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Pushing for personalized public health

When a research colleague asked Colleen McBride if she'd like to join him on a sailing trip along the Turkish coast, she accepted immediately. No matter that she did not know the other four people who were taking the trip. Or that she didn't know how to sail. Or that she is prone to seasickness.

So why would she go?

"Why not?" says McBride, a behavioral epidemiologist.

McBride, whose sailing adventure turned out just fine, brings that venturesome spirit to her new post as chair of the Department of Behavioral Sciences and Health Education. She plans to build on her previous work as the founding chief and senior investigator of the Social and Behavioral Research Branch of the National Human Genome Research Institute (NHGRI). In that position, McBride was among the first to focus on using genetic information to inform public health interventions—the public health equivalent of personalized medicine.

"All the discoveries coming out of basic science, particularly genetics, are shaking up other fields, but they are not making a lot of changes in the way things are done in behavioral science," says McBride. "I would like to see us apply scientific imagination in bringing the worlds of genetics and behavioral sciences together."

Specifically, McBride would like to put that scientific imagination to work in addressing a vexing problem for behavioral scientists—relapse rates. "We can get people to lose weight, but they gain it back," she says. "We can get people to exercise, but they fall off. We can get people to stop smoking, but they start again. And we don't pay a lot of attention to why that happens."

Genetics can provide some answers, she believes. How people react to behavior change interventions is influenced by their genetic makeup. Some people get a "runner's high" when they exercise, for example. Others take more effort to get the same high or do not get one at all. Some people suffer mood dips when they are calorie deprived, and others don't. If people could be grouped by different traits, perhaps interventions could be tailored to provide a better fit.

"I'm not envisioning that we could customize interventions to each individual's genome," says McBride. "But if we could identify phenotypes—groups of people who share similar traits—we could get away from the one-size-fits-all interventions and move toward customization."

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