Given tight budgets, it is now essential to focus on health promotion initiatives that have been proven effective. This is an increasing requirement from funders, which is forcing those on the ground to transform their approaches and practices. This issue of La Santé en action sheds light on these challenges, coinciding with the agency’s launch of Reperprev, the national registry that catalogs effective or promising prevention interventions based on a rigorous and independent selection process. This platform is similar to others in Europe, notably the one maintained by the National Institute for Public Health in the Netherlands. In an interview, an expert from the Dutch registry, established in 2014, describes how community health services are strongly encouraged to use it, even though it took time for prevention specialists to adopt such a scientific knowledge tool and apply it effectively.
Other structures are also being established to guide prevention practitioners, such as the Resource and Evidence Center of the National Solidarity Fund for Autonomy (CNSA); it offers robust programs on physical activity, nutrition, and cognitive function preservation to promote “healthy aging.”

Health mediation put to the test

The effectiveness of prevention interventions must be demonstrated in real-world settings to ensure they deliver the expected health benefits to the population. This is the purpose of evaluation, the expectations of which are described in an article. The number of evaluated initiatives remains low in France, as the process is complex and costly, requiring significant resources (control groups, academics, etc.).

In Marseille, the “13 en santé” project aims to improve vaccination (flu, COVID-19, etc.) and screening for certain cancers in the city’s disadvantaged neighborhoods through an outreach program. While the benefits of health mediation are now well documented, high-level evidence-based studies are needed for this approach to be classified as an effective intervention. The evaluation of this project represents a major undertaking, described at the beginning of this issue by the various stakeholders involved, each offering their own perspective: the scientific team in charge of the evaluation, the Provence-Alpes-Côte d’Azur Regional Health Agency (ARS-Paca), and one of the associations deploying mediators in the northern neighborhoods of Marseille.

Foreign programs adapted and developed in France

It is also possible for stakeholders to adopt international programs that have already been evaluated. Two articles describe how scientifically validated programs—originating in the United States, Quebec, or Europe—focused on preventing addictive behaviors and psychosocial risks among young people are being implemented in schools and adapted to the local context while adhering to the original methodological framework. However, large-scale replication proves challenging, requiring monitoring to ensure that the essential components of the intervention are maintained over the long term.
This issue of La Santé en action thus highlights the growing number of resources enabling project leaders to rely on proven approaches to improve prevention.

Finally, in this issue, an article highlights the tools available to local authorities to protect the most vulnerable populations against heat waves by addressing the social determinants of health (housing, urban planning, etc.).