‘If you want to resolve the big challenges in healthcare, you have to work across disciplines’
Marieke Adriaanse is Professor of Behavioural Interventions in Population Health and researches behavioural science issues in health. She advocates for better interdisciplinary collaboration and a new form of recognition and rewards within academia. ‘We have to stop being so blinkered,’ she says in her inaugural lecture.
Adriaanse’s chair is within the Population Health Living Lab interdisciplinary programme. ‘If you want to work on the big societal challenges in health, such as reducing health inequalities or the rising number of people with lifestyle-related conditions, you have to bring knowledge together. To do so, you need to work not only with other disciplines but also with patients and professionals, for instance.’
Invest in one another
Interdisciplinary research begins with investing in one another, says Adriaanse. ‘That takes time. You have to know where people come from and learn their language. The interdisciplinary programmes are about big themes, the big challenges facing society. You can’t compartmentalise such issues. Knowledge from one discipline should reinforce knowledge from another and help find answers to complex questions, for instance relating to health.’
When Adriaanse tells people about her remit, she is sometimes asked whether she lets others set her research agenda and whether that can really be the intention. ‘That response is really interesting because it illustrates how we are often mainly concerned with ourselves. That we think we have to stake out our own field and be hyper-specialised in something.’
Supporting and maintaining behaviour change
Adriaanse mainly sees advantages in collaboration. ‘My expertise is not in a specific topic such as exercise or eating, but in how the behavioural sciences tackle health-related problems. It’s from this perspective that we try to understand and research opportunities to support and sustain behaviour change.’
Although interdisciplinary collaboration can be incredibly fun and informative, she does acknowledge that there are also barriers. ‘It takes a lot of time and can make you feel insecure. You discover all the things that you’re not an expert in. You suddenly have to learn a new language. In my first month at the LUMC, half the time I didn’t understand what people were talking about. I did wonder for a while whether I really was suited to this. And it can make you have a bit of a wobble. But you learn a lot from it. You broaden your knowledge and ultimately end up with better research questions.’
One of the themes of her research is behaviour change in healthcare professionals such as GPs. ‘If we want to keep healthcare affordable and to do something about the growing numbers of chronically ill people, we will have to change our lifestyles. That means behaviour change in not only citizens and patients, but also healthcare professionals. They will have to give lifestyle advice more often, for example, and prescribe fewer pills. But just as how behaviour change is difficult for patients and generally requires more than knowledge alone, the same is also true for professionals. They too have all sorts of habits and routines that you won’t break just by changing a guideline.’
Recognition and rewards
Interdisciplinary work requires openness and a climate of trust. ‘You need a safe environment that encourages people to work together, where different contributions and qualities are valued and where what comes first is the common interest rather than your own.’ In her inaugural lecture, Adriaanse will therefore make the case for a new form of recognition and rewards. ‘We haven’t thought about what we understand quality to be for a long time. We have very much relied on certain incentives and a fairly narrow definition of excellence.’ She calls for a rethink. ‘If you want people to invest time in collaboration, you’ll need a broader view of quality, and we shouldn’t just judge people on how much they have published.’
This rethink is not just needed for academics who do interdisciplinary work, Adriaanse emphasises. ‘The excessive pressure to succeed, the focus on quantity rather than quality and the undervaluing of teaching is problematic for all of academia, also for the people who work entirely within their own discipline.’ Talking about this is easy, she admits. ‘As academics we’re good at analysing problems. But the problems aren’t just with others. They affect us all. We’ll have to stop being so blinkered and start doing things differently. Particularly if you are in a leadership role.’
Text: Tom Janssen