RWJF Media Release

New Program To Tackle Physical Inactivity, Smoking, Poor Diet, and Risky Drinking Through Primary Care

RWJF To Award Up To $5 Million In Grants To Help Health Care Providers Promote Healthy Behaviors Among Their Patients

Princeton, N.J. – The Robert Wood Johnson Foundation (RJWF) and the Agency for Healthcare Research and Quality (AHRQ), working together, are launching a five-year program aimed at developing effective, practical strategies for changing Americans’ unhealthy behaviors through primary care.

The goal is to reverse four risky behaviors that have been identified as the nation’s leading causes of preventable disease and premature death: physical inactivity, poor diet, tobacco use, and risky alcohol use. The new program, called Prescription for Health, will seek to identify ways for primary care physicians and their staff, including nurse practitioners and physician assistants, to help their patients become more physically active, eat better, avoid or quit smoking, and use alcohol in moderation.

“Primary care providers who see patients every day have enormous power to motivate people to make healthy lifestyle changes,” said J. Michael McGinnis, M.D., senior vice president and director of RWJF’s health group. “We hope this program can help those on the frontlines of health care lead the way for active, healthy living.”

Research shows that unhealthy behaviors account for 40 percent of premature deaths in this country. More than 46.5 million American adults continue to smoke, despite the well-known dangers. Nearly 14 million adults drink too much alcohol, raising their risk for liver disease, accidents, and trauma. More than 60 percent of American adults are overweight and nearly 40 percent are too sedentary—increasing their susceptibility to heart disease, diabetes, and high blood pressure.

“We need to start a revolution in human health behavior, and primary care physicians are in a perfect position to lead that revolution,” said Larry Green, M.D., director of Prescription for Health and a professor of family medicine at the University of Colorado Health Sciences Center. “Most people go to their primary care provider for most of their health care. These visits are great opportunities for providers to teach their patients healthy behaviors.”

Collaborating with RWJF on Prescription for Health is the federal Agency for Healthcare Research and Quality (AHRQ), which will provide $6 million over two years to help the PBRNs develop the systems and infrastructures they need to develop and test their ideas. Under Prescription for Health, RWJF will award up to $5 million in two rounds of grants to identify strategies for two or more risky behaviors that can be applied in routine primary care practice, evaluated and disseminated widely. Primary care practice-based research networks (PBRNs) – groups of practices whose principal purpose is to provide patient care but affiliate with each other to conduct state-of-the-art research – will be eligible to apply for these grants.

“These networks are laboratories in which we hope to find practical solutions for advancing primary care,” Green said. “In that way, the ideas for this program will be coming from people who are where the rubber meets the road.”

In the first round of grants, the Foundation will support up to 20 16-month innovation grants of up to $125,000 each. Proposed innovations will outline new models of care or tools for changing health-related behaviors. These may include:

• innovations to expand and improve health behavior counseling in primary care settings;
• strategies for integrating behavior change interventions more easily into everyday care – for example, by changing staff responsibilities or implementing patient reminder systems;
• tapping into community resources – such as schools, public health departments, and social service agencies – to increase patients’ options and support them in their efforts to change or avoid unhealthy behaviors.

“By coming up with even a handful of effective innovations, we will be able to improve and extend the lives of millions of people,” Green said.

A subsequent call for proposals to be issued in 2004 will solicit a second round of innovation grants, as well as controlled studies to further test and refine promising first-round innovations.

A resource center directed by the Indiana University School of Medicine and the National Opinion Research Center will provide technical and consultative support to grantees. It will be funded by the Agency for Healthcare Quality and Research and the National Institutes of Health – Office of Behavioral and Social Science Research.

Green said he envisions posting best practices identified through the program on the Prescription for Health web site. In addition, he said, the program will foster collaborations with a number of key primary care societies so that important information and lessons learned can be communicated nationwide.

Guidelines for grant applications with complete instructions are available at www.prescriptionforhealth.org. Deadline for proposals is 2 pm ET, Feb. 28, 2003.

The Robert Wood Johnson Foundation, based in Princeton, N.J., is the nation’s largest philanthropy devoted exclusively to health and health care. It concentrates its grantmaking in four goal areas: to assure that all Americans have access to basic health care at reasonable cost; to improve care and support for people with chronic health conditions; to promote healthy communities and lifestyles; and to reduce the personal, social and economic harm caused by substance abuse—tobacco, alcohol, and illicit drugs.