefits of other LWs will depend on a number of factors that are unknown in advance or difficult to quantify, such as the current interest of local media in green infrastructure and green buildings (Tomalty and Komorowski, 2010), the significance of the project or its singularity. Nevertheless, noteworthy greening systems, such as LWs, undoubtedly have a positive marketing impact, especially when installed in locations where the environmental friendly aspect is valued. In fact, most of the respondents in Wong et al.’s (2010) study agreed that vertical greenery 146
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was found to be the high maintenance costs incurred due to the size of the LW used in the model (over 200 m2) which also led to an elevated installation cost. This is an important point as maintenance costs are often computed per area unit, though they depend on other variables such as the type and complexity of the LW or its height. This means that bigger LWs usually have higher maintenance costs but do not necessarily entail a higher media repercussion or more psychological benefits. Perini and Rosasco (2016) point again to the installation and maintenance costs as the key factors for the economic sustainability of greening systems, which might be improved by means of incentives such as tax reductions. Notwithstanding, actually improving the economic sustainability of these systems relies on being capable of quantifying the wide range of benefits procured by them.
Positive reactions towards the LW observed in the respondents are correlated with the perception of benefits and the support of those systems. A low-moderate positive correlation is observed among the emotions felt (i.e., happiness, pleasantness, serenity) and the belief that LWs may improve psychological well-being and have a therapeutic effect (Spearman’s rho = 0.348–0.446; p = 0.000). A similar relationship was found for green roofs (Jungels et al., 2013). This fact also affects the value given to the existence of vegetation and, hence, the willingness to pay for it. For instance, in Dallimer et al. (2014), individuals reporting higher well-being when visiting natural parks were WTP more than those with lower scores. Our results show a positive correlation (Spearman’s rho = 0.26; p = 0.000) between the economic and environmental psychological values of green infrastructure such as LWs. The tendency to pay more for urban environments that are perceived to be greener (Mell et al., 2016) is also related. Many variables affect opinions about green spaces, but several authors have suggested that age and education are significant factors (Aytulkasapoglu and Ecevit, 2002; Jungels et al., 2013; Lakhan and Lavalle, 2002). For example, younger people tend to show more negative reactions to green roofs (Jungels et al., 2013), this improving with age. Qin et al. (2013) described a higher overall satisfaction with green spaces for elderly people compared with young and middle-aged participants. In our study, older participants also showed more positive reactions towards the LW. This can be explained by their having more interest in gardening and plants than younger respondents. Also the age groups of 36–45 and 46–60 are WTP slightly more than other groups, which can be related to their income levels. Some authors have reported gender differences in the perceptions and use of green spaces (Kaczynski et al., 2009; Ode Sang et al., 2016). Ode et al. (2009) determined that gender—but not age—had an effect on people’s preferences for different degrees of naturalness. Women, for example, saw greater aesthetic value in green spaces than men did, and had higher self-reported well-being associated with urban green spaces. All the same, in our study significant gender-based differences were not found in the responses. Curiously, only when asked about how much the hospital should invest on vegetation did women generally respond with lower quantities than men (F = 11.361; p = 0.01). The positive influence of the LW observed on the hospital personnel is particularly important as they are present in the hospital on a daily basis and it may affect their performance at work. Some authors have detected an improvement of workplace attitude when there is visual access to greenery (Lottrup et al., 2013). Leather et al. (1998) found that having a view of a green outdoor environment from the workplace window resulted in the employees feeling less uptight. Pati et al. (2008) established that nurses exposed to a nature view showed improved alertness level and reduced stress. This supports the fact that more than 75% of the hospital workers interviewed agreed with the investment made on the LW. However, it is interesting to note that, among the participants thinking that the hospital should not spend more than 100 € per year on vegetation, 24.5% are workers. In the case of patients or visitors, the percentage was only around 15%. This could be explained because hospital workers believe that investments should be made in other, more important items. Also, there was a significance difference in the interest in gardening and plants between workers and the rest of the sample (F = 4.907; p = 0.002). Taking all of this into account, the main question that remains is: can an LW actually be considered a cost-effective investment? Even according to the results shown in this study, the answer to this question is still inconclusive. It will depend on the factors considered, as many indirect intangible benefits are in play. For example, Perini and Rosasco (2013) concluded that an LW of the same type as the one installed in the hospital was not economically sustainable. In their study, they quantified the energy use reduction, the expenses reduction in the façade management, the air quality improvement and the increase in property value. Nonetheless, other soft benefits, such as the ones considered in this study, were not included. The main reason for the unsustainability
5. Conclusions Urban greening systems, and in particular LWs, have many benefits, some of which are difficult to measure. Exposing and quantifying those benefits can play an important role in order to incentivise their use. In this work, we have aimed to assess the value that the LW added to the hospital in terms of (i) publicity and media impact, and (ii) its effect on the hospital personnel and users. In this study case, the media impact was significant due to the novelty of the news and the wide diffusion obtained. This led to a high cost recovery ratio (investment vs. returns in publicity). Nevertheless, no such impact is expected for every LW installation. Although not much importance is given to gardening by some of the participants in the study, most of them describe having positive feelings and reactions when they are in the presence of vegetation. Many of them have not heard about LWs before, but when they see one, most think that these elements have a positive effect, improving the psychological well-being and contributing to recovering the health of those who perceive them. However, 50% of respondents believe that those effects can be also gained with conventional gardens. In any case, when there is not much space available, LWs represent a good choice in order to include vegetation in a building. In fact, people generally think that there should be investments in green areas though they are not always willing to pay for them. Therefore, most participants in this study totally agree with the investment made by the hospital and preferred having an LW over other options (green or not). They would even choose a hospital with more presence of vegetation over another with similar characteristics but no plants. The results obtained involving people’s perceptions about LWs provide an insight into public preferences towards these systems. This can be useful for companies and professionals, such as architects, landscapers or LW designers. It can also serve as a reason to install LWs, given that they seem to be appreciated and induce positive emotions. Acknowledgments We would like to express our gratitude to Quirónsalud Sagrado Corazón Hospital, especially to Ms. Berta Pascual for her help and willingness. We also thank the spin-off company Terapia Urbana S.L. for providing the information about the living wall and its impact in the media. Appendix A. Supplementary data Supplementary data associated with this article can be found, in the online version, at http://dx.doi.org/10.1016/j.ufug.2017.04.002. References Özgüner, H., Kendle, a. D., 2006. Public attitudes towards naturalistic versus designed landscapes in the city of Sheffield (UK). Landsc. Urban Plan. 74, 139–1573. http://dx. doi.org/10.1016/j.landurbplan.2004.10.003.
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Original article
Media and social impact valuation of a living wall: The case study of the Sagrado Corazon hospital in Seville (Spain)
MARK
⁎
Luis Pérez-Urrestarazua, , Ana Blasco-Romeroa, Rafael Fernández-Cañerob a
Urban Greening & Biosystems Engineering Research Group, Area of Agro-Forestry Engineering, Universidad de Sevilla, ETSIA Ctra, Utrera km. 1, 41013, Seville, Spain Urban Greening & Biosystems Engineering Research Group, Department of Agro-Forestry Sciences, Universidad de Sevilla, ETSIA Ctra, Utrera km. 1, 41013, Seville, Spain
b
A R T I C L E I N F O
A B S T R A C T
Keywords: Marketing Soft benefits Users’ perception Vertical garden Vertical greening systems
Vertical greening systems have increased in popularity during the last years due to their experienced added ecological and aesthetic value for current clients. The use of living walls is in line with a service sector focusing on environmental consciousness. Still, scientific evidence is lacking regarding the multiple benefits of LW. There is also a lingering fear of high installation and maintenance costs. Therefore, it is important to assess the intangible benefits that increase the value of living walls and, hence, of the place in which they are installed. The main objective of this work is the valuation of the returns obtained because of the publicity related to a living wall installed in the ‘Quirónsalud Sagrado Corazón’ Hospital in Seville (Spain) and the assessment of the public’s perception towards it. The investment that the hospital would have made in order to obtain a similar media impact has been estimated. The living wall proved to be very profitable in terms of publicity as the installation costs were recovered six times over. Also, the attitude towards the presence of such a greening system in the premises was assessed. To do so, 555 questionnaires were handed out face-to-face to patients, visitors and workers present at the hospital. Most participants concurred that the living wall induced positive reactions and improved their psychological well-being. Therefore, they completely agreed with the investment made by the hospital on such a vertical greening system.
1. Introduction Many cities are currently facing several problems related to a high construction density and lack of green spaces. For this reason, unconventional urban greening methods such as green roofs and vertical greening systems are being implemented. The use of living walls (LW) is becoming popular, even indoors, as a way of introducing plants into the built environment. However, in many cases, an LW is not installed because of the expenditure it involves, especially regarding installation and maintenance costs. For this reason, it is important to take into account the advantages of these technologies, several of which involve an economic gain that contributes to recovering the investment. In some cases, non-economic characteristics such as aesthetics and environmental protection are key motivators (Balram and Dragićević, 2005) which incentivise LW installations. In the service sector, users or clients are more environmentally conscious, so these systems can provide an added ecological value that is highly appreciated. Also, some authors point to an increase of the property value when there are green areas around (Bengochea Morancho, 2003; Czembrowski and Kronenberg, 2016; Netusil et al., 2014). In the case of an LW, these ⁎
increments have been estimated at between 2 and 5% (Perini and Rosasco, 2013). Of course, these figures are inconclusive as they depend on multiple variables (characteristics of the building, location, type and dimensions of the LW, etc.). Over the last years, the scientific community has been researching about the multiple ecological and environmental benefits associated with LWs, such as enriching urban biodiversity, improving air quality or enhancing building thermal performance (Pérez-Urrestarazu et al., 2015). Sometimes, the effect of an LW can be measured directly or determined using models. For example, noise attenuation or indoor temperature modulation due to an LW can be empirically tested. Therefore, there are some studies that quantify those benefits in terms of economic impact (e.g., energy savings). But in other cases, people benefit from an environmental amenity without consciously using it (Tomalty and Komorowski, 2010). This indirect use value is considered as a soft or intangible benefit, not directly tradable and quite difficult to quantify (e.g., users’ positive feelings towards a ‘greener’ space or marketing benefits related with the public’s interest in environmentally friendly products and sustainability). As an example, Tomalty and Komorowski (2010) quantified the economic value of different green
Corresponding author. E-mail addresses: [email protected] (L. Pérez-Urrestarazu), [email protected] (A. Blasco-Romero), [email protected] (R. Fernández-Cañero).
http://dx.doi.org/10.1016/j.ufug.2017.04.002 Received 21 November 2016; Received in revised form 6 March 2017; Accepted 4 April 2017 Available online 13 April 2017 1618-8667/ © 2017 Elsevier GmbH. All rights reserved.
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point of view concerning the presence of vegetation (specially the LW) were assessed by means of a survey in order to estimate the benefit obtained from it. The first working hypothesis is that the LW in the hospital had a monetary return in marketing making its installation worthwhile. The second involves the belief that the LW positively influenced the hospital personnel, visitors and patients, who agreed with the investment made by the medical centre.
roof case studies. For each benefit considered they used a different method to make the estimations. For instance, the value of the publicity gained as a direct consequence of green roof investments was assessed as a marketing benefit. The Noise Sensitivity Depreciation Index (NSDI) (Andersson et al., 2013) was used to estimate the financial gain due to sound attenuation. Stormwater retention was valued considering the cost of regular stormwater retention infrastructure required to have the same effect as the green roofs studied. Yang et al. (2008) calculated the economic benefit linked with the pollutant removal capacity of a green roof. Economic science has developed specific methods to estimate the value of environmental assets in monetary units (Bengochea Morancho, 2003; Tomalty and Komorowski, 2010). In ‘Stated preference’ techniques, such as contingent valuation, the economic value is attributed by asking people their Willingness To Pay (WTP) for certain services or benefits provided by green infrastructure (Bengochea Morancho, 2003; de Groot et al., 2002; Jim and Chen, 2006; Tomalty and Komorowski, 2010). This WTP can be related to how people perceive and interact with the green infrastructure, and their self-reported well-being and preferences (Dallimer et al., 2014; Mell et al., 2013). There are several studies using contingent valuation to establish the economic value of green infrastructure (Breffle et al., 1998; Dallimer et al., 2014; Jim and Chen, 2006; Mell et al., 2016, 2013). Most of them are related to conventional green infrastructures, mainly parks and open areas. There are some experiences with green roofs (Bianchini and Hewage, 2012; Clark et al., 2008; Claus and Rousseau, 2012; Tomalty and Komorowski, 2010), but an absence of them in LWs. Part of the value attributed to vegetated environments lies in their positive effect on health and well-being, providing relief from the pressures of high-density living. Even a passive involvement with nature, relying on the visual amenity, can bring about considerable psychological benefit (Özgüner and Kendle, 2006; Ulrich, 1984). Buildings with certain types of integrated vegetation seem to be more liked, aesthetically pleasing, and restorative than those without vegetation (White and Gatersleben, 2011). As viewing nature has been reported to relieve stress and pain, it makes it an ideal medium for use in healthcare settings (Vincent et al., 2010). Particularly, in the case of hospital confinement, some patients see their access to outdoor environments almost entirely limited to views through windows. Patients in hospital rooms with plants and flowers or even with access to a vegetated sight had significantly shorter hospitalisations, fewer intakes of analgesics, lower ratings of pain, anxiety and fatigue, more positive feelings and higher satisfaction (Bringslimark et al., 2009; Park et al., 2004; Park and Mattson, 2009, 2008; Ulrich, 1984). These findings emphasise the therapeutic value of plants in the hospital environment. Citizens generally have a positive attitude towards green infrastructure elements and these reactions are related with their support for them (Jungels et al., 2013). Environmental satisfaction is affected by many factors, such as gender or age, but also depends on the characteristics of the green spaces (type of vegetation, colours, smells) (Qin et al., 2013), so it is important to assess people’s response to their interaction with nature. Measuring individual stances towards urban green spaces has received sparse coverage in the environment and planning literature (Balram and Dragićević, 2005). Some studies are available involving positions regarding urban green spaces (Balram and Dragićević, 2005; Carrus et al., 2015; Jim and Chen, 2006; Mell et al., 2013), but few of them involve green roofs or green façades (Fernandez-Cañero et al., 2013; Jungels et al., 2013; Rahman et al., 2015; White and Gatersleben, 2011 Yuen and Nyuk Hien, 2005) and only Wong et al. (2010) referred to vertical greening systems in general. The main objective of this work is the valuation of the effect of an LW installed in a hospital in Seville (Spain) in terms of its impact in the media and on people. The media repercussion due to the LW was evaluated considering it as a marketing investment. On the other hand, the influence of the LW on the hospital personnel and users and their
2. Methods 2.1. The hospital and the living wall Quirónsalud Sagrado Corazón Hospital (QSCH) is part of Quirónsalud, a Spanish hospital group made up of several private hospitals. In 2015, QSCH received around 138,000 patients and had 575 workers. Apart from the main hospital building, QSCH has three medical centres in different locations in Seville (Spain). In 2012, the main building was remodelled and an LW was installed outdoors in August 2012 on an external façade facing the main hall of the hospital. The LW has an approximate area of 40 m2 (17 m long by 2.2 m high). In its design, inspired by Burle Marx’ “Suspended Garden”, around 1400 plants of 40 different species were used. For the LW installation, a felt system, composed of 1 × 1 modules with pockets in which the plant rootballs are inserted, was used. The LW can be viewed from the main hall through a large window (Fig. 1) and from some of the rooms for patients.
2.2. Media impact assessment All the QSCH media appearances due to the LW were identified from its installation until the end of 2015 in order to calculate the return on investment of the LW in terms of media impact. The comparable cost methodology (Tomalty and Komorowski, 2010) was used as a way of estimating the marketing benefits of green infrastructure by assessing the value of the free publicity received as a direct consequence of the LW’s presence. To do so, the real cost these media appearances would have entailed has been calculated. Those costs are broken down into the ad production charge (not taken into account in this study), plus the cost of running the advertisement. A slightly different process was adopted for each medium considering several factors. For radio and television, the aspects influencing the cost were the channel/radio station, duration of the interview/report (including only the minutes talking about the hospital’s LW), air time and audience. In the case of the written press, the process was more complex and the information on the estimated cost of each published article was provided by a specialised company (Acceso Group S.L.) which made an internal report for the hospital. Only the articles about the LW were taken into account. The variables involved to make the estimation were the newspaper in which the article was published, the total of copies distributed, section, number of pages, area covered by the article and% of the page occupied by it (page coverage), position on the page, the average number of readers and the author of the article. Finally, the advertising rates in each channel, station or newspaper were considered according to the factors previously described. For the digital press, the parameters usually employed are the number of visits and the CPM or cost per thousand impressions (Kumar and Sethi, 2009), where an impression can be defined as the display of an ad while a user is viewing a web page. However, the number of visits refers to the digital newspaper and not to a certain article, so the estimation using this number is not accurate. Therefore, the impact on the digital press was finally excluded from the study. Also, appearances in internet social networks, as well as in blogs, were not taken into account due to the difficulty of estimating the number of viewings or the value of a ‘like’ or a ‘share’. 142
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Fig. 1. View of the LW from the hall and participant filling out the questionnaire.
Well-Being Gain (Dallimer et al., 2014) and stances with respect to the LW. Lastly, ‘Contingent valuation’ questions were posed to identify the respondent’s WTP or how much they think the hospital should invest in the LW. Gathering WTP and self-reported well-being measures from the same individuals at the same time and place enables a direct comparison to be made between two radically different measures of value (Dallimer et al., 2014). In most questions, Likert scale options were used, though multiple-choice options were also employed. Question 18 used a Semantic Differential scale and required being in front of the LW to be answered. Therefore, it was not included in the form utilised at the QSCH-SE. A pilot test was conducted before implementing the fullscale survey. Prior to the statistical analysis, a data quality control was performed.
2.3. Survey methods and questionnaire design In studies about postures towards green infrastructure, the use of questionnaires is the most frequent resource to assess the population’s opinion about green infrastructure. The usual questionnaire approach to measure urban green spaces views is to include a range of semanticdifferential (with good/bad options for example) and Likert items (with agree/disagree options) to operationalise the attitude construct (Balram and Dragićević, 2005). In this work, a questionnaire was delivered in situ and face-to-face to 555 individuals present at the hospital (i.e., patients, visitors, workers) by a trained interviewer who gave explanations to respondents when necessary. Most of the surveys (453) were conducted from April to October 2015 at the QSCH main building where the respondents could view the LW. The rest of them (101) were performed from November 2015 to February 2016 at the Sagrado Corazón Quirónsalud Medical Centre Sevilla Este (QSCH-SE) in order to have responses from people visiting a medical centre of the same characteristics but with no LW. Prior to starting, each participant was given a brief description of the study, some instructions to complete the questionnaire and an assurance of anonymity. An informed consent was obtained verbally and participation was voluntary with no compensation. Table 1 shows the 26 pre-coded questions and the options for responses to each question can be seen in Annex B. The form had four different types of queries. The first one focused on the respondents’ personal data and descriptors, such as age, gender, occupation or the reason for being in the hospital. Then, general questions about attitude towards plants and green spaces were introduced in order to evaluate the respondents’ preference for plants, interest in gardening and previous knowledge about LWs. In the third type of questions, the survey’s respondents were asked about Self-Reported Psychological
2.4. Statistical analysis Survey responses were recorded and organised using Excel 2007 (Microsoft). Data were analysed applying SPSS 17 for Windows (IBM SPSS). Variables were assessed using the nonparametric Kruskal–Wallis one-way ANOVA test, as the data were not normally distributed. Dunnett’s C test was employed for multiple comparisons. Spearman’s rho correlation coefficient was also employed to investigate the association between categorical variables, since the data were not showing a normal distribution. The significance level was defined at p = 0.05.
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Table 1 Questions asked in the questionnaire. Question number
Question
A B C D 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22
Gender Age Occupation Type of job Why are you in the hospital? How often do you visit the hospital? Are you interested in gardening? Do you have plants at home? How many green areas are there close to your residence? How often do you visit parks or public gardens? How much would you be eager to pay monthly to increase/improve green areas close to your residence? Which of these emotions or reactions does being near plants inspire in you? How much do you value the presence of vegetation in your working environment? Are there any plants in your working environment? Did you ever hear about LWs before? LWs may favour a closer and more frequent contact between urban dwellers and green areas, improving their psychological well-being LWs have the same effects on those who perceive them as conventional gardens An LW may have a therapeutic effect contributing to improving the health of those who perceive it Would you like to view LWs in the building where you live or work? If you are in the hospital hall and look through the window, what would you like to see? In an LW, what most attracts your attention? (State your order of preference) When you look at the LW through the hall window, what reactions does it inspire in you? The investment made by the hospital for installing the LW in order to improve comfort and aesthetics through the presence of plants is appropriate How much should the hospital annually spend on LW and plants? Value from 0 to 5 the following alternatives to make the hospital more inviting If you had a choice between two hospitals with the same quality of care and services at the same price, would you choose the one with a greater presence of vegetation?
3. Results
questions in that line were posed. 39% were quite or very fond of gardening (where 61% were women, being 56.7% over 45 years old) while 26% had little or no interest at all. Nonetheless, nearly 80% claimed to have plants at home. Whereas 88% have green areas close to their residence, only 29% visit parks frequently (daily or several times a week). On the other hand, 34% rarely use green areas. Most participants (87.4%) value the presence of vegetation in their working environment, this being very important for 22% of them. On the other hand, 22% declare not having any plants in their workplace. When the participants were asked if they knew about LWs prior to this study, nearly 40% responded negatively. Previous knowledge about LWs significantly influenced (F = 30.715; p = 0.000) a higher desire of enjoying an LW where they live or work and the positive belief that LWs help to improve health (F = 17.802; p = 0.000) and psychological welfare (F = 26.121; p = 0.000). They also agreed more with the hospital investment in vegetation and had higher WTP quantities (F = 26.710; p = 0.001). Anyway, people generally think that these systems have a positive effect on those close to them. For instance, 81.5% of the respondents agreed that LWs may favour a closer contact with nature, improving their psychological well-being. A smaller number (51.4%) believed that an LW may have a therapeutic effect contributing to improving the health of those who perceive it. However, this seems not to be only related to LWs but with the presence of vegetation in general, as 50.6% of respondents think that LWs have the same effects as conventional gardens on those who perceive them. Only 6.5% of the participants would not like to have an LW at home or at their workplace, and 70% were quite or very attracted to that idea. 76.2% of the hospital workers surveyed thought that the LW helps to improve psychological wellbeing. In fact, 82% of them declared to feel happy and calm when viewing the LW. Notwithstanding, 40% of the hospital personnel respondents had little or no interest in it (taking into account the whole sample, the value was 26%). Yet, only 17% of workers did not value having plants at work. In order to determine if having the LW had a positive impact on people, the participants were asked how they felt about being close to vegetation. Different options were provided (several of which could be
3.1. Media impact assessment The media coverage due to QSCH’s LW included 30 appearances in 23 different newspapers, 2 radio interviews and 3 reports in a regional channel and 1 in national TV (accumulating more than 10 min talking about the LW). The total investment the hospital would have made to obtain the same repercussion is 198,945 €, as shown in Annex A for the different media considered. The printed press represented the highest amount: 107,705 €. Television appearances were valued at 87,149 €, while radio would only have cost 173 €. These figures have been compared with the investment made (26,162 €). To do so, only the installation cost has been taken into account as operation and maintenance costs are too variable. Therefore, the Return on Investment (ROI), defined as the difference between the gain and the cost of investment divided by the cost, is 660%. This means that more than 6 times the investment was recovered. Of course, when including operation (water and energy) and maintenance costs, ROI would decrease. As an example, considering maintenance costs in 2015 (approximately 4200 €, including pruning, disease control, cleaning of filters and tanks, adjusting irrigation times, plants replacements and SCADA system maintenance) being the same over a period of 15 years, ROI will still represent 122.4%.
3.2. Users’ perception and WTP A total of 555 people – 60.4% women and 39.6% men- were surveyed in both hospital locations. The age ranged between 18 and 86 years old, distributed as shown in Fig. 2. 69.3% of the respondents were employed and 9.3% unemployed, while 11.3% were students and 10.1% retired. It is interesting to note that less than 10% usually work outdoors. Around 19% were hospital workers who daily spend several hours inside the building. 26% were patients and 37.6% were visiting. 62.5% of those surveyed only visited the hospital sometimes. In order to take into account the possible influence of the respondents’ interest in gardening and plants on their answers, some 144
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Fig. 2. Distribution of male and female respondents: age group and type (1: worker; 2: patient; 3: visitor; 4: others).
Fig. 3. Semantic Differential scale chart showing respondents reactions when facing the LW.
response (53%). Also, they were asked to rate from 0 to 5 (5 being the most preferred) three different options to make the hospital more inviting. In this case, the most valued option was again introducing vegetation by means of planters and LWs (M = 4.06, SD = 1.17), compared to putting up a collection of paintings (M = 2.75, SD = 1.47) or installing TV monitors (M = 2.1, SD = 1.5). In order to estimate the economic value attributed to green infrastructure, the participants were asked how much they were WTP monthly to increase/improve green areas close to their residence. They were also asked about how much the hospital should annually spend on LW and plants. Table 2 shows the number of respondents answering certain amounts of money for each question. 22.4% declared to be WTP ‘nothing’ while most of them (59%) responded between 1 and 5 € and only 18.6% were WTP 10 € or more. On the other hand, 40.1% answered that the hospital should invest between 100 and 1000 €, 35.7% between 1000 and 10,000 € and 5.7% more than 10,000 €. Only 4.4% thought that the hospital ought not to spend any money on vegetation. A moderate positive correlation is observed between the responses to both questions (Spearman’s rho = 0.272; p < 0.02). Among those thinking that the hospital should not invest on plants, 87% were not WTP for green areas close to their residence. Those WTP more than 10 € represented 47% of the ones believing the hospital should spend more than 10,000 €. Conversely, 38% of respondents not WTP any money on green areas considered that the hospital should devote more than 1000 € to LWs and vegetation. In any case, 85.3% agree that the investment made by the hospital for installing the LW in order to improve comfort and aesthetics through the presence of plants is appropriate and only 2.8% disagree. Lastly, they were asked if they
selected at the same time), some of them considered positive (i.e., welfare, serenity, happiness), others negative (i.e., allergy, disgust) or no reaction at all. Most of them (87.7%) expressed feeling one or more positive emotions or reactions when being near plants. Around 60% experience serenity or welfare and 31% happiness. Though 30% of the respondents showed negative (mainly allergies) or no reactions, most of them felt positive ones at the same time. Therefore, only 12.3% of the respondents did not indicate any positive response at all. Further in the questionnaire, the participants (only the ones actually looking at the LW) were asked about the reactions the LW inspired in them. In this case, this aspect was approached associating these reactions with antagonist words using a Semantic Differential scale. ‘Calm’ and ‘happiness’ were the answers preferred (Fig. 3), followed by ‘pleasant’ and ‘stimulating’. Curiously, 6.2% of the respondents considered the LW more ‘Artificial’ than ‘Natural’. In any case, only 3.8% expressed indifference or negative feelings in all the items at that particular moment. With the purpose of evaluating people’s preferences concerning LWs, the participants were asked to rank different characteristics according to which one drew their attention more (1 being the first choice and 5 the last). The respondents prefer the mix of colours (M = 2.11, SD = 1.17) and a natural and wild aspect (M = 2.18, SD = 1.25) over order (M = 3.53, SD = 1.27) and uniformity in an LW (M = 4.05, SD = 1.16). Different textures are also appreciated (M = 2.92, SD = 1.21). When the hospital users were asked about what they would like to see through the windows of the hall, 93.4% of the answers involved some kind of vegetated landscape, though an LW was the favourite 145
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Table 2 Number of respondents WTP certain amount of money for green areas vs. quantities they think the hospital should annually spend on LWs and plants. How much should the hospital annually spend on LWs and plants
WTP monthly for green areas
a
Nothing 1€ 5€ 10 € > 10 € Totala
Nothing
1–100 €
100–1000 €
1000–10,000 €
> 10,000 €
Totala
20 1 2 0 0 23 (4.4%)
20 27 25 1 1 74 (14.1%)
33 60 81 27 10 211 (40.1%)
41 33 74 27 13 188 (35.7%)
4 3 4 5 14 30 (5.7%)
118 (22.4%) 124 (23.6%) 186 (35.4%) 60 (11.4%) 38 (7.2%)
Values in parentheses correspond to percentages referring to the 526 respondents who answered both questions.
Table 3 Interest in vegetation according to age groups. Age group
> 60
Interest in gardening Value vegetation at workplace Plants at home Would pay for green areas
3.91 4.20 4.09 2.36
± ± ± ±
46–60 0.133 0.123 0.135 0.161
a a a ab
3.56 3.90 3.66 2.77
± ± ± ±
36–45 0.083 0.082 0.097 0.096
a a a a
2.97 3.56 3.06 2.61
± ± ± ±
< 35 0.081 0.084 0.111 0.099
b b b ab
2.87 3.28 3.19 2.43
± ± ± ±
ANOVA 0.074 0.078 0.096 0.080
b b b b
F = 25.144; p = 0.000 F = 16.668; p = 0.000 F = 13.064; p = 0.000 F = 3.018; p = 0.029
Mean and SD values according to a Likert scale were 1: Highly disagree/None/Nothing; 5: Highly agree/Many/ > 10. Different letters within the same row denote significant differences following Dunnett’s C test.
systems can increase a building’s property value, visual interest and marketability. However, having proper maintenance is essential, as a poor state of the LW will cause exactly the opposite, undesired effect. Additionally, publicity or media dissemination can be favoured or incentivised. For example, launching a marketing campaign when an LW is installed can be a way of increasing its visibility and potentiating its positive effects. If done in a controlled manner, a small investment in marketing can produce a higher return. By employing this sort of initiatives, vertical greening systems will become more popular and be known by the population at large. Indeed, one of the reasons that may cause these systems not to be more widely used is the lack of knowledge about them. Many people are still unfamiliar with LWs (40% of the participants in this study did not know about them), which can even lead to prejudices and misconceptions. Yet, other non-ordinary urban greening technologies are becoming more known. For example, Jungels et al. (2013) found that most respondents (73%) in their study were aware of green roofs as a concept. This fact affected their perceptions or views in comparison to those people not familiar with green roofs. It appears that people in urbanised societies commonly believe that contact with nature provides them with recuperation from stress and fatigue and improves their health and well-being (van den Berg et al., 2007). In general, they think that vertical greenery systems will result in closer and more frequent contact with nature, therefore enhancing the psychological well-being of city dwellers, and that vertical greenery systems do have therapeutic effects by improving the health of their users (Wong et al., 2010). This is consistent with the findings of our study in which most people agreed with these assertions. Only a few expressed negative feelings, such as distress or disgust, when looking at the LW. There is also evidence in other studies of people recognising natural areas to be scary, disgusting and uncomfortable (Bixler and Floyd, 1997). But the most frequent reaction experienced was serenity or calmness, followed by welfare. This relaxing effect of vegetation has been also observed in experiences with green roofs (Rahman et al., 2015). Knowing what characteristic of the green infrastructure contributes the most to these feelings can be valuable. It seems that the mix of colours is one of the most important factors affecting the overall satisfaction of people with their vegetation environment, which is consistent with Qin et al.’s (2013) findings. Also the textures and wild aspect favour positive responses. This may be of importance for LW designers.
would choose a hospital with more presence of vegetation over another with the same quality of care and services and at the same price. In this case, 76.2% would choose the one with vegetation, while 19.3% do not really care. Lastly, the responses obtained were analysed according to the respondents’ characteristics (age, gender, occupation). The only significant difference in responses was found among the groups of age considered. Table 3 shows the attitude towards vegetation according to age groups. The respondents over 45 years old showed more interest in gardening and vegetation was more appreciated. Also, older respondents gave higher values in response to questions 13 (F = 4.947; p = 0.002), 14 (F = 7.405; p = 0.000), 15 (F = 5.552; p = 0.001), 19 (F = 6.642; p = 0.000) and 22 (F = 2.795; p = 0.04), the last one being less significant. 4. Discussion The results show that the investment the hospital should have made to obtain the same media coverage as that achieved due to the existence of the LW is close to 200,000 € This amount might be even higher, as only written press, radio and television appearances were considered, but the presence in social media (Facebook, YouTube, etc.) and online press was also extensive. A similar approach was used by Tomalty and Komorowski (2010), who estimated the returns in free publicity since the construction of a rooftop garden in a commercial building in Toronto (Canada) at $83,126. Still, it is difficult to assure that those values can be considered as an economic turnover both for the hospital or the commercial building as we do not know if the managers/owners would have made this marketing investment had the green infrastructure studied not existed. Moreover, in the QSCH the media coverage has been unusually broad due to the novelty of installing such a green infrastructure in a hospital. Therefore, it is improbable that other installations would have a similar impact. The marketing benefits of other LWs will depend on a number of factors that are unknown in advance or difficult to quantify, such as the current interest of local media in green infrastructure and green buildings (Tomalty and Komorowski, 2010), the significance of the project or its singularity. Nevertheless, noteworthy greening systems, such as LWs, undoubtedly have a positive marketing impact, especially when installed in locations where the environmental friendly aspect is valued. In fact, most of the respondents in Wong et al.’s (2010) study agreed that vertical greenery 146
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was found to be the high maintenance costs incurred due to the size of the LW used in the model (over 200 m2) which also led to an elevated installation cost. This is an important point as maintenance costs are often computed per area unit, though they depend on other variables such as the type and complexity of the LW or its height. This means that bigger LWs usually have higher maintenance costs but do not necessarily entail a higher media repercussion or more psychological benefits. Perini and Rosasco (2016) point again to the installation and maintenance costs as the key factors for the economic sustainability of greening systems, which might be improved by means of incentives such as tax reductions. Notwithstanding, actually improving the economic sustainability of these systems relies on being capable of quantifying the wide range of benefits procured by them.
Positive reactions towards the LW observed in the respondents are correlated with the perception of benefits and the support of those systems. A low-moderate positive correlation is observed among the emotions felt (i.e., happiness, pleasantness, serenity) and the belief that LWs may improve psychological well-being and have a therapeutic effect (Spearman’s rho = 0.348–0.446; p = 0.000). A similar relationship was found for green roofs (Jungels et al., 2013). This fact also affects the value given to the existence of vegetation and, hence, the willingness to pay for it. For instance, in Dallimer et al. (2014), individuals reporting higher well-being when visiting natural parks were WTP more than those with lower scores. Our results show a positive correlation (Spearman’s rho = 0.26; p = 0.000) between the economic and environmental psychological values of green infrastructure such as LWs. The tendency to pay more for urban environments that are perceived to be greener (Mell et al., 2016) is also related. Many variables affect opinions about green spaces, but several authors have suggested that age and education are significant factors (Aytulkasapoglu and Ecevit, 2002; Jungels et al., 2013; Lakhan and Lavalle, 2002). For example, younger people tend to show more negative reactions to green roofs (Jungels et al., 2013), this improving with age. Qin et al. (2013) described a higher overall satisfaction with green spaces for elderly people compared with young and middle-aged participants. In our study, older participants also showed more positive reactions towards the LW. This can be explained by their having more interest in gardening and plants than younger respondents. Also the age groups of 36–45 and 46–60 are WTP slightly more than other groups, which can be related to their income levels. Some authors have reported gender differences in the perceptions and use of green spaces (Kaczynski et al., 2009; Ode Sang et al., 2016). Ode et al. (2009) determined that gender—but not age—had an effect on people’s preferences for different degrees of naturalness. Women, for example, saw greater aesthetic value in green spaces than men did, and had higher self-reported well-being associated with urban green spaces. All the same, in our study significant gender-based differences were not found in the responses. Curiously, only when asked about how much the hospital should invest on vegetation did women generally respond with lower quantities than men (F = 11.361; p = 0.01). The positive influence of the LW observed on the hospital personnel is particularly important as they are present in the hospital on a daily basis and it may affect their performance at work. Some authors have detected an improvement of workplace attitude when there is visual access to greenery (Lottrup et al., 2013). Leather et al. (1998) found that having a view of a green outdoor environment from the workplace window resulted in the employees feeling less uptight. Pati et al. (2008) established that nurses exposed to a nature view showed improved alertness level and reduced stress. This supports the fact that more than 75% of the hospital workers interviewed agreed with the investment made on the LW. However, it is interesting to note that, among the participants thinking that the hospital should not spend more than 100 € per year on vegetation, 24.5% are workers. In the case of patients or visitors, the percentage was only around 15%. This could be explained because hospital workers believe that investments should be made in other, more important items. Also, there was a significance difference in the interest in gardening and plants between workers and the rest of the sample (F = 4.907; p = 0.002). Taking all of this into account, the main question that remains is: can an LW actually be considered a cost-effective investment? Even according to the results shown in this study, the answer to this question is still inconclusive. It will depend on the factors considered, as many indirect intangible benefits are in play. For example, Perini and Rosasco (2013) concluded that an LW of the same type as the one installed in the hospital was not economically sustainable. In their study, they quantified the energy use reduction, the expenses reduction in the façade management, the air quality improvement and the increase in property value. Nonetheless, other soft benefits, such as the ones considered in this study, were not included. The main reason for the unsustainability
5. Conclusions Urban greening systems, and in particular LWs, have many benefits, some of which are difficult to measure. Exposing and quantifying those benefits can play an important role in order to incentivise their use. In this work, we have aimed to assess the value that the LW added to the hospital in terms of (i) publicity and media impact, and (ii) its effect on the hospital personnel and users. In this study case, the media impact was significant due to the novelty of the news and the wide diffusion obtained. This led to a high cost recovery ratio (investment vs. returns in publicity). Nevertheless, no such impact is expected for every LW installation. Although not much importance is given to gardening by some of the participants in the study, most of them describe having positive feelings and reactions when they are in the presence of vegetation. Many of them have not heard about LWs before, but when they see one, most think that these elements have a positive effect, improving the psychological well-being and contributing to recovering the health of those who perceive them. However, 50% of respondents believe that those effects can be also gained with conventional gardens. In any case, when there is not much space available, LWs represent a good choice in order to include vegetation in a building. In fact, people generally think that there should be investments in green areas though they are not always willing to pay for them. Therefore, most participants in this study totally agree with the investment made by the hospital and preferred having an LW over other options (green or not). They would even choose a hospital with more presence of vegetation over another with similar characteristics but no plants. The results obtained involving people’s perceptions about LWs provide an insight into public preferences towards these systems. This can be useful for companies and professionals, such as architects, landscapers or LW designers. It can also serve as a reason to install LWs, given that they seem to be appreciated and induce positive emotions. Acknowledgments We would like to express our gratitude to Quirónsalud Sagrado Corazón Hospital, especially to Ms. Berta Pascual for her help and willingness. We also thank the spin-off company Terapia Urbana S.L. for providing the information about the living wall and its impact in the media. Appendix A. Supplementary data Supplementary data associated with this article can be found, in the online version, at http://dx.doi.org/10.1016/j.ufug.2017.04.002. References Özgüner, H., Kendle, a. D., 2006. Public attitudes towards naturalistic versus designed landscapes in the city of Sheffield (UK). Landsc. Urban Plan. 74, 139–1573. http://dx. doi.org/10.1016/j.landurbplan.2004.10.003.
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