Within the abstract Downes states that the majority of chronic diseases i.e. heart disease, diabetes mellitus, and hypertension etc. (which is the leading cause of death/disability in the United States due its nature of only being controlled rather than cured) can be prevented by lifestyle behaviors. Formulating the research through the exploration of “physical activity,” “dietary habits,” and lastly, “weight status related to motivators and barriers of healthy lifestyle choices” of 106 college students. Downes introduces the issue that the majority of the American population does not heed the recommended physical activity and dietary habits in order to maintain optimum health and in turn causes such chronic diseases to develop overtime…show more content… An example would be gender and way of performing the exercise. In this sense male college students were shown to exercise more vigorously than females. Another determinant significant to both genders is social support. The study also focused on facilitators and barriers as being representative of PA and DH. Factors identified as facilitators included “self-efficacy,” the ability to succeed in specific situations, perceived benefits of PA, and overall physical appearance whether good or bad. Barriers reported as lack of motivation and time play keys roles as well. In accords to Affordable Care Act, it initiated the transformation of health care from a disease-oriented model to focusing more so on a prevention-model in hopes of further preventing chronic diseases and promoting PA/DH. It provides other resources through an extensive array of funding from investment in established community-related public health programs and initiatives. Nurse Practitioners, otherwise known as NPs, provide cost-effective care, they are also well educated to minister health care with accentuation on healthy living habits (PA/DH) and disease prevention. NPs in college-based health clinics can practice, intervention and cognitive behavior and skills-building related to a healthy lifestyle which will lead to an increase in PA among students. To improve a healthier lifestyle and reduce the chance of developing a chronic disease suggested by Healthy People 2020 is to consume healthy foods.