The Mon Bilan Prévention device has just crossed a regulatory milestone that redistributes roles among health professionals. Since October 1, 2026, physiotherapists can voluntarily conduct this assessment, expanding the territorial network of a program previously limited to doctors, midwives, nurses, and pharmacists. This extension concretely modifies the daily health prevention chain and deserves a detailed examination of its technical implications.
Mon Bilan Prévention: What Changes with the Inclusion of Physiotherapists
The assessment covers five areas: nutrition, physical activity, sleep, addictions, and mental health. Until now, the capacity for musculoskeletal evaluation was lacking in the device.
A physiotherapist identifies postural deficits, joint limitations, or strength imbalances that other qualified professionals do not test in standard consultations. The personalized prevention plan now incorporates a functional component, allowing for the prescription of adapted physical activity based on biomechanical principles rather than simple generic recommendations.
We observe that this evolution also addresses an access issue: in areas underserved by doctors, physiotherapy practices often serve as the first point of contact for patients with the healthcare system. Making the assessment accessible through these practitioners mechanically increases the completion rate without creating additional costs for the insured, as the device remains free and without upfront costs.
You can find all the news from J’améliore ma Santé that regularly detail the developments of this type of program.
Sleep and Public Policy: A Shift Towards the Collective Environment
Classic sleep hygiene recommendations (screen off, cool room, regular hours) saturate public health content. The notable change in 2026 concerns the framework in which these recommendations are situated.
The government plans to act on the environment rather than solely on individual behavior. The approach includes creating quiet spaces, adapting collective schedules, and considering urban noise disturbances as factors degrading sleep. This represents a methodological shift: moving from a logic of holding the sleeper accountable to a logic of improving the living environment.
For health professionals, this orientation changes the nature of prescriptions. Recommending “better sleep” without addressing ambient noise or professional time constraints has always posed an effectiveness problem. If the announced measures materialize, we will have an additional argument to guide patients towards territorial devices rather than simple advice sheets.
Prevention and Funding: Senate Report No. 789
The Senate report No. 789, published on June 24, 2026, proposes a structural reorganization of prevention in France. Three measures stand out to practitioners:
- The creation of a national coalition of prevention operators, which would coordinate actors currently dispersed among ARS, health insurance funds, local authorities, and associations
- The integration of adapted physical activity into certain mandatory guarantees of complementary health insurance, which would transform APA from a reimbursed option on a case-by-case basis into an enforceable right
- The establishment of a digital prevention booklet, aimed at ensuring the traceability of assessments and actions taken throughout life
This last point deserves attention. An interoperable digital prevention booklet would fill the current gap in follow-up between Mon Bilan Prévention and city consultations. Today, a patient who completes their assessment with a pharmacist and then consults a physiotherapist six months later starts from scratch due to the lack of standardized transmission.
Adapted Physical Activity: HAS Thresholds and Their Real Application
The Haute Autorité de santé recommends promoting physical activity and reducing sedentary behavior among adults. In practice, we recommend distinguishing three levels of intervention based on the patient’s profile.
The first concerns strictly sedentary individuals, for whom any increase in daily movement (walking, climbing stairs, prolonged standing) yields measurable benefits on metabolic markers. The second targets insufficiently active individuals, who move but below recommended thresholds. The third focuses on patients with chronic conditions, for whom adapted physical activity functions as a non-drug treatment with specific protocols.
The potential integration of APA into mandatory guarantees of complementary health insurance would change the game for this third group. Today, out-of-pocket costs hinder participation: a cycle of twelve supervised sessions represents a cost that many patients cannot bear without coverage.
Dementia and Modifiable Factors: The New WHO Guidelines
According to the new WHO guidelines released in September 2026, up to 45% of dementia cases could be prevented or delayed by addressing modifiable factors. This proportion, which is an increase from previous estimates, expands the list of recognized levers.
Among the targeted factors are hypertension, sedentary behavior, social isolation, depression, diabetes, and uncorrected hearing loss. The latter remains underestimated in prevention consultations: unassisted hearing deficits accelerate cognitive decline by reducing sensory and social stimulation.
For professionals involved in Mon Bilan Prévention, these guidelines reinforce the relevance of systematic screening for sensory disorders starting from mid-life assessments, and not just for patients who spontaneously complain about their hearing.
The interplay between these various advancements (expansion of the Prevention Assessment, public sleep policy, funding for APA, dementia prevention) outlines a system where prevention ceases to be an optional supplement. The digital booklet proposed by the Senate could become the guiding thread, provided its deployment does not replicate the delays experienced by Mon Espace Santé.
