Since 2019, 581 Sports-Health Centers have been deployed; they are not exclusively dedicated to exercise on prescription. Yet a public inspection report published in late 2025 reveals that this network is advancing without a shared compass: highly unequal services from one center to another, individual follow-up exists and assessments are widespread, but harmonized longitudinal follow-up and cohort evaluation remain to be developed, with no certainty that the most sedentary people are those being reached. Deployment is real. Elements of effectiveness exist, but long-term follow-up and evaluation of user outcomes must be strengthened.
The essentials
- 581 Sports-Health Centers exist in France as of April 2026, with over 870,000 people supported since the program’s launch.
- The 2025 IGÉSR-IGAS report documents profound heterogeneity: statuses, services, resources, and access arrangements vary significantly from one structure to another.
- The absence of a common monitoring system prevents measuring the real effects of the network on the health of supported populations.
- The scheme provides for priority populations, but the report recommends additional actions to better reach precarious populations and those far from physical activity.
- The next phase must both continue targeted deployment of Sports-Health Centers and consolidate their management, evaluation, and user follow-up.
A network that grew fast
The program started in 2019. Sports-Health Centers were created to facilitate everyone’s access to physical activity for health purposes and to adapted physical activity, particularly for people with chronic diseases. The principle of adapted physical activity—a sport prescribed by a doctor and supervised by a specialized professional—had existed in law since 2016. Sports-Health Centers were meant to become its local infrastructure.
In June 2025, the inspection counted 535 structures. About four months later, the Ministry of Sports announced 581 centers and over 870,000 people supported. The progression is rapid: it is equivalent to a new structure opening every ten days over six years.
This speed is not a defect in itself. It reflects a clear political decision and genuine mobilization of local stakeholders—sports associations, local authorities, health facilities, and mutual aid organizations. Without this deployment drive, the network would not exist. But speed has a cost: when you open fast, you standardize late.
Houses that don’t have the same walls
This structural heterogeneity also produces heterogeneity in professional trajectories within the network. Adapted physical activity educators working in well-resourced centers can specialize, progress, and develop advanced skills for specific chronic diseases. Those working in lighter structures, often part-time and on fragile funding, face instability that undermines the continuity of support. Yet continuity is precisely what distinguishes effective follow-up from a simple visit. When a professional leaves the structure, the link with the patient is often broken, and resuming adapted physical activity means starting over with a different contact person who knows neither the journey nor the specific obstacles the person faces.
Labeling defined the conditions for entering the network but did not stabilize the economic model at the same pace as territorial deployment. A labeled structure can therefore struggle to recruit qualified professionals and offer them sustainable working conditions. As long as this economic foundation remains fragile in a significant portion of centers, service heterogeneity will persist, regardless of national coordination efforts.
The report documents profound heterogeneity among Sports-Health Centers. Some are run by a hospital, others by a sports federation, others still by a local authority or association. Some have a full-time sports physician; others rely on a single part-time sports educator.
The services offered vary in similar proportions. Physical fitness assessment, medical consultation, referral to clubs, individual or collective support, coordination with the family physician: not all these components are found everywhere. Joint regional authorization by the Regional Health Agency and Regional Youth and Sports Directorate applies a national framework set by decree and order, but Sports-Health Centers maintain highly heterogeneous organizations and service offerings. It guarantees a minimum framework, not comparable service levels.
This heterogeneity has an immediate consequence for patients. Depending on where they live, the support they receive can be radically different. A resident of Rennes referred to a Sports-Health Center and a resident of a mid-sized town in the Massif Central labeled as such do not receive the same service, even if their doctor filled out the same prescription.
What you don’t measure won’t improve
The second problem raised by the inspection is even more fundamental. There is currently no common information system allowing follow-up of the journeys of supported people. The network has annual estimates of the number of people supported; the ministry’s figure of 870,000 constitutes an estimate, not an exhaustive and individual count of all users. The outcome of all users is not tracked by a national cohort, despite existing impact assessments on some beneficiaries.
The network lacks standardized answers to these questions. Assessment tools exist, but evaluation of behaviors over time and long-term health impact need to be developed, notably to measure continuity of practice after leaving the program. Data are collected through heterogeneous tools and incompletely, despite annual national reporting.
This is a serious limitation for public health policy. Without follow-up data, it is impossible to identify what works, adjust what functions less well, or defend the program against budget trade-offs. A network that does not measure its effects produces spending without being able to prove its usefulness, which ultimately weakens it.
The monitoring question points to a longer-standing tension in French sports policies, which the reading notes on Human Rights and Sport by Sarah Joseph document well: formal rights and infrastructure created to exercise them are insufficient if accountability mechanisms are lacking.
Profile of people who use the centers
Available data reveal underrepresentation of populations from priority territories, but their incomplete nature limits analysis. The global count alone is insufficient, but territorial indicators already allow partial assessment of reaching target publics. A center showing high activity volume sometimes reaches people already sensitized who could have found another physical activity service on their own. Impact on sedentary behavior in the population depends on actually reaching target publics, even if attendance indicators seem satisfactory. This gap between measured activity and real impact is a classic problem with voluntary prevention schemes.
It is not resolved by making centers more attractive or visible; accessibility alone does not primarily draw distant populations. It is resolved through outreach work supported by trusted intermediaries for distant publics: neighborhood doctors, precarity structures, municipal social services. These relays require coordination that exceeds the sports-health center alone and involves the entire primary care system. Without this explicitly organized articulation, the network risks functioning well for part of the population while not reaching sufficiently those for whom it was designed.
The third tension identified by the report is perhaps the most politically delicate. It concerns the profile of supported people.
Sports-Health Centers were designed to reach populations most distant from physical activity: people with chronic illnesses, those in precarious situations, immobile patients, territories underserved in sports offerings. Sports-Health Centers welcome diverse publics, including a significant share of people with pathologies, long-term conditions, or risk factors. Despite regulatory targeting of fragile and priority publics, Sports-Health Centers still struggle to reach them in sufficient proportion.
This phenomenon is not unique to sports-health. It is found in cardiovascular prevention programs, in access to cancer screening, in nutrition consultations. The most informed and mobile people are first through the door. Priority populations arrive later, if schemes have been designed to reach them, which requires active work directing them by family physicians, social workers, and town halls.
The report does not say that Sports-Health Centers are failing. Available evaluations support positive impact, but data show that some priority publics remain insufficiently reached and long-term follow-up must be strengthened. This is an important distinction: one would be a finding of failure, the other an invitation to build tools that would allow deciding.
Measurement practices in other countries
A few countries have launched comparable programs with more robust evaluation protocols. Sweden, for example, developed through its public health agency a physical activity on prescription program, FYSS, with a national register system allowing patient follow-up over twelve to eighteen months. Published results show measurable improvement in physical fitness and reduced medical consultations for patients most assiduous in the program.
The European EUPAP program, coordinated by public health agencies of several member countries including Sweden, seeks precisely to federate these disparate approaches around common protocols. France participates, which opens a concrete path to catch up on measurement without starting from scratch.
Sports-Health Centers rely on their own logic, rooted in the French associative fabric. Cohort studies and improved information systems could strengthen use of support data.
Consolidate rather than accelerate
The political moment is particular. The network has reached critical mass: 581 structures is sufficient to cover a significant part of the territory. The report recommends continuing deployment while standardizing certain norms, management, and monitoring tools.
Network stakeholders—sports federations, regional health agencies, adapted physical activity professionals—have begun working on these issues. Shared assessment tools are emerging in some regions. The strengthened authorization framework stems mainly from the March 2023 decree and April 2023 order. These developments go in the right direction, but remain dispersed.
The next step is both technical and political: build a national information system, define a base of services each center must offer, and explicitly clarify the populations toward which to direct efforts. General practitioners, natural prescribers of adapted physical activity, could be better equipped to prioritize referring patients who need it most.
These questions do not challenge the network’s existence. They are the condition for the 870,000 people supported to attest to activity volume and allow measuring real health impact, and for the program to remain defensible at a time when prevention budgets face tight trade-offs.
Sources
- General Inspectorate of Education, Sport and Research (IGÉSR) and General Inspectorate of Social Affairs (IGAS), Report on Sports-Health Centers, December 2025
- Ministry of Sports, assessment of the Sports-Health Centers network, April 2026 (institutional communication)
- Swedish Public Health Agency, FYSS program (Fysisk aktivitet i Sjukdomsprevention och Sjukdomsbehandling), patient follow-up data (no certified URL)
- European EUPAP program (European Physical Activity on Prescription), coordinated by several European national public health agencies (no certified URL)
