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.)

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.

Immaterial practices of prevention and care have existed since ancient times. However, the diversification of practices, the multiplication of professions at the intersection of prevention, care, and social assistance, and the globalization of information systems have leveled these services and obscured them at a time when medicine has made significant advances in the early detection and diagnosis of health issues. The interdisciplinary and multisectoral approach of the NPIS generates a value chain, from the design of practices to their implementation, regulation, and financing.

Innovative economic model initiatives are emerging worldwide, including fee-for-service, bundled payments, social economy provisions, offers promoting sustainable development, e-health economy, human innovation bundles, and long-term economy (World Economic Forum, 2024). The NPIS Prospective Pole, led by Michel Noguès, documents these initiatives in books (Noguès, 2022; Noguès, 2024). The NPIS Forums invite all innovators to share their experiences.

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.

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.

Indeed, the NPI Registry contributes to the development of precision medicine. For example, how can we advance this field in the non-pharmacological treatment of pain without confusing patients when a prestigious medical school like Stanford publishes such a vague, incomplete, and unranked list on its website?

• Physical activity
• Acupressure
• Acupuncture
• Application of heat or cold
• Aquatherapy
• Art therapy
• Biofeedback
• Family coaching
• Individual coaching
• Psychological conditioning
• Desensitization
• Therapeutic education
• Occupational therapy
• Horticultural therapy
• Hypnosis
• Physiotherapy
• Massage lotions
• Meditation
• Music therapy
• Posturology
• Companion presence
• Psychosocial support
• Transcutaneous electrical nerve stimulation (TENS)
• Comfort therapy
• Theatre therapy
• Psychosocial therapy
• Tonification and strengthening
• Yoga

How many hopes dashed? How much time wasted? How many futile efforts? How much money squandered? How many unnecessary carbon emissions from transport? This subtly highlights pharmacological treatments and pain surgeries, which have precise contents and proven effects. The NPIS and its partners propose a solution to break this deadlock in favor of those affected by health issues. The goal is to provide reliable information on the most relevant NPI. It is also about no longer opposing pharmacological and non-pharmacological therapies, but rather associating them wisely and at the right time.