Health Restoration, Resilience, Disease Prevention, and Health Promotion Across the Lifespan

Introduction and Explanation of Need

There continues to be a growing interest in the use of complementary and integrative health approaches for preventing the onset of mental, emotional, and behavioral disorders, promoting psychological and physical health and well-being, and enhancing cognitive, emotional, and behavioral resilience in people who have experienced stressful or adverse life events. However, there has been limited research to examine the usefulness of these approaches as strategies for early intervention among individuals at increased risk for the purpose of preventing disease progression and supporting health restoration. Research has demonstrated the feasibility of conducting interventions that incorporate complementary and integrative health approaches, especially meditative approaches, for health promotion and disease prevention, particularly among adult populations. Additional research is needed to evaluate the feasibility of a wider range of interventions (e.g., music, guided imagery, qi gong, massage, dietary interventions), including multicomponent interventions (e.g., spinal manipulation combined with meditation), across the full lifespan and in diverse populations and settings.

The evidence base for the efficacy and effectiveness of complementary and integrative approaches in the context of prevention, health promotion, resilience, and health restoration is limited and primarily includes studies of single systems at the individual level. NCCIH-funded studies have shown efficacy primarily for mindfulness-based stress reduction for improving factors related to many physical and mental health conditions in adults, including indices of immune, endocrine, metabolic, and neurological function.

Rigorously designed, developmentally appropriate studies are needed to determine the efficacy and effectiveness of a wider array of complementary and integrative health approaches that include a focus on multiple systems to support whole person health and that address multiple levels of influence (e.g., interpersonal, community, societal) on health outcomes. It is also essential to gain a better understanding of mechanisms related to resilience and health restoration in response to these interventions and to determine what works, for whom, and under what conditions. In fact, there is a fundamental lack of translational research on the mechanisms of resilience and health restoration in humans. In particular, the mechanisms of physical, psychological, and nutritional interventions in restoring health after an acute illness, or reversing the course of a chronic one, is an understudied area that needs a multisystem approach to identify mechanisms and predictive biomarkers that could be used to optimize and predict the beneficial effects of the interventions. NCCIH therefore seeks to support research that could expand the mechanistic and evidence base on complementary health approaches for preventing mental, emotional, and behavioral disorders and for promoting psychological and physical health, resilience, and health restoration.

What Does Success Look Like?

NCCIH supports a robust portfolio of efficacy and effectiveness life course–specific studies with a range of complementary and integrative health approaches for health promotion and restoration, resilience, and disease prevention among diverse populations.
This portfolio includes studies that use multicomponent interventions to study multisystem contributions to health promotion and restoration, resilience, and disease prevention.
Basic and mechanistic research leads to the discovery of mechanisms and biomarkers of multicomponent interventions for health promotion and restoration, resilience, and disease prevention.

Priorities

Encourage research to develop and test the efficacy and effectiveness of complementary and integrative approaches for health promotion and restoration, resilience, and disease prevention in diverse settings⁴ and among health disparity and other vulnerable populations⁵ across the full lifespan.
Support research on the use of complementary and integrative health approaches among health disparity and vulnerable populations to overcome the role of social and structural determinants of health.
Support multicomponent interventions designed to have an impact on a broad array of outcomes and multiple systems and assess the utility of these interventions for improving whole person health.
Investigate innovative mechanisms of action and identify predictive biomarkers underlying behavioral processes and biological, neurobiological, and psychological mechanisms that are modified by one or multiple interventions across multiple systems.
Conduct impactful translational research on the mechanisms of multicomponent interventions on health promotion and restoration, resilience, and disease prevention that may be used to optimize the beneficial effects of these interventions.
Develop and refine innovative technologies (e.g., smartphone apps and wearable activity monitors) that can be used to deliver and measure interventions and outcomes in real time.

⁴Examples of diverse settings include families, schools, Federally Qualified Health Centers, child welfare and juvenile justice systems, and homeless shelters.

⁵NIH-designated health disparity populations include racial and ethnic minorities (Blacks/African Americans, Hispanics/Latinos, American Indians/Alaska Natives, Asians, and Native Hawaiians and other Pacific Islanders), sexual and gender minorities, socioeconomically disadvantaged populations, and underserved rural populations. Other vulnerable populations include high-risk pregnant women, homeless youth, children with disabilities, children who have experienced abuse, and military families.

Prenatal Through Young Adulthood

Develop and test theory-based early interventions for adolescents and young adults at high risk for adverse health outcomes to slow progression of disease, support health restoration, and improve resilience.
Develop and test complementary and integrative prevention approaches that include the adults most influential in children’s lives (e.g., parents, teachers, and other caregivers), with the goal of improving development and well-being of children.
Test implementation strategies for improving uptake, scale-up, and sustainability of evidence-based interventions for promoting mental, emotional, and behavioral health among children and adolescents in diverse settings.
Conduct innovative mechanistic studies and identify predictive biomarkers underlying the effects of multicomponent interventions across multiple systems for health promotion, restoration, resilience, and disease prevention in adolescents and young adults.

Older Populations

Develop and test nutritional, psychological, and physical interventions focused on older populations⁶, including the general population and those at increased risk for depression, anxiety, and other mental health disorders.
Perform impactful basic and translational research on the mechanisms of multicomponent interventions in promoting healthy aging, health restoration, resilience, and disease prevention in older populations.

⁶NIH defines an older adult as an individual 65 years of age or older.