Precision Prevention for Health: The Global Alliance Framework for the Promotion of Physical Activity

Abstract This conceptual, implementation-oriented paper proposes a framework for precision prevention centred on physical activity promotion and early risk mitigation, aiming to support a shift from reactive disease management toward proactive prevention. The proposed framework focuses on the early identification of risk trajectories by integrating biological, environmental, and social determinants of health through systems thinking, multi-omics technologies, digital health, and behavioural science. It aims to inform tailored, context-sensitive interventions that will help to mitigate chronic non-communicable diseases (NCDs), while supporting lifelong resilience. Within this framework, physical activity is positioned as the central, modifiable anchor behaviour through which personalised prevention strategies may be operationalised. Building on the 2025 Hamburg Declaration and the Global Alliance for the Promotion of Physical Activity’s (GA@PA) mission, this conceptual paper proposes a multidimensional model, combining personalised strategies for physical activity, nutrition, sleep, and mental health with contextual environmental adaptations. By bringing together stakeholders across multiple sectors, including healthcare, education, urban planning, sport organisations, industry, and community groups, GA@PA aims to strengthen global collaboration and to accelerate the implementation of evidence-based strategies for physical activity promotion. Emerging technologies, including digital twins, wearable biosensors and artificial intelligence (AI)-driven analytics, are discussed as potential enabling tools for real-time monitoring and for providing input for adaptive interventions, while mobile health platforms may extend access to underserved populations. Rather than providing prescriptive solutions, the paper outlines key implementation fundamentals. These include technological infrastructure with interoperable biosensors and AI aligned with prevailing ethical frameworks such as the AI Act and UNESCO recommendations; interdisciplinary research on resilience and outlier populations; policy and education reform, including routine assessment of physical activity as a vital sign within healthcare encounters; and cross-sector collaboration spanning urban design to sport-for-development initiatives such as the International Olympic Committee (IOC)’s Olympism365. Sports organisations may support broader participation through sport-for-all programmes. The framework emphasises equity, cultural adaptation, and community co-design as critical features for scalability across diverse global contexts, highlighting the role of sport, fitness, and public health partnerships in creating a context where healthy choices become accessible and sustainable. Overall, this conceptual paper outlines a practice-informed framework proposing precision prevention as an evolving and testable implementation framework for supporting sustainable and equitable prevention systems. By integrating science, technology and policy through a multisectoral lens, precision prevention is proposed as a testable pathway to reduce the NCD burden, to enhance the health span and to foster resilient societies.

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Publication Details

Journal
Sports Medicine
Published
2026-09-21
DOI
https://doi.org/10.1007/s40279-026-02495-4
Primary Topic
Physical Activity and Health
Type
article
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article

Precision Prevention for Health: The Global Alliance Framework for the Promotion of Physical Activity

Federica FAGNANI, Fabio Pigozzi, Lena Tepohl, Wilhelm Bloch et al.
Sports Medicine
Physical Activity and Health
article

Precision Prevention for Health: The Global Alliance Framework for the Promotion of Physical Activity

Federica FAGNANI, Fabio Pigozzi, Lena Tepohl, Wilhelm Bloch, Philippe Jean-Luc Gradidge, Theodora Papadopoulou, Mikio Hiura, Merling Phaswana, Bernhard Schwaab, Xiangchen Li, Norbert Bachl, Sandra Rozenštoka, Federica Duregon, Hashel Al Tunaiji, Vahur Ööpik, Leigh Gordon, Félix Albuquerque Drummond, Willem van Mechelen, Uğur Erdener, Lars Fredrik Engebretsen, Camille Tooth, Fréderic Dutheil, Mats Börjesson, Jiao Jiao, Wolfgang Schobersberger, Gunnar Treff, Diana Marcela Ramos‐Caballero, Sophia Papamichalopoulos, Umutcan Kayıkçı, Johannes Zwerver, Mandisa Simamane, Benedict Wee Bor Tan, Borja Muñiz-Pardos, Sergio Migliorini, Petra Zupet, José A. Casajús, Chiara FOSSATI, Evert A.L.M. Verhagen, Sulin Cheng, Dina C. Janse van Rensburg, Kim R. Quimby, Martin Halle, Nicolaas P. Pronk, Jill Borresen, Luigi Di Luigi, Francesca Battista, Mourad Ghrairi, Demitri Constantinou, В. А. Бадтиева, Jürgen Michael Steinacker, Christine Joisten, Hans Hauner, José Kawazoe Lazzoli, Bülent Ülkar, Daniel Neunhäeuserer, Bernd Wolfarth, Érica Mabel Mancera-Soto, Christian Schneider, Pedro Manonelles, Yiannis Koutedakis, Emin Ergen, Jean‐François Kaux, Jeroen Swart, Marcela González‐Gross, Natalia Neophytou, Georgia Torres, Mamosilo Lichaba, Martine Duclos, Lisset Pantoja‐Arévalo, Minhao Xie, Anastasia Noel Fischer, Robert Clive Landis, Maher Zahar, Ana Cintrón‐Rodríguez, Elelwani Nevhufumba, Ruediger Reer, Julio Motta-Pensabene, Ka Ki Wong, Mark R. Hutchinson, Fotini Tsofliou, Robert Sallis, Herbert Löllgen, Vincent Onywera, Carl Ward, Guoping Li, Francisco Arroyo, Kiera Wason, Xia Zhang, Xiuqiang Wang, Jason Constantinou, Christina Howitt, Clea Papaellina, Tony Lei Shi, Ingrid Burrowes, Pieter D‘Hooghe, Feng Qiang, Andrea Ermolao, Luz Divina De La Cruz Lastre, Adewale S. Adebero, Robert Ojiambo
article en

Abstract

Abstract This conceptual, implementation-oriented paper proposes a framework for precision prevention centred on physical activity promotion and early risk mitigation, aiming to support a shift from reactive disease management toward proactive prevention. The proposed framework focuses on the early identification of risk trajectories by integrating biological, environmental, and social determinants of health through systems thinking, multi-omics technologies, digital health, and behavioural science. It aims to inform tailored, context-sensitive interventions that will help to mitigate chronic non-communicable diseases (NCDs), while supporting lifelong resilience. Within this framework, physical activity is positioned as the central, modifiable anchor behaviour through which personalised prevention strategies may be operationalised. Building on the 2025 Hamburg Declaration and the Global Alliance for the Promotion of Physical Activity’s (GA@PA) mission, this conceptual paper proposes a multidimensional model, combining personalised strategies for physical activity, nutrition, sleep, and mental health with contextual environmental adaptations. By bringing together stakeholders across multiple sectors, including healthcare, education, urban planning, sport organisations, industry, and community groups, GA@PA aims to strengthen global collaboration and to accelerate the implementation of evidence-based strategies for physical activity promotion. Emerging technologies, including digital twins, wearable biosensors and artificial intelligence (AI)-driven analytics, are discussed as potential enabling tools for real-time monitoring and for providing input for adaptive interventions, while mobile health platforms may extend access to underserved populations. Rather than providing prescriptive solutions, the paper outlines key implementation fundamentals. These include technological infrastructure with interoperable biosensors and AI aligned with prevailing ethical frameworks such as the AI Act and UNESCO recommendations; interdisciplinary research on resilience and outlier populations; policy and education reform, including routine assessment of physical activity as a vital sign within healthcare encounters; and cross-sector collaboration spanning urban design to sport-for-development initiatives such as the International Olympic Committee (IOC)’s Olympism365. Sports organisations may support broader participation through sport-for-all programmes. The framework emphasises equity, cultural adaptation, and community co-design as critical features for scalability across diverse global contexts, highlighting the role of sport, fitness, and public health partnerships in creating a context where healthy choices become accessible and sustainable. Overall, this conceptual paper outlines a practice-informed framework proposing precision prevention as an evolving and testable implementation framework for supporting sustainable and equitable prevention systems. By integrating science, technology and policy through a multisectoral lens, precision prevention is proposed as a testable pathway to reduce the NCD burden, to enhance the health span and to foster resilient societies.

Sports Medicine
University College Dublin (IE), Beijing Normal-Hong Kong Baptist University (CN), Centre National de la Recherche Scientifique (FR), University of Vienna (AT), American College of Sports Medicine (US), International Olympic Committee (CH), Nationwide Children's Hospital (US), University Medical Center Groningen (NL), Kaiser Permanente (US), German Sport University Cologne (DE), University of Padua (IT), Hong Kong Baptist University (HK), University of Thessaly (GR), Ankara University (TR), University of Cape Town (ZA), Universität Hamburg (DE), Universidade Federal Fluminense (BR), The University of Queensland (AU), University of Groningen (NL), Sechenov University (RU), University of Oslo (NO), University of the Witwatersrand (ZA), Universidad de Guadalajara (MX), Johannes Gutenberg University Mainz (DE), Université Clermont Auvergne (FR), University of Puerto Rico System (PR), Foro Italico University of Rome (IT), Beijing Normal University (CN), Universidad de Zaragoza (ES), Paracelsus Medical University (AT), Netaji Subhas National Institute of Sports (IN), Sahlgrenska University Hospital (SE), European Society of Cardiology (FR), Aomori University of Health and Welfare (JP), Latvian Academy of Sport Education (LV), KCA University (KE), Universidad Nacional de Colombia (CO), Humboldt-Universität zu Berlin (DE), University of Illinois Chicago (US), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (FR), Hospital Madre Teresa (BR), Boston Scientific (Barbados) (BB), Institute for Sports Medicine (DE), Medical Defence Union (GB), Qatar Orthopaedic and Sports Medicine Hospital (QA), German Society of Sport Science (DE), University of Clermont Auvergne (FR), Austrian Institute for Health Technology Assessment GmbH (AT), General Administration of Sport of China (CN), D•A•CH-Gesellschaft (DE), Laboratoire de Psychologie Sociale et Cognitive (FR), Zayed Military Hospital (AE), Ross University School of Medicine (BB), Ziekenhuis Gelderse Vallei (NL), Riga Stradiņš University (LV), Research Centre for Medical Genetics (RU), China Institute of Sport Science (CN), Unidad de Cirugía Cardiovascular de Guatemala (GT), Berlin Institute of Health at Charité - Universitätsmedizin Berlin (DE), Barbados Community College (BB), GGD Amsterdam (NL), Centre National de la Médecine et des Sciences des Sports (TN), Tecan (Switzerland) (CH), Weill Cornell Medical College in Qatar (QA), Dubai Medical College (AE), International Federation of Sports Medicine (CH), University of the West Indies (BB), Hong Kong Footwear Federation (CN), University Hospital Innsbruck (AT), Aomori University (JP), The Ohio State University (US), HealthPartners (US), University of Tartu (EE), Technical University of Munich (DE), Hacettepe University (TR), Universidad Católica de Murcia (ES), University of Pretoria (ZA), Charité - Universitätsmedizin Berlin (DE), University of Roehampton (GB), Universidad Politécnica de Madrid (ES), University of Gothenburg (SE), Universidad del Rosario (CO), Zayed University (AE), Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
Partnerships for the goals
Openalex Percentile: Top 11%
Physical Activity and Health
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