Individually-adapted physical activity programs

There is strong evidence that individually-adapted physical activity programs increase physical activity and physical fitness for children and adults (CG-Physical activity, Cochrane-Foster 2005, Kahn 2002). Behavior change techniques such as goal setting and self-monitoring, components of individually-adapted physical activity programs, have been shown to increase physical activity among overweight and obese adults (Samdal 2017, Annesi 2015).

Programs that focus on goal setting, self-monitoring, building social support, behavioral reinforcement, and structured problem solving have been shown to increase physical activity and physical fitness in a variety of settings, including worksites and schools (CG-Physical activity); these behavior change techniques have been shown to enhance school-based, family-based, and community-based physical activity interventions (Bleich 2018). Participants in individually-adapted physical activity programs that use behavior change techniques such as goal setting, progress monitoring, and self-regulating also improve mood when their physical activity increases by at least two sessions per week (Annesi 2015).

There is some evidence suggesting individually-adapted interventions can have positive spillover effects among parents and siblings in nutrition-related outcomes (Brown 2024a). An Australia-based study of a multi-component school-based intervention with personalized physical activity plans suggests such plans increase time spent in moderate-to-vigorous physical activity (MVPA) among adolescents in disadvantaged schools (Sutherland 2016).

Programs that combine professional guidance and self-direction appear to have more consistent effects than programs that lack professional guidance (Cochrane-Foster 2005). Program effects may be stronger when programs provide in-person training to facilitators; online facilitator training may not be as impactful but can be effective in some places (Lee 2019a). In some circumstances, when behavioral change interventions are combined with exercise programs, participants have been shown to improve weight status (Lombard 2009, Cislak 2012, Verweij 2011).

It is unclear what impact individually-adapted physical activity interventions have on disparities in physical activity between populations with different racial/ethnic backgrounds, ages, and income levels.

Black men experience higher mortality rates from chronic conditions compared to Black women and men in other racial or ethnic groups (Newton 2014). Physical activity, nutrition, and obesity prevention interventions have successfully used individually-adapted behavioral change strategies, especially self-monitoring, goal setting, progress monitoring, and planning, to increase physical activity levels among Black men (Newton 2014).

Data from 2013 to 2023 suggests that female and LGBTQ+ youth were less likely to meet recommended levels of physical activity than their peers, and the percentage of Hispanic and Black adolescents meeting physical activity guidelines decreased (CDC-YRBSS 2025). Available evidence shows Hispanic, Black, Native American, and Alaska Native adults, especially with lower incomes, are less likely to engage in leisure time physical activity than white and Asian adults, especially with higher incomes (Hawes 2019, ACSM AFI-Sallis 2019, CDC-API), likely due in part to living in neighborhoods with less access to safe places for physical activity and lack of supports for active lifestyles (Patel 2022b). Overall, communities whose residents are primarily people of color with lower incomes have less access to parks and recreational facilities for physical activity than white and high income neighborhoods (ALR-Disparities 2011), though quality of parks and the built environment can vary widely at the local level (ACSM AFI-Sallis 2019).

The built environment in under-resourced communities is a significant contributor to health inequities for people of color with low incomes (Prochnow 2022, McAndrews 2022, Brookings-Semmelroth 2020). During the Industrial Revolution, parks were largely developed to allow wealthy residents access to space that was free from unsanitary conditions and the congestion of crowded cities (NRPA-Equity 2021). Discriminatory housing, lending, and exclusionary zoning policies led to concentrated poverty and entrenched residential segregation (Kaplan 2007), including segregation of parks and recreation facilities. Between 1930 and the 1970s, while the government invested in parks in wealthier, white neighborhoods, parks and facilities in minority areas were neglected (NRPA-Equity 2021). City ordinances outlawed integrated forms of recreation (NRPA-Fleming 2021). Disinvestment in and unequal distribution of recreational facilities, parks, and green space means that communities with low incomes and communities of color have fewer places to engage in outdoor activities, have less access to cooling shade, and experience poorer air quality (CAP-Rowland-Shea 2020, TPL-Chapman 2021).

Today, these formerly redlined, low income neighborhoods are more likely to be considered physical activity deserts, without access to gyms, safe green spaces, and built environments conducive to physical activity (VWH-Brown 2022). Urban areas, which are often primarily populated by individuals of color, usually have the least amount of green space available per person, limiting communities’ access to free physical activity. Four of the five cities in the U.S. with the least amount of green space are majority people of color (MH-Lawrence 2020).

Available evidence clearly shows the benefits of physical activity for health, however as people get older, their physical activity declines (Suryadinata 2020). Individually-adapted interventions were designed to use widely applicable behavioral management skills to support individuals in initiating and maintaining healthier behaviors, including physical activity (Kahn 2002). These interventions are intended to be effective even with the structural barriers or challenges present in many communities (Rhodes 2024).

• What physical activity programs are available in your community that can be individually adapted? What are programs doing to increase accessibility and affordability for participants?
• How are physical activity programs designed to support individuals in neighborhoods with low incomes? Or racially/ethnically diverse communities? Are programs culturally adapted to encourage participation among different communities of color?
• Who is making decisions about physical activity program offerings and budgets in your community? What community engagement strategies could help identify and address barriers to participation?

Individually-adapted physical activity programs are implemented throughout the country. Programs can be implemented as independent single component programs or combined to compliment other interventions. Examples include the University of North Carolina’s program A New Leaf…Choices for Healthy Living (A New Leaf), the Community Healthy Activities Model Program for Seniors (CHAMPS), the University of New Mexico’s Step into Cuba program (UNM PRC-Step into Cuba), the MEND program (UCL-MEND) and the Move Your Way program (US DHHS-Move). The National Cancer Institute maintains a list of evidence-based physical activity programs (NCI-PA list).

There are several physical activity programs designed to be adaptive to be accessible for people with disabilities, including the Indiana University’s Adapted Movement Programs (IU-AMP) and the 14 Weeks to a Healthier You program by the National Center on Health, Physical Activity and Disability (NCHPAD-14 weeks).

CDC-PA strategies - Centers for Disease Control and Prevention (CDC). Strategies that work for increasing physical activity.

Results for America-IAPAP - Results for America. (n.d.). Individually-adapted physical activity programs. Retrieved April 15, 2025.

* Journal subscription may be required for access.

A New Leaf - WiseWoman. A new leaf…choices for healthy living: Assessment and counseling for nutrition, physical activity, smoking cessation, and osteoporosis prevention.

ACSM AFI-Sallis 2019 - Sallis J. Disparities in the quality of physical activity environments. American College of Sports Medicine (ACSM) American fitness index. 2019.

ALR-Disparities 2011 - Active Living Research (ALR). Do all children have places to be active? Disparities in access to physical activity environments in racial and ethnic minority and lower-income communities. Princeton: Robert Wood Johnson Foundation (RWJF); 2011.

Annesi 2015 - Annesi JJ, Nandan M, McEwen K. Effects of two cognitive-behavioral physical activity and nutrition treatments on psychosocial predictors of changes in fruit/vegetable and high-fat food intake, and weight. Hellenic Journal of Psychology. 2015;12(1):40-64.

Bleich 2018* - Bleich SN, Vercammen KA, Zatz LY, et al. Interventions to prevent global childhood overweight and obesity: A systematic review. The Lancet Diabetes & Endocrinology. 2018;6(4):332-346.

Brookings-Semmelroth 2020 - Semmelroth L. How Wilmington, Del. is revitalizing vacant land to rebuild community trust. Washington, D.C.: Brookings Institution; 2020.

Brown 2024a - Brown, V., Tran, H., Jacobs, J., Ananthapavan, J., Strugnell, C., Backholer, K., Sultana, M., Alsubhi, M., Allender, S., Novotny, R., & Nichols, M. (2024). Spillover effects of childhood obesity prevention interventions: A systematic review. Obesity Reviews, 25(4), e13692.

CAP-Rowland-Shea 2020 - Rowland-Shea J, Doshi S, Edberg S, Fanger R. The nature gap: Confronting racial and economic disparities in the destruction and protection of nature in America. Washington, D.C.: Center for American Progress (CAP); 2020.

CDC-API - Centers for Disease Control and Prevention (CDC). Adult physical inactivity outside of work.

CDC-YRBSS 2025 - Centers for Disease Control and Prevention. (2024). Youth risk behavior survey data summary & trends report for dietary, physical activity, and sleep behaviors: 2013–2023. U.S. Department of Health and Human Services.

CG-Physical activity - The Guide to Community Preventive Services (The Community Guide). Physical activity.

CHAMPS - Community Healthy Activities Model Program for Seniors (CHAMPS). University of California San Francisco.

Cislak 2012* - Cislak A, Safron M, Pratt M, Gaspar T, Luszczynska A. Family-related predictors of body weight and weight-related behaviours among children and adolescents: A systematic umbrella review. Child: Care, Health and Development. 2012;38(3):321-31.

Cochrane-Foster 2005* - Foster C, Hillsdon M, Thorogood M, Kaur A, Wedatilake T. Interventions for promoting physical activity. Cochrane Database of Systematic Reviews. 2005;(1):CD003180.

Hawes 2019 - Hawes AM, Smith GS, McGinty E, et al. Disentangling race, poverty, and place in disparities in physical activity. International Journal of Environmental Research and Public Health. 2019;16(7):1193-1205.

IU-AMP - Indiana University (IU). (n.d.). Adapted Movement Program (AMP): Making activity accessible for everyone. Retrieved April 15, 2025.

Kahn 2002* - Kahn, E. B., Ramsey, L. T., Brownson, R. C., Heath, G. W., Howze, E. H., Powell, K. E., Stone, E. J., Rajab, M. W., & Corso, P. (2002). The effectiveness of interventions to increase physical activity. A systematic review. American Journal of Preventive Medicine, 22(4 Suppl), 73–107.

Kaplan 2007* - Kaplan J, Valls A. Housing discrimination as a basis for Black reparations. Public Affairs Quarterly. 2007;21(3):255-273.

Lee 2019a - Lee, R. M., Barrett, J. L., Daly, J. G., Mozaffarian, R. S., Giles, C. M., Cradock, A. L., & Gortmaker, S. L. (2019). Assessing the effectiveness of training models for national scale-up of an evidence-based nutrition and physical activity intervention: A group randomized trial. BMC Public Health, 19(1), 1587.

Lombard 2009 - Lombard CB, Deeks AA, Teede HJ. A systematic review of interventions aimed at the prevention of weight gain in adults. Public Health Nutrition. 2009;12(11):2236-46.

McAndrews 2022* - McAndrews C, Schneider RJ, Yang Y, et al. Toward a gender-inclusive Complete Streets movement. Journal of Planning Literature. 2022;38(1):3-18.

MH-Lawrence 2020 - Lawrence A. How race, class, and geography keep some people from great workouts. Men’s Health (MH). 2020.

NCHPAD-14 weeks - National Center on Health, Phyiscal Activity and Disability. (n.d.). 14 weeks to a healthier you: Engage in wellness. Your move. Your way. Retrieved April 15, 2025.

NCI-PA list - U.S. Department of Health and Human Services, National Institutes for Health, National Cancer Institute (NCI). (n.d.). Physical activity evidence-based programs listing. Retrieved April 15, 2025.

Newton 2014 - Newton RL, Griffith DM, Kearney WB, Bennett GG. A systematic review of weight loss, physical activity and dietary interventions involving African American men. Obesity Reviews. 2014;15(S4):93-106.

NRPA-Equity 2021 - National Recreation and Park Association (NRPA). Equity in parks and recreation: A historical perspective.

NRPA-Fleming 2021 - Fleming K. Observing from a lens of equity. National Recreation and Park Association (NRPA). 2021.

Patel 2022b - Patel, N. A., Kianoush, S., Jia, X., Nambi, V., Koh, S., Patel, J., Saeed, A., Ahmed, A., Al-Mallah, M., Agarwala, A., Virani, S., & Al Rifai, M. (2022). Racial/ethnic disparities and determinants of sufficient physical activity levels. Kansas Journal of Medicine, 15(2), 267–272.

Prochnow 2022* - Prochnow T, Valdez D, Curran LS, et al. Multifaceted scoping review of Black/African American transportation and land use expert recommendations on activity-friendly routes to everyday destinations. Health Promotion Practice. 2022.

Rhodes 2024 - Rhodes, R. E., Hollman, H., & Sui, W. (2024). Family‐based physical activity interventions and family functioning: A systematic review. Family Process, 63(1), 392–413.

Samdal 2017 - Samdal GB, Eide GE, Barth T, Williams G, Meland E. Effective behaviour change techniques for physical activity and healthy eating in overweight and obese adults; Systematic review and meta-regression analyses. International Journal of Behavioral Nutrition and Physical Activity. 2017;14:42.

Suryadinata 2020 - Suryadinata, R. V., Wirjatmadi, B., Adriani, M., & Lorensia, A. (2020). Effect of age and weight on physical activity. Journal of Public Health Research, 9(2), jphr.2020.1840.

Sutherland 2016 - Sutherland R, Campbell E, Lubans DR, et al. ‘Physical Activity 4 Everyone’ school-based intervention to prevent decline in adolescent physical activity levels: 12 month (mid-intervention) report on a cluster randomised trial. British Journal of Sports Medicine. 2016;50:488-495.

TPL-Chapman 2021 - Chapman R, Foderaro L, Hwang L, et al. Parks and an equitable recovery. San Francisco, CA: The Trust for Public Land (TPL); 2021.

UCL-MEND - Medical Research Council Childhood Nutrition Research Centre, UCL Institute of Child Health. (n.d.). Mind, Exercise, Nutrition...Do it! (MEND) Program: An evidence-based practice. Retrieved April 15, 2025.

UNM PRC-Step into Cuba - University of New Mexico Prevention Research Center (UNM PRC). Increasing physical activity in New Mexico communities: Evidence- and practice-based strategies. Individually adapted programs: Step into Cuba.

US DHHS-Move - U.S. Deparment of Health and Human Services, Office of Disease Prevention and Health Promotion. (n.d.). Move your way: Walk. Run. Dance. Play. What's your move? Retrieved April 15, 2025.

Verweij 2011* - Verweij LM, Coffeng J, van Mechelen W, Proper KI. Meta-analyses of workplace physical activity and dietary behaviour interventions on weight outcomes. Obesity Reviews. 2011;12(6):406-29.

VWH-Brown 2022 - Brown S. Do you live in an ‘exercise desert’? Verywell Health (VWH). 2022.