Individually-adapted physical activity programs
Individually-adapted physical activity programs teach behavioral skills that can help participants incorporate physical activity into their daily routines. Behavioral skills often include goal setting, self-monitoring, positive self-talk, and self-reward systems. Individually-adapted programs are developed to align with personal interests, preferences, and abilities. Programs also include efforts to develop social support systems and proactive plans to prevent relapse into sedentary behavior1, 2.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Increased physical activity
Improved physical fitness
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Improved weight status
Improved mental health
What does the research say about effectiveness?
There is strong evidence that individually-adapted physical activity programs increase physical activity and physical fitness for children and adults1, 2, 3. 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 adults4, 5.
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 schools2; these behavior change techniques have been shown to enhance school-based, family-based, and community-based physical activity interventions6. 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 week5.
There is some evidence suggesting individually-adapted interventions can have positive spillover effects among parents and siblings in nutrition-related outcomes7. 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 schools8.
Programs that combine professional guidance and self-direction appear to have more consistent effects than programs that lack professional guidance3. 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 places9. In some circumstances, when behavioral change interventions are combined with exercise programs, participants have been shown to improve weight status10, 11, 12.
How could this strategy advance health equity? This strategy is rated inconclusive impact on disparities.
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 groups21. 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 men21.
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 decreased22. 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 incomes23, 24, 25, likely due in part to living in neighborhoods with less access to safe places for physical activity and lack of supports for active lifestyles26. 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 neighborhoods27, though quality of parks and the built environment can vary widely at the local level24.
What is the relevant historical background?
The built environment in under-resourced communities is a significant contributor to health inequities for people of color with low incomes28, 29, 30. 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 cities31. Discriminatory housing, lending, and exclusionary zoning policies led to concentrated poverty and entrenched residential segregation32, 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 neglected31. City ordinances outlawed integrated forms of recreation33. 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 quality34, 35.
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 activity36. 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 color37.
Available evidence clearly shows the benefits of physical activity for health, however as people get older, their physical activity declines38. Individually-adapted interventions were designed to use widely applicable behavioral management skills to support individuals in initiating and maintaining healthier behaviors, including physical activity1. These interventions are intended to be effective even with the structural barriers or challenges present in many communities39.
Equity Considerations
- 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?
Implementation Examples
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 Living13, the Community Healthy Activities Model Program for Seniors14, the University of New Mexico’s Step into Cuba program15, the MEND program16 and the Move Your Way program17. The National Cancer Institute maintains a list of evidence-based physical activity programs18.
There are several physical activity programs designed to be adaptive to be accessible for people with disabilities, including the Indiana University’s Adapted Movement Programs19 and the 14 Weeks to a Healthier You program by the National Center on Health, Physical Activity and Disability20.
Implementation Resources
‡ Resources with a focus on equity.
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.
Footnotes
* Journal subscription may be required for access.
1 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.
2 CG-Physical activity - The Guide to Community Preventive Services (The Community Guide). Physical activity.
3 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.
4 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.
5 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.
6 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.
7 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.
8 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.
9 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.
10 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.
11 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.
12 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.
13 A New Leaf - WiseWoman. A new leaf…choices for healthy living: Assessment and counseling for nutrition, physical activity, smoking cessation, and osteoporosis prevention.
14 CHAMPS - Community Healthy Activities Model Program for Seniors (CHAMPS). University of California San Francisco.
15 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.
16 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.
17 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.
18 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.
19 IU-AMP - Indiana University (IU). (n.d.). Adapted Movement Program (AMP): Making activity accessible for everyone. Retrieved April 15, 2025.
20 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.
21 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.
22 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.
23 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.
24 ACSM AFI-Sallis 2019 - Sallis J. Disparities in the quality of physical activity environments. American College of Sports Medicine (ACSM) American fitness index. 2019.
25 CDC-API - Centers for Disease Control and Prevention (CDC). Adult physical inactivity outside of work.
26 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.
27 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.
28 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.
29 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.
30 Brookings-Semmelroth 2020 - Semmelroth L. How Wilmington, Del. is revitalizing vacant land to rebuild community trust. Washington, D.C.: Brookings Institution; 2020.
31 NRPA-Equity 2021 - National Recreation and Park Association (NRPA). Equity in parks and recreation: A historical perspective.
32 Kaplan 2007 - Kaplan J, Valls A. Housing discrimination as a basis for Black reparations. Public Affairs Quarterly. 2007;21(3):255-273.
33 NRPA-Fleming 2021 - Fleming K. Observing from a lens of equity. National Recreation and Park Association (NRPA). 2021.
34 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.
35 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.
36 VWH-Brown 2022 - Brown S. Do you live in an ‘exercise desert’? Verywell Health (VWH). 2022.
37 MH-Lawrence 2020 - Lawrence A. How race, class, and geography keep some people from great workouts. Men’s Health (MH). 2020.
38 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.
39 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.
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