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

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.