Améliorer la connaissance et la reconnaissance des interventions non médicamenteuses : implications pour la santé publique d’une étude participative et de consensus.

Introduction: In the absence of a consensus on the definition and evaluation of non-pharmacological interventions (NPI)-despite the use of the concept by the World Health Organization, the French Health Authority, the Ministry of Health, and the European Centre for Disease Prevention and Control-this study has co-constructed a consensus-based paradigm aligned with international health research standards. This article outlines its relevance and limitations for public health.

Method: Over a two-year period, the study engaged all stakeholders, i.e., more than 1,000 participants. Participatory workshops based on international health research recommendations and experiential knowledge, and consensus sessions were conducted under the guidance of a multidisciplinary committee and with the logistical support of the Non-Pharmacological Intervention Society. These efforts helped to identify the key descriptive and evaluative invariants specific to NPIs. Four phases followed: development, improvement, voting, and consultation.

Results: The term NPI refers to prevention or care protocols with a physical, nutritional, or psychosocial focus, targeting a health issue and personalized by a qualified professional. The evaluation framework comprises 77 invariants-14 ethical and 63 methodological-distributed across five types of study: mechanistic, observational, prototypical, interventional, and implementation. The NPIS Model paradigm was endorsed by 31 learned societies and three French health authorities.

Conclusion: The term NPI should be reserved for prevention and care protocols that are described, explainable, effective, safe, and implementable. The consensual framework for co-constructed evaluation should promote the transfer of NPIs from research to practice, their interprofessional coordination, contextual adaptation, continuous improvement, training, and, finally, their recognition. This scientific paradigm strengthens the role of public health professionals in developing targeted, efficient, and potentially fundable interventions for at-risk or ill populations. It paves the way for the development of an open registry of intangible health care practices that can be codified, shared, traced, and improved, informed by user feedback. This paradigm does not, however, cover all areas of public health.