An independent healthcare professional or a multidisciplinary team from a multi-professional health center, a care network, a hospital, a medico-social establishment, a medico-educational facility, a nursing home, a prevention center, an occupational health service, a school/university service, or a palliative care service can select one or more NPI to integrate into an individual's personalized health pathway. This applies to individuals facing loss of autonomy (e.g., a frail person over 90 years old), at increased risk of illness (e.g., a smoker), living with a disability (e.g., loss of autonomy due to paraplegia), or suffering from an illness (e.g., a neurodegenerative disease). Given that health issues are now multifactorial and complex, the solutions available to improve each person's health are diverse and depend on local availability. Multiple NPI can be offered in prevention, care, and support by a physician, any authorized healthcare professional (e.g., pharmacist, nurse, midwife, physiotherapist), or a team. They are cataloged in a centralized digital platform, the NPI Registry. These NPI complement other health solutions provided at various points in a person's life journey (e.g., medication, medical devices, hospitalization, social assistance). They evolve over time based on the individual's health status, fragility, and needs (Figure 4).

Each NPI file in the NPI Registry has been submitted by a practitioner or researcher through the dedicated platform hosted by the NPIS. Each file undergoes review by an independent and integrated scientific committee. This committee invites relevant scientific societies and health authorities to validate the NPI files and/or to oversee the decisions made. Each validated file is then reviewed by a committee of users and professionals. Once labeled NPIS©, the file is translated into at least English and French and integrated into the NPI Registry.

The file contains standardized content supported by scientific studies that align with the NPIS definition of NPI, the expected specifications (Table 2), and the consensual evaluation framework for NPI, known as the NPIS Model. It includes a manual for professionals, an information notice for users, a section on funding options, and an area for anonymous user feedback. This ensures the file remains dynamic and part of a virtuous cycle of continuous improvement for the NPI.

A minimum of one prototypical study, one mechanistic study, two interventional studies, and one implementation study published in a peer-reviewed journal is required for an NPI proposal to be accepted by the expert committee tasked with validating the NPI file and awarding the NPIS© label. Specifically, experts must have evidence to anonymously vote on each criterion of the NPI file proposed to the NPIS by a submitter:

• Described (≥ 1 prototypical study)
• Explainable (≥ 1 mechanistic study)
• Effective (≥ 2 interventional studies)
• Safe (≥ 2 interventional studies)
• Implementable (≥ 1 implementation study in the country)

A professional must understand all the specifics of the NPI, the criteria justifying its use, how to implement its protocol, whom to contact, useful tips, required materials, and any prerequisite training needed.

The NPIS has outlined a roadmap from 2021 to 2030 aligned with the strategies of European and international health institutions. To this end, it has initiated discussions with the European Public Health Association (EUPHA), involved in health service innovation, the European Centre for Disease Prevention and Control (ECDC), which is planning to create a registry, the European Commission, which aims to promote "health, nutrition, mental health, and psychosocial support to communities," and WHO Europe, which intends to identify the "most effective health interventions" by 2030. The NPIS submitted several European projects in 2024.

The NPIS is also engaging with WHO, which has advocated for "self-care interventions" since 2022, included NPI in its Global Action Plan for Mental Health published in 2022, and identified "the most effective and feasible interventions in a national context" in a report published in 2021. Additionally, it is collaborating with other international organizations such as UNESCO, which has promoted "specific health and well-being education interventions" since 2016, UNICEF, which has advocated for sharing "effective health interventions" since 2016 and developing "primary healthcare" since 2018, the UN, which has called for "accelerating essential health services" since 2023, and the Coalition of Partnerships for Universal Health Coverage and Global Health, advocating for "people-centered, comprehensive, and integrated services" since 2021.

Thus, an ecosystem for NPI, from research to practice through training and delivery, is being constructed, with NPIS actively participating. It involves all stakeholders, both academic and non-academic, to create a true value chain benefiting personalized and precision medicine based on science, sustainable health, and equitable longevity. With over 2.1 billion people aged over 60 by 2050, multistakeholder collaborations will be the foundation of a sustainable and equitable longevity economy.

This is why forums on NPI have been organized since 2024 in France and Europe, called NPIS Forum. An international summit titled NPIS Summit takes place every year in October, and regional events called NPIS Satellite gather professionals and users around a health theme.

Moving, eating, drinking, sleeping, talking, reading, writing, painting, listening to music, watching a movie, dancing, laughing, walking, singing, meditating, gardening, socializing, etc., are all activities of daily life. Some of these can generate joy, pleasure, personal growth, and well-being. In a democratic country, everyone is free to interpret and experience these activities in their own way. This relates to life philosophy, lifestyle, the art of living, and personal development. In other words, a daily activity is not an intervention, even if it can occasionally and randomly contribute to the health of certain individuals. Occupational activities and treatments for health problems identified by medicine are different.

The following products are not considered NPI:

• Hygiene and beauty products (shampoo, toothpaste, brush, body cream, etc.)
• Natural products (plants, food, mushrooms, essential oils, etc.)
• Health products (medications, implantable biological materials, dietary supplements, etc.)
• Medical devices (artificial organs, prosthetics, orthotics, digital applications, monitoring systems, etc.)

The following goods and services are not considered NPI:

• Cultural products or services (video games, books, podcasts, artistic practices, museum visits, theater, writing, etc.)
• Everyday consumer products or services (haircuts, aesthetic treatments, dining out, etc.)

The following actions are not considered NPI:

• Public health promotion activities (communication campaigns, videos, posters, booklets, websites, social media posts, etc.)
• Architectural adaptations (creating access ramps, etc.)
• Environmental adaptations (reforestation of a park, creation of a sports workshop, etc.)

The following approaches are not considered NPI:

• Professional disciplines (physiotherapy, psychology, dietetics, public health, etc.)
• Educational approaches (personal development, etc.)
• Esoteric practices (spiritual practices, religious worship, divination, witchcraft, etc.)

The following organizations are not considered NPI :

• Health organizations (networks, platforms, clinics, health centers, healthcare establishments, etc.)
• Health systems (digital platforms, etc.)

The following measures are not considered NPI :

• Health policies (strategies, plans, programs, etc.)
• Regulations (decrees, laws, etc.)
• Judicial decisions (warnings, convictions, etc.)

PSYCHOSOCIAL DOMINANCE

Psychotherapies:

• Cognitive Stimulation Therapy for memory strategies in Alzheimer’s disease in 14 sessions by a psychologist in a healthcare facility, health center, or private practice.
• Mindfulness Based Stress Reduction (MBSR-BC) program against anxiety during cancer treatments in 8 group sessions by a clinical psychologist, psychiatrist, or physician in an oncology department, a patient association, a private practice, a health center, or a healthcare facility.
• Acceptance and Commitment Therapy for chronic pain in 9 group sessions by a clinical psychologist or psychiatrist in a healthcare facility, health center, or private practice.
• Cognitive Behavioral Therapy for Insomnia (CBT-I) in 6-8 individual sessions, either remote or in-person, by a neuropsychologist, clinical psychologist, psychiatrist, or neurologist in a healthcare facility, health center, or private practice.
• Now I Can Do Heights program using virtual reality to treat acrophobia (fear of heights) by a clinical psychologist or psychiatrist in a private practice or health center.

Health Prevention Programs:

• Living Well with COPD therapeutic education program against symptoms and exacerbations of COPD over 2 months with 4 sessions, in-person or remote, by a nurse, physician, or pharmacist in a healthcare facility, health center, or private practice.
• CHESS Method (Chronic Headache Education and Self-management) for migraine self-management by a nurse or physician in a healthcare facility, health center, or private practice.
• MyFriend Youth Program for preventing anxiety and depression among students aged 12 to 15 years, 10 sessions by a school psychologist or school nurse in an educational institution.
• Spiegel Hypnotherapy Method specialized in smoking cessation in 3 sessions by a psychologist, nurse, physician, or hypnotherapist in a private practice, healthcare facility, health center, or private practice.
• Cognitive Behavioral Therapy for Depression (CBT-d) by a clinical psychologist or psychiatrist in a healthcare facility, health center, or private practice.

CORPOREAL DOMINANCE

Physiotherapy Protocols:

• McKenzie Method for back pain by a physiotherapist in a healthcare facility, health center, or private practice.
• Pelvic Floor Muscle Training (PFMT) program by a midwife or physiotherapist in a health center or private practice.
• Rehabilitation program following hip prosthesis in 6 to 10 sessions by a physiotherapist in a healthcare facility, health center, or private practice.

Adapted Physical Activity Programs:

• Dance Therapy for Parkinson’s Disease addressing psychological symptoms of Parkinson’s by a physical activity instructor in a healthcare facility, health center, or private practice.
• Re-exercise program at ventilatory threshold against dyspnea caused by COPD by a physical activity instructor or physiotherapist in a healthcare facility, health center, or private practice.
• Anti-fatigue APA program during treatments for breast, prostate, or colon cancer by a physical activity instructor in a healthcare facility, health center, or private practice.

Thermal Treatments:

• Specialized thermal cure for gonarthrosis by a physiotherapist or thermal agent in a thermal facility.

NUTRITIONAL DOMINANCE

• Gluten-free diet for celiac disease by a dietitian in a healthcare facility, health center, or private practice.
• FODMAP diet for gastrointestinal disorders by a dietitian in a healthcare facility, health center, or private practice.

Interoperability between the information systems of healthcare providers and funders is crucial for the efficiency of NPI. Assigning a unique code to an NPI enhances information sharing, decision-making, implementation quality, traceability, monetization, and impact analysis. This way, an NPI becomes an identifiable act within an institutional nomenclature. The characteristics of an NPI are described and justified by studies published in peer-reviewed scientific journals that meet international health research standards. They must conform to the NPIS Model. Innovative practices, through a process of standardization and independent expertise, become NPI labeled as NPIS©. They can be integrated into personalized health pathways by a professional, a multidisciplinary team, a health center, a care facility, a medico-social organization, a health network, a digital platform, or any other organization authorized to provide health solutions. With a unique coding system for each NPI that is interoperable with insurance and professional nomenclatures, authorities in a country and insurance systems can implement monitoring and feedback procedures regarding the use of NPI according to their risk management levels. Data from user experiences, professionals, healthcare providers, and institutions can lead to new research questions. Research can foster innovations, such as isolating more specific, effective, implementable, and efficient NPI within local platforms and organizations.