Since the early 2000s, physical activity has become a component of the national nutrition and health plan, whose overall goal is to improve the health of the entire population. The prescription of physical activity “tailored to the patient’s condition, physical abilities, and medical risks in cases of long-term illness” was introduced in the law modernizing the healthcare system and subsequently extended to all patients with chronic conditions. The issue of La Santé en action No. 462 traces the history of this advancement and reports on various initiatives implemented throughout France through numerous testimonials.

Furthermore, the 2019–2024 National Sport-Health Strategy aims to “improve the population’s health by promoting daily physical and sports activity for everyone, with or without a medical condition, at all stages of life.” This public policy is part of the framework for the 2024 Olympic and Paralympic Games to be held in France.

Sedentary lifestyles and lack of physical activity: major health risk factors

Physical inactivity and sedentary behaviors are now widely recognized as major health risk factors but also as a cause of preventable mortality. Physical activity is considered a therapeutic intervention in its own right for certain diseases (diabetes, obesity, depression, strokes, cancers, etc.), and beneficial for neurodegenerative diseases and other conditions or disorders.

Promoting physical activity systematically to motivate the French population over the long term

Policies to promote physical activity now cover the various levels of prevention—primary, secondary, and tertiary—and their scope also includes maintaining independence as people age. These policies take the form of national and regional communication campaigns and the development of adapted physical activity (APA) and health-focused sports programs across regions. The goal is to offer and promote a wide range of health-focused physical activities to citizens, with a focus on motivating them to stick with these activities over the long term and fostering social interaction.

Regular physical activity is best fostered through supportive communities

To achieve this, the focus should be on reaching out to communities that are not currently engaged in physical activity rather than inviting them to participate in established programs at gyms or sports clubs. Supporting people in becoming physically active therefore requires creating supportive environments, strengthening the community-based approach, and developing individual skills. The strategy is comprehensive and draws on individuals’ resources and expectations with the goal of establishing new norms for an “active lifestyle” concerning not only physical or sports activities but also mobility (walking, cycling) and limiting screen time.
Currently, the professional offerings in adapted physical activity (APA) are inconsistent. Various regional “Sport, Health, and Well-being” strategies are being implemented across the country, led by doctors, sports associations, and local governments.

Prescribing adapted physical activity: a challenge for doctors

In their daily practice, doctors face numerous obstacles when prescribing adapted physical activity for their patients. Indeed, the law has only partially paved the way: doctors, the central link in the system, lack both the necessary time and the network to prescribe such activities; furthermore, adapted physical activity is not necessarily covered by health insurance.

Innovative programs exist throughout France

In this issue, you’ll find a few examples of concrete initiatives being carried out across the country to promote physical activity.

• In Aquitaine, “bridge programs” help patients engage in “tailored” physical activity based on their health status.

• In Villeurbanne, patients have easy access to adapted physical activity thanks to a program implemented by the city.

• In Dunkirk, a bus equipped as a gym travels through neighborhoods and the surrounding countryside.

• In Clermont-Ferrand, an association has opened workplace gyms at the request of companies.

• In the Provence-Alpes-Côte d’Azur region, social workers visit the homes of isolated older adults to invite them to join prevention workshops on physical activity and nutrition.

• In Bordeaux, an organization offers young people with cancer physical activities tailored to their preferences. A similar initiative is in place for anyone receiving treatment at the Lyon Cancer Center.

• In French Guiana, the Maison Sport-Santé in Matoury offers residents who have been unable to participate in sports the opportunity to resume such activities.

Several patient testimonials describe the conditions under which they resumed adapted physical activity, including that of an expert patient with diabetes who helps others with the same condition follow the same path.