An evidence-based data point is a theoretical or practical knowledge acquired through rigorous and integrated scientific methods and reasoning. The NPIS Model follows this logic in the health field (see Figure 3). It provides specific methodological and ethical recommendations for NPI for studies focusing on their mechanisms and explanatory processes (mechanistic study), their content (prototypical study), their evolution over time (observational study), their benefits and risks (interventional study), and their application and personalization modalities (implementation study).

The choice and implementation of an NPI at a given moment in a person's prevention and care journey do not depend on the NPI Registry, nor on the mission of the NPIS. These decisions are influenced by individual health situations, preferences, the availability of professionals, the qualifications of practitioners, accessibility in a given area, and socio-cultural contexts. The art of combining NPI with each other and with other health solutions at the right time lies with professionals, expert systems, interdisciplinary organizations, and the healthcare system in place in a specific country. The NPI Registry highlights essential practices that have proven effective and continue to evolve through research and feedback analysis. The NPIS has no authority to impose a choice of NPI. Each professional is free to follow them, to pursue others, or to create new ones. The same applies to each healthcare organization.

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.

In France, the term "professional" is broader than the term "practitioner," which is limited to the 24 healthcare professionals defined in the Public Health Code (CSP). For example, a clinical psychologist and a teacher in adapted physical activity (APA) are professionals who work for the health of individuals by offering NPI for preventive or therapeutic purposes, but they are not considered "health professionals" in the strict sense of the CSP. Some professions fall under the Social Action and Families Code (e.g., specialized educator) or the Sports Code. In Europe and worldwide, the issue becomes more complex because health-related professions do not share the same designations. For instance, "masseur-kinésithérapeute" in France is referred to as "physiotherapist" in most other countries. NPI can serve as common denominators across countries, as they will have a unique code and specification sheet.

This criterion was established for the scientific validation of medications. It is impossible to think that psychotherapy led by a psychologist or a diet plan supervised by a dietitian can be concealed from a study participant. Every effort has been made to establish the best causal link between the proposal of a practice and its effects on health, taking into account the specificities of NPI without compromising the expected rigor and ethics of health research. Our recommendations aim to minimize biases and enhance validity and reproducibility. However, this will never prevent some individuals or promoters from committing fraud. Given the lower health risks of NPI compared to rapid-action health products (such as surgery, fast-acting medications, or implantable medical devices) and their potential interest in prevention, pragmatic real-world trials or effectiveness studies best address the consideration of risks. Additionally, the evaluation of an NPI has justified conducting an implementation study within the specific country to avoid extrapolating results from one cultural context to another.

The term NPI has been used by scientists working in the health field since 1975. However, it is not the only term; other similar terms are used synonymously, especially in PubMed. There are ten English terms to describe non-pharmacological processes and twenty-eight to describe methods of operation. An exhaustive inventory of NPI on a scientific article search engine is currently impossible due to the variety of terms researchers use, each with distinct meanings: rehabilitation intervention, psychosocial intervention, mental intervention, cognitive intervention, psychological intervention, behavioral intervention, psychosomatic intervention, nutrition intervention, dietary intervention, food intervention, physical intervention, body intervention, exercise intervention, manual intervention, salutogenic intervention, natural intervention, self-help intervention, nursing intervention, therapy intervention, care intervention, disease management intervention, multimodal intervention...

A search on PubMed from August 15, 2024, indicates 55,689 articles citing the term "non-pharmacological" or its equivalent up to 2023. While these figures do not challenge the trend, they are likely underestimated due to the database's focus on health products rather than services, biological treatments over psychosocial ones, studies on North American populations, and journals published by North American organizations. This aligns with an official U.S. government site managed by the National Center for Biotechnology Information and hosted by the National Library of Medicine, part of the National Institutes of Health (NIH).

A search on PubMed from August 15, 2024, also reveals 11,642 articles citing the term "non-pharmacological intervention" or its equivalent up to 2023. Both curves demonstrate an increase since 2000, with a notable acceleration since 2010.

The French National Authority for Health has been encouraging the use of the term NPI in health since 2011.