Four teenagers sitting together with their backs facing forward, chatting.

Six key ways to help young people engage in better, healthier lives

25 March 2024
Project Spotlight: Health4Life

In this edition of our Project Spotlight, we chat with Dr Katrina Champion from the Health4Life project. We discuss the six modifiable risk factors that affect young people’s health, how Health4Life utilises digital wellbeing approaches, and what they want to see from the project long-term.

the words health4life written in multicolours, with a circle with intersecting sides on the right.

Australians face growing health challenges around long-term health as data shows rising rates of mental ill-health and obesity in the country. Statistics from the National Health Survey 2022 showed that one in two Australians have at least one chronic condition in their lifetime, with mental and behavioural conditions and chronic illnesses often associated with sedentary lifestyles most common. 

Sedentary lifestyles are related to rising rates of obesity in the country, which also shares many underlying behavioural risk factors with mental ill-health. As many of these behavioural risk factors can be prevented, researchers at the Matilda Centre are investigating methods to support young Australians towards positive lifestyle factors for their long-term health.  

Health4Life aims to use evidence-based resources and rigorous evaluation to help modify six identified risk factors. The program, after being trialled with over 6600 school students in Australia, has resulted in a world-first school-based program that uses interactive cartoon storylines and web-based delivery to engage students on goal-setting and self-monitoring of behaviours. 

The six major risk factors are:

Young people are recommended to sleep between 9-11 hours (5-13 year olds) per night, and 8-10 hours (14-17 year olds) per night.

Young people are recommended to limit their consumption of sugar sweetened beverages.  

Children and young people are recommended to do at least 60 minutes of moderate to vigorous physical activity each day.

Young people are not recommended to consume more than two hours of recreational sedentary screen time a day.

People under 18 are recommended to not consume alcohol in any capacity. Tobacco has no national guidelines.  

We caught up with Dr Katrina Champion to ask about recent research into the program, why the six risk factors, and what makes Health4Life different from other wellbeing options. 

What is the purpose of the Health4Life program?

Health4Life is a school-based eHealth intervention that we developed in consultation with students and teachers across Australia and a large multidisciplinary research team. The aim of the program is to empower young people to improve their health and wellbeing by targeting six key risk factors associated with chronic disease (“the Big Six”).

Why the Big Six risk factors? How did the program get to six, and why those ones?  

We [the Health4Life team] chose to focus on these big six risk factors because we know that they are strongly associated with chronic disease and mental illness. These factors are also prevalent among Australian youth and commonly co-occur with one another. This was important as we hoped that because they were inter-related, we could target them together to have greater impact.

There are many different programs on the market that claim to support mental health and ‘wellbeing.’ How is Health4life different?

A key point of difference when we were designing the program was that we were using a multiple health behaviour change approach.

Many of the programs that had already been developed targeted risk factors in isolation. For example, there were programs for alcohol use or programs for physical activity, whereas we adopted a holistic approach to try and target multiple risk factors at the same time in a more efficient way.

What has the Health4Life study found over the years?

From 2019 to 2022, our team trialled the Health4Life intervention via a rigorous clinical trial in 71 secondary schools and 6640 students across WA, QLD and NSW, making it one of the largest prevention trials in Australian adolescents. Half of the schools received Health4Life and the other half delivered their usual health education. Our dedicated research assistants, including current research assistants Bridie Osman and Emily Hunter from the Matilda Centre, achieved outstanding retention rates, collecting data from over 75% of the original sample two years later.

Overall, there were no differences between students who received Health4Life versus those who didn’t, in terms of their health behaviours. However, Health4Life did significantly improve students’ knowledge about the Big Six, with effects lasting for up to two years. Teachers and students also rated the program favourably and found it easy to implement in a school setting. As part of her PhD, Scarlett Smout is looking at the impact of Health4Life on students' mental health, with results to be published soon.

Do we see any differences in regional/rural areas, as opposed to cities? 

This is something that Lyra Egan is investigating as part of her PhD. For the most part, we didn't find any differences. When we looked at the outcomes of the trial by schools in regional areas compared to major cities and different socio-economic groups we didn't find any big differences in terms of the outcomes.

One reason behind this disparity in results is that Health4Life was not specifically designed for regional areas, which may have unique characteristics and challenges that the intervention did not adequately address.

One area we did see a difference geographically was that Health4Life had varying effects on diet and diet-related intentions. We found that Health4Life participants in regional areas had higher odds of reporting a poor diet, while those in major cities had higher odds of improving diet-related intentions, compared to the control group.

What does the team want to see out of Health4life long-term? 

We are working on several things at the moment, including two large MRFF-funded studies to expand our work in this area.

We are developing a new intervention for parents to help them to understand how they can promote healthy lifestyles among their teenage children. This study has a specific focus on parents and teens from low socio-economic backgrounds, as we know that rates of the Big 6 are higher among these populations.

Dr Louise Thornton is also leading a study to understand ways to get young people to better engage with apps such as the Health4Life app.  

Finally, we are also looking at ways to refine the Health4Life program, before making it available to schools via the OurFutures Institute.

Health4Life is currently recruiting participants for a trial to understand how to best engage adolescents with health apps. To find out more, get in contact with the team today.