I 
110TH CONGRESS 
2D SESSION 
H. R. 5835 
To provide for increased planning and funding for health promotion programs 
of the Department of Health and Human Services. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 17, 2008 
Ms. SCHAKOWSKY (for herself, Mr. BURGESS, Ms. DEGETTE, Mr. TOWNS, Mr. 
GENE GREEN of Texas, Mr. GORDON of Tennessee, Mr. TERRY, Mr. 
HINOJOSA, Mr. FERGUSON, Ms. BORDALLO, Ms. SOLIS, and Mrs. CAPPS) 
introduced the following bill; which was referred to the Committee on En-
ergy and Commerce 
A BILL 
To provide for increased planning and funding for health 
promotion programs of the Department of Health and 
Human Services. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Health Promotion 
Funding Integrated Research, Synthesis, and Training 
Act’’ or the ‘‘Health Promotion FIRST Act’’. 
SEC. 2. FINDINGS. 
Congress makes the following findings: 
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(1) Lifestyle factors are responsible for almost 
half of the premature deaths in developed nations, 
and a large portion of the deaths in developing na-
tions. 
(2) Lifestyle factors are a primary cause of the 
6 leading causes of death in the United States, in-
cluding heart disease, cancer, stroke, respiratory dis-
eases, accidents, and diabetes, which account for al-
most 75 percent of all deaths in the United States. 
(3) A significant portion of the health dispari-
ties in the United States are caused by lifestyle fac-
tors, which could be improved by health promotion 
programs. 
(4) The United States is experiencing epidemics 
in diabetes and obesity among adults and children, 
at the same time a majority of the population is sed-
entary and eats an unhealthy diet. 
(5) Per capita medical care costs in the United 
States are more than double those of all but 2 other 
countries in the world, yet the United States ranks 
26th in terms of disability adjusted life expectancy, 
infant mortality, and other positive lifestyle meas-
ures. 
(6) Medical care costs are second only to edu-
cation in State government budgets. 
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(7) Lifestyle factors are responsible for at least 
1⁄4 of employers’ medical care costs in the United 
States. 
(8) National costs of obesity account for 9.1 
percent of all medical costs, reaching $93,000,000 in 
2002. Approximately 1⁄2 of these costs were paid by 
the Medicare and Medicaid programs. 
(9) Significant gaps exist in the basic and ap-
plied research base of health promotion regarding 
how to best reach and serve people of color, low-in-
come people, people with little formal education, chil-
dren, and older adults, how to create long-term 
health improvements, how to create supportive envi-
ronments, and how to address gender issues. More 
focused research can reduce these gaps. 
(10) Significant gaps exist between the best and 
the typical health promotion programs. Better syn-
thesis and dissemination of results can reduce these 
gaps. 
(11) Health promotion is the art and science of 
motivating people to enhance their lifestyles to 
achieve complete health, not just the absence of dis-
ease. Complete health involves a balance of physical, 
mental, and social health. 
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(12) Health promotion programs focus on prac-
tices such as exercising regularly, eating a nutritious 
diet, maintaining a healthy weight, managing stress, 
avoiding dangerous substances such as tobacco and 
illegal drugs, drinking alcohol in moderation or not 
at all, driving safely, being wise consumers of health 
care, and a number of other health related practices. 
(13) The most effective health promotion pro-
grams include a combination of strategies to in-
crease awareness, facilitate behavior change, and de-
velop cultures and physical environments that en-
courage and support healthy lifestyle practices. 
(14) Health promotion programs can be pro-
vided in family, clinical, child care, school, work-
place, Federal, State, and community settings. 
SEC. 3. HEALTH PROMOTION RESEARCH AND DISSEMINA-
TION. 
The Public Health Service Act (42 U.S.C. 201 et 
seq.) is amended by adding at the end the following: 
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‘‘TITLE 
XXX—HEALTH 
PRO-
MOTION RESEARCH AND DIS-
SEMINATION 
‘‘Subtitle A—Coordination of Pro-
grams of the Department of 
Health and Human Services 
‘‘SEC. 3001. PLAN FOR HEALTH PROMOTION PROGRAMS. 
‘‘(a) IN GENERAL.—The Secretary shall develop, and 
periodically review and as appropriate revise, a plan in ac-
cordance with this section for activities of the Department 
of Health and Human Services relating to health pro-
motion. The plan shall include provisions for coordinating 
all such activities of the Department, including activities 
under section 1701 to— 
‘‘(1) formulate national goals, and a strategy to 
achieve such goals, with respect to health informa-
tion and health promotion, preventive health serv-
ices, and education in the appropriate use of health 
care; 
‘‘(2) analyze the necessary and available re-
source for implementing the goals and strategy for-
mulated pursuant to paragraph (1), and recommend 
appropriate educational and quality assurance poli-
cies for the needed manpower resources identified by 
such analysis; 
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‘‘(3) undertake and support necessary activities 
and programs to— 
‘‘(A) incorporate appropriate health pro-
motion concepts into our society, especially into 
all aspects of education and health care; 
‘‘(B) increase the application and use of 
health knowledge, skills, and practices by the 
general population in its patterns of daily liv-
ing; and 
‘‘(C) establish systematic processes for the 
exploration, development, demonstration, and 
evaluation of innovative health promotion con-
cepts; and 
‘‘(4) undertake and support research and dem-
onstration programs relating to health information 
and health promotion, preventive health services, 
and education in the appropriate use of health care. 
‘‘(b) BASIC AND APPLIED SCIENCE.—The plan devel-
oped under subsection (a) shall contain provisions to ad-
dress how to best develop the basic and applied science 
of health promotion, including— 
‘‘(1) a research agenda; 
‘‘(2) an identification of the best combination of 
Federal agency, university, and other community re-
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sources most qualified to pursue each of the compo-
nents of such agenda; 
‘‘(3) protocols to facilitate ongoing cooperation 
and collaboration among the Federal agencies to 
pursue the agenda; and 
‘‘(4) budgetary requirements with respect to the 
agenda. 
‘‘(c) DISSEMINATION OF INFORMATION.—The plan 
developed under subsection (a) shall contain provisions to 
address how to best synthesize and disseminate health 
promotion research findings to scientists, professionals, 
and the public, including provisions for the following: 
‘‘(1) Protocols for ongoing monitoring of all 
health promotion research. 
‘‘(2) Preparation of systematic reviews and 
meta-analyses. 
‘‘(3) Distillation of findings into practice guide-
lines for programs offered in clinical, workplace, 
school, home, neighborhood, municipal, and State 
settings. 
‘‘(4) Strategies to incorporate findings into col-
lege, university, and continuing educational cur-
riculum for all related health professions. 
‘‘(5) Communication of key findings to policy 
makers in business, government, educational and 
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community settings who influence investment deci-
sions. 
‘‘(6) Identification of the optimal combination 
of government agencies to coordinate the matters re-
ferred to in paragraphs (1) through (5). 
‘‘(d) SUPPORT
AND DEVELOPMENT
OF PROFES-
SIONAL AND SCIENTIFIC COMMUNITY.—The plan devel-
oped under subsection (a) shall contain provisions to ad-
dress how to best support and develop the health pro-
motion professional and scientific community through en-
hancement of existing or development of new professional 
organizations. 
‘‘(e) INTEGRATION OF HEALTH PROMOTION; INTER-
NAL
DEPARTMENT
ACTIVITIES.—The plan developed 
under subsection (a) shall contain provisions to address 
how resources, policies, structures, and legislation within 
the Department of Health and Human Services can best 
be modified or developed to integrate health promotion 
into all health professions and sectors of society and make 
health promoting opportunities available to all members 
of the public. 
‘‘(f) INTEGRATION OF HEALTH PROMOTION EXTER-
NAL ACTIVITIES.—The plan developed under subsection 
(a) shall contain provisions to address how overall Federal 
Government policies, structures, and legislation external 
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to the Department of Health and Human Services can 
best be modified or developed to integrate health pro-
motion into all health professions and sectors of society 
and to make health promoting opportunities available to 
all individuals. 
‘‘(g) PERSPECTIVES.—Due to 30 years of experience 
showing that traditional medical and educational ap-
proaches are not sufficient to motivate people to make and 
sustain basic health behavior changes, in developing the 
plan under subsection (a), the Secretary shall seek per-
spectives from individuals representing a diverse range of 
disciplines, including the following areas: 
‘‘(1) Agriculture. 
‘‘(2) Anthropology. 
‘‘(3) Child development. 
‘‘(4) City planning. 
‘‘(5) Commerce. 
‘‘(6) Economics. 
‘‘(7) Environmental planning and design. 
‘‘(8) Exercise physiology. 
‘‘(9) Financial analysis. 
‘‘(10) Health education. 
‘‘(11) Health policy. 
‘‘(12) Individual psychology. 
‘‘(13) Management. 
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‘‘(14) Medicine. 
‘‘(15) Nursing. 
‘‘(16) Nutrition. 
‘‘(17) Organization psychology. 
‘‘(18) Taxation. 
‘‘(19) Transportation planning. 
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated $6,000,000 for fiscal year 2009, 
$4,000,000 for fiscal year 2010, and $3,000,000 for each 
of fiscal years 2011 through 2013. Such authorization is 
in addition to other authorizations that are available for 
carrying out such purpose. 
‘‘Subtitle 
B—Science 
Programs 
Through National Institutes of 
Health 
‘‘SEC. 3011. SCIENCE OF HEALTH PROMOTION. 
‘‘(a) PLAN.—The Director of the National Institutes 
of Health (referred to in this subtitle as ‘NIH’), acting 
through the Office of Behavioral and Social Sciences Re-
search, shall develop, and periodically review and as appro-
priate revise, a plan on how to best develop the science 
of health promotion through the NIH agencies. The plan 
shall be consistent with and shall elaborate upon applica-
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ble provisions of the Departmental plan under section 
3001(a). 
‘‘(b) CERTAIN COMPONENTS OF PLAN.—The plan 
developed under subsection (a) shall include the following 
provisions: 
‘‘(1) A research agenda to develop the science 
of health promotion. 
‘‘(2) Recommendations on funding levels for the 
various areas of research on such agenda. 
‘‘(3) Recommendations on the best combination 
of NIH agencies and non-Federal entities to carry 
out research under the agenda. 
‘‘(c) ALLOCATION OF RESOURCES.—Subject to com-
pliance with appropriation Acts, the plan developed under 
subsection (a) shall provide for the allocation of resources 
for research under such plan relative to other areas of 
health, as appropriate taking into account the burden of 
lifestyle factors on morbidity and mortality, and the 
progress likely in advancing the science of health pro-
motion given the current and evolving level of science on 
health promotion, and the relative cost of conducting re-
search on health promotion compared to other areas of 
research. 
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‘‘SEC. 3012. EARLY RESEARCH PROGRAMS. 
‘‘(a) PLAN.—The Director of NIH, acting through 
the Office of Behavioral and Social Sciences Research, 
shall conduct or support early research programs and re-
search training regarding health promotion. 
‘‘(b) FUNDING.— 
‘‘(1) AUTHORIZATION
OF
APPROPRIATIONS.— 
For the purpose of carrying out subsection (a), there 
is authorized to be appropriated $30,000,000 for fis-
cal year 2009. Such authorization is in addition to 
other authorizations that are available for carrying 
out such purpose. 
‘‘(2) RESERVATION.—The Secretary shall re-
serve not less than 90 percent of the amount appro-
priated under paragraph (1) to carry out subsection 
(a) through the awarding of grants, cooperative 
agreements, or contracts to public and private enti-
ties, including universities, hospitals, research orga-
nizations and health promotion venders. Of the 
amounts so reserved, the Secretary shall designate a 
portion of such amounts to support research train-
ing under subsection (a) to enhance the skills and 
increase the numbers of scientists trained in health 
promotion. 
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‘‘Subtitle C—Applied Research Pro-
grams Through Centers for Dis-
ease Control and Prevention 
‘‘SEC. 3021. RESEARCH AGENDA. 
‘‘The Secretary, acting through the Director of the 
Centers for Disease Control and Prevention (referred to 
in this subtitle as the ‘Director of CDC’), shall develop, 
and periodically review and as appropriate revise, a plan 
that establishes for such Centers a research agenda re-
garding health promotion. The plan shall be consistent 
with and shall elaborate upon applicable provisions of the 
Departmental plan developed under section 3001(a). 
‘‘SEC. 3022. PREVENTION RESEARCH CENTERS. 
‘‘(a) IN GENERAL.—The Director of the National 
Center for Chronic Disease Prevention and Health Pro-
motion (referred to in this section as the ‘Director’) shall 
award grants, on a competitive basis, to eligible entities 
to enable such entities to develop Prevention Research 
Centers (referred to in this section as ‘Centers’). 
‘‘(b) ELIGIBLE ENTITY.—In this section, the term 
‘eligible entity’ includes— 
‘‘(1) institutions of higher education; 
‘‘(2) public and private research institutions; 
‘‘(3) departments or schools of— 
‘‘(A) business; 
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‘‘(B) city planning; 
‘‘(C) education; 
‘‘(D) nursing; 
‘‘(E) psychology; 
‘‘(F) public policy; 
‘‘(G) transportation; 
‘‘(H) social work; 
‘‘(I) agriculture; 
‘‘(J) nutrition; 
‘‘(K) engineering; 
‘‘(L) architecture; and 
‘‘(M) any other program that can make a 
compelling connection to improving the health 
of the public; and 
‘‘(4) private research, membership, or service 
organizations. 
‘‘(c) APPLICATION.—An eligible entity that desires to 
receive a grant under this section shall submit an applica-
tion to the Director at such time, in such manner, and 
containing such information as the Director may require. 
An eligible entity may apply for not more than 3 grants 
each with a duration of 5 years. 
‘‘(d) AWARDING OF GRANTS.— 
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‘‘(1) NUMBER
OF
CENTERS.—The Director 
shall award grants for the development of not more 
than— 
‘‘(A) 8 new Centers in fiscal year 2009; 
‘‘(B) 8 new Centers in fiscal year 2010; 
‘‘(C) 8 new Centers in fiscal year 2011; 
‘‘(D) 8 new Centers in fiscal year 2012; 
and 
‘‘(E) 8 new Centers in fiscal year 2013. 
‘‘(2) MINIMUM
FUNDING
OF
EXISTING
CEN-
TERS.—No new Centers shall be funded until each 
Center in existence before January 1, 2009, is 
awarded funding of not less than $1,000,000 per 
year. 
‘‘(3) GRANT PERIOD.—Grants awarded under 
this section shall be for a period of 5 years. 
‘‘(4) FUNDING NEW CENTERS.—A grant award 
to a new Center shall be in an amount not to ex-
ceed— 
‘‘(A) $500,000 in the first year of the 
grant award; 
‘‘(B) $1,000,000 in the second year of the 
grant award; and 
‘‘(C) $2,000,000 in each of the third, 
fourth, and fifth years of the grant award. 
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‘‘(5) REQUIREMENT FOR FUNDING.—To qualify 
for funding that is more than $1,000,000 per year, 
Centers shall demonstrate collaborative efforts with 
community or other academic partners, and at least 
50 percent of the funding that exceeds $1,000,000 
shall be conveyed to those partners. Partners may 
include other schools or departments with the same 
university or other large organization. 
‘‘(6) FOCUS OF CENTERS.—In awarding grants 
under this section, the Director shall ensure that— 
‘‘(A) not less than 1 Center concentrates 
the Center’s efforts on developing the applied 
science of health promotion in each of the fol-
lowing areas: 
‘‘(i) the workplace; 
‘‘(ii) schools; 
‘‘(iii) families; 
‘‘(iv) clinical settings; and 
‘‘(v) community settings; and 
‘‘(B) not less than 1 other Center focuses 
the Center’s work on each of the following 
areas: 
‘‘(i) program evaluation; 
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‘‘(ii) training and support of the 
health promotion professional workforce; 
and 
‘‘(iii) health promotion policy at the 
Federal, State, and local level. 
‘‘(7) 
REQUIREMENT.—In 
awarding 
grants 
under this section, the Director shall ensure that not 
less than 30 and not more than 50 of the Centers 
shall be schools of public health or departments of 
preventive medicine. 
‘‘(e) USES OF FUNDS.— 
‘‘(1) IN GENERAL.— 
‘‘(A) PROVISION OF ADVICE AND ORGANI-
ZATION.—A Center that is developed from 
funds from a grant awarded under this section 
shall invest approximately 10 percent of the 
Center’s staff time and resources to— 
‘‘(i) forming relationships with, and 
providing limited ongoing advice to, health 
departments in the county and State where 
the entity is located; and 
‘‘(ii) organizing local networks of sci-
entists, program managers, vendors, and 
other professionals interested in health 
promotion and disease prevention. 
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‘‘(B) USE OF OUTSIDE PROVIDERS.—When 
conducting intervention research or research on 
other health promotion programs, a Center that 
is developed from funds from a grant awarded 
under this section shall review the capabilities 
of local nonprofit and for-profit program pro-
viders to provide the programming and services 
required for the programs. The Center shall use 
such program providers if the program pro-
viders provide a clear quality and cost advan-
tage relative to developing such capabilities in-
ternally. 
‘‘(C) ADDRESSING
PRIORITIES
AND
RE-
SEARCH AGENDA.—A Center that is developed 
from funds from a grant awarded under this 
section shall address the priorities identified in 
the health promotion research agendas devel-
oped by the Centers for Disease Control and 
Prevention, the National Science Foundation, 
and the Department of Health and Human 
Services. 
‘‘(2) PERMISSIVE USES.—An eligible entity that 
receives a grant under this section may use the 
grant funds for faculty salaries, student fellowships, 
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