Disease Prevention and Health Promotion Across the Lifespan
Introduction and Explanation of Need
Research on theory-based prevention interventions has been applied across the lifespan, from interventions to prevent difficulties early in life (e.g., to prevent maternal substance abuse during pregnancy, infant mortality, and child abuse and neglect), through prevention strategies for childhood (e.g., to reduce violence, mental health problems, and obesity), adolescence (e.g., to prevent delinquency, bullying, drug abuse, and suicidal ideation and behaviors), young adulthood (e.g., to prevent risky sexual behaviors and sexual assault), and adulthood (e.g., to prevent substance use disorders). While the targeted developmental stage may change, the primary focus of these interventions is on reducing risk and increasing protective factors that can modify proximal outcomes (e.g., self-regulation, skill development) as well as long-term, distal outcomes including psychological health, substance abuse, physical health, and other important areas (e.g., improved academic achievement and employment). Indeed, interventions designed to prevent mental illnesses and substance abuse disorders have shown efficacy and effectiveness in modifying a wide array of individual outcomes such as improving cognitive ability, emotional regulation, and physical health, and reducing risky behavior. These interventions have also been shown to improve other outcomes not targeted by the interventions (e.g., risky sexual behaviors and suicidal ideation and behaviors).
There has been a growing interest in the use of complementary health approaches, especially meditative approaches, for the prevention of mental, emotional, and behavioral disorders, and for the promotion of psychological and physical health, well-being, and resilience. 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, and neurological function. However, the evidence for the use of complementary modalities in the context of prevention and health promotion is modest. Furthermore, a small body of research examining the use of complementary and integrative approaches for the prevention of substance abuse, mental health problems, and obesity in youth exists, though the evidence base is quite limited.
There is a great interest in determining whether these approaches have an impact on a wide array of behaviors that promote health and prevent disease, particularly for children, adolescents, families, and young adults. Rigorously designed, developmentally appropriate studies are needed to determine the efficacy and effectiveness of complementary and integrative health approaches for health promotion and disease prevention across the lifespan. It is also essential to gain a better understanding of the mechanisms of action of these interventions and to determine what works, for whom, and under what conditions. NCCIH, therefore, seeks to support research that could expand the evidence base on meditative approaches for preventing mental, emotional, and behavioral disorders and for the promotion of psychological and physical health.
What Does Success Look Like?
Over the course of the next 5 to 10 years, the research NCCIH supports in this area will lead to an increased number of efficacious and effective life-course specific complementary health-promoting and disease-prevention approaches (e.g., mind and body interventions) that can be delivered at different levels (e.g., universal, selective, indicated), in different contexts (e.g., family, school, community, medical centers, child welfare and juvenile justice systems, and homeless shelters) that also include populations at risk (e.g., families living in poverty, children who have experienced abuse, and military families).
- Develop and test theory-based interventions that are, in general, developmentally appropriate and that also target vulnerable populations1 across levels of intervention in different settings.2 The interventions should be designed to have an impact on a broad array of outcomes, including cognitive, emotional, behavioral, and physical health.
- Investigate mechanisms of action, including underlying behavioral processes and the underlying biological and neurobiological mechanisms that are modified by an intervention.
- Develop and refine sensors and other innovative technologies (e.g., smartphone apps and wearable activity monitors) that can be used to deliver and measure prevention intervention effects and outcomes.
Prenatal Through Young Adulthood
- Develop and test complementary and integrative prevention approaches that include the adults most influential in children’s lives (e.g., teachers, parents, and other caregivers), with the goal of improving the development and well-being of children.
- Utilize outcome measures that employ multiple methods (e.g., neurobiological, behavioral) for those involved in, or the focus of, the intervention (e.g., students, teachers, parents).
- Develop and test theory-based mind and body prevention interventions for adolescents and young adults, including universal interventions for the general population and selective, indicated interventions for those who are particularly vulnerable.
- Develop and test theory-based mind and body prevention interventions focused on older populations, including the general population and those at increased risk for depression, anxiety, and other mental health disorders.
Areas of Low Programmatic Priority
- Natural products interventions for prevention and health promotion across the lifespan.
1Examples of vulnerable populations include children and families living in poverty, including high-risk pregnant women; racial/ethnic minorities; and sexual minorities.
2Examples of settings include families, schools, health care, child welfare, juvenile justice, and the workplace (e.g., employer-based wellness settings).
Top Scientific Priorities
- Nonpharmacologic Management of Pain
- Neurobiological Effects and Mechanisms
- Innovative Approaches for Establishing Biological Signatures of Natural Products
- Disease Prevention and Health Promotion Across the Lifespan
- Clinical Trials Utilizing Innovative Study Designs To Assess Complementary Health Approaches and Their Integration Into Health Care
- Communications Strategies and Tools To Enhance Scientific Literacy and Understanding of Clinical Research