Outlook: Newsletter of the Society of Behavorial Medicine

Summer 2026

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Promoting Physical Activity in the Era of Climate Change: Expert Perspectives on the Co-Benefits, Tradeoffs, and Future Directions

Jimikaye Courtney, PhD1; Dahlia Stott, PhD2; Jacob Szeszulski, PhD3; Hannah Arem, PhD4; Lauren Bohlen, PhD5 - Evidence Based Behavioral Medicine SIG

Behavioral medicine researchers are increasingly called to understand how physical activity can both influence, and be influenced by, climate change. The Evidence-Based Behavioral Medicine Special Interest Group asked leading international experts to explore this intersection: Karim Abu-Omar (Friedrich-Alexander-Universität), Paquito Bernard and Guillaume Chevance (École des Hautes Études en Santé Publique), Jay Maddock (Texas A&M University), Emily Mailey (Kansas State University), and Kevin Lanza (UTHealth Houston).

Where do we see the strongest co-benefits?

The experts converged on active transportation as the strongest evidence-based approach to simultaneously promoting physical activity and mitigating climate change.1 Lanza and Maddock emphasized that shifting travel away from single-occupancy vehicles toward walking, cycling, and public transit increases physical activity while reducing carbon emissions.2,3 Bernard and Chevance reinforced that these benefits occur only when active modes replace car travel rather than supplement it.4 Urban design supports or limits people’s ability to engage in active transportation, but Mailey noted a significant evidence gap in low- and middle-income countries.

What important gaps and tradeoffs remain?

The carbon cost of physical activity is complex. Abu-Omar noted that, like dietary choices, physical activity varies in its environmental consequences depending on geography and season. Promoting accessible regional and seasonal activities that require minimal motorized transport can meaningfully reduce carbon costs.5 Abu-Omar, Bernard, and Chevance emphasized regionality in organized sports, given that travel can account for up to 80% of the total footprint.6,7 Lanza highlighted a further gap in understanding how electric options like e-bikes and e-scooters shape behavior and emissions, while Mailey called for more rigorous evaluation of nature-based interventions with measurable climate outcomes.

How can behavioral medicine theories, models, and frameworks help?

Multiple experts highlighted that existing theories, models, and frameworks, including Social Cognitive Theory, the Social Ecological Model, the COM-B model, and Intervention Mapping,8–10 can be reoriented toward sustainable physical activity, as opposed to creating new frameworks. Bernard and Chevance have advanced the Climate Change and Health Behaviors Feedback Loops Model as a dedicated tool for mapping reciprocal associations between climate change and health behaviors.11 Lanza highlighted that members of SBM developed Y-PATHS framework as useful for assessing climate-related hazards on youth physical activity interventions.12

How do we ensure equity?

Equity requires intentionality from the outset. Lanza states that there is significant overlap between populations most at risk of physical inactivity and those most vulnerable to climate-related hazards.13,14 When designing interventions, policies and other solutions, we should understand the lived experiences of these populations. Bernard and Chevance emphasize that mitigation efforts should target high-emitting groups, while adaptation support should prioritize disadvantaged communities facing the greatest heat and pollution exposure.15,16 Abu-Omar adds that climate-conscious recommendations must navigate cultural traditions and equity across populations with different cultures and carbon footprints.13,14

What are recommendations for physical activity researchers and practitioners who are interested in integrating climate considerations into their work?

Lanza recommended becoming more familiar with climate change literature, beginning with the National Climate Assessment's human health chapter, then mapping climate impacts onto one's own work.18 Three of these experts agreed that there is a need to build climate goals into intervention designs from the start, and not as an afterthought.17 By designing and framing interventions with multifaceted goals for planetary and human health, we can promote sustainable physical activity.  

Affiliations:

  1. Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
  2. Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania
  3. Department of Nutrition, Texas A&M University
  4. Implementation Science, Healthcare Delivery Research, MedStar Health Research Institute
  5. Department of Behavioral and Social Sciences, Brown University

References:

  1. Ding D, Luo M, Infante MFP, et al. The co-benefits of active travel interventions beyond physical activity: a systematic review. The Lancet Planetary Health. 2024;8(10):e790-e803. doi:10.1016/S2542-5196(24)00201-8
  2. Millard-Ball A, Reginald M, Yusuf Y, Bian C. Global health and climate benefits from walking and cycling infrastructure. Proc Natl Acad Sci USA. 2025;122(24):e2422334122. doi:10.1073/pnas.2422334122
  3. Brand C. Active Travel’s Contribution to Climate Change Mitigation: Research Summary and Outlook. Active Travel Studies. 2021;1(1). doi:10.16997/ats.1036
  4. Bernard P, Chevance G, Kingsbury C, et al. Climate Change, Physical Activity and Sport: A Systematic Review. Sports Med. 2021;51(5):1041-1059. doi:10.1007/s40279-021-01439-4
  5. Creutzig F, Jochem P, Edelenbosch OY, et al. Transport. In: Shukla PR, Skea J, Slade R, et al., eds. Climate Change 2022: Mitigation of Climate Change. Contribution of Working Group III to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge University Press; 2022. doi:10.1017/9781009157926.012
  6. McCullough BP, Collins A, Roberts J, Villalobos S. Sport Events and Emissions Reporting: An Analysis of the Council for Responsible Sport Standard in Running Events. Sustainability. 2023;15(19):14375. doi:10.3390/su151914375
  7. Grofelnik H, Perić M, Wise N. Evaluating the travel carbon footprint of outdoor sports tourists. Journal of Outdoor Recreation and Tourism. 2023;43:100678. doi:10.1016/j.jort.2023.100678
  8. Beauchamp MR, Crawford KL, Jackson B. Social cognitive theory and physical activity: Mechanisms of behavior change, critique, and legacy. Psychology of Sport and Exercise. 2019;42:110-117. doi:10.1016/j.psychsport.2018.11.009
  9. Michie S, van Stralen MM, West R. The Behaviour Change Wheel: A new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6:42. doi:10.1186/1748-5908-6-42
  10. Bartholomew Eldredge LK. Planning Health Promotion Programs: An Intervention Mapping Approach. Fourth edition. Jossey-Bass & Pfeiffer Imprints, Wiley; 2016.
  11. Chevance G, Fresán U, Hekler E, et al. Thinking Health-related Behaviors in a Climate Change Context: A Narrative Review. Annals of Behavioral Medicine. 2023;57(3):193-204. doi:10.1093/abm/kaac039
  12. Szeszulski J, Lanza K, Dooley EE, et al. Y-PATHS: A Conceptual Framework for Classifying the Timing, How, and Setting of Youth Physical Activity. Journal of Physical Activity and Health. 2021;18(3):310-317. doi:10.1123/jpah.2020-0603
  13. World Report on Social Determinants of Health Equity. Accessed June 10, 2026. https://www.who.int/teams/social-determinants-of-health/equity-and-health/world-report-on-social-determinants-of-health-equity
  14. National Academies of Sciences, Engineering, and Medicine; Division on Earth and Life Studies; Environmental Health Matters Initiative. Communities, Climate Change, and Health Equity: Proceedings of a Workshop—in Brief. (Reich A, Ulman A, Berkower C, eds.). National Academies Press (US); 2022. Accessed June 10, 2026. http://www.ncbi.nlm.nih.gov/books/NBK576618/
  15. Hsu A, Sheriff G, Chakraborty T, Manya D. Disproportionate exposure to urban heat island intensity across major US cities. Nat Commun. 2021;12(1):2721. doi:10.1038/s41467-021-22799-5
  16. Deivanayagam TA, English S, Hickel J, et al. Envisioning environmental equity: climate change, health, and racial justice. The Lancet. 2023;402(10395):64-78. doi:10.1016/S0140-6736(23)00919-4
  17. Epel ES, White KE, Brownell KD, et al. Transforming Health Psychology and Behavioral Medicine to Address the Climate Crisis: A Call for Strategic Research and Advocacy. Annals of Behavioral Medicine. 2025;59(1):kaae088. doi:10.1093/abm/kaae088
  18. Ebi KL, Balbus J, Luber G, et al. Chapter 14 : Human Health. Impacts, Risks, and Adaptation in the United States: The Fourth National Climate Assessment, Volume II. U.S. Global Change Research Program; 2018. doi:10.7930/NCA4.2018.CH14
  19. Maddock JE, Frumkin H. Physical Activity in Natural Settings: An Opportunity for Lifestyle Medicine. American Journal of Lifestyle Medicine. 2025;19(1):73-87. doi:10.1177/15598276241253211
  20. Peng T, Zhang Z, Zhang J, Liang W, Tang X. An integrative review of the physical, mental, and socioeconomic benefits of outdoor hiking. Front Public Health. 2026;13:1700325. doi:10.3389/fpubh.2025.1700325