Behavioural Research Group
Dr Gaby Judah
What we do
We are researchers who apply behavioural sciences to understand and address a broad range of challenges in health and healthcare. This includes reducing burnout in healthcare workers, and improving transitions of care e.g. when patients leave the hospital or for older patients with dementia. The directly patient-focussed research includes increasing cancer screening uptake, and understanding medication adherence. Much of this work is part of the Imperial NIHR Patient Safety Translational Research Centre, under Theme 1 of Safer systems across the continuum of care.
Why it is important
Many challenges in health and healthcare are linked to unhealthy behaviours, or lack of unhealthy behaviours. Furthermore, there are several behaviours that occur in a clinical context that may result in less safe care. The application of behavioural science theories and methods allows understanding of the underlying predictors of the behaviour, so that they can be addressed in an effective way.
How it can benefit patients
Increasing uptake of behaviours beneficial to health will have a direct impact on the health of patients and the public. Addressing key types of healthcare worker behaviour can lead to safer care, therefore benefitting patients.
Knowing effective ways to change behaviours such as cancer screening uptake and medication adherence will improve patient health, by increasing early detection of cancers when treatment is more likely to be effective, and through reducing morbidity and mortality caused by non-adherence to prescribed medications.
Transitions in care, e.g. when patients leave hospital, are known to be points susceptible to patient safety errors. Improving communication around these transitions will improve the care received by patients, and may reduce the likelihood of unnecessary readmission. Burnout in doctors and nurses has been associated with more unsafe care, and increased desire to leave the profession. Using behavioural science approaches to reduce burnout in doctors and nurses would benefit both healthcare workers and patients.
Summary of current research
Improving transitions of care
Much of our research in this area explores patient safety during transitions of care from hospital to community settings. This has included gaining consensus of the key safety issues following discharge, and exploration of the determinants of underlying behaviours of healthcare professionals that threaten safe patient transitions into the community. This will lead to the design of an intervention to improve communication during this transition of care. This work has mainly used qualitative methods, and has been led by Ola Markiewicz.
Another workstream, led by Lisa Gould considers person centred and compassionate care for patients in acute care, with a particular focus on transitions of care for older people with dementia.
Reducing burnout in healthcare workers
Alix Brazier is leading the work aiming at reducing burnout in healthcare workers. Previous work has focussed on understanding predictors of burnout in trainee anaesthetists, and conducting a trial of an SMS intervention aiming to reduce burnout in this group. Current work will use qualitative methods to understand burnout in nurses; an area less researched than burnout in doctors. This will lead to the design and test of an intervention to address burnout in this group, using principles from behavioural sciences. The work on burnout is being conducted with the Behavioural Insights Team.
In addition, Lisa Gould is working on an analysis of data collected during the pandemic from "YouGov" and "Our frontline" with a perspective of staff safety and wellbeing.
Increasing cancer screening uptake
An ongoing programme of work is looking to improve cancer screening uptake, particularly in breast and cervical cancer. Approaches include surveys to understand barriers to attendance, qualitative methods, and big data analysis to learn more about the profiles of non-attenders. These methods contribute to the selection of appropriate behaviour change techniques for intervention design. Interventions are predominantly delivered using SMS, but include different behaviour change techniques depending on the findings from the research to understand determinants of attendance. There is particular interest in improving uptake in hard-to-reach groups, and reducing inequalities.
Current research is being led by Amish Acharya, with input from Sarah Huf. The work is in collaboration with Public Health England, and NHS England and Improvement.
Understanding medication adherence
In collaboration with Professor Peter Sever at the National Heart and Lung Institute at Imperial, we are looking to understand psychological determinants of adherence to statin and antihypertensive medication. The work is being conducted with patients in primary care, and will lead to the design and test of targeted interventions to improve medication adherence.
- Ola Markiewicz (co-supervised with Professor Ara Darzi, and Dr Fabiana Lorencatto)
- Amish Acharya (co-supervised with Professor Ara Darzi)
- Alix Brazier (co-supervised with Professor Ara Darzi)