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How can evidence-based health promotion and disease prevention policies and actions be designed and implemented? In its report, the French General Inspectorate of Social Affairs (IGAS) first analyzes the concept of scientific evidence from a broad perspective before focusing on local HPDP initiatives aimed at modifying health-damaging behaviors.

In France, health promotion and disease prevention encompasses a wide and heterogeneous range of interventions. These vary depending on the targeted risk factors (tobacco use, alcohol consumption, nutrition, etc.), the priority populations, the methods used (taxation, social marketing, regulation, etc.), and the stakeholders involved (local authorities, healthcare professionals).

In Anglo-Saxon countries and Northern Europe, health promotion and disease prevention strategies have, since the 1990s, been increasingly informed by scientific evidence, drawing inspiration from the principles of evidence-based medicine—which grounds practices in data from clinical trials and real-world evaluations.

Key Findings

Initially, the task force outlines this evidence-based approach to HPDP interventions. In France, the lack of a structured evaluation system for the effectiveness and efficiency of health promotion and disease prevention programs means that public policy prioritization criteria are often absent. This can lead either to a narrow cost-saving approach focused on reducing healthcare expenditures or to a fragmented and uncoordinated implementation of HPDP actions.

The research on local HPDP initiatives reveals that most stakeholders agree on the need to rely on "evidence of effectiveness" when designing and implementing such actions. However, putting this principle into practice remains difficult. The main obstacles include the weak academic infrastructure in the field of health promotion and disease prevention and limited funding to support research and evidence-based implementation.

Rather than following a planned, coordinated approach, the rollout of evidence-based programs tends to follow an "opportunistic" logic. Local actors develop pilot projects based on their remaining budget capacity and the availability of motivated partners. This fragmented organization runs counter to the national ambition of developing social and emotional learning (SEL) in children through a multi-year strategy based on robust evidence regarding the short- and medium-term effectiveness and efficiency of
such programs—not only in terms of health outcomes, but also school climate and academic achievement.

Three Key Recommendations

Against this backdrop, the task force outlines three main areas for actionable recommendations :

• Develop cost-effectiveness studies for health promotion and disease prevention interventions and appoint an institution responsible for setting public health priorities based on evidence-based recommendations;

• Launch the nationwide implementation of social and emotional learning in schools over a three-year timeline, in partnership with regional education authorities, regional health agencies, and the national health insurance system. This initiative, whose positive impact on school climate is well documented, would align with the prioritization of mental health in 2025;

• Lastly, the Health Innovation Agency’s work under the “Prevention Acceleration Strategy” should support the development of the academic field of public health intervention research, helping to establish a stronger evidence base for future actions.

Access to the entire report in French

• La prise en compte des preuves scientifiques dans les actions de prévention et de promotion santé