Advising modifiable lifestyle changes and public health: The role, knowledge, and education of UK optometrists

  • Nicola Julie Milhench

Student thesis: Doctoral ThesisDoctor of Optometry


Improvements in life expectancy are starting to stall, which is accompanied by a reduction in quality of-life due to the effect of non-communicable diseases (NCD) (Raleigh, 2021) and eye conditions. Many of which can be improved by modifying lifestyle choices (JBS3, 2014). UK government initiatives have been designed to address this growing healthcare concern (Patel et al., 2020).

People visit UK optometrists when they are in good and poor health, including those who do not see a general practitioner. A person’s risk of NCDs and eye conditions can be identified via questioning during a routine sight test (The College of Optometrists, 2021). Currently this information is not routinely used beyond the association with the eye examination.

One ongoing UK government initiative, Making Every Contact Count, encourages primary care healthcare professionals to discuss modifiable lifestyle changes (Public Health England, 2016) with patients. The optometric profession does not have specific guidelines for modifiable lifestyle change counselling, therefore the overall aim of this thesis was to determine if optometrists have the skills and knowledge to advise patients in this way and whether it is appropriate for them to do so.

The findings from the systematic review indicated no previous study had assessed these questions regarding UK optometrists. In the present study the NUTCOMP questionnaire, adapted for UK optometrists, indicated a lack in confidence and competence regarding lifestyle modification counselling, an agreement it was within their scope of practice and a desire for further education. A
Delphi Analysis to investigate the preferred methods of learning by UK optometrists, indicated a desire for multi-faceted education with in-person and on-line learning both in theory and practice. Therefore this thesis has identified that with appropriate support and training optometrists could have the skills and knowledge to participate actively in modifiable lifestyle change counselling.
Date of AwardMar 2023
Original languageEnglish
SupervisorNicola Logan (Supervisor) & Duane Mellor (Supervisor)


  • Optometry
  • nutrition
  • smoking
  • non-communicable diseases
  • curriculum
  • Delphi Analysis

Cite this