Jürgen M Steinacker, Willem van Mechelen, Lars Engebretsen, Evert Verhagen, Mats Börjesson, Marcela González-Gross, Mark R Hutchinson, Petra Zupet, Herbert Löllgen, Dina C Janse van Rensburg, Norbert Bachl, Sergio Migliorini, Pieter D'Hooghe, Christian Schneider, Jiao Jiao, Ka Ki Wong, Jeroen Swart, Leigh Gordon, Victoria Badtieva, Borja Muniz-Pardos, Tony Lei Shi, Li Xiangchen, Feng Qiang, Guoping Li, Minhao Xie, Xia Zhang, Uğur Erdener, Federica Fagnani, Fabio Pigozzi, Chiara Fossati, Luigi Di Luigi, Francisco Arroyo, Jean-François Kaux, Camille Tooth, Shulin Cheng, Xiuqiang Wang, Emin Ergen, Bülent Ülkar, Frederic Dutheil, Ruediger Reer, Theodora Papadopoulou, Clea Papaellina, Demitri Constantinou, Jason Constantinou, Merling Phaswana, Mamosilo Lichaba, Philippe Gradidge, Mandisa Simamane, Georgia Torres, Natalia Neophytou, Elelwani D Nevhufumba, Bernhard Schwaab, José Antonio Casajús Mallen, Martin Halle, Martine Duclos, Daniel Neunhaeuserer, Andrea Ermolao, Francesca Battista, Federica Duregon, Julio Motta-Pensabene, Yiannis Koutedakis, Lena Tepohl, Wilhelm Bloch, Nicolaas P Pronk, Anastasia Fischer, Lisset Pantoja-Arévalo, Ana V Cintrón, Adewale S Adebero, Jill Borresen, Johannes Zwerver, Diana M Ramos-Caballero, Erica M Mancera-Soto, Pedro Manonelles, Benedict Tan, Ingrid Burrowes, Carl Ward, Kim R Quimby, Christina Howitt, Robert Clive Landis, Hans Hauner, Mikio Hiura, Luz Divina De La Cruz Lastre, Gunnar Treff, Fotini Tsofliou, José Kawazoe Lazzoli, Umutcan Kayıkçı, Mourad Ghrairi, Vincent Onywera, Robert Ojiambo, Robert Sallis, Sophia Papamichalopoulos, Maher Zahar, Christine Joisten, Bernd Wolfarth, Sandra Rozenstoka, Hashel Al Tunaiji, Kiera Wason, Felix Drummond, Wolfgang Schobersberger, Vahur Ööpik, Eve Unt, Anna Jegier, Stéphane Doutreleau, Seung Hoon Han, Jörg F Debatin, Nils Schumacher, Luís B Sardinha, Lenka Dienstbach-Wech, Tuba Melekoğlu, Sheng Zeng, Maurizio Casasco, Kristy Howells, Eva-Maria Klinkisch, James Bilzon, Gregory Heath, Thomas Horstmann, Eduardo H De Rose, Nick Webborn, Klaus-Michael Braumann, Li Jing, Xiao Xu, Elizabeth Moxley, Yi Zheng, Alison V September, Malcolm Collins, Olena Andrieieva, Svitlana Drozdovska, Andreas Michael Nieß, Rikke Helene Moe, Carolin Knoke, Silvano Zanuso, Francesco Zanatta, Veronika Všetíčková, Spyridon Zormpas, Christoforos D Giannaki, Brian P Carson, Matthew P Herring, Ciara McCormack, Marco Vecchiato, Thomas Yvert, Makro Korenjak, Benjamin Billet, Andréia Lópes Azevedo, Naama Constantini, Sigmund Loland, Aaron Leigh Baggish, Luis Monteiro, Nuray Yazihan, Yannis P Pitsiladis
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.