Empowering everyone to improve their own health

I’m an applied social psychologist, with a speciality in designing and evaluating behaviour change interventions. In the UK I’m registered to practice as a health psychologist, but this doesn’t involve one-to-one consultations or a focus on mental health issues. I’m a public health psychologist.

The role of the public health psychologist is to help people change their lifestyle, so that they either prevent themselves getting these conditions or manage them optimally. We need effective behaviour change for people with physical health problems and this cannot be managed through one-to-one appointments.

The people I help have common physical problems such as pain, cardiovascular disease and diabetes. Many conditions, including diabetes and cardiovascular diseases, are so widespread. Diabetes and cardiovascular problems are based, in large part, on our rising overweight and obesity levels. By encouraging people to lose weight by changing their diet and physical activity we can help prevent diabetes.

I’ve just spent part of my morning thinking about virtual groups. In an osteoporosis project led by Professor Kim Bennell, participants can log into their group which could include people in remote locations across Australia. We can then help them exercise to manage their osteoporosis.

By strengthening their muscles, they may have less pain and be less likely to use health services, experience the negative effects of pain killers or need to see their GP. Interventions like this can promote a person’s wellbeing as well as save costs for health services.

Technology brings with it a whole new set of resources. Computers can help people monitor their physical activity and whether their energy intake from food is too great. Combining group-based interventions with smart phones and devices can really begin to offer a new way for people to change.

But we also need government level intervention. The UK is investing in such interventions as part of the NHS Diabetes Prevention Programme, which provides tailored, personalised support to reduce a person’s risk of type 2 diabetes. This includes education about healthy eating and lifestyle, weight loss help and exercise plans.

I’d like to see compulsory labelling of food and not just the energy content. I’d like simple guidance, something like a traffic light system of red, green, amber. Green is good for your health, amber could have some issues that you need to check and red is probably bad for your health. I think this would really help us to make choices that benefit us.

The current food labelling is complicated and it’s really challenging for people to distinguish between healthy and less healthy foods. It’s all very well saying everyone knows that salads are good for you, but a salad drenched in dressing may be much higher in kilojoules than another salad with very little sweet dressing.

I’m looking at ‘calories are walking times’ labelling with Dr Paschal Sheeran at the University of North Carolina. Experimental evidence suggests that providing an average adult with the walking time it takes to burn that food off might change the way they respond to labelling. If I tell you this bar of chocolate includes 300 calories, you’ve got to think, how many calories have I had in fat today, how many should I have, how many will I use?

If I say instead this bar is a ‘60’, that is, it will take the average adult 60 minutes to burn this amount of energy, you may better understand whether or not, given your daily exercise, you want to eat it. So, this could be more of a more simple and practical approach.

You don’t want people obsessing about their food. You want to help them to set up new habits so that they don’t have to think about eating healthily – so ‘calories are walking times’ labelling may help.

Healthcare systems only work if everybody isn’t sick. Healthcare costs are increasingly becoming a taxation burden across the world, so effective public health behaviour change can save governments a lot of money. But we need this change at organisational, community and state level. If you reduce obesity and cardiovascular problems you create a fitter, more productive population with greater wellbeing who, consequently, generate less health care costs.

We need to help people look after their health so they don’t get sick – not just to treat them when they are. The Faculty of Medicine, Dentistry and Health Sciences is keen to develop more effective and cost-effective public health interventions. I’m particularly interested in using groups, combined with smart technology, to change health-related behaviour patterns and habits. We plan to set up the Melbourne Centre for Behaviour Change to progress research in this area.

It’s very rewarding when you see people who have turned their lives around. They may have, for example, avoided becoming diabetic or are much more active because they’re controlling their pain or just have a better quality of life. This is what public health psychology can deliver at individual, organisational, community and population level.

- As told to Cheryl Critchley

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