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Note: The interactive links within ICSI PDF guidelines may not work on some mobile devices. However, the GoodReader App (and possibly some other "reader" applications) will allow anyone to open ICSI interactive PDF Guidelines on their mobile device and utilize most of the interactive capabilities.

Scope and Target Population:
This guideline, Healthy Lifestyles, outlines the existing evidence for the effectiveness of strategies and programs designed to help adults optimize health by adopting healthy lifestyles (increased physical activity, improved nutrition, decreased tobacco use and exposure, decreased hazardous and harmful drinking/alcohol use and practiced positive thinking). It also outlines how these programs might be integrated into preventive services in health care systems, which traditionally have focused on early detection of disease or treatment of risk factors rather than intervening to preserve health.

Nearly all individuals would derive measurable benefits from healthy lifestyles; even small improvements across a large portion of the population would have a greater impact than focusing on a small portion of the population that is at the upper end of the risk distribution. Therefore, the target population for this guideline includes all adults (age 18 and older) in the community, irrespective of their utilization of the health care system.

Aims:

1. Increase the percentage of population, age 18 years and older, screened for presence of healthy lifestyles and who have screening results discussed.
   
2. Increase the percentage of population, age 18 years and older, who are not at a recommended healthy goal with regards to five healthy behaviors – increased physical activity, improved nutrition, decreased tobacco use and exposure, decreased hazardous and harmful drinking and alcohol and increased practice positive thinking use – who set goals toward reaching recommended healthy goals.
   
3. Increase the percentage of health plans, public health organizations, fitness programs, worksite healthy behaviors and employer incentives statewide or for a defined geographic region offering resources that address fair healthy lifestyles: increased physical activity, improved nutrition, decreased tobacco use, exposure and decreased alcohol use and practiced positive thinking.
   
4. Increase the percentage of population in the community who are aware of one or more community resources that are available to address each of the five healthy lifestyles: increased physical activity, improved nutrition, decreased tobacco use and exposure, decreased alcohol use and practiced positive thinking.

Clinical Highlights:

• Four lifestyle behaviors – adequate physical activity, a diet that emphasizes fruits and vegetables, abstinence from tobacco and avoidance of tobacco smoke, and avoidance of hazardous and harmful drinking – are associated with a decade or more of increased life expectancy. Individuals who adopt this lifestyle, at any age, have significantly lower total mortality rates. A fifth factor, practice positive thinking, has been shown to increase reports of happiness and decrease symptoms of depression.
  
• Medical groups cannot be given the sole responsibility for supporting healthy lifestyle. There is a growing recognition and understanding of the role that community networks, physical and social environments, and public policy all play in fostering healthy lifestyles.
  
• A broad approach is necessary to achieve and support healthy lifestyles in individuals. It requires individual commitment, health care system redesign, as well as community, employer and payer support.
  
• Health assessments are most effective when combined with feedback and access to interventions that support healthy lifestyles.
  
• Collaborative decision-making and brief, combined interventions are effective in helping motivate and engage patients in maintaining or adopting healthy lifestyles.