HHIT Series Episode 8: Childhood obesity, cystic fibrosis and healthcare worker burnout, with Gerardine Doyle
On October 17th, 2023, the Human Health, Impact and Technology series (#HHITseries) welcomed Gerardine Doyle, Full Professor of Accounting in UCD College of Business, Visiting Scholar at Harvard Business School 2023/24 and former Director of the UCD Michael Smurfit Graduate Business School. She spoke to host Professor Patricia Maguire about her wide-ranging research interests, including childhood obesity, cystic fibrosis and healthcare worker burnout.
Career
Gerardine embarked on a unique career journey that involved pursuing a Bachelor of Science degree in pharmacology and physiology in UCD, transitioning to become a chartered accountant and chartered tax adviser with KPMG, returning to UCD as a faculty member, before merging the disciplines of medicine and accounting for her PhD studies. This interdisciplinary approach opened doors to becoming a principal investigator in many EU-funded health projects, leading to a rewarding research career and international collaborations across various academic disciplines within UCD and beyond.
The person in the patient
Gerardine’s work centres around prioritising the individual and the patient, focusing on the person as the unit of analysis. Her research involves collecting real-world data within healthcare organisations, identifying ways to optimise patient health outcomes, ultimately aiming for societal impact.
Two key areas of her research are the measurement of health literacy, which empowers individuals and the measurement of the value delivered by health services to optimise patient outcomes.
“Health literacy is really about empowerment,” she says. “It’s about empowering the individual to have the skill set and the competencies to be able to access, understand, appraise and apply health information to manage their own health and well-being and that of their loved ones.”
Her extensive involvement in health literacy research for over 15 years has grown from eight countries in the first European Health Literacy Survey to 17 countries in the second data collected (MPOHL) and now spans 28 countries. The unique European instrument for measuring health literacy is being considered for use in a global comparative study by the World Health Organisation.
Cystic Fibrosis
During Gerardine’s previous fellowship at Harvard Business School in 2017, she began a collaborative research study with experts from Harvard Business School, Boston Children's Hospital, Temple Street Children’s Hospital and UCD College of Business to conduct a transatlantic comparative study on the care of children with cystic fibrosis. The study revealed that care team composition differed between sites – at Boston Children's Hospital the pulmonary physician and registered dietician spent the most total time with patients whereas in Temple Street Children’s Hospital it was the clinical nurse specialist and the registered dietician who spent most time with the patients and so the care in Ireland was more cost-effective and provides a different patient experience for the child and parent.
“We discovered that in Boston the most expensive healthcare professional was working with the patients but for a much shorter period of time,” she says. “Whereas in Ireland our specialist CF nurses spent a much longer time with our patients.”
Notably, Ireland’s inclusion of a specialist CF pharmacist has been pivotal in staying at the forefront of new therapies, which have contributed to improved outcomes for children with cystic fibrosis. Clinical improvements being Improved lung function (FEV1), reduced exacerbations, improved BMI and reduced hospitalisation rates. Patients have reported Improved levels of comfort, enhanced energy levels and greater freedom in daily activities.
This research highlights the value of international collaboration and knowledge exchange in enhancing patient care and patient outcomes.
Healthcare worker burnout
Gerardine’s latest research, in collaboration with Professor Susanna Gallani at Harvard Business School, looks at the growing problem of healthcare provider burnout reflected in high turnover of staff.
“Doctors and also nurses are leaving the profession to go into other areas. For example, many are moving into professional services firms to work in consulting. We thought it would be really important to try to understand the reasons and the causes for this feeling of burnout,” she says.
By combining Robert Simons’ framework for designing high performance jobs as a diagnostic tool to identify potential antecedents of professional engagement, satisfaction, and burnout with Christine Maslach’s Burnout Inventory scale, a measurement instrument for burnout, Gerardine and Susanna are striving to uncover the root causes of burnout. They are also examining potential managerial interventions that may reduce the incidence of burnout. As health care is provided by multidisciplinary teams they are also seeking to understand the role of teams and teaming, including psychological safety, in mitigating burnout among healthcare professionals on both sides of the Atlantic. This research seeks to provide actionable insights for improving the wellbeing of healthcare providers and addressing the challenges of burnout within the profession.
Childhood obesity
Gerardine was a Principal Investigator of the EU Horizon 2020 study BigO (Big data against childhood obesity). This research was prompted by the alarming prediction that 18% of girls and 20% of boys may be obese or overweight by 2030. BigO was a collaborative study involving multiple countries (Ireland, Greece, Sweden) and multiple experts. School teachers, clinicians and policymakers from each country were members of the consortium along with industry partners, aimed at identifying priorities policy areas for addressing childhood obesity.
Our objective was to gather information needed to better understand the complex relationship between environmental and behavioral factors and childhood obesity, and to create analytical models to inform policy makers in addressing this global problem.
“What was revealed from that study was that the built environment was really important. The opportunities that children have going to and from school to buy foods that are energy dense and highly calorific.”
The development of a unique app allowed for the collection of a wide array of data, including children’s physical activity, screen time, mood and dietary habits. The children uploaded photographs of the food they were eating and food advertisements encountered in their offline environment.
The GPS component of the app gave insights into the proximity of schools to fast food and other outlets and the availability of green spaces for outdoor activities, highlighting the role of policymakers in shaping the built environment to support healthier lifestyles for children.
Sugar Tax
Gerardine’s work has already helped to bring about Ireland’s Sugar Sweetened Beverage Tax in 2018 which has had a significant impact on the formulation of sugary drinks. Manufacturers have responded by reducing the sugar content in their drinks. Lucozade and Ribena reduced their sugar content from 13 grams and 10 grams respectively to 4.5 grams per 100 millilitres. The tax has also spurred an important strategic partnership between the Department of Health and the Food Safety Authority of Ireland through the Food Reformulation Task Force, which aims to improve the Irish diet not only by reducing sugar but also by targeting high fat and high salt foods. The purpose of the Task Force is to implement a (opens in a new window)Roadmap for Food Product Reformulation in Ireland
“While they will be issue their final report in 2025 they are publishing reports as their work progresses” she says. “I would suggest that everyone tuned in today log onto their website because they are producing reports on a regular basis.”