These are my slides from the European Health Psychology Society 2013 Conference Roundtable: Provocations for future directions in health psychology, convened by Kerry Chamberlain and myself. My proposition was that health psychologists are risking to become behavioral engineers with participants as objects on whom behavior change techniques are tried on to find most effective ways to achieve intervention objectives drawn from health guidelines. Other provocateurs were James C. Coyne, Britta Renner, Marie Santiago-Delefosse, and Charles Abraham.

1. EHPS 2013 Roundtable
Provocation 6
PilvikkiAbsetz, AdjunctProfessor, PhD
University of Tampere, Finland

2.  Health guidelinesarebased on
careful, systematicevaluation of
researchevidenceconductedbycommittees of
leadingexperts in
eachspecificfielde.g., physicalactivity, nutritio
n, sleep, oralhygiene etc.
 The aim is to help organizations and
professionals to promotehealth and to
supportindividuals in
leadinghealthylivesbygivingtargets forAbsetz EHPS 2013

3. The message to individuals
is thatthesearenot just
”SIMPLE BEHAVIORS”
thatwillkeepyouhealthy…

4. … butthatdoingthem is
actuallyfun!

5.  75% attendhealthcareappointments as
scheduled
 50% takemedication as described
 40% brushteethwith the
recommendedfrequency, of them 40%
doitcorrectly
 30% followhealthydiet
 25% getsufficientphysicalactivity
 <10 % of thosewithoverweightmanage to
looseweight and maintain the weightloss
Even in the
successfulinterve
ntions,
mostparticipants
don’treach&main
tain the
intervention
objectives
Absetz EHPS 2013

6.  A problemwithguidelines is thattheyarebased
on populationestimates
 Applicability on individuallevelvariesbetween
0 and 1 (none - fully)
 Guidelinesimply the use of expert-
drivenapproaches and a compliancemodel
Absetz EHPS 2013

7. Behavioralscientistshaveputtheirexpertiz
e into practice in the
healthbehaviorchangemovement:

8. To
identifypathway
s and
modelbehaviorch
ange, and to help
the
medicalprofessio
n to
effectivelyengine
erpeople’sbehavi
or?
Absetz EHPS 2013

9. To
developtranspar
entways of
helpingpeopleby
doingtogetherwi
ththemthingstha
ttheyfinduseful
and valuable?
Absetz EHPS 2013

10. Looking at the ”Futuredevelopments” of the 2013
BCTTaxonomypaperdoesnot look
encouragingfrom the participatoryperspective

11. A literaturesearch in a leading
HP journalconfirmed the
pessimisticview:
•Simple, broadsearchstrategy
("Health psychology"[Journal])
AND ("intervention"[AllFields])
June 2012 to 2013
• 43 articles, 17
originalresearchreporting
intervention findings
•Only 3 mentionedanyrole of
targetpopulation:

12. Typically, intervention researchreports*
treatparticipants as objectswhoreceive an
intervention and areexpected to achieve
the objectivesgivenby the researchers
*The studyshownhereis a randomlyselectedexamplefrom intervention
articlespublished in NEJM in 2012, to serve as an example, not to point
at the authors. I mustadmitthat my ownresearch is not an exception in
thisrespect.

13.  One potentialapproach: ParticipatoryAppreciative Action
Research - PAAR
 Participatory: Equality and engagement
 Appreciative: Identifying and playing to strengths& to
whatpeoplewant
 Action Research: Process of activelyparticipating in a
changesituationwhilstconductingresearch
“Whatareoursuccesse
s?
Howcanweamplifythe
m to build and sustain
a
betterfuturefromvalu
edaspects of the
positivepresent?”
Doingresearchtogetherwithpe
ople, not on them:
Everyonewilllearnmoreusing
the sum of
individualknowledge and self-
awareness
Absetz EHPS 2013