We are making excellent progress in our efforts to introduce our proposed "Health Promotion Research Act." We are in ongoing discussions with members of Congress in the Senate and House of Representatives who are interested in introducing and supporting this legislation.

A draft of the bill is below. By the time this editorial is published, we expect to have introducers confirmed for the Senate and the bills either introduced in the Senate and House or be in the process of adding original co-sponsors before being introduced. Once introduced, we need to persuade at least 51 Senators and 218 Representatives to support the bill. Realistically, this effort will flow into 2003.

I have called for your support on this effort in the past and some of you have responded. Our grass roots advocacy network now has representatives in 35 states and 150 congressional districts. To generate the support we need to pass this legislation, we need advocates in ALL of the 50 states and 435 congressional districts. We can easily achieve that goal by attracting all of our subscribers to join this effort. I hope you are ready to become involved. This work will take only a few hours per month, and all you need to do is call your two Senators and one Representative to ask them to support this legislation. We will provide detailed instructions on how to do this. I promise, this is fun and empowering work. See our website (http://www.HealthPromotionAdvocates.org.) for the current status of the bill and the specific actions you should take.

The mission of our advocacy effort is "To promote healthy lifestyles among all Americans and thereby reduce medical costs and utilization, improve quality of life, and enhance productivity." During the next decade, we expect to develop and pass a series of federal and state legislation to make this a reality.

Developing and passing the "Health Promotion Research Act" is just the first step. We chose this as our first step because it best meets the criteria below which we use to select issues to advocate

1. Contributes to our mission. The Health Promotion Research Act contributes to our mission in two ways. First, health promotion is not PERCEIVED as a legitimate science by most scientists, or even by physicians. It will never be an important part of the health care system until it is legitimized. To be legitimized, we must produce a critical mass of research comparable to other areas of science. Second, we have huge holes in the ACTUAL science base of health promotion. We do have an abundance of research showing the link between lifestyle factors, morbidity, mortality, and medical care costs. We also have a large body of research showing that health promotion programs can reduce morbidity, mortality, and medical care costs. What we do NOT have is research showing which protocols are most effective in producing long-term changes, especially for the young and old, people of color, and people with low income or education.

2. Addresses the priorities of our extended advocacy team. The Health Promotion Research Act will provide two huge benefits to health promotion professionals. First, it will provide an annual cash infusion of approximately $145 million dollars directly to the health promotion field through contracts and grants to not-for-profit and for-profit non-government organizations including universities, hospitals, research organizations, and local health promotion venders. This will create new jobs and enhance existing careers. Second, all health promotion professionals will have access to more effective strategies, and thus better success rates for their programs.

3. Realistic given our resources and political realities. Although $200 million is a huge sum of money for our field, it is modest by federal standards, especially considering the $23 billion dollar budget of the National Institutes of Health. Furthermore, providing additional funding for research is non-partisan and non-controversial, especially compared to changing the tax structure, reforming Medicare, or imposing regulations on health care organizations or schools. As we become more sophisticated and experienced advocates, we can tackle some of these more difficult issues.

The main points of our proposed Health Promotion Research Act are below. The actual content of the bill will be developed by Congress in the next few months.

This legislation will secure approximately $200 million in additional annual funding to create a focused and coordinated effort to develop the basic and applied science of health promotion.

Approximately $5 million would be allocated to a central coordinating office which would articulate a research agenda, identify the best combination of federal agency, university, and other community resources most qualified to conduct this research and facilitate cooperation and collaboration among the agencies to execute this research agenda. The Office of Disease Prevention and Health Promotion within the office of the Secretary of the Department of Health and Human Services might serve in this coordinating role.

A portion of these funds would be used to determine how federal government policies and structures could be modified to further stimulate adoption of health promotion concepts in federal policy and throughout society. The Office of the Assistant Secretary for Planning and Evaluation might lead such a study.

Approximately $60 million would be allocated to the National Institutes of Health (NIH) for basic research on the psychological and physiological mechanisms of health related behavior. This would be coordinated through a trans-institute initiative, possibly coordinated through the Office of Behavioral and Social Sciences Research. At least $45 million of this would be distributed through contracts and grants to not-for-profit and for-profit non-government organizations including universities, hospitals, research organizations, and local health promotion venders. Some of this funding would support training grants to enhance the skills and increase the number of scientists trained in health promotion.

Approximately $120 million would be allocated to the Centers for Disease Control and Prevention (CDC) for applied research to develop the most effective individual and group strategies for clinical, workplace, school, and community-based programs. At least $90 million of this would be distributed through contracts and grants to not-for-profit and for-profit non-government organizations including universities, hospitals, research organizations, and local health promotion venders through collaborative efforts. Some of this funding would support training grants to enhance the skills of health promotion practitioners. Within CDC, the National Center for Chronic Disease Prevention and Health Promotion, and the Office of Extramural Research might coordinate this work.

Approximately $15 million would be allocated to synthesize the research into recommended best practice strategies for individuals and groups in clinical, workplace, school, and community-based programs, and to disseminate these findings to researchers and practitioners. Information on the health and financial impact of health promotion programs would be disseminated to policy makers in government, academic, and business settings. At least $10 million of this funding would be distributed through contracts and grants to for-profit and not-for profit non-government organizations including universities, hospitals, publishers, research organizations, and local health promotion venders through collaborative efforts. This work might be coordinated by the Agency for Healthcare Research and Quality.

For all of the grants and contracts above, mechanisms would be developed to simplify the grants and contract process to attract the most qualified individuals and organizations, rather than those most sophisticated in contracting and grant application processes.

Michael P. O'Donnell, PhD, MBA, MPH
Editor in Chief, American Journal of Health Promotion