UF program to change risky behaviors could save taxpayer dollars

November 16, 2009

GAINESVILLE, Fla. — Tech-savvy young people will receive a prescription for healthier living before they actually see the doctor, says a University of Florida professor whose team is developing a laptop program for use in the waiting room.

The program designed for adults between 18 and 24 presents positive images and messages about wellness at the touch of a fingertip, said Chad Werch, director of the Addictive and Health Behaviors Research Institute in UF’s Department of Health Education and Behavior.

Images such as a slim and fit young person will be part of the tutorials that encourage participants to exercise, eat healthy, manage stress wisely, stop smoking, practice safe sex and avoid abusing alcohol and prescription drugs, Werch said.

“Not only are these high-risk behaviors a major cause of illness, injury and death, but they cost billions of dollars,” he said. “If we’re able to control them, it can mean a tremendous savings for the state and nation.”

The public health program, being developed with a two-year $926,607 federal stimulus grant, aims to change many bad habits at the same time, but not by resorting to the lecture method or browbeating young people with dire warnings about dangerous lifestyles, he said.

Rather, the program provides participants with favorable descriptions of what young adult peers look like who regularly engage in healthy behavior – such as exercising vigorously, eating nutritionally or practicing stress management. In addition, the program encourages participants to develop positive mental images of what they would look like in the future if they changed their health behavior, and helps them identify steps to reach those goals, he said.

After filling out the necessary paperwork, a patient will sit down in front of a notebook computer in a quiet spot in the waiting room, where they will respond to a series of questions about their health risk behavior, Werch said. Based on their responses, they will be asked to identify goals for specific behavioral changes, he said.

The computer will then print a copy of an individual contract and a calendar log, which will help them to monitor their behavioral changes over time, and provide a list of health resources in case they need online or local support, he said.

The topic is timely as the nation discusses the multibillion dollar questions about health care, Werch said. “While that debate is about health insurance, this is much more important because it addresses the underlying risk factors for health care costs,” he said. “In industrialized countries like the United States, things like physical inactivity, poor nutrition, inability to handle stress and misusing alcohol and tobacco drive health care costs. Addressing these can cut expenses dramatically.”

Current prevention efforts are more limited in scope, focusing on the importance of having specific procedures such as mammograms or colonoscopies, he said.

“The real cost savers are any kind of preventative or health promotion type of activities that get young people to engage in health-enhancing behaviors and avoid those behaviors that are going to damage their health either immediately like getting into a car and driving drunk or 20 years down the road by eating a diet full of saturated fat,” he said.

Traditionally it’s been considered too difficult for someone to change more than one bad habit at a time, but the reality is that people often have many problems in their lives, Werch said. “It’s not uncommon for young people who are physically inactive to also suffer from poor nutrition and experience considerable stress, for example,” he said.

The project will test the effects of a public health model called Screening Brief Intervention and Referral to Treatment, which has been used to treat problems with alcohol or tobacco. It will be tried at a UF clinic in Jacksonville, with participants evaluated three months later for changes in behavior.

Instead of merely giving warnings about health hazards, the program will present positive illustrations and messages about the merits of living a fit and healthy lifestyle, Werch said. The prototype of a physically active person, for example, might be one who is slim, has clear skin and has other desirable qualities, such as being smart and popular, he said.

“That’s quite a bit different from the typical risk message that might say ‘if you’re going to misuse prescription drugs, you’re going to end up in jail or get liver cancer,’” he said.

Using computers allows participants to tailor the program to their individual needs, as well as saves the expense of regular appointments with doctors or nurses, Werch said. Applying it in a doctor’s office will allow the medical staff to provide additional health promotion and prevention services, if needed, including referrals for drug treatment, he said.