emergence of academic /professional bodies to promote research and practice in health psychology was followed by the publication of a series of textbooks which began to lay out the interests of the discipline. objectives understanding behavioral and contextual factors health psychologists conduct research to identify behaviors and experiences that promote health, give rise to illness, and influence the effectiveness of health care. they also recommend ways to improve health care policy. health psychologists have worked on developing ways to reduce smoking and improve daily nutrition in order to promote health and prevent illness. they have also studied the association between illness and individual characteristics. for example, health psychology has found a relation between the personality characteristics of thrill seeking, impulsiveness, hostility/anger, emotional instability, and depression, on one hand, and high-risk driving, on the other. health psychology is also concerned with contextual factors, including economic, cultural, community, social, and lifestyle factors that influence health. physical addiction impedes smoking cessation. some research suggests that seductive advertising also contributes to psychological dependency on tobacco, although other research has found no relationship between media exposure and smoking in youth. ohp research indicates that people in jobs that combine little decision latitude with a high psychological workload are at increased risk for cardiovascular disease. other research reveals a relation between unemployment and elevations in blood pressure. epidemiologic research documents a relation between social class and cardiovascular disease. health psychologists also aim to change health behaviors for the dual purpose of helping people stay healthy and helping patients adhere to disease treatment regimens (also see health action process approach). health psychologists employ cognitive behavioral therapy and applied behavior analysis (also see behavior modification) for that purpose. preventing illness health psychologists promote health through behavioral change, as mentioned above; however, they attempt to prevent illness in other ways as well. health psychologists try to help people to lead a healthy life by developing and running programmes which can help people to make changes in their lives such as stopping smoking, reducing the amount of alcohol they consume, eating more healthily, and exercising regularly. campaigns informed by health psychology have targeted tobacco use. those least able to afford tobacco products consume them most. tobacco provides individuals with a way of controlling aversive emotional states accompanying daily experiences of stress that characterize the lives of deprived and vulnerable individuals. practitioners emphasize education and effective communication as a part of illness prevention because many people do not recognize, or minimize, the risk of illness present in their lives. moreover, many individuals are often unable to apply their knowledge of health practices owing to everyday pressures and stresses. a common example of population-based attempts to motivate the smoking public to reduce its dependence on cigarettes is anti-smoking campaigns. health psychologists help to promote health and well-being by preventing illness. some illnesses can be more effectively treated if caught early. health psychologists have worked to understand why some people do not seek early screenings or immunizations, and have used that knowledge to develop ways to encourage people to have early health checks for illnesses such as cancer and heart disease. health psychologists are also finding ways to help people to avoid risky behaviors (e.g., engaging in unprotected sex) and encourage health-enhancing behaviors (e.g., regular tooth brushing or hand washing). health psychologists also aim at educating health professionals, including physicians and nurses, in communicating effectively with patients in ways that overcome barriers to understanding, remembering, and implementing effective strategies for reducing exposures to risk factors and making health-enhancing behavior changes. there is also evidence from ohp that stress-reduction interventions at the workplace can be effective. for example, kompier and his colleagues have shown that a number of interventions aimed at reducing stress in bus drivers has had beneficial effects for employees and bus companies. illness, disabilities and long-term conditions health psychologists investigate how disease affects individuals' psychological well-being. an individual who becomes seriously ill or injured faces many different practical stressors. these stressors include problems meeting medical and other bills, problems obtaining proper care when home from the hospital, obstacles to caring for dependents, the experience of having one's sense of self-reliance compromised, gaining a new, unwanted identity as that of a sick person, and so on. these stressors can lead to depression, reduced self-esteem, etc. health psychologists can support people living with long-term conditions to improve or maintain quality of life, self-manage their conditions, and adjust to life with an illness, disability or long-term condition. health psychology also concerns itself with bettering the lives of individuals with terminal illness. when there is little hope of recovery, health psychologist therapists can work within a multi-disciplinary palliative care team to improve the quality of life of the patient by helping the patient recover at least some of his or her psychological well-being. health psychologists are also concerned with providing therapeutic services for the bereaved. critical analysis of health policy critical health psychologists explore how health policy can influence inequities, inequalities and social injustice. these avenues of research expand the scope of health psychology beyond the level of individual health to an examination of the social and economic determinants of health both within and between regions and nations. the individualism of mainstream health psychology has been critiqued and deconstructed by critical health psychologists using qualitative methods that zero in on the health experience. conducting research like psychologists in the other main psychology disciplines, health psychologists have advanced knowledge of research methods. health psychologists apply this knowledge to conduct research on a variety of questions. for example, health psychologists carry out research to answer questions such as: what influences healthy eating? how is stress linked to heart disease? what are the emotional effects of genetic testing? how can we change people's health behavior to improve their health? teaching and communication main article: health communication health psychologists can also be responsible for training other health professionals on how to deliver interventions to help promote healthy eating, stopping smoking, weight loss, etc. health psychologists also train other health professionals in communication skills such as how to break bad news or support behavior change for the purpose of improving adherence to treatment. applications improving doctor–patient communication health psychologists aid the process of communication between physicians and patients during medical consultations. there are many problems in this process, with patients showing a considerable lack of understanding of many medical terms, particularly anatomical terms (e.g., intestines). one area of research on this topic involves "doctor-centered" or "patient-centered" consultations. doctor-centered consultations are generally directive, with the patient answering questions and playing less of a role in decision-making. although this style is preferred by elderly people and others, many people dislike the sense of hierarchy or ignorance that it inspires. they prefer patient-centered consultations, which focus on the patient's needs, involve the doctor listening to the patient completely before making a decision, and involving the patient in the process of choosing treatment and finding a diagnosis. improving adherence to medical advice health psychologists engage in research and practice aimed at getting people to follow medical advice and adhere to their treatment regimens. patients often forget to take their pills or consciously opt not to take their prescribed medications because of side effects. failing to take prescribed medication is costly and wastes millions of usable medicines that could otherwise help other people. estimated adherence rates are difficult to measure (see below); there is, however, evidence that adherence could be improved by tailoring treatment programs to individuals' daily lives. additionally, traditional cognitive-behavioural therapies have been adapted for people with chronic illnesses and comorbid psychological distress to include modules that encourage, support and reinforce adherence to medical advice as part of the larger treatment approach. ways of measuring adherence health psychologists have identified a number of ways of measuring patients' adherence to medical regimens: counting the number of pills in the medicine bottle using self-reports using "trackcap" bottles, which track the number of times the bottle is opened. managing pain health psychology attempts to find treatments to reduce or eliminate pain, as well as understand pain anomalies such as episodic analgesia, causalgia, neuralgia, and phantom limb pain. although the task of measuring and describing pain has been problematic, the development of the mcgill pain questionnaire has helped make progress in this area. treatments for pain involve patient-administered analgesia, acupuncture (found to be effective in reducing pain for osteoarthritis of the knee), biofeedback, and cognitive behavior therapy. health psychologist roles below are some examples of the types of positions held by health psychologists within applied settings such as the uk's nhs and private practice. consultant health psychologist: a consultant health psychologist will take a lead for health psychology within public health, including managing tobacco control and smoking cessation services and providing professional leadership in the management of health trainers. principal health psychologist: a principal health psychologist could, for example lead the health psychology service within one of the uk's leading heart and lung hospitals, providing a clinical service to patients and advising all members of the multidisciplinary team. health psychologist: an example of a health psychologist's role would be to provide health psychology input to a center for weight management. psychological assessment of treatment, development and delivery of a tailored weight management program, and advising on approaches to improve adherence to health advice and medical treatment. research psychologist: research health psychologists carry out health psychology research, for example, exploring the psychological impact of receiving a diagnosis of dementia, or evaluating ways of providing psychological support for people with burn injuries. research can also be in the area of health promotion, for example investigating the determinants of healthy eating or physical activity or understanding why people misuse substances. health psychologist in training/assistant health psychologist: as an assistant/in training, a health psychologist will gain experience assessing patients, delivering psychological interventions to change health behaviors, and conducting research, whilst being supervised by a qualified health psychologist. training united kingdom the term "health psychologist" is a protected title, with health psychologists required to register with the health professions council (hpc) and have trained to a level to be eligible for full membership of the division of health psychology within the bps. registered health psychologists who are chartered with the bps will have undertaken a minimum of six years of training, with three of those years dedicated to health psychology training. following the completion of a bps-accredited undergraduate degree in psychology, aspiring health psychologists must first complete a bps-accredited masters in health psychology (stage 1 training). once the trainee has completed stage 1 training, they can either choose to complete the bps' independent stage 2 training route or sign up to an accredited health psychology doctorate program at a uk university (dhealthpsy). both training routes require trainees to demonstrate they meet the core competencies of: professional skills (including implementing ethical and legal standards, communication, and teamwork), research skills (including designing, conducting, and analyzing psychological research in numerous areas), consultancy skills (including planning and evaluation), teaching and training skills (including knowledge of designing, delivering, and evaluating large and small scale training program), intervention skills (including delivery and evaluation of behavior change interventions). at present, there are limited opportunities for trainees to receive fully funded training. the nhs education scotland (nes) stage 2 program funds several trainee health psychologists each year, providing trainees with fixed-term posts within nhs boards across scotland. in 2022, a pilot scheme was launched by health education england (hee) to provide similar opportunities to aspiring health psychologists across england. once qualified, health psychologists can work in a range of settings, for example the nhs, universities, schools, private healthcare, and research and charitable organizations. a health psychologist in training might be working within applied settings while working towards registration and chartered status. all qualified health psychologists must also engage in and record their continuing professional development (cpd) for psychology each year throughout their career. australia health psychologists are registered by the psychology board of australia. the standard pathway to becoming an endorsed health psychologists involves a minimum of six years training and a two-year registrar program. health psychologists must also undertake continuing professional development (cpd) each year. new zealand health psychologists are registered by the new zealand psychologists board within the psychologist scope of practice. the training pathway to becoming a registered health psychologist requires a masters in health