Concept: Multilevel Physical Activity Interventions To Improve Health and Well-Being Initiative

Project Concept Review

Council Date: September 25, 2020 

Program Director: Lanay M. Mudd, Ph.D., NCCIH; Jacqueline Lloyd, Ph.D., M.S.W., ODP         

Background

The National Center for Complementary and Integrative Health (NCCIH) currently participates in a variety of funding opportunities in support of our strategic priority to “Foster Health Promotion and Disease Prevention.” NCCIH recognizes the importance of promoting healthy behaviors, such as physical activity, and that complementary and integrative health approaches may be useful for promoting healthy behaviors. In fact, National Health Interview Survey data show that over 60 percent of adults who practice yoga say yoga motivated them to exercise more (see Survey data).  

NCCIH actively works with the National Institutes of Health (NIH) Office of Disease Prevention (ODP) on health promotion and disease prevention initiatives across a variety of topics. ODP coordinates NIH-wide activities and initiatives focused on disease prevention. Today, about half of all American adults—117 million people—have one or more preventable chronic diseases. Seven of the 10 most common chronic diseases are favorably influenced by regular physical activity. Despite the well-established health benefits of physical activity, 80 percent of adults are not meeting the Physical Activity Guidelines for both aerobic and muscle-strengthening activity, while only about half meet the guidelines for aerobic physical activity. 

A growing body of research continues to provide insight into what works to engage people in physical activity, both at the individual and community levels (Physical Activity Guidelines for Americans, 2nd edition, 2018). While evidence indicates that interventions provided simultaneously at several levels, for example, across the Socio-Ecological Model (individual, interpersonal, organizational, community, and policy), are most likely to be successful in achieving increases in physical activity, the interventions that have been tested are primarily focused on one level (e.g., individual, community, or built environment). The 2018 Physical Activity Guidelines Advisory Committee identified the need to develop and systematically test multicomponent interventions that span multiple socioecological levels as a research gap, which is important and critical for informing the scientific base for physical activity guidelines.

Purpose of Proposed Initiative

This initiative is intended to encourage highly innovative and promising research aimed at developing and testing multilevel physical activity interventions to improve health and well-being. The proposed initiative will solicit research on interventions acting on at least two socioecological levels or two or more domains or levels of the National Institute on Minority Health and Health Disparities Research Framework. Furthermore, this initiative will be targeted toward research to increase health-enhancing physical activity: 1) in persons or groups that can benefit from such activity; 2) that can be implemented in settings where these populations are and can be accessed, and 3) that could be made scalable and sustainable for broad use across the nation. 

Research priorities will include physical activity as a primary outcome; studies that examine physical activity in relation to clinical and health outcomes; studies on the role of health disparities and social determinants of health in physical activity promotion; implementation science research; and application of technology innovations for physical activity promotion. Engagement and partnership with community and relevant sector partners in the research will be encouraged. The initiative will encourage research planning activities, developmental work, feasibility and pilot studies, and large-scale clinical trial studies. 

As the lead office at NIH responsible for facilitating and stimulating research in disease prevention, ODP will lead the initiative and will seek NIH-wide participation. At this time, there are eight participating Institutes, Centers, and Offices: NCCIH, the National Cancer Institute, the National Institute on Aging, the National Institute on Alcohol Abuse and Alcoholism, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute on Drug Abuse, the National Institute on Minority Health and Health Disparities, and ODP. ODP will consider providing co-funding to meritorious projects that NCCIH (or another participating Institute or Center) chooses to fund. This initiative would address a critical need for research on multilevel interventions to promote health-enhancing physical activity across a variety of populations.

Objectives

The objectives to be met by the initiative include but are not limited to the following: 

• Encourage and support research to address gaps and build the evidence base for multilevel interventions to increase health-enhancing physical activity. 
• Encourage and support research to build the knowledge and evidence base for strategies to adopt, implement, and sustain evidence-based multilevel physical activity interventions in the places and settings where people live, work, play, and spend their time. 
• Encourage and support research to address multilevel social and structural determinants of health and develop evidence-based multilevel physical activity interventions for populations that are underserved, are marginalized, and experience health disparities. 
• Encourage and support studies that engage key community, sector, and relevant setting stakeholders in research on health-enhancing physical activity multilevel interventions. 

NCCIH-specific objectives for this concept would include the incorporation of mind and body approaches in multilevel interventions that address the above objectives. This concept fully aligns with NCCIH’s strategic priority to foster health promotion and disease prevention.