Promotion de la santé par la mise en place d'une activité physique sur le lieu de travail

Texte intégral

(1)Promotion de la santé par la mise en place d’une activité physique sur le lieu de travail Jo-Hanna Planchard. To cite this version: Jo-Hanna Planchard. Promotion de la santé par la mise en place d’une activité physique sur le lieu de travail. Médecine humaine et pathologie. 2014. �dumas-01201540�. HAL Id: dumas-01201540 https://dumas.ccsd.cnrs.fr/dumas-01201540 Submitted on 17 Sep 2015. HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers.. L’archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d’enseignement et de recherche français ou étrangers, des laboratoires publics ou privés..

(2)

(3) 81,9(56,7e1,&(623+,$$17,32/,6 )$&8/7e'(0('(&,1( . 352027,21'(/$6$17(3$5/$ 0,6((13/$&('¶81($&7,9,7e3+<6,48( 685/(/,(8'(75$9$,/ THESE 3UpVHQWpHHWSXEOLTXHPHQWVRXWHQXHGHYDQWOD)DFXOWpGH0pGHFLQHGH1LFH /HVHSWHPEUH 3DU Mme Jo-Hanna PLANCHARD 1pHOHDYULOj1LFH $OSHV0DULWLPHV

(4) 3RXUREWHQLUOHJUDGHGH'RFWHXUHQ0pGHFLQH GLSO{PHG¶pWDW

(5) Jury de thèse:. Président du jury : 0RQVLHXUOH3URIHVVHXU&KULVWLDQ35$',(5 Assesseurs : 0RQVLHXUOH3URIHVVHXU3DWULFN%$48( 0RQVLHXUOH3URIHVVHXU'RPLQLTXH35,1*8(< 0DGDPHOH'RFWHXU(YHO\QH%$55( 0DGDPHOH'RFWHXU&DULQH5(%28,//$76$9< Directeur de thèse : 0RQVLHXUOH'RFWHXU.DULP7,)5$7(1(.

(6) UNIVERSITÉ DE NICE-SOPHIA ANTIPOLIS. FACULTÉ DE MÉDECINE _________ Liste des professeurs au 1er novembre 2013 à la Faculté de Médecine de Nice. Doyen. M. BAQUÉ Patrick. Assesseurs. M. BOILEAU Pascal M. HÉBUTERNE Xavier M. LEVRAUT Jacques. Conservateur de la bibliothèque. M. SCALABRE Grégory. Chef des services administratifs. Mme CALLEA Isabelle. Doyens Honoraires. M. AYRAUD Noël M. RAMPAL Patrick M. BENCHIMOL Daniel. Professeurs Honoraires M. BALAS Daniel M. BLAIVE Bruno M. BOQUET Patrice M. BOURGEON André M. BOUTTÉ Patrick M. BRUNETON Jean-Noël Mme BUSSIERE Françoise M. CHATEL Marcel M. COUSSEMENT Alain M. DARCOURT Guy M. DELMONT Jean M. DEMARD François M. DOLISI Claude M. FREYCHET Pierre M. GÉRARD Jean-Pierre M. GILLET Jean-Yves M. GRELLIER Patrick M. HARTER Michel M. INGLESAKIS Jean-André M. LALANNE Claude-Michel M. LAMBERT Jean-Claude M. LAPALUS Philippe M. LAZDUNSKI Michel M. LEFEBVRE Jean-Claude M. LE BAS Pierre M. LE FICHOUX Yves. M. LOUBIERE Robert M. MARIANI Roger M. MASSEYEFF René M. MATTEI Mathieu M. MOUIEL Jean Mme MYQUEL Martine M. OLLIER Amédée M. ORTONNE Jean-Paul M. SCHNEIDER Maurice M. SERRES Jean-Jacques M. TOUBOL Jacques M. TRAN Dinh Khiem M. ZIEGLER Gérard.

(7) M.C.A. Honoraire. Mlle ALLINE Madeleine. M.C.U. Honoraires. M. ARNOLD Jacques M. BASTERIS Bernard Mlle CHICHMANIAN RoseMarie M. EMILIOZZI Roméo M. GASTAUD Marcel M.GIRARD-PIPAU Fernand M. GIUDICELLI Jean M. MAGNÉ Jacques Mme MEMRAN Nadine M. MENGUAL Raymond M. POIRÉE Jean-Claude Mme ROURE Marie-Claire. PROFESSEURS CLASSE EXCEPTIONNELLE M. AMIEL Jean M. BENCHIMOL Daniel M. CAMOUS Jean-Pierre M. DARCOURT Jacques M. DELLAMONICA Pierre M. DESNUELLE Claude Mme EULLER-ZIEGLER Liana M. FENICHEL Patrick (54.05) M. FRANCO Alain M. FUZIBET Jean-Gabriel M. GASTAUD Pierre M. GILSON Éric M. GRIMAUD Dominique M. HASSEN KHODJA Reda M. HÉBUTERNE Xavier M. HOFMAN Paul M. LACOUR Jean-Philippe Mme LEBRETON Élisabeth (50.04) M. MICHIELS Jean-François M. PRINGUEY Dominique M QUATREHOMME Gérald M. SANTINI Joseph M. THYSS Antoine M. VAN OBBERGHEN Emmanuel. Urologie (52.04) Chirurgie Générale (53.02) Thérapeutique (48.04) Biophysique et Médecine Nucléaire (43.01) Maladies Infectieuses ; Maladies Tropicales (45.03) Biologie Cellulaire (44.03) Rhumatologie (50.01) Biologie du Développement et de la Reproduction Gériatrie et Biologie du vieillissement (53.01) Médecine Interne (53.01) Ophtalmologie (55.02) Biologie Cellulaire (44.03) Anesthésiologie et Réanimation Chirurgicale (48.01) Chirurgie Vasculaire (51.04) Nutrition (44.04) Anatomie et Cytologie Pathologiques (42.03) Dermato-Vénéréologie (50.03) Chirurgie Plastique, Reconstructrice et Esthétique Anatomie et Cytologie Pathologiques (42.03) Psychiatrie d'Adultes (49.03) Médecine Légale et Droit de la Santé (46.03) O.R.L. (55.01) Cancérologie, Radiothérapie (47.02) Biochimie et Biologie Moléculaire (44.01). .

(8) PROFESSEURS PREMIERE CLASSE M. M. M. M. M. Mme M. M. M. M. M. M. Mme M. M. M. M. M. M. M. Mme M. Mme M. M. M. M.. BATT Michel BÉRARD Étienne BERNARDIN Gilles BOILEAU Pascal BONGAIN André CRENESSE Dominique DE PERETTI Fernand DRICI Milou-Daniel ESNAULT Vincent FERRARI Émile GIBELIN Pierre GUGENHEIM Jean ICHAI Carole LONJON Michel MARQUETTE Charles-Hugo MARTY Pierre MOUNIER Nicolas MOUROUX Jérôme PADOVANI Bernard PAQUIS Philippe PAQUIS Véronique RAUCOULES-AIMÉ Marc RAYNAUD Dominique ROBERT Philippe ROSENTHAL Éric SCHNEIDER Stéphane TRAN Albert. Chirurgie Vasculaire (51.04) Pédiatrie (54.01) Réanimation Médicale (48.02) Chirurgie Orthopédique et Traumatologique (50.02) Gynécologie-Obstétrique (54.03) Physiologie (44.02) Anatomie-Chirurgie Orthopédique (42.01) Pharmacologie Clinique (48.03) Néphrologie (52-03) Cardiologie (51.02) Cardiologie (51.02) Chirurgie Digestive (52.02) Anesthésiologie et Réanimation Chirurgicale (48.01) Neurochirurgie (49.02) Pneumologie (51.01) Parasitologie et Mycologie (45.02) Cancérologie, Radiothérapie (47.02) Chirurgie Thoracique et Cardiovasculaire (51.03) Radiologie et Imagerie Médicale (43.02) Neurochirurgie (49.02) Génétique (47.04) Anesthésie et Réanimation Chirurgicale (48.01) Hématologie (47.01) Psychiatrie d’Adultes (49.03) Médecine Interne (53.01) Nutrition (44.04) Hépato Gastro-entérologie (52.01). PROFESSEURS DEUXIEME CLASSE M. ALBERTINI Marc Mme ASKENAZY-GITTARD Florence M. BAHADORAN Philippe M. BAQUÉ Patrick M. BARRANGER Emmanuel M. BENIZRI Emmanuel Mme BLANC-PEDEUTOUR Florence M. BREAUD Jean Mlle BREUIL Véronique M. CANIVET Bertrand M. CARLES Michel M. CASSUTO Jill-Patrice M. CASTILLO Laurent M. CHEVALLIER Patrick M. DUMONTIER Christian M. FERRERO Jean-Marc M. FOURNIER Jean-Paul M. FREDENRICH Alexandre (54.04) Mlle GIORDANENGO Valérie. Pédiatrie (54.01) Pédopsychiatrie (49.04) Cytologie et Histologie (42.02) Anatomie - Chirurgie Générale (42.01) Gynécologie Obstétrique (54.03) Chirurgie Générale (53.02) Cancérologie – Génétique (47.02) Chirurgie Infantile (54-02) Rhumatologie (50.01) Médecine Interne (53.01) Anesthésiologie Réanimation (48.01) Hématologie et Transfusion (47.01) O.R.L. (55.01) Radiologie et Imagerie Médicale (43.02) Chirurgie plastique Cancérologie ; Radiothérapie (47.02) Thérapeutique (48-04) Endocrinologie, Diabète et Maladies métaboliques Bactériologie-Virologie (45.01). .

(9) M. GUÉRIN Olivier M. HANNOUN-LEVI Jean-Michel M. IANNELLI Antonio M. JOURDAN Jacques M. LEVRAUT Jacques M. PASSERON Thierry M. PICHE Thierry M. PRADIER Christian (46.01) M. ROGER Pierre-Marie M. ROHRLICH Pierre M. RUIMY Raymond M. SADOUL Jean-Louis (54.04) M. STACCINI Pascal M. THOMAS Pierre M. TROJANI Christophe M. VENISSAC Nicolas. Gériatrie (48.04) Cancérologie ; Radiothérapie (47.02) Chirurgie Digestive (52.02) Chirurgie Thoracique et Cardiovasculaire (51.03) Anesthésiologie et Réanimation Chirurgicale (48.01) Dermato-Vénéréologie (50-03) Gastro-entérologie (52.01) Épidémiologie, Économie de la Santé et Prévention Maladies Infectieuses ; Maladies Tropicales (45.03) Pédiatrie (54.01) Bactériologie-virologie (45.01) Endocrinologie, Diabète et Maladies Métaboliques Biostatistiques et Informatique Médicale (46.04) Neurologie (49.01) Chirurgie Orthopédique et Traumatologique (50.02) Chirurgie Thoracique et Cardiovasculaire (51.03). PROFESSEUR DES UNIVERSITÉS M. SAUTRON Jean-Baptiste. Médecine Générale. MAITRES DE CONFÉRENCES DES UNIVERSITÉS - PRATICIENS HOSPITALIERS Mme ALUNNI-PERRET Véronique M. AMBROSETTI Damien Mme BANNWARTH Sylvie M. BENOLIEL José Mme BERNARD-POMIER Ghislaine Mme BUREL-VANDENBOS Fanny M. DELOTTE Jérôme M. DOGLIO Alain Mme DONZEAU Michèle (54.05) M. FOSSE Thierry M. FRANKEN Philippe M. GARRAFFO Rodolphe Mme HINAULT Charlotte Mlle LANDRAUD Luce Mme LEGROS Laurence Mme MAGNIÉ Marie-Noëlle Mme MUSSO-LASSALLE Sandra M. NAÏMI Mourad M. PHILIP Patrick Mme POMARES Christelle Mlle PULCINI Céline M. ROUX Christian M. TESTA Jean (46.01) M. TOULON Pierre. Médecine Légale et Droit de la Santé (46.03) Cytologie et Histologie (42.02) Génétique (47.04) Biophysique et Médecine Nucléaire (43.01) Immunologie (47.03) Anatomie et Cytologie pathologiques (42.03) Gynécologie-Obstétrique (54.03) Bactériologie-Virologie (45.01) Biologie du Développement et de la Reproduction Bactériologie-Virologie-Hygiène (45.01) Biophysique et Médecine Nucléaire (43.01) Pharmacologie Fondamentale (48.03) Biochimie et biologie moléculaire (44.01) Bactériologie–Virologie (45.01) Hématologie et Transfusion (47.01) Physiologie (44.02) Anatomie et Cytologie pathologiques (42.03) Biochimie et Biologie moléculaire (44.01) Cytologie et Histologie (42.02) Parasitologie et mycologie (45.02) Maladies Infectieuses ; Maladies Tropicales (45.03) Rhumatologie (50.01) Épidémiologie Économie de la Santé et Prévention Hématologie et Transfusion (47.01). .

(10) PROFESSEURS ASSOCIÉS M. M. M. M. Mme. DIOMANDE Mohenou Isidore HOFLIGER Philippe MAKRIS Démosthènes PITTET Jean-François POURRAT Isabelle. Anatomie et Cytologie Pathologiques Médecine Générale Pneumologie Anesthésiologie et Réanimation Chirurgicale Médecine Générale. MAITRES DE CONFÉRENCES ASSOCIÉS Mme M. Mme M.. CHATTI Kaouthar GARDON Gilles MONNIER Brigitte PAPA Michel. Biophysique et Médecine Nucléaire Médecine Générale Médecine Générale Médecine Générale. PROFESSEURS CONVENTIONNÉS DE L’UNIVERSITÉ M. M. M. Mme M. M.. BERTRAND François BROCKER Patrice CHEVALLIER Daniel FOURNIER-MEHOUAS Manuella MAGNÉ Jacques QUARANTA Jean-François. Médecine Interne Médecine Interne Option Gériatrie Urologie Médecine Physique et Réadaptation Biophysique Santé Publique. .

(11) REMERCIEMENTS Aux membres du Jury :. Monsieur le Professeur Christian PRADIER, Président du Jury, SRXUO¶KRQQHXU TX¶LO PH IDLW HQ DFFHSWDQW OD SUpVLGHQFH GH PRQ MXU\ GH WKqVH HW P¶DYRLU SHUPLV G¶DGKpUHUjFHSURMHWSHUPHWWH]PRLGHYRXVH[SULPHUPRQSURIRQGUHVSHFWHWPD JUDWLWXGH A Monsieur le Professeur Patrick BAQUE, SRXUVRQHQVHLJQHPHQWTXHM¶DLUHoX GqV PHV SUHPLqUHV DQQpHV G¶pWXGHV HQ PpGHFLQH VR\H] DVVXUp GH WRXWH PRQ DGPLUDWLRQ A. Monsieur. le. Professeur. Dominique. PRINGUEY,. SRXU O¶H[SpULHQFH. HQULFKLVVDQWH TXH M¶DL HX ORUV GH PRQ SDVVDJH GH VL[ PRLV SDUPL YRV LQWHUQHV YHXLOOH]UHFHYRLUO¶H[SUHVVLRQGHPDSURIRQGHUHFRQQDLVVDQFH A Monsieur le Docteur Karim TIFRATENE, SRXUVRQVRXWLHQVDSDWLHQFHHWVRQ DLGH WRXW DX ORQJ GH FH WUDYDLO 0HUFL GH P¶DYRLU IDLW GpFRXYULU OD VSpFLDOLWp GH 6DQWp 3XEOLTXH 0HUFL G¶DYRLU DFFHSWp GH GLULJHU FHWWH WKqVH &¶HVW XQH FKDQFH SRXUPRLG¶DYRLUSXWUDYDLOOHUj YRVF{WpVHWMH YRXVUHPHUFLHSURIRQGpPHQWSRXU WRXWFHOD A Madame le Docteur Carine REBOUILLAT-SAVY, TXLDVXPHUDVVXUHUHWPH JXLGHU FHWWH GHUQLqUH DQQpH G¶LQWHUQDW 0HUFL SRXU YRWUH DFFXHLO HW YRWUH JHQWLOOHVVH A Madame le Docteur Evelyne BARRE, SRXU P¶DYRLU IDLW GpFRXYULU FHWWH EHOOH VSpFLDOLWp TX¶HVW OD PpGHFLQH GX WUDYDLO 0HUFL SRXU YRV FRQVHLOV HW YRV HQFRXUDJHPHQWV. .

(12) -HGpGLHFHWUDYDLO A mon mari et ma fille, DYHFWRXWPRQDPRXU A mes parents, DYHFWRXWHPRQDIIHFWLRQHWPDUHFRQQDLVVDQFH A mes grands-parents, « LQPHPRULDPª A ma famille A mes amis $O¶HQVHPEOHGHVPpGHFLQVTXLRQWSDUWLFLSpjPDIRUPDWLRQ $X[pTXLSHVGHVGLIIpUHQWVVHUYLFHVGHWHUUDLQGHVWDJHGHPRQLQWHUQDW $PHVFRLQWHUQHVHWFDPDUDGHVGHO¶LQWHUQDW . .

(13) LISTE DES ABREVIATIONS AG2R AVVRFLDWLRQGpQpUDOHGHRHWUDLWHSDURpSDUWLWLRQ APAFWLYLWpPK\VLTXH CECRPLWpG¶EQWUHSULVH CHUCHQWUHHRVSLWDOLHUUQLYHUVLWDLUH CHSCT CRPLWpG¶H\JLqQHGHSpFXULWpHWGHVCRQGLWLRQVGHTUDYDLO CODES CoPLWpDpSDUWHPHQWDOG¶EGXFDWLRQSRXUODSDQWp DRH DLUHFWLRQGHVRHVVRXUFHVHXPDLQHV IMC IQGLFHGHMDVVHCRUSRUHOOH INPESIQVWLWXWNDWLRQDOGHPUpYHQWLRQHWG¶EGXFDWLRQSRXUODSDQWp INSERM IQVWLWXW NDWLRQDOGHOD SDQWp HWGHOD RHFKHUFKH MpGLFDOH IPAQIQWHUQDWLRQDOPK\VLFDOAFWLYLW\QXHVWLRQQDLUHV OMS OUJDQLVDWLRQMRQGLDOH GHOD SDQWp PNAPS PODQ NDWLRQDOGHPUpYHQWLRQ SDUO¶AFWLYLWp PK\VLTXH et SSRUWLYH PNNS PURJUDPPH NDWLRQDOH NXWULWLRQSDQWp PSLTPURPRWLRQGHODSDQWpVXUOHLLHXGHTUDYDLO RHRHVVRXUFHVHXPDLQHV RPSRLVTXHVPV\FKRSRFLDX[ STAPSSFLHQFHVHWTHFKQLTXHVGHVAFWLYLWpVPK\VLTXHVHWSSRUWLYHV TMSTURXEOHVMXVFXORSTXHOHWWLTXHV UE UQLRQEXURSpHQQH UNS UQLYHUVLWpNLFHSRSKLD$QWLSROLV UPE 06UQLRQPRXUOHVEQWUHSULVHVGHV$OSHV0DULWLPHV .

(14) TABLE DES MATIERES . INTRODUCTION. 14. JUSTIFICATION DU PROJET. 16. . *(1(5$/,7(6. 16. . 1,9($8;'¶$&7,9,7(3+<6,48((1)5$1&(. 18. . (7$76'(6/,(8;'$16/¶81,21(8523((11(. 21. . &216(48(1&(6'(/$6('(17$5,7(. 23. . 35(9(17,21'(60$/$',(612175$160,66,%/(63$5/¶$&7,9,7(3+<6,48(. 25. . 352027,21'(/$6$17(685/(/,(8'(75$9$,/. 33. . &2876'(/$6('(17$5,7(. 41. . $57,&8/$7,21(175(6$17($875$9$,/(76$17(38%/,48(. 43. . '(),1,7,216. 44. 1. La santé. 44. 2. La santé publique. 45. 3. La médecine du travail. 46. 4. L’activité physique. 47. 5. Qualité de vie. 49. 6. Qualité de vie au travail. 50. MATERIEL ET METHODES I : LE PROJET. 52. . 25,*,1('8352-(7. 52. . $3352&+(,17(56(&725,(//(. 53. . &$/(1'5,(5,1,7,$/. 56. . 2%-(&7,)6'8352-(7. 56. . /¶(175(35,6(72851$,5(. 57. . /(*5283('(75$9$,/. 58. . /(65(81,216'(75$9$,/. 59. . 0$3$57,&,3$7,21$8352-(7. 62. . /$9,6,7('(/¶(175(35,6(. 63. . 3$57(1$5,$7$9(&/$)$&8/7('(63257'(1,&(. 66. . 0,6((13/$&('(/¶,17(59(17,21. 66. MATERIEL ET METHODES II : EVALUATION. 69. . 5(&+(5&+(%,%/,2*5$3+,48(. 69. . 5(&+(5&+('¶81287,/'¶(9$/8$7,21. 69. . &5,7(5(6'(&+2,;'¶8148(67,211$,5(. 70. .

(15) 1. Critères liés à l’étude. 70. 2. Critères liés au questionnaire. 70. 3. Validité des questionnaires choisis. 71. . (/$%25$7,21'848(67,211$,5(. 76. . $'0,1,675$7,21'848(67,211$,5(. 77. . 5(&8(,/(76$,6,('(6'211((6. 78. . $1$/<6(667$7,67,48(6. 78. RESULTATS . 79. $1$/<6('(6&5,37,9(. 79. 2.. Variables qualitatives. 81. 3.. Partie EVREST du questionnaire « poste de travail ». 82. 4.. Variables quantitatives. 83. 5.. Tableaux descriptifs croisés. 85. . 3$57,($1$/<7,48(. 87. . (148(7(5($/,6((3$5/$)$&8/7('(63257'(1,&(. 92. . '211((6'(65(66285&(6+80$,1(6. 94. DISCUSSION. 97. . 5(680('(635,1&,3$8;5(68/7$76. 97. . &203$5$,621$9(&/(6'211((6'(/$/,77(5$785(. 98. . /,0,7(6'(/¶(78'(. . 102. 1.. Contraintes et freins rencontrés. 102. 2.. Activité « TaiChi ». 105. 3.. Biais de sélection. 105. *(1(5$/,6$7,215(/$7,9($/$0('(&,1('875$9$,/(7$/$6$17(38%/,48(. 106. CONCLUSION. 109. TABLE DES FIGURES. 110. ANNEXES. 111. BIBLIOGRAPHIES. 127. SERMENT D'HIPPOCRATE. 1ϯϱ. . .

(16) ©/D VDQWp HVW XQH UHVVRXUFH HVVHQWLHOOH TX LO IDXW HQWUHWHQLU WRXW DX ORQJ GH VD YLHª &KDUWHG¶2WWDZDSRXUODSURPRWLRQGHODVDQWpHQ

(17) . .

(18) . INTRODUCTION 'DQV OHV SD\V LQGXVWULDOLVpV O¶pYROXWLRQ GX PRGH GH YLH V¶DFFRPSDJQH G¶XQ DEDQGRQ SURJUHVVLI GH OD GpSHQVH SK\VLTXH GDQV OHV DFWLYLWpV SURIHVVLRQQHOOHV FRPPH GDQV FHOOHV GH OD YLH FRXUDQWH 6L OH ODEHXU SK\VLTXH H[FHVVLI GDQV OHV SpULRGHV DQWpULHXUHV D FRQWULEXp j XQ YLHLOOLVVHPHQW SUpPDWXUp GH OD SRSXODWLRQ DXMRXUG¶KXL O¶DXJPHQWDWLRQ GX WUDYDLO VpGHQWDLUH SULYH XQH PDMRULWp G¶LQGLYLGXV G¶XQHVWLPXODWLRQSK\VLTXHQpFHVVDLUHDXERQpTXLOLEUHHWjODVDQWp /DFRPPXQDXWpLQWHUQDWLRQDOHUHFRQQDvWOHOLHXGHWUDYDLOFRPPHVLWHDSSURSULpGH SURPRWLRQGHODVDQWpHWVRQLPSRUWDQFHDpWpVRXOLJQpHORUVGHFRQIpUHQFHUpXQLH FRQMRLQWHPHQW SDU O¶2UJDQLVDWLRQ LQWHUQDWLRQDOH GX WUDYDLO HW O¶2UJDQLVDWLRQ PRQGLDOHGHOD6DQWp /HWUDYDLOHWVRQFDGUHVRQWGHVGpWHUPLQDQWVGHVDQWpLOV SHUPHWWHQWG¶LQIOXHQFHUOHVFRPSRUWHPHQWVG¶XQHIRUWHSDUWLHGHODSRSXODWLRQYLV jYLVGHODVDQWpHWGHPHQHUGHVLQWHUYHQWLRQVUpSpWpHVjGLYHUVQLYHDX[HQYXH G¶LQIOXHQFHU FHV FRPSRUWHPHQWV &RPPH QRXV O¶LQGLTXH OH 3URJUDPPH 1DWLRQDO 1XWULWLRQ 6DQWp 3116

(19) GDQV VRQ JXLGH j O¶XVDJH GHV HQWUHSULVHV GpYHORSSHU OH ELHQrWUHDXWUDYDLOGHYLHQWXQHSULRULWpFURLVVDQWHDXVHLQGHVHQWUHSULVHVLOV¶DJLW G¶XQHGHPDQGHGHVVDODULpVWDQWSRXUO¶DPpOLRUDWLRQGHODTXDOLWpGXWUDYDLOUpDOLVp TXHSRXUO¶pSDQRXLVVHPHQWSHUVRQQHO 'HSOXVHQSOXVRQVRXOLJQHO¶LPSRUWDQFH GHFUpHUGHVHQYLURQQHPHQWVGHWUDYDLOIDYRUDEOHVjODVDQWpFDUOHWHPSVSDVVp DXWUDYDLOUHSUpVHQWHXQHIUDFWLRQLPSRUWDQWHGHODYLHTXRWLGLHQQHGHVVDODULpVOD PRLWLpGHQRWUHWHPSVGHYHLOOH /¶DFWLYLWp SK\VLTXH UpJXOLqUH HW PRGpUpH HVW UHFRQQXH SDU OD FRPPXQDXWp VFLHQWLILTXH HW PpGLFDOH FRPPH IDFWHXU G¶DPpOLRUDWLRQ GH OD VDQWp $LQVL GHV WUDYDX[ UpFHQWV RQW PRQWUp OHV HIIHWV SRVLWLIV VXU OD VDQWp GHV VDODULpV DLQVL TXH VXU O¶HQWUHSULVH G¶XQH SUDWLTXH VSRUWLYH UpJXOLqUH GDQV OH FDGUH SURIHVVLRQQHO ELHQrWUH GHV VDODULpV GLPLQXWLRQ GH O¶DEVHQWpLVPH DXJPHQWDWLRQ GH OD FDSDFLWp GH WUDYDLO (Q V¶DSSX\DQW VXU XQH GpPDUFKH GH VDQWp SXEOLTXH YDOLGpH OH GpSDUWHPHQWGHVDQWpSXEOLTXH &+81LFH

(20) HQFROODERUDWLRQDYHFO¶83( 8QLRQ SRXU O HQWUHSULVH

(21) $*5 /$ 021',$/( RUJDQLVPH GH SURWHFWLRQ VRFLDOH HW GH UHWUDLWHFRPSOpPHQWDLUH

(22) HWOH/$0+(66 ODERUDWRLUH0RWULFLWp+XPDLQH(GXFDWLRQ 6SRUW6DQWp

(23) GHOD)DFXOWpGHV6FLHQFHVGX6SRUWGH1LFHDFRQVWUXLWXQSURMHWGH .

(24) SURPRWLRQGHO¶DFWLYLWpSK\VLTXHHQHQWUHSULVHEDVpVXUODSDUWLFLSDWLRQDFWLYHGHV VDODULpVDYHFO DSSXLGHO HQFDGUHPHQWGLULJHDQWHWGHVUHVVRXUFHVKXPDLQHV(Q SDUDOOqOHXQVXLYLHWXQHpYDOXDWLRQVRQWPLVHQSODFHDILQG DSSUpFLHUOHVHIIHWVGH FHWWH DFWLRQ HQ HQWUHSULVH GH GpFHOHU OHV REVWDFOHV UHQFRQWUpV DILQ GH OHV VXUPRQWHU UDSLGHPHQW HW GH PHVXUHU O¶HIILFDFLWp HW O¶HIILFLHQFH GHV UpVXOWDWV DWWHQGXV &HWUDYDLOGHWKqVHSURSRVHGHGpFULUHHWG¶pYDOXHUODPLVHHQSODFHG XQHDFWLYLWp SK\VLTXHUpJXOLqUHVXUOHOLHXGHWUDYDLO,OYLVHDXVVLjREVHUYHUOHVFRQVpTXHQFHV GH FH SURMHW VXU OH SODQ LQGLYLGXHO DX WUDYHUV G¶LQGLFDWHXUV WHOV TXH OD TXDOLWp GH YLH OD PRWLYDWLRQ SRXU OHV DFWLYLWpV SK\VLTXHV PDLV pJDOHPHQW DX QLYHDX GH O HQWUHSULVHDXWUDYHUVG¶LQGLFDWHXUVWHOVTXHO DEVHQWpLVPHO DPELDQFHDXWUDYDLO ODSURGXFWLYLWp / RULJLQDOLWp GH FH SURMHW UpVLGH GDQV OH IDLW TX LO V DJLW G XQH DFWLRQ FRFRQVWUXLWH DYHFODSDUWLFLSDWLRQYRORQWDLUHHWDFWLYHGHVVDODULpV&HVGHUQLHUVRQWHX[PrPHV LGHQWLILpHWVpOHFWLRQQpOHVW\SHVG DFWLYLWpSK\VLTXHjPHWWUHHQSODFHDXVHLQG¶XQ JURXSHGHWUDYDLOFRPSRVpGHPHPEUHVGX&RPLWpG¶K\JLqQHGHVpFXULWpHWGHV FRQGLWLRQVGHWUDYDLO &+6&7

(25) GHVUHVVRXUFHVKXPDLQHV 5+

(26) GHODGLUHFWLRQGX PpGHFLQ GX WUDYDLO GHV PpGHFLQV H[SHUWV HQ VDQWp SXEOLTXH '63

(27) HW GX /DERUDWRLUH0RWULFLWp+XPDLQH(GXFDWLRQ6SRUW6DQWp /$0+(668)567$36 1LFH

(28) . .

(29) . JUSTIFICATION DU PROJET . 1. Généralités /¶DFWLYLWp SK\VLTXH HVW XQ FRPSRUWHPHQW TXL D XQ HIIHW SURWHFWHXU j O¶pJDUG GH GLIIpUHQWHVPDODGLHVFKURQLTXHVHWTXLHVWDVVRFLpjGHQRPEUHX[SDUDPqWUHVGH VDQWp LPSRUWDQWV /D VpGHQWDULWp TXDQW j HOOH HVW XQ IDFWHXU GH ULVTXH GH PDODGLHVFKURQLTXHVHWVDGLPLQXWLRQHVWDVVRFLpHjGHVEpQpILFHVSRXUODVDQWp /¶DFWLYLWpSK\VLTXHHVWXQVXMHWG¶DFWXDOLWpHQWHUPHVGHSURPRWLRQGHVDQWpHWGH SUpYHQWLRQ GHV PDODGLHV /HV EpQpILFHV SRXU OD VDQWp TXL OXL VRQW FRQIpUpV VRQW PDLQWHQDQWELHQGRFXPHQWpVHWVHVHIIHWVVRQWGpPRQWUpVTXHOVTXHVRLHQWO¶kJH HWOHVH[H'HFHIDLWO¶DFWLYLWpSK\VLTXHV¶LQVFULWDXMRXUG¶KXLGDQVODSOXSDUWGHV UHFRPPDQGDWLRQV GH SURPRWLRQ GH VDQWp HW LQWpUHVVH GH QRPEUHX[ VHFWHXUV VDQWp VRFLDO VSRUW XUEDQLVPH HQYLURQQHPHQW TXL V¶LOV FROODERUHQW HQWUH HX[ SHXYHQWDJLUGHPDQLqUHVLJQLILFDWLYH /D VpGHQWDULWp V¶HVW SURJUHVVLYHPHQW GpYHORSSpH HW FRQFHUQH DXMRXUG¶KXL OD SOXSDUWGHVSD\VTXHOTXHVRLWOHXUQLYHDXGHGpYHORSSHPHQW (OOHUHSUpVHQWH XQIDFWHXUGHULVTXHPDMHXUGDQVQRWUHVRFLpWpRHOOHHVWFRQVLGpUpHDXMRXUG¶KXL FRPPH OD SUHPLqUH FDXVH QRQ WUDQVPLVVLEOH GH PRUWDOLWp GDQV OH PRQGH 206 -RXUQpHPRQGLDOHGHODVDQWpDYULO

(30) 3RXU DJLU VXU O¶pWDW GH VDQWp LO IDXW GRQF j OD IRLV OLPLWHU OD VpGHQWDULWp HW SURPRXYRLU O¶DFWLYLWp SK\VLTXH /H GpYHORSSHPHQW GH SROLWLTXH GH SURPRWLRQ VXU OHV WKqPHV GH O¶DOLPHQWDWLRQ HW GH O¶DFWLYLWp SK\VLTXH V¶HVW ODUJHPHQW DFFUX FHV GHUQLqUHV DQQpHV WDQW DX QLYHDX national GDQV OH FDGUH GX 3116 TX¶DX[ QLYHDX[ européen (XURSHDQ 3ODWIRUP IRU DFWLRQ RQ GLHW SK\VLFDO DFWLYLW\ DQG KHDOWK(XURSHDQ1HWZRUNIRUWKHௗSURPRWLRQRIௗKHDOWKHQKDQFLQJSK\VLFDODFWLYLW\ LQWHUQDWLRQDO:RUOG+HDOWK2UJDQL]DWLRQ*OREDO6WUDWHJ\RQGLHWSK\VLFDODFWLYLW\ DQGKHDOWK $X SODQ international O¶LQWpUrW SRXU O¶DFWLYLWp SK\VLTXH V¶HVW DFFUX VXLWH j O¶DGRSWLRQ GH OD 6WUDWpJLH PRQGLDOH SRXU O¶DOLPHQWDWLRQ O¶H[HUFLFH SK\VLTXH HW OD VDQWp SUpFpGpH SDU OD PLVH HQ SODFH SDU O¶206 G¶XQH MRXUQpH LQWHUQDWLRQDOH .

(31) GpGLpH j O¶DFWLYLWp SK\VLTXH © 0RYHௗIRUௗKHDOWKௗGD\ ª DYULO

(32) VXLWH DX ODQFHPHQW GDQV OHV DQQpHV G¶XQ ODUJH PRXYHPHQW GH SURPRWLRQ GH O¶DFWLYLWp SK\VLTXH GDQV O¶eWDW GH 6mR 3DXOR DX %UpVLO GHYHQX DXMRXUG¶KXL PRXYHPHQWPRQGLDO . Figure 1 : Pyramide de l'exercice. 12. 'LIIpUHQWHV VWUDWpJLHV VRQW GpILQLHV SRXU HQFRXUDJHU XQ VW\OH GH YLH DFWLI WRXWHV IRQGpHV VXU OD GLIIXVLRQ GH UHFRPPDQGDWLRQV )LJXUH

(33) (Q PDWLqUH G¶DFWLYLWp SK\VLTXH OHV UHFRPPDQGDWLRQV OHV SOXV UpFHQWHV VRQW FHOOHV GLIIXVpHV HQ DX[ eWDWV8QLV SRXU OHV DGXOWHV GH SUDWLTXHU XQH DFWLYLWp SK\VLTXH G¶HQGXUDQFH G¶LQWHQVLWp PRGpUpH G¶XQH GXUpH PLQLPDOH GH PLQXWHV SDU VHPDLQH RX DX PRLQV PLQXWHV G¶DFWLYLWp SK\VLTXH G¶LQWHQVLWp YLJRXUHXVH RX HQFRUH XQH FRPELQDLVRQ pTXLYDOHQWH G¶DFWLYLWpV PRGpUpHV HW YLJRXUHXVHV SRXYDQW rWUH FXPXOpHV SDU SpULRGHV G¶DX PRLQV PLQXWHV G¶DIILOpH ,O HVW GH SOXV UHFRPPDQGp GH SUDWLTXHU GHV DFWLYLWpV GH UHQIRUFHPHQW PXVFXODLUH DX PRLQV GHX[IRLVSDUVHPDLQH. .

(34) . Figure 2 : Recommandations OMS 2010. (Q)UDQFHODUHFRPPDQGDWLRQGLIIXVpHGDQVOHFDGUHGX3116GHSXLVHVW GHSUDWLTXHUO¶pTXLYDOHQWG¶DXPRLQVPLQXWHVGHPDUFKHUDSLGHSDUMRXU )LJXUH

(35) (OOHFRUUHVSRQGjODSUHPLqUHUHFRPPDQGDWLRQGHVDQWpSXEOLTXHSXEOLpHSDU OH &ROOqJH DPpULFDLQ GH PpGHFLQH GX VSRUWHQ OHV GHUQLqUHV SXEOLFDWLRQV D\DQWHVVHQWLHOOHPHQWSUpFLVpTXHODIUpTXHQFHG¶DFWLYLWpSK\VLTXHSRXYDLWrWUHGH FLQT MRXUV SDU VHPDLQH HW OD TXDQWLWp G¶DFWLYLWp SK\VLTXH UpSDUWLH GDQV OD VHPDLQH . 2. Niveaux d’activité physique en France $XMRXUG¶KXLWURSSHXGHSHUVRQQHVSUDWLTXHQWUpJXOLqUHPHQWXQHDFWLYLWpSK\VLTXH IDYRUDEOHjODVDQWp /HSURIHVVHXU-HDQ)UDQoRLV7RXVVDLQWIDLWOHPrPHFRQVWDWGDQVVRQUDSSRUW 3ODQ QDWLRQDO GH SUpYHQWLRQ SDU O¶DFWLYLWp SK\VLTXH RX VSRUWLYH 31$36

(36) LQWLWXOp ©UHWURXYHU VD OLEHUWp GH PRXYHPHQWª UHPLV j OD PLQLVWUH GH OD VDQWp HW GHV VSRUWVDXPRLVG¶RFWREUH/DWHQGDQFHjODVpGHQWDULWpFURLVVDQWHTXLV¶HVW DFFpOpUpHGHSXLVODGHX[LqPHPRLWLpGX;;HVLqFOHFRQFHUQHDXMRXUG¶KXLOHVGHX[ WLHUV GHV )UDQoDLV HW WRXFKH SOXV HQFRUH OHV MHXQHV JpQpUDWLRQV &HUWDLQHV SHUVRQQHVVRQWPrPHVHQVLWXDWLRQGH©VpGHQWDULWpDEVROXHª. .

(37) 'DQVOHVVRFLpWpVGpYHORSSpHVO¶XUEDQLVDWLRQODWHUWLDULVDWLRQGHO¶pFRQRPLHHWOD VXEVWLWXWLRQGHO¶pQHUJLHPpFDQLTXHHWGHODPRWRULVDWLRQQRWDPPHQWDXWRPRELOH j O¶pQHUJLH SK\VLTXH RQW FRQGXLW j OD UpGXFWLRQ GH OD GpSHQVH pQHUJpWLTXH GHV LQGLYLGXV /¶DFWLYLWp SK\VLTXH TXRWLGLHQQH PR\HQQH GHV )UDQoDLV HVW SDVVpH GH SOXV GH KXLW KHXUHV DX ;9,,,HVLqFOH j PRLQV G¶XQH KHXUH DXMRXUG¶KXL /H WHPSV G¶DFWLYLWpSK\VLTXHDpWpSUDWLTXHPHQWGLYLVpSDUGL[ )LJXUH

(38) . Figure 3 : Evolution séculaire de l'activité physique quotidienne des français. 6HORQ O¶HQTXrWH GX %DURPqWUH 6DQWp 1XWULWLRQ GH O¶,QVWLWXW QDWLRQDO GH SUpYHQWLRQ HW G¶pGXFDWLRQ SRXU OD VDQWp ,13(6

(39) UpDOLVpH DXSUqV G¶XQ pFKDQWLOORQ UHSUpVHQWDWLI GH )UDQoDLV kJpV GH j DQV PRLQV GH OD PRLWLp GHV VXMHWV LQWHUURJpV

(40) DWWHLJQHQWOHQLYHDXG¶DFWLYLWpSK\VLTXHIDYRUDEOHjODVDQWpDX PRLQVPLQXWHVG¶DFWLYLWpSK\VLTXHPRGpUpHSDUMRXU &HWWHSURSRUWLRQHVWVLPLODLUHjFHOOHUHWURXYpHGDQVG¶DXWUHVHQTXrWHVPHQpHVHQ )UDQFHHQSRSXODWLRQJpQpUDOH /D SURSRUWLRQ GH VXMHWV DWWHLJQDQW OHV UHFRPPDQGDWLRQV YDULH VHORQ OH VH[H OHV IHPPHV VRQW SURSRUWLRQQHOOHPHQW PRLQV QRPEUHXVHV j DWWHLQGUH FHV UHFRPPDQGDWLRQV YV SRXU OHV KRPPHV

(41) &HSHQGDQW FKH] OHV KRPPHVFHSRXUFHQWDJHYDULHHQIRQFWLRQGHO¶kJHDYHFXQHEDLVVHVLJQLILFDWLYH GHjDQV .

(42) . . . . . 'pSODFHPHQWV. . . . . /RLVLUV +RPPHV. 7UDYDLO )HPPHV. ௗ. . . Figure 4 : Répartition des hommes et des femmes déclarant une AP selon le contexte de pratique (en %) Baromètre Santé Nutrition 2008. . &RPPHRQSHXWO¶REVHUYHUVXUOD)LJXUHORUVG¶XQHVHPDLQHKDELWXHOOHODPRLWLp GHV )UDQoDLV kJpV GH j DQV

(43) GpFODUHQW SUDWLTXHU XQH DFWLYLWp SK\VLTXH SHQGDQW OHXUV ORLVLUV GDQV OHV GpSODFHPHQWV HW DX WUDYDLO &HVRQWOHVKRPPHVTXLGpFODUHQWPDMRULWDLUHPHQWHIIHFWXHUXQHDFWLYLWpSK\VLTXH DXWUDYDLO

(44) YLHQWHQVXLWHO¶DFWLYLWpSK\VLTXHGHORLVLUV

(45) SXLVSRXU VHGpSODFHU

(46) &KH]OHVIHPPHVF¶HVWO¶DFWLYLWpSK\VLTXHSRXUVHGpSODFHU TXLHVWODSOXVIUpTXHPPHQWFLWpH

(47) SXLVO¶DFWLYLWpSK\VLTXHDXWUDYDLO

(48) HWHQILQO¶DFWLYLWpSK\VLTXHGHORLVLUV

(49) &RQFHUQDQWODGXUpHG¶DFWLYLWp SK\VLTXHWRWDOHVHGpURXOHQWDXWUDYDLOVRQWFRQVDFUpHVjO¶DFWLYLWp SK\VLTXH SRXU VH GpSODFHU HW XQ TXDUW GX WHPSV UHYLHQW j O¶DFWLYLWp SK\VLTXH GH ORLVLUV

(50) /¶DFWLYLWpSK\VLTXHWRWDOHHVWpYDOXpHjHQYLURQKPLQXWHVSDU MRXU DYHF XQH PR\HQQH GH PLQXWHV G¶DFWLYLWp SK\VLTXH GH ORLVLUV SDU MRXU GH PLQXWHVSRXUOHVGpSODFHPHQWVHWGHKPLQXWHVSRXUO¶DFWLYLWpSK\VLTXHDX WUDYDLO 'DQV O¶HQVHPEOH OHV KRPPHV VRQW SOXV DFWLIV TXH OHV IHPPHV TXHO TXH VRLW O¶kJH PDLV RQ REVHUYH XQH EDLVVH GH O¶DFWLYLWp SK\VLTXH DYHF O¶kJH HVWLPpH SRXU O¶HQVHPEOH GH O¶pFKDQWLOORQ j HQYLURQ K PLQXWHV SDU MRXU 3OXV SUpFLVpPHQWF¶HVWODSDUWGXWHPSVFRQVDFUpjO¶DFWLYLWpSK\VLTXHGHORLVLUVTXLD. .

(51) WHQGDQFH j GLPLQXHU DYHF O¶kJH DORUV TXH OD SDUW GX WHPSV FRQVDFUp j O¶DFWLYLWp SK\VLTXHSRXUVHGpSODFHUDSOXW{WWHQGDQFHjDXJPHQWHU. Figure 5 : Baromètre Nutrition 2002. 19. 6HORQ O¶HQTXrWH GX %DURPqWUH 6DQWp 1XWULWLRQ )LJXUH

(52) GHV VXMHWV LQWHUURJpVQHSUDWLTXHQWSDVOHQLYHDXG¶DFWLYLWpSK\VLTXHUHFRPPDQGp DXPRLQV PLQXWHV G¶DFWLYLWp SK\VLTXH PRGpUpH

(53) (Q DQQpHV OH QRPEUH GH VXMHWV Q¶DWWHLJQDQW SDV OH QLYHDX G¶DFWLYLWp IDYRUDEOH j OD VDQWp D DXJPHQWp G¶HQYLURQ . 3. Etats des lieux dans l’Union Européenne 6HORQ O¶206 HQ GHX[ WLHUV GH OD SRSXODWLRQ DGXOWH GH O¶8QLRQ HXURSpHQQH 8(

(54) DYDLHQW XQH DFWLYLWp SK\VLTXH LQVXIILVDQWH F¶HVWjGLUH XQ PRGH GH YLH VpGHQWDLUH (Q 8( XQH SHUVRQQH VXU FLQT QH SUDWLTXH SDV G¶DFWLYLWp SK\VLTXH GHV FLWR\HQV IRQW GX VSRUW DX PRLQV XQH IRLV SDU VHPDLQH HW SUDWLTXHQW XQH DFWLYLWp SK\VLTXH TXHOFRQTXH PDLV VRQW SUHVTXH WRWDOHPHQW LQDFWLIV &¶HVW FH TXL UHVVRUW G¶XQH HQTXrWH VSpFLDOH (XUREDURPqWUH VXU OH VSRUW HW O¶DFWLYLWp SK\VLTXH UpDOLVpH DXSUqV GH FLWR\HQV HW SXEOLpH OH PDUV SDU OD &RPPLVVLRQHXURSpHQQH . .

(55) '¶XQH PDQLqUH JpQpUDOH HQ (XURSH OHV KRPPHV IRQW SOXV GH VSRUW TXH OHV IHPPHV7RXWHIRLVFHWWHGLVSDULWpHVWSDUWLFXOLqUHPHQWYLVLEOHFKH]OHVDQV OHV KRPPHV MHXQHV D\DQW WHQGDQFH j IDLUH EHDXFRXS SOXV G¶H[HUFLFH TXH OHV IHPPHVMHXQHV /HQRPEUHG DFWLYLWpVVSRUWLYHVSUDWLTXpHVGpFURvWSDUDOOqOHPHQWjO DXJPHQWDWLRQ GH O kJH &HSHQGDQW GHV UpSRQGDQWV GX JURXSH GHV DQV RX SOXV IRQW WRXMRXUVGXVSRUW '¶XQH PDQLqUH JpQpUDOH OHV FLWR\HQV GHV SD\V QRUGLTXHV HW GHV 3D\V%DV VRQW OHVSOXVVSRUWLIVGHO¶8($O¶RSSRVpOHVFLWR\HQVGHVSD\VPpGLWHUUDQpHQVHWGHV QRXYHDX[ (WDWV PHPEUHV RQW WHQGDQFH j IDLUH PRLQV G¶H[HUFLFH TXH OD PR\HQQH 6LOHVDFWLYLWpVSK\VLTXHVVHSUDWLTXHQWGDQVXQHJUDQGHYDULpWpG¶HQGURLWVIRUPHOV jWUDYHUVO¶8(GHX[WLHUVGHVUpSRQGDQWVQHVRQWPHPEUHVG¶DXFXQFOXERXFHQWUH VSRUWLI /HV UpSRQGDQWV DIILUPHQWIDLUHSULQFLSDOHPHQW GX VSRUWSRXUDPpOLRUHU OHXU VDQWp '¶DXWUHV UDLVRQV WHOOHV TX¶rWUH HQ PHLOOHXUHIRUPH VHGpWHQGUHRXV¶DPXVHU VRQW pJDOHPHQWSRSXODLUHV Lemanque de tempsHVWGHORLQODUDLVRQODSOXVFLWpHSRXUMXVWLILHUO¶DEVHQFHGH SUDWLTXHG¶DFWLYLWpVVSRUWLYHV. .

(56) . . . Figure 6 : Question 1 de la nouvelle enquête 2013 "Quelle est la fréquence de votre pratique 20 sportive?". 6XU OD )LJXUH OH QRPEUH GH SHUVRQQHV GpFODUDQW QH MDPDLV SUDWLTXHU G DFWLYLWp SK\VLTXHRXVSRUWLYHDDXJPHQWpGHSRLQWVGHSRXUFHQWDJHLOHVWSDVVpGH j HQ DQV 8QH SURSRUWLRQ VLPLODLUH GH SHUVRQQHV SUDWLTXH XQH DFWLYLWp SK\VLTXHRXVSRUWLYHDXPRLQVXQHIRLVSDUVHPDLQHVRLWFHTXLUHSUpVHQWH XQHDXJPHQWDWLRQG¶XQSRLQWGHSRXUFHQWDJHSDUUDSSRUWjO HQTXrWH . 4. Conséquences de la sédentarité 'HWRXWWHPSVO¶KRPPHDpWpDFWLI4XHFHVRLWSDUQpFHVVLWpYLWDOHLQLWLDOHPHQWRX SOXV WDUG SRXU VRQ ORLVLU 1RV DQFrWUHV KRPR VDSLHQV GHYDLHQW VH GpSHQVHU SK\VLTXHPHQWSRXUDOOHUFKHUFKHUOHXUQRXUULWXUH,OVGHYDLHQWrWUHHQGXUDQWVjOD PDUFKHSRXUODFKDVVHHWODFXHLOOHWWHUDSLGHVHWYLIVSRXUpFKDSSHUDX[GDQJHUV GHV SUpGDWHXUV $YHF O¶pYROXWLRQ GX GpYHORSSHPHQW GHV FRQQDLVVDQFHV OHV UpYROXWLRQV LQGXVWULHOOHV O¶XUEDQLVDWLRQ HW OHV SURJUqV GDQV OHV WHFKQRORJLHV DXWRPDWLTXHV OD VRFLpWp V¶HVW SURJUHVVLYHPHQW VpGHQWDULVpH /¶DFWLYLWp SK\VLTXH HVW FHUWHV EpQpILTXH PDLV F¶HVW VXUWRXW O¶LQDFWLYLWp OD VpGHQWDULWp TXL HVW GDQJHUHXVH /H WHPSV SDVVp HQ SRVLWLRQ DVVLVH (time spent sitting) SHXW rWUH .

(57) FRQVLGpUp FRPPH XQ IDFWHXU GH ULVTXH HVVHQWLHO SRXU OH GpYHORSSHPHQW GH PDODGLHVFKURQLTXHV0rPHVLOHVPLQXWHVG¶DFWLYLWpSK\VLTXHTXRWLGLHQQHVRQW UHVSHFWpHV OD SRVLWLRQ DVVLVH SURORQJpH SHXW j HOOH VHXOH HQWUDvQHU GHV HIIHWV QpIDVWHVVXUODVDQWp(too much sitting) /D VpGHQWDULWp HVW O¶XQ GHV IDFWHXUV GH ULVTXH DYHF O¶DOLPHQWDWLRQ HW OH WDEDF GH VXUYHQXH GH PDODGLHV QRQ WUDQVPLVVLEOHV 017

(58) /HV FLQT 017 OHV SOXV IUpTXHQWHV VRQW OHV DIIHFWLRQV FDUGLDTXHV OHV DFFLGHQWV YDVFXODLUHV FpUpEUDX[ $9&

(59) OHVFDQFHUVOHVPDODGLHVUHVSLUDWRLUHVHWOHGLDEqWH &RPPH RQ SHXW OH FRQVWDWHU VXU OD )LJXUH GHV GpFqV WRWDX[ WRXV kJHV FRQIRQGXVKRPPHVHWIHPPHVVRQWGXVDX[017 . Figure 7 : Proportion des causes de décès dans le monde (2008). 2. /HV GRQQpHV VFLHQWLILTXHV V¶DFFRUGHQW SRXU PRQWUHU TX¶XQH DOLPHQWDWLRQ VDLQH HW XQHDFWLYLWpSK\VLTXHVXIILVDQWHMRXHQWXQU{OHLPSRUWDQWGDQVODSUpYHQWLRQGHFHV PDODGLHV2QHVWLPHTXHGHVDIIHFWLRQVFDUGLDTXHVGHV$9&GXGLDEqWHGH. .

(60) W\SHDLQVLTXHGHVFDQFHUVSRXUUDLHQWrWUHpYLWpVjO¶DLGHGHPHVXUHVSHX FRWHXVHVHWG¶XQHIRUWHHIILFDFLWpSRUWDQWVXUOHVIDFWHXUVGHULVTXHVSULPDLUHV . 5. Prévention des l’activité physique. Maladies. Non. Transmissibles par. 'HQRPEUHXVHVHWUpFHQWHVpWXGHVUDQGRPLVpHVFRQWU{OpHVRQWSHUPLVGHUpDOLVHU SOXVLHXUV UHYXHV V\VWpPDWLTXHV HW PpWDDQDO\VHV VXU OHV HIIHWV GH O¶H[HUFLFH SK\VLTXHGDQVODSULVHHQFKDUJHGHVPDODGLHVFKURQLTXHV /HVPpFDQLVPHVH[SOLTXDQWODIDoRQGRQWO¶DFWLYLWpSK\VLTXHUpGXLWODSURJUHVVLRQ GH PDODGLHV FKURQLTXHV DLQVL TXH OD VXUYHQXH GH KDQGLFDSV UHODWLIV j FHOOHVFL YRLUH GH GpFqV VRQW PXOWLSOHV HW FRPSOpPHQWDLUHV /D ILJXUH HQ UpVXPH TXHOTXHVXQV /HV PHVXUHV OHV SOXV FRQVLVWDQWHV FRQFHUQHQW O¶DPpOLRUDWLRQ GH OD FDSDFLWp DpURELHHW GH ODIRUFHPXVFXODLUH/HV HIIHWVPpWDEROLTXHV WHOV TXHSDU H[HPSOHOHFRQWU{OHJO\FpPLTXHORUVGHUpVLVWDQFHjO¶LQVXOLQHRQWOHXULPSRUWDQFH WRXWFRPPHO¶pOpYDWLRQVDQJXLQHGHVWDX[GH+'/FKROHVWpURO/DUpGXFWLRQGHOD UpVLVWDQFH YDVFXODLUH SpULSKpULTXH FRQGXLVDQW j XQH FRUUHFWLRQ GH OD SUHVVLRQ DUWpULHOOH GRLW pJDOHPHQW rWUH VRXOLJQpH GH PrPH TXH OD GLPLQXWLRQ GH O¶DJUpJDWLRQSODTXHWWDLUHUpVXOWDQWG¶XQHIRQFWLRQHQGRWKpOLDOHDPpOLRUpHRXHQILQ OHVHIIHWVFODLUVVXUODUpGXFWLRQGHODPDVVHGHJUDLVVHYLVFpUDOHFKH]O¶DGXOWHRX GHO¶,0&SOXVYLVLEOHFKH]O¶HQIDQWHWSRXUWHUPLQHUOHVHIIHWVQHXURWURSLTXHVDX QLYHDXGXV\VWqPHQHUYHX[FHQWUDO. .

(61) . Figure 8 : Impact de l'activité physique sur les différents systèmes physiologiques. . . 23.

(62) ¾ 0DODGLHVFDUGLRYDVFXODLUHV 0&9

(63) /H U{OH EpQpILTXH TXH MRXH O DFWLYLWp SK\VLTXH GDQV OD SUpYHQWLRQ GHV PDODGLHV FDUGLRYDVFXODLUHV HVW XQH QRWLRQ ELHQ DGPLVH 1RPEUHXVHV VRQW OHV pWXGHV pSLGpPLRORJLTXHVTXLFRQILUPHQWXQHUHODWLRQLQYHUVHHQWUHODSUDWLTXHGHO DFWLYLWp SK\VLTXHHWO LQFLGHQFHGHODPDODGLHFRURQDULHQQHGHO LQIDUFWXVGXP\RFDUGHHW GH OD PRUWDOLWp SDU DWKpURPH FRURQDULHQ /D SUDWLTXH UpJXOLqUH G¶XQH DFWLYLWp SK\VLTXH SHUPHW XQH GLPLQXWLRQ GH GX WDX[ GH PRUWDOLWp SDU LQIDUFWXV GX P\RFDUGHFKH]OHVSDWLHQWVVRXIIUDQWG¶XQHPDODGLHFRURQDULHQQH %HDXFRXSGHPDODGLHVFDUGLRYDVFXODLUHVRQWSRXURULJLQHO¶DOWpUDWLRQGHVIRQFWLRQV GHODSDURLGHVYDLVVHDX[/¶HQGRWKpOLXPHVWODPRQRFRXFKHGHFHOOXOHVWDSLVVDQW OD VXUIDFH LQWHUQH LQWLPD

(64) GH WRXV OHV YDLVVHDX[ /RQJWHPSV FRQVLGpUp FRPPH XQH VLPSOH © HQYHORSSH ª LPSOLTXpH GDQV OHV SURFHVVXV G¶KpPRVWDVH O¶HQGRWKpOLXP V¶DYqUH rWUH XQH JODQGH HQGRFULQH HW DXVVL XQ LQWpJUDWHXU GHV SURFHVVXVWLVVXODLUHVVRXVMDFHQWV $LQVL OH PRQR[\GH G¶D]RWH 12

(65) HVW XQ PHVVDJHU UDGLFDODLUH SURGXLW HQ SHUPDQHQFHSDUO¶HQGRWKpOLXPHWTXLUHPSOLWORFDOHPHQWGHQRPEUHXVHVIRQFWLRQV GRQWOHVPLHX[UHFRQQXHVVRQWODUHOD[DWLRQGHVFHOOXOHVPXVFXODLUHVOLVVHVVRXV MDFHQWHV HW O¶LQKLELWLRQ GH O¶DJUpJDWLRQ SODTXHWWDLUH $YHF O¶DYDQFpH HQ kJH HQ SUpVHQFH RX QRQ G¶XQH K\SHUWHQVLRQ DUWpULHOOH LO H[LVWH XQH DOWpUDWLRQ GH OD IRQFWLRQ HQGRWKpOLDOH YLD XQH DOWpUDWLRQ GH OD YRLH GX 12 HW XQH SURGXFWLRQ GH UDGLFDX[ OLEUHV TXL FRPSURPHWWHQW VHFRQGDLUHPHQW OD GLVSRQLELOLWp HQ 12 DLQVL TX¶XQ pWDW LQIODPPDWRLUH FKURQLTXH GH EDV JUDGH TXL PRGLILH pJDOHPHQW OD ELRGLVSRQLELOLWpGH12&HWWHDQRPDOLHSUpGRPLQHDXQLYHDXGHVDUWqUHVSOXW{WTXH GHV DUWpULROHV HW FRQWULEXH j IDYRULVHU OH GpYHORSSHPHQW GH O¶DWKpURPH /¶HQWUDvQHPHQW HQ HQGXUDQFH DWWpQXH OD GLPLQXWLRQ GH OD UpSRQVH YDVRGLODWDWULFH PXVFXODLUHTXLpYROXHDYHFO¶DYDQFpHHQkJH2QVDLWGpVRUPDLVTX¶LOHVWSRVVLEOH GHOLPLWHUFHVPRGLILFDWLRQVSDUODSUDWLTXHG¶XQHDFWLYLWpSK\VLTXH /D PDMRULWp GHV pWXGHV UpDOLVpHV FKH] GHV VXMHWV SRUWHXUV GH SDWKRORJLHV FDUDFWpULVpHV SDU XQH DOWpUDWLRQ GH OD YDVRGLODWDWLRQ 12GpSHQGDQWH K\SHUWHQVLRQK\SHUFKROHVWpUROpPLHGLDEqWH«

(66) RQWGpPRQWUpXQHDPpOLRUDWLRQGH FHWWHIRQFWLRQGDQVOHVJURVYDLVVHDX[SDUO¶H[HUFLFHSK\VLTXH7HQDQWFRPSWHGHV .

(67) OLHQVSK\VLRSDWKRORJLTXHVHWSURQRVWLTXHVIRUWVHQWUHOHVDQRPDOLHVIRQFWLRQQHOOHV HW VWUXFWXUDOHV YDVFXODLUHV HW OD VXUYHQXH G¶pYpQHPHQWV FDUGLRYDVFXODLUHV OD SUDWLTXH G¶XQH DFWLYLWp SK\VLTXH UpJXOLqUH DSSDUDvW HVVHQWLHOOH SRXU OD SULVH HQ FKDUJHGHVSDWLHQWVSRUWHXUVGHFHVSDWKRORJLHV /¶DFWLYLWp SK\VLTXH D pJDOHPHQW XQ HIIHW SRVLWLI FKH] OHV LQVXIILVDQWV FDUGLDTXHV QRWDPPHQW HQ DPpOLRUDQW OD FRQVRPPDWLRQ PD[LPDOH G¶R[\JqQH 92 PD[

(68) HQ DPpOLRUDQW O¶HQGXUDQFH j O¶H[HUFLFH HW HQ DXJPHQWDQW OD GLVWDQFH GH PDUFKH DX WHVWGHVL[PLQXWHV ¾ 'LDEqWHGHW\SH /DSUDWLTXHG¶XQH[HUFLFHSK\VLTXHLQIOXHVXUOHVWDWXWPpWDEROLTXHG¶XQGLDEpWLTXH RXG¶XQHSHUVRQQHjULVTXHGHGLDEqWH&HWWHLQIOXHQFHVHPDQLIHVWHGHPDQLqUH GLIIpUHQWHHQIRQFWLRQGHO kJHGHO pWDWQXWULWLRQQHOGXW\SHGHVSRUWGHVDGXUpH HWGHVRQLQWHQVLWp'HWUqVQRPEUHX[IDFWHXUVUpJLVVHQWODUpSRQVHSHUVRQQHOOHGH FKDTXH LQGLYLGX ORUV GH OD SUDWLTXH GH O H[HUFLFH SK\VLTXH LO HVW GRQF GLIILFLOH G pWDEOLUGHVUqJOHVFRPPXQHVjWRXVOHVGLDEpWLTXHVTXLGpILQLUDLHQWOHVFRQGLWLRQV GHSUDWLTXHGXVSRUW8QFHUWDLQQRPEUHGHUHFRPPDQGDWLRQVSHXYHQWQpDQPRLQV rWUHIDLWHV,OHVWHVWLPpTX¶HQYLURQGHO¶LQFLGHQFHGXGLDEqWHGHW\SHHVWOLp jODVpGHQWDULWp/DSUDWLTXHG¶XQH[HUFLFHSK\VLTXHHQHQGXUDQFHUpGXLWOHULVTXH GH GLDEqWH GH W\SH GH HQWUH OHV SHUVRQQHV DFWLYHV HW FHOOHV TXL VRQW VpGHQWDLUHV /HV HIIHWV PpWDEROLTXHV DVVRFLpV DYHF OD SUDWLTXH UpJXOLqUH G¶XQ H[HUFLFH HQ HQGXUDQFHVRQW XQHDOWHUQDQFHK\SRJO\FpPLHK\SHUJO\FpPLH XQH DXJPHQWDWLRQ GH OD VHQVLELOLWp j O¶LQVXOLQH RQ VDLW TXH O¶LQVXOLQRUpVLVWDQFH MRXHXQU{OHFHQWUDOGDQVOHGLDEqWHGHW\SH XQHDXJPHQWDWLRQGHODPDVVHPXVFXODLUH XQHDPpOLRUDWLRQGXSURILOOLSLGLTXH XQHUpGXFWLRQGXSRLGVHWGHO¶LQGH[GHPDVVHFRUSRUHOOH XQHGLPLQXWLRQGXSRXUFHQWDJHGHJUDLVVHGDQVO¶RUJDQLVPH XQHUpGXFWLRQGHODSURGXFWLRQKpSDWLTXHGHJOXFRVH .

(69) XQH GLPLQXWLRQ GH OD SUHVVLRQ DUWpULHOOH TXL HVW XQ IDFWHXU GH ULVTXH FDUGLR YDVFXODLUHWUqVOLpDYHFOHGLDEqWH /¶H[HUFLFHSK\VLTXHSHXWrWUHSUHVFULWSRXUIDLUHEDLVVHUOHQLYHDXGHODJO\FpPLH FKH] XQH SHUVRQQH SUpVHQWDQW XQ GLDEqWH GH W\SH /¶H[HUFLFH PXVFXODLUH SHXW DXJPHQWHU O¶H[WUDFWLRQ GX JOXFRVH GX VDQJ GH j IRLV FH TXL SHUPHW HIIHFWLYHPHQWGHUpGXLUHODJO\FpPLH ¾ 0DODGLHVUHVSLUDWRLUHV /HV pWXGHV VXU O¶HIILFDFLWp GH O¶DFWLYLWp SK\VLTXH SRXU SUpYHQLU OHV PDODGLHV UHVSLUDWRLUHVVRQWUDUHVHWOD%3&2 EURQFKRSQHXPRSDWKLHREVWUXFWLYH

(70) FRQFHQWUH ODTXDVLWRWDOLWpGHVWUDYDX['HX[pWXGHVUpFHQWHVVXUXQJUDQGQRPEUHGHVXMHWV DSSRUWHQW GHV pOpPHQWV GH SUHXYH FRQYDLQFDQWV 'DQV XQH SUHPLqUH pWXGH XQ VXLYL GH VXMHWV VXU DQV D PRQWUp TXH OHV IXPHXUV DFWLIV SUDWLTXDQW XQH DFWLYLWpSK\VLTXHpJDOHRXVXSpULHXUHjKHXUHVSDUVHPDLQHRQWXQULVTXHUpGXLW GHGpYHORSSHUXQH%3&2FRPSDUDWLYHPHQWDX[IXPHXUVGRQWODTXDQWLWpG¶DFWLYLWp SK\VLTXHHVWLQIpULHXUHjFHVHXLO/DPrPHpTXLSHVXLYDQWSDWLHQWVDWWHLQWV GH%3&2SHQGDQWDQVDYDLWSUpFpGHPPHQWPRQWUpSRXUFHWWHPrPHTXDQWLWp G¶DFWLYLWp SK\VLTXH XQH UpGXFWLRQGH GHV KRVSLWDOLVDWLRQV HWGH ODPRUWDOLWp G¶RULJLQHUHVSLUDWRLUH /H UHFRXUV j O¶DFWLYLWp SK\VLTXH FRPPH RXWLO WKpUDSHXWLTXH SURYLHQW GX PRGqOH LQLWLDO GpILQL GDQV OHV DQQpHV GX FHUFOH YLFLHX[ GX GpFRQGLWLRQQHPHQW RX VSLUDOH GH OD G\VSQpH /H PDODGH UHVSLUDWRLUH HVVRXIIOp HQ UDLVRQ GH VD PDODGLH SDUW UHVSLUDWRLUH GH OD G\VSQpH

(71) FHVVH WRXWH DFWLYLWp FH TXL FRQGXLW j XQ © GpFRQGLWLRQQHPHQWªF¶HVWjGLUHjXQHSHUWHGHVILEUHVHWGHVHQ]\PHVGHODYRLH PpWDEROLTXHPXVFXODLUHR[\GDWLYH7RXWH[HUFLFHHVWDORUVHVVHQWLHOOHPHQWUpDOLVp DYHF OHV ILEUHV ODFWLTXHV 'LUHFWHPHQW RX LQGLUHFWHPHQW O¶DFLGH ODFWLTXH IRUPp VWLPXOHDORUVOHVFHQWUHVUHVSLUDWRLUHVFHTXLDJJUDYHODG\VSQpHSUpH[LVWDQWH SDUW PXVFXODLUHGHODG\VSQpH

(72) /HUpHQWUDvQHPHQWjO¶HIIRUWDGRQFSRXUREMHFWLIGHUHVWDXUHUODYRLHR[\GDWLYHDILQ G¶LQWHUURPSUH FH FHUFOH YLFLHX[ ,O GLPLQXH OD G\VSQpH GHV SDWLHQWV HQ DPpOLRUDQW VD SDUW PXVFXODLUH VDQV PRGLILFDWLRQ GH OD IRQFWLRQ UHVSLUDWRLUH JOREDOH &H .

(73) PRGqOH DXMRXUG¶KXL GpPRQWUp HVW DFWXHOOHPHQW FRPSOpWp /D %3&2 HVW XQH PDODGLH LQIODPPDWRLUH j WRXV OHV QLYHDX[ UHVSLUDWRLUH VDQJXLQ PXVFXODLUH« /¶DFWLYLWp SK\VLTXH D XQ HIIHW DQWLLQIODPPDWRLUH HW DQWLR[\GDQW TXL SDUWLFLSH QpFHVVDLUHPHQW j F{Wp G¶DXWUHV SKpQRPqQHV j O¶DPpOLRUDWLRQ GH O¶pWDW GH FHV SDWLHQWV /HV HIIHWV GX UpHQWUDvQHPHQW j O¶HIIRUW FKH] OH SDWLHQW SUpVHQWDQW XQH %3&2 RQW IDLWO¶REMHWGHGL]DLQHVG¶pWXGHVFRQWU{OpHVTXLGHSXLVRQWpWpFRPSLOpHVVRXV IRUPH GH PpWDDQDO\VH RX DQDO\VpHV HQ WHUPHV G¶© evidence-based medicine ª /HV UpVXOWDWV VRQW SDUWLFXOLqUHPHQW UHPDUTXDEOHV OD G\VSQpH OD WROpUDQFH j O¶HIIRUWODTXDOLWpGHYLHHWOHQRPEUHG¶H[DFHUEDWLRQVVRQWDPpOLRUpVDXQLYHDXGH SUHXYHOHSOXVpOHYp $

(74) HQWHUPHG¶©evidence-basedmedicine ª ¾ &DQFHUV F{ORQHWVHLQ

(75) / DFWLYLWpSK\VLTXHHVWDVVRFLpHjXQHGLPLQXWLRQGXULVTXHGHSOXVLHXUVFDQFHUV OH SRXUFHQWDJH GH GLPLQXWLRQ GX ULVTXH GH FDQFHU GX F{ORQ HVW HVWLPp j SRXUOHVSHUVRQQHVSK\VLTXHPHQWDFWLYHVSDUUDSSRUWDX[QRQDFWLYHV ' DSUqV XQH UHYXH GH OD OLWWpUDWXUH SRUWDQW VXU OHV pWXGHV GH FRKRUWH OH SRXUFHQWDJHGHGLPLQXWLRQGXULVTXHGHFDQFHUGXVHLQHVWHVWLPpjHQYLURQ SRXUOHVIHPPHVOHVSOXVDFWLYHVSDUUDSSRUWDX[PRLQVDFWLYHV /HVIHPPHV TXL RQW O DFWLYLWp SK\VLTXH GH ORLVLUV OD SOXV LPSRUWDQWH RQW XQ ULVTXH GHFDQFHUGHO HQGRPqWUHGLPLQXpGHSDUUDSSRUWDX[PRLQVDFWLYHV 3RXU G DXWUHV FDQFHUV SRXPRQ SDQFUpDV SURVWDWH RYDLUH OHV GRQQpHV VRQW HQFRUHLQVXIILVDQWHVSRXUHQWLUHUGHVFRQFOXVLRQVGpILQLWLYHV / DFWLYLWpSK\VLTXHGLPLQXHOHULVTXHGHSULVHGHSRLGVGHVXUSRLGVHWG REpVLWp / DFWLYLWpSK\VLTXHSRXUUDLWDLQVLpJDOHPHQWH[HUFHUXQHIIHWSURWHFWHXULQGLUHFWYLV jYLVGHVORFDOLVDWLRQVGHFDQFHUVSRXUOHVTXHOOHVLOH[LVWHXQOLHQDYHFVXUSRLGVHW REpVLWp j VDYRLU OHV FDQFHUV GH O °VRSKDJH GH O HQGRPqWUH GX UHLQ GX F{ORQ UHFWXPGXVHLQDSUqVODPpQRSDXVHGXSDQFUpDVHWGHODYpVLFXOHELOLDLUH . .

(76) ¾ $XWUHV017 2VWpRSRURVH 6¶LO H[LVWH GHV IDFWHXUV GH ULVTXH G¶RVWpRSRURVHQRQ PRGLILDEOHV O¶kJH OH VH[H IpPLQLQ OD JpQpWLTXH DQWpFpGHQWVIDPLOLDX[ G¶RVWpRSRURVH

(77) LO HVWSRVVLEOH G¶DJLU VXU EHDXFRXS G¶DXWUHV QRWDPPHQW SDU O¶REVHUYDWLRQ GH UqJOHV G¶K\JLqQH GH YLH /¶LQDFWLYLWpSK\VLTXHHVWXQIDFWHXUGHULVTXHG¶RVWpRSRURVHUHFRQQX /¶H[HUFLFHSK\VLTXHDXQHIIHWEpQpILTXHVXUODGpPLQpUDOLVDWLRQRVVHXVH ¾ FKH] O¶HQIDQW HW O¶DGROHVFHQW LO MRXH XQ U{OH SUpSRQGpUDQW GDQV O¶pWDEOLVVHPHQWGXSLFGHPDVVHRVVHXVH ¾ FKH]ODIHPPHPpQRSDXVpHO¶H[HUFLFHUDOHQWLWODGLPLQXWLRQGHODPDVVH RVVHXVH HW FH EpQpILFH SHUVLVWH PrPH VL OD IHPPH DEDQGRQQH FHWWH DFWLYLWp ¾ jWRXWkJHO¶LQWpUrWG¶XQHDFWLYLWpSK\VLTXHHVWLQFRQWHVWp ¾ &KH] OH VXMHW kJp HQ SOXV GX EpQpILFH SRXU OD PDVVH RVVHXVH O¶H[HUFLFHHQWUHWLHQWODPXVFXODWXUHHWO¶pTXLOLEUHHWGLPLQXHOHULVTXHGH FKXWHHWGHIUDFWXUH 'pSUHVVLRQ /D GpSUHVVLRQ HVW XQH PDODGLH WUqV UpSDQGXH TXL WRXFKHUDLW SUqV GH GHV SRSXODWLRQV GDQV OHV SD\V RFFLGHQWDX[ / DFWLYLWp SK\VLTXH D XQ LPSDFW SRVLWLI UHFRQQX/DPRLWLpGHVSHUVRQQHVSUpVHQWDQWGHVWURXEOHVGpSUHVVLIVUHoRLYHQWXQ WUDLWHPHQW HW VHXOHPHQW XQ WLHUV GH FHX[ TXL VRQW WUDLWpV YRLHQW OHXUV V\PSW{PHV GLPLQXHU /HV WURXEOHV GH O¶KXPHXU QDLVVHQW j SDUWLU G¶XQH VWUXFWXUH GX FHUYHDX QRPPpH O¶KLSSRFDPSH GDQV OH FDGUH GH SURFpGXUHV GLWHV GH QHXURJpQqVH TXL VHUDLHQW SHUWXUEpHV /¶DFWLYLWp SK\VLTXH FRQGXLW j DXJPHQWHU OHV WDX[ G¶HQGRPRUSKLQHV OHV EpWD HQGRPRUSKLQHV TXL VRQW GLUHFWHPHQW OLpHV j OD QHXURJpQqVH /HV HQGRPRUSKLQHV UpGXLVHQW OD GRXOHXU HW SURYRTXHQW XQ pWDW HXSKRULTXH/DSKHQ\OHWK\ODPLQHTXLHVWXQHQHXURDPLQHHQGRJqQHMRXHXQU{OH GDQVOHQLYHDXG KXPHXUG DWWHQWLRQHWG pQHUJLHSK\VLTXH(OOHDJLUDLWpJDOHPHQW VXU O HXSKRULH GHV FRXUHXUV GH IRQG TXL pWDLW MXVTX j PDLQWHQDQW HQWLqUHPHQW DWWULEXpH DX[ HQGRPRUSKLQHV /¶H[HUFLFH SK\VLTXH DXJPHQWH OH IDFWHXU GH .

(78) FURLVVDQFH HQGRWKpOLDO OLp pJDOHPHQW j O¶DFWLYLWp GH O¶KLSSRFDPSH 7RXMRXUV VRXV O¶HIIHW G¶XQ H[HUFLFH SK\VLTXH OD VpFUpWLRQ G¶XQ IDFWHXU QHXURWURSKLTXH LVVX GX FHUYHDX D XQ U{OH PDMHXU GDQV OH GpYHORSSHPHQW HW OD VXUYLH GHV QHXURQHV &H IDFWHXU DXJPHQWH DYHF OD SULVH G¶DQWLGpSUHVVHXUV HW FHWWH DXJPHQWDWLRQ HVW EHDXFRXS SOXV UDSLGH SRXU FHX[ TXL SUDWLTXHQW UpJXOLqUHPHQW XQ H[HUFLFH SK\VLTXH /D VpURWRQLQH HVW LPSOLTXpH GDQV OHV HIIHWV DQWL GpSUHVVHXUV GH O¶H[HUFLFH SK\VLTXH /D SUDWLTXH UpJXOLqUH G¶XQH DFWLYLWp SK\VLTXH DXJPHQWH OD V\QWKqVHG¶HQ]\PHVSUpFXUVHXUVGHODVpURWRQLQH 7URXEOHVPXVFXORVTXHOHWWLTXH 706

(79) /H QRPEUH GH 706 QH FHVVH G¶DXJPHQWHU GHSXLV SOXVLHXUV DQQpHV HW FRQVWLWXH XQHSULRULWpHQPDWLqUHGHSUpYHQWLRQGHODVDQWpDXWUDYDLODXQLYHDXLQWHUQDWLRQDO (Q HQ )UDQFH 706 RQW pWp LQGHPQLVpV /H QRPEUH GH QRXYHDX[ FDV GH 706 LQGHPQLVpV V¶DFFURLW HQYLURQ GH SDU DQ GHSXLV /HV706 UHSUpVHQWHQW OD SUHPLqUH FDXVH GH PDODGLH SURIHVVLRQQHOOH WDEOHDX Q 03 $QQH[H

(80) HQ(XURSHHWHQ)UDQFH 6RXUFH(XURVWDW

(81) DYHFGHVFRWVKXPDLQVHW VRFLRpFRQRPLTXHVFRQVLGpUDEOHV (Q WHUPHV GH SDWKRORJLHV GH O¶DSSDUHLO PXVFXORVTXHOHWWLTXH LO H[LVWH XQH pYLGHQFH FODLUH GH O¶DPpOLRUDWLRQ GH OD GRXOHXU HW GH OD IRQFWLRQ JOREDOH FKH] OHV SDWLHQWV VRXIIUDQW GH JRQDUWKURVH GH FR[DUWKURVH GH SRO\DUWKULWH UKXPDWRwGH G¶DUWKULWHMXYpQLOHLGLRSDWKLTXHHWGHVSRQG\ODUWKULWHDQN\ORVDQWHQRWDPPHQWJUkFH DX[H[HUFLFHVHQPRGHDpURELHHWDX[H[HUFLFHVGHUHQIRUFHPHQWPXVFXODLUHGHV PHPEUHVLQIpULHXUV ,O HVW pJDOHPHQW FODLUHPHQW pWDEOL TXH GHV H[HUFLFHV UpJXOLHUV HQ SDUWLFXOLHU GHV H[HUFLFHV GH UHQIRUFHPHQW PXVFXODLUH GH OD VDQJOH ORPERDEGRPLQDOH HW GH SURSULRFHSWLRQ FKH] OHV SDWLHQWV ORPEDOJLTXHV SHUPHWWHQW XQH DPpOLRUDWLRQ GHV GRXOHXUVHWXQHGLPLQXWLRQGXWHPSVG¶DUUrWGHWUDYDLO . .

(82) . 6. Promotion de la sante sur le lieu de travail /LHX[SURSLFHVjO¶DFWLYLWpSK\VLTXH ,O UpVXOWH G¶XQ H[DPHQ GH OD OLWWpUDWXUH TXH OD FUpDWLRQ RX O¶DPpOLRUDWLRQ G¶XQ DFFqVjGHVOLHX[G¶DFWLYLWpSK\VLTXHSHXWHQWUDLQHUXQHDXJPHQWDWLRQGHGX QRPEUH GH SHUVRQQHV TXL IRQW GH O¶H[HUFLFH DX PRLQV WURLV IRLV SDU VHPDLQH HQ SDUWLFXOLHU VL O¶RQ GLIIXVH SDUDOOqOHPHQW GHV LQIRUPDWLRQV VXU OHV SRVVLELOLWpV GH PHQHU XQH YLH DFWLYH HW OHV DYDQWDJHV TXL HQ UpVXOWHQW(Q SOXV GH PRGLILFDWLRQV GH O¶HQYLURQQHPHQW EkWL GH WHOOHV LQWHUYHQWLRQV RQW SOXV GH FKDQFHV G¶rWUH HIILFDFHVGDQVWURLVOLHX[OHVpFROHVles lieux de travailHWOHVpWDEOLVVHPHQWVGH VRLQVGHVDQWp /LHX[GHWUDYDLO 'HQRVMRXUVGHSOXVHQSOXVG¶HPSORLVVRQWVpGHQWDLUHVHQODPRLWLpGHV SHUVRQQHVLQWHUURJpHVjO¶RFFDVLRQG¶XQHHQTXrWHGHO¶8(RQWGpFODUpTX¶HOOHVQH SUDWLTXDLHQW SDV RX JXqUH G¶DFWLYLWp DX WUDYDLO /H QRPEUH GH SHUVRQQHV TXL VH UHQGHQWDXWUDYDLOHQYRLWXUHHVWHQDXJPHQWDWLRQSHUPDQHQWH 2Q GLVSRVH GH QRPEUHXVHV GRQQpHV FRQFHUQDQW O¶HIILFDFLWp G¶LQWHUYHQWLRQV VXU OH OLHX GH WUDYDLO FHOXLFL R OD SOXSDUW GHV DGXOWHV SDVVHQW VHSW j KXLW KHXUHV SDU MRXU RIIUHV G¶LPSRUWDQWHV SRVVLELOLWpV GH VWLPXOHU O¶DFWLYLWp SK\VLTXH QRWDPPHQW JUkFHjODPLVHjGLVSRVLWLRQG¶LQVWDOODWLRQVG¶H[HUFLFHHWjO¶DGRSWLRQGHSROLWLTXHV TXLIDYRULVHQWODPDUFKHjSLHGRXO¶XWLOLVDWLRQGXYpORSRXUVHUHQGUHDXWUDYDLO /HV SURJUDPPHV G¶DFWLYLWp VXU OH OLHX GH WUDYDLO FRPSUHQQHQW VRXYHQW G¶DXWUHV pOpPHQWV WHOV TX¶XQH DFWLRQ G¶pGXFDWLRQ SRXU OD VDQWp XQ GpSLVWDJH FRQFHUQDQW OHV IDFWHXUV GH ULVTXH HW GHV RULHQWDWLRQV YHUV G¶DXWUHV VHUYLFHV /D SOXSDUW GHV SDUWLFLSDQWV j FHV SURJUDPPHV ©PL[WHVª RQW VLJQDOp XQH SHUWH GH SRLGV XQH UpGXFWLRQGHODJUDLVVHFRUSRUHOOHHWXQHDPpOLRUDWLRQGHODVDQWpFDUGLRYDVFXODLUH HW G¶DXWUHV DVSHFWV GH OD VDQWp 'HV pWXGHV PHQpHV VXU GHV OLHX[ GH WUDYDLO RQW SHUPLV GH FRQVWDWHU TXH OHV DYDQWDJHV QHWV SDU SHUVRQQH GpSDVVHQW ODUJHPHQW OHVFRWVG¶DPpOLRUDWLRQGHO¶DFFqVjGHVOLHX[G¶DFWLYLWpSK\VLTXH /HVHPSOR\HXUVSHXYHQWrWUHSDUWLFXOLqUHPHQWSHUVXDVLIVORUVTX¶LOVUHFRPPDQGHQW GHV GpSODFHPHQWV j YpOR j GHVWLQDWLRQ HW DX GpSDUW GX OLHX GH WUDYDLO HQ .

(83) UHPERXUVDQW OHV GpSHQVHV FRUUHVSRQGDQWHV HW HQ PHWWDQW j OD GLVSRVLWLRQ GHV VDODULpVGHVGRXFKHVHWGHVOLHX[GHUDQJHPHQWGHYpOR . Figure 9 : Question 7 de la nouvelle enquête 2013 "Où les citoyens s'adonnent-ils à des activités sportives et autres activités physiques?". 20. 6XU OD )LJXUH RQ QRWH TXH VHXOHPHQW GHV UpSRQGDQWV j O¶HQTXrWH GH O¶(XUREDURPqWUHTXLSUDWLTXHQWXQHDFWLYLWpSK\VLTXH QRQSURIHVVLRQQHOOH

(84) OH IRQWVXUOHOLHXGHWUDYDLO ([HPSOHGHPHVXUHVJpQpUDOHVjSUHQGUHGDQVOHVHQWUHSULVHV x 'RQQHUO¶H[HPSOHHQFRQVWLWXDQWVXUOHOLHXGHWUDYDLO, des comités de vie activeTXLUHSUpVHQWHQWWRXVOHVpFKHORQVGHVV\QGLFDWVGHVDVVRFLDWLRQV SURIHVVLRQQHOOHV HW GH OD GLUHFWLRQ HQ HQFRXUDJHDQW OHV GpSODFHPHQWV j YpOR SDU H[HPSOH YLD OD PLVH j GLVSRVLWLRQ G¶HPSODFHPHQWV SRXU ELF\FOHWWHV

(85) HW HQ GpFRXUDJHDQW O¶XWLOLVDWLRQ GH OD YRLWXUH QRWDPPHQW HQ V¶DEVWHQDQWGHYHUVHUGHVLQGHPQLWpVFRXYUDQWOHVIUDLVUHODWLIVDX[YRLWXUHV HWDXVWDWLRQQHPHQW

(86) HQSHUPHWWDQWO¶DFWLYLWpSK\VLTXHVXUOHOLHXGHWUDYDLO JUkFH j GHV SURJUDPPHV GH PDLQWLHQ HQ FRQGLWLRQ SK\VLTXH j GHV GRXFKHVjGHVYHVWLDLUHVHWDXVRXWLHQGHFOXEVVSRUWLIVHWGHFRPSpWLWLRQ DX[TXHOOHVSXLVVHQWSDUWLFLSHUOHVVDODULpV

(87) RXHQYHUVDQWGHVVXEYHQWLRQV. .

(88) HQ YXH GH O¶XWLOLVDWLRQ SDU OHV DJHQWV G¶LQVWDOODWLRQV ORFDOHV V¶LO Q¶HVW SDV SRVVLEOHGHFUpHUGHVLQVWDOODWLRQVSURSUHVjO¶HQWUHSULVH x Le rôle de l’employeur est fondamental (QFRXUDJHU OHV HPSOR\HXUV j DGRSWHU GHV SROLWLTXHV HW GHV SUDWLTXHV VLPLODLUHV HW FROODERUHU DYHF HX[ ORUVTX¶XQHLQWHUYHQWLRQQpFHVVLWHXQVRXWLHQRXGHVFRPSpWHQFHVSUpFLVHV )pOLFLWHU SXEOLTXHPHQW OHV HQWUHSULVHV TXL RIIUHQW GHV SRVVLELOLWpV GH SUDWLTXHU XQH $3 j OHXUV VDODULpV FI FKDUWH ©(QWUHSULVHV DFWLYHV GX 3116ª

(89) x 0HWWUH HQ SODFH HW SURPRXYRLU GHV itinéraires sûrs et actifs pour se rendre au travaiO DILQ GH IDYRULVHU OD PDUFKH j SLHG OH F\FOLVPH HW O¶XWLOLVDWLRQ GH V\VWqPH GH WUDQVSRUW UDSLGHV HW HIILFDFHV HQ FRPELQDLVRQ DYHFFHVPRGHVGHGpSODFHPHQWVDFWLIV x Aménager l’environnement urbainHQORFDOLVDQWOHVOLHX[GHWUDYDLOHWOHV HQWUHSULVHV GDQV GHV TXDUWLHUV PL[WHV RX SURFKHV GHV LWLQpUDLUHV GH WUDQVSRUWVHQFRPPXQ x &UpHU DX VHLQ GHV VHUYLFHV GH VDQWp SXEOLTXH XQH LQVWDQFH GpGLpH DX[ OLHX[ GH WUDYDLO HW j OD YLH DFWLYH TXL UDVVHPEOH OHV SHWLWHV HW JUDQGHV HQWUHSULVHVG¶XQHYLOOHTXLH[SULPHQWXQLQWpUrWSRXUO¶DPpOLRUDWLRQGHO¶DFFqV jO¶DFWLYLWpSK\VLTXHSRXUOHXUVVDODULpV/RUVTXHFHODHVWDSSURSULppWDEOLU GHV OLHQV HQWUH OHV HQWUHSULVHV HW OHV VHUYLFHV HW SURJUDPPHV ORFDX[ GH ORLVLUVHWG¶DFWLYLWpSK\VLTXH ,QLWLDWLYHLQVWLWXWLRQQHOOHFRQFHUQDQWODVDQWpHQHQWUHSULVH OMS OUJDQLVDWLRQ MRQGLDOHGHODSDQWp

(90) :(QOHUDSSRUWGHO¶206LQVLVWDLW VXU OH U{OH GH O¶HPSOR\HXU HQ PDWLqUH GH SUpYHQWLRQ GH FHUWDLQHV PDODGLHV SDU O¶DOLPHQWDWLRQHWO¶H[HUFLFHSK\VLTXH /H PLOLHX GH WUDYDLO LQIOXH GLUHFWHPHQW VXU OH ELHQrWUH SK\VLTXH PHQWDO pFRQRPLTXHHWVRFLDOGHVWUDYDLOOHXUVHWpJDOHPHQWVXUODVDQWpGHOHXUVIDPLOOHV GHV FRPPXQDXWpV HW GH OD VRFLpWp ,O RIIUH XQ FDGUH HW XQH LQIUDVWUXFWXUH LGpDOH SRXU VRXWHQLU OD SURPRWLRQ GH OD VDQWp G XQ ODUJH SXEOLF /H FRQFHSW GH OD SURPRWLRQ GH OD VDQWp HQ PLOLHX GH WUDYDLO ZRUNSODFH KHDOWK SURPRWLRQ OXL DSSDUDLW GH SOXV HQ SOXV SHUWLQHQW QRWDPPHQW GX IDLW GH OD PRQGLDOLVDWLRQ TXL .

(91) FRQGLWLRQQH OD UpXVVLWH j OD SRVVLELOLWp GH EpQpILFLHU G¶HPSOR\pV HQ ERQQH VDQWp TXDOLILpV HW PRWLYpV /¶206 QRWH TXH SRXU OHV QDWLRQV OH GpYHORSSHPHQW GH OD SURPRWLRQGHODVDQWpDXWUDYDLOVHUDXQSUpUHTXLVSRXUOHGpYHORSSHPHQWVRFLDOHW pFRQRPLTXHGXUDEOH /HV WUDYDX[ GX JURXSH GH WUDYDLO GH O¶206 ©DFWLYLWp GH SURPRWLRQ GH OD VDQWpª VRXOLJQHQWTXHO¶pGXFDWLRQjODVDQWpSHXWDLGHUOHVWUDYDLOOHXUVjpYLWHUOHVHIIHWV QpJDWLIVFRPELQpVGHIDFWHXUVGHULVTXHVOLpVDXPRGHGHYLHHWGHVH[SRVLWLRQV SURIHVVLRQQHOOHV,OVFRQFOXHQWTXHOHVSROLWLTXHVSXEOLTXHVGHVSD\VHQPDWLqUHGH SURPRWLRQ GH OD VDQWp GRLYHQW LQFOXUH OD VWUDWpJLH GH SURPRWLRQ GH OD VDQWp DX WUDYDLO INPES : (Q )UDQFH O¶,QVWLWXW QDWLRQDO GH SUpYHQWLRQ HW G¶pGXFDWLRQ SRXU OD VDQWp ,13(6

(92) DSRXUPLVVLRQVGH ¾. PHWWUHHQ°XYUHSRXUOHFRPSWHGHO¶(WDWHWGHVHVpWDEOLVVHPHQWV. SXEOLFVGHVSURJUDPPHVGHVDQWpSXEOLTXH ¾. H[HUFHU XQH IRQFWLRQ G¶H[SHUWLVH HW GH FRQVHLO HQ PDWLqUH GH. SUpYHQWLRQHWGHSURPRWLRQGHODVDQWp ¾. DVVXUHUOHGpYHORSSHPHQWGHO¶pGXFDWLRQjODVDQWpVXUO¶HQVHPEOHGX. WHUULWRLUH SDUWLFLSHU j OD GHPDQGH GX PLQLVWUH FKDUJp GH OD VDQWp j OD JHVWLRQ GHV VLWXDWLRQV XUJHQWHV RX H[FHSWLRQQHOOHV D\DQW GHV FRQVpTXHQFHV VDQLWDLUHV FROOHFWLYHV QRWDPPHQW HQ SDUWLFLSDQW j OD GLIIXVLRQGHPHVVDJHVVDQLWDLUHVHQVLWXDWLRQG¶XUJHQFH ¾. pWDEOLUOHVSURJUDPPHVGHIRUPDWLRQjO¶pGXFDWLRQjODVDQWp. (QDYULOO¶,13(6FRQVDFUDLWHQSDUWHQDULDWDYHFOHVPLQLVWqUHVGHODVDQWpHW GX WUDYDLO O¶$1$&7 $JHQFH 1DWLRQDOH SRXU O¶$PpOLRUDWLRQ GHV &RQGLWLRQV GH 7UDYDLO

(93) O¶,156 ,QVWLWXW QDWLRQDO GH UHFKHUFKH HW GH VpFXULWp SRXU OD SUpYHQWLRQ GHV DFFLGHQWV GX WUDYDLO HW GHV PDODGLHV SURIHVVLRQQHOOHV

(94) OD 0XWXDOLWp VRFLDOH DJULFROH 06$

(95) HWO¶,671) ,QVWLWXWGHVDQWpDXWUDYDLOGX1RUGGHOD)UDQFH

(96) XQH VHVVLRQ GH FHV MRXUQpHV GH OD SUpYHQWLRQ VXU OH WKqPH GH OD SUpYHQWLRQ GHV ULVTXHV HW OD SURPRWLRQ GH OD VDQWpHQ HQWUHSULVH HW FRQVDFUDLWXQGRVVLHU VXU FH WKqPH GDQV VRQ PDJD]LQH © /D VDQWp GH O¶KRPPH ª /HV MRXUQpHV GH OD SUpYHQWLRQ,13(6GHMXLQYRQWFRQVDFUHUXQHSDUWLHGHVGpEDWVjODVDQWpDX WUDYDLO .

(97) PNNS PURJUDPPH NDWLRQDO NXWULWLRQ SDQWp

(98) : 'HSXLV OHV SRXYRLUV SXEOLFV RQW PLV HQ °XYUH XQH SROLWLTXH QXWULWLRQQHOOH GH 63 DX WUDYHUV GX 3116 HQ DJLVVDQW VXU OHV GHX[ YHUVDQWV GH OD QXWULWLRQ j VDYRLU O¶DOLPHQWDWLRQ HW O¶DFWLYLWp SK\VLTXH /DUpXVVLWHGX3116UHSRVHVXUODFDSDFLWpGHPRELOLVDWLRQGHVPXOWLSOHVDFWHXUV VRFLpWDX[/HOLHXGHWUDYDLOFRQVWLWXHXQGHVWHUUDLQVSULYLOpJLpVSRXUWRXFKHUXQH WUqVODUJHSRSXODWLRQ/DSHUWLQHQFHG¶LQWpJUHUGHVHQWUHSULVHVSULYpHVHWSXEOLTXHV FRPPH GHV DFWHXUV PDMHXUV GH 63 VXU XQH EDVH YRORQWDLUH UHSRVH VXU OH IDLW TXHVRXYHQWOHVDFWLIVHQVLWXDWLRQG¶HPSORLSDVVHQWXQHSDUWLPSRUWDQWHGHOHXU YLHVXUOHXUOLHXGHWUDYDLO /D FKDUWH ©(QWUHSULVHV DFWLYHV GX 3116ª $QQH[H

(99) RIIUH O¶RSSRUWXQLWp DX[ HQWUHSULVHVGHV¶LQVFULUHGDQVXQHGpPDUFKHFLWR\HQQHHQSURSRVDQWGHVDFWLRQV j GHVWLQDWLRQ GHV VDODULpV DOODQW GDQV OH VHQV GHV REMHFWLIV GX 3116 HW V¶DSSX\DQWVXUOHFDGUHGHUpIpUHQFHRIIHUWSDUOH3116/¶LGpHHVWGHSHUPHWWUH DX[ HQWUHSULVHV GH PHWWUH HQ °XYUH OHV DFWLRQV j OHXU SRUWpH RXYUDQW VXU XQ YpULWDEOHGLDORJXHVXUFHVTXHVWLRQVDXVHLQGHO¶HQWUHSULVH /DSURFpGXUHG¶DWWULEXWLRQG¶XQORJR3116 )LJXUH

(100) DSRXUREMHFWLIVG¶DPSOLILHU OD FRPPXQLFDWLRQ GX 3116 GH JDUDQWLU OD FRKpUHQFH GHV LQIRUPDWLRQV QXWULWLRQQHOOHV HW G¶DXWRULVHU O¶XWLOLVDWLRQ GX ORJR 3116 SRXU GHV DFWLRQV RX GRFXPHQWVUpDOLVpVSDUGHVSURPRWHXUV. Figure 10 : Logo PNNS "Manger Bouger". .

(101) 8Q FRPLWp QDWLRQDO G¶pYDOXDWLRQ SRXU O¶DWWULEXWLRQ GX ORJR 3116 FRRUGRQQp SDU O¶,13(6 D SRXU IRQFWLRQ G¶DQDO\VHU OD FRQIRUPLWp GHV GHPDQGHV G¶DWWULEXWLRQ DX UHJDUG GX UHVSHFW GX FDKLHU GHV FKDUJHV HW GH OD TXDOLWp GHV GRFXPHQWV RX GHV DFWLRQVSURSRVpV $QQH[H

(102) /HV GRFXPHQWV RX DFWLRQV GRLYHQW YLVHU DX PRLQV O¶XQ GHV REMHFWLIV SULRULWDLUHV JpQpUDX[RXGHVREMHFWLIVVSpFLILTXHVGHFHSURJUDPPHHQIDFLOLWHUO¶DWWHLQWHVDQV DOOHU j O¶HQFRQWUH G¶DXFXQ DXWUH REMHFWLI GH IDoRQ H[SOLFLWH RX SDU RPLVVLRQ GLUHFWHPHQWRXLQGLUHFWHPHQWHWGRLYHQWHQUHVSHFWHUO¶HQVHPEOHGHVSULQFLSHV ,OV GRLYHQW HQ RXWUH rWUH FRPSDWLEOHV DYHF OHV UHSqUHV GH FRQVRPPDWLRQ HW FRQVHLOVTXLILJXUHQWGDQVOHVJXLGHVSXEOLpVSDUO¶,13(6GDQVOHFDGUHGX3116 (Q DQQH[H RQ UHWURXYH XQ H[HPSOH G¶DWWULEXWLRQ GX ORJR 3116 SRXU XQH HQWUHSULVHSULYpH Le Centre d’analyse stratégique (CAS) : DWHQWpjSDUWLUG¶XQHpWXGHUpDOLVpHHQ SDU OH &HQWUH QDWLRQDO GH OD UHFKHUFKH VFLHQWLILTXH GH PLHX[ pYDOXHU GDQV TXHOOH PHVXUH OH OLHX GH WUDYDLO SHXW FRQWULEXHU j O¶HVVRU GH O¶DFWLYLWp SK\VLTXH HW VSRUWLYH SRXU WRXV 6HORQ FHWWH pWXGH SRXU OHV HPSOR\HXUV HW OHV V\QGLFDWV OH VSRUW pWDLW VRXYHQW SHUoX FRPPH UHOHYDQW GH OD YLH SULYpH GHV VDODULpV HW F{Wp VDODULpVXQFOLYDJHVHPEODLWH[LVWHUHQWUHG¶XQHSDUWOHVHPSOR\pVHWOHVRXYULHUV HWG¶DXWUHSDUWOHVFDGUHV SOXVHQFOLQVjIDLUHGXVSRUWHQJpQpUDO

(103) ,OQRWDLWTXHOH VSRUW pWDLW VRXYHQW DVVLPLOp j XQ ORLVLU HW SRXYDLW GRQQHU O¶LPSUHVVLRQ TXH FHX[ TXLOHSUDWLTXDLHQWPrPHjO¶KHXUHGXGpMHXQHUpWDLHQWPRLQVLPSOLTXpVGDQVOHXU WUDYDLO /H &$6 VRXOLJQDLW pJDOHPHQW OD SHUFHSWLRQ SRWHQWLHOOH GH OD JHVWLRQ GX VSRUWGDQVODVSKqUHSURIHVVLRQQHOOHFRPPH©XQRXWLOGHFRQWU{OHGHVGLULJHDQWV VXUOHVVDODULpVORUVTXHOHVDFWLYLWpVSURSRVpHVQHVRQWSDVJpUpHVSDUOHFRPLWp G¶HQWUHSULVH &(

(104) PDLV SDU OD GLUHFWLRQ GHV UHVVRXUFHV KXPDLQHV '5+

(105) ª ,O SUpFLVDLWTX¶XQJUDQGQRPEUHG¶RUJDQLVDWLRQVRIIUDLHQWjOHXUVVDODULpVODSRVVLELOLWp GH SUDWLTXHU XQH DFWLYLWp SK\VLTXH OD SOXSDUW GX WHPSV SDU OH ELDLV GX &( 7RXWHIRLV FHV RUJDQLVDWLRQV UpSRQGDLHQW DX SURILO W\SH GHV JUDQGHV HQWUHSULVHV XUEDLQHV HW OHV GLPHQVLRQV GH FRPPXQLFDWLRQ HW G¶LPDJH pWDLHQW GDYDQWDJH j O¶RULJLQH GH FHV GpPDUFKHV TX¶XQH PRWLYDWLRQ YLVDQW j O¶DPpOLRUDWLRQ GH OD VDQWp GHVVDODULpV. .

(106) 'DQV VRQ pWDW GHV OLHX[ OH &$6 PHQWLRQQDLW TX¶HQ GHV IUDQoDLV SUDWLTXDLHQW XQ VSRUWGH PDQLqUH UpJXOLqUH DX PRLQV XQHIRLV SDU VHPDLQH

(107) GRQW 13 % sur le lieu de travail DYHF GHV YDULDWLRQV PDMHXUHV VHORQ OD WDLOOH GH O¶RUJDQLVDWLRQ $LQVL OH &$6 VRXOLJQDLW TXH OD WDLOOH GH O¶RUJDQLVDWLRQ HW OD SUpVHQFH G¶XQ &( RX G¶XQ pTXLYDOHQW pWDLHQW GHV FULWqUHV WUqV LPSRUWDQWV ,O QRWDLWpJDOHPHQW TXH GDQV OHV SHWLWHV RUJDQLVDWLRQV LO pWDLW © GLIILFLOH GH GpOpJXHU RFFDVLRQQHOOHPHQW XQH SDUWLH GH VRQ WUDYDLO PrPH SRXU TXHOTXHV KHXUHV SDU VHPDLQHV SRXU IDLUH GX VSRUWª ,O UDSSHODLW pJDOHPHQW OD PLVH HQ SODFH SDU OH 0('() 0RXYHPHQW GHV (QWUHSULVHV GH )UDQFH

(108) HQ G¶XQH PLVVLRQ © VSRUW HW HQWUHSULVH ª O¶RUJDQLVDWLRQHQSDUOH&RQVHLOLQWHUIpGpUDOGXVSRUWG¶HQWUHSULVHDXVHLQGX FRPLWp QDWLRQDO RO\PSLTXH HW VSRUWLI IUDQoDLV &126)

(109) GHV SUHPLqUHV DVVLVHV GX VSRUWHQHQWUHSULVHHWO¶pGLWLRQHQSDUOH0('()HWOH&126)G¶XQ©JXLGH SUDWLTXH GX VSRUW HQ HQWUHSULVH ª &H JXLGH LQFLWDLW © OHV HPSOR\HXUV j IDLUH GX VSRUWXQRXWLOGHPDQDJHPHQWGHFRPPXQLFDWLRQHWG¶DPpOLRUDWLRQGHODVDQWpª 3DUPLOHVUHFRPPDQGDWLRQVSRXUSHUPHWWUHjWRXVOHVW\SHVGHSXEOLFGHSUDWLTXHU XQ VSRUW VXU OH OLHX GH WUDYDLO OH &$6 LQVLVWDLW OD QpFHVVLWp GH VHQVLELOLVHU OHV HPSOR\HXUV HW OHV HPSOR\pV j O¶HQMHX GH OD VDQWp SDU OH VSRUW ,O SUpFRQLVDLW XQH GLYHUVLILFDWLRQ GH O¶RIIUH VSRUWLYH SRXU WRXV OHV SURILOV GH VDODULpV HW GHV DPpQDJHPHQWV G¶KRUDLUHV GH WUDYDLO SRXU IDFLOLWHU OHV DFWLYLWpV SK\VLTXHV HW VSRUWLYHV ,O VRXOLJQDLW pJDOHPHQW O¶LPSRUWDQFH G¶LQWpJUHU OH VSRUW GDQV OHV SROLWLTXHV GH PDQDJHPHQW GHV UHVVRXUFHV KXPDLQHV HQ SDUWLFXOLHU j GHVWLQDWLRQ GHVVHQLRUV Charte d’Ottawa/DSUHPLqUH&RQIpUHQFHLQWHUQDWLRQDOHSRXUODSURPRWLRQGHOD VDQWpUpXQLHj2WWDZDDDGRSWpOHQRYHPEUHXQH©FKDUWHªHQYXHGH FRQWULEXHUjODUpDOLVDWLRQGHO¶REMHFWLIGHODVDQWpSRXUWRXVG¶LFLjO¶DQHWDX GHOj © /D SURPRWLRQ GH OD VDQWp D SRXU EXW GH GRQQHU DX[ LQGLYLGXV GDYDQWDJH GH PDvWULVH GH OHXU SURSUH VDQWp HW GDYDQWDJH GH PR\HQV GH O¶DPpOLRUHU 3RXU SDUYHQLUjXQpWDWGHFRPSOHWELHQrWUHSK\VLTXHPHQWDOHWVRFLDOO¶LQGLYLGXRXOH. .

(110) JURXSH GRLW SRXYRLU LGHQWLILHU HW UpDOLVHU VHV DPELWLRQV VDWLVIDLUH VHV EHVRLQV HW pYROXHUDYHFVRQPLOLHXRXV¶\DGDSWHUª /D FKDUWH SUpFLVH QRWDPPHQW TXH OD SURPRWLRQ GH OD VDQWp DSSXLH OH GpYHORSSHPHQW LQGLYLGXHO HW VRFLDO JUkFH j O¶LQIRUPDWLRQ j O pGXFDWLRQ SRXU OD VDQWpHWDXSHUIHFWLRQQHPHQWGHVDSWLWXGHVLQGLVSHQVDEOHVjODYLH(OOHVRXOLJQH O¶LPSRUWDQFHGHSHUPHWWUHDX[JHQVG¶DSSUHQGUHjIDLUHIDFHjWRXVOHVVWDGHVGH OHXUYLHHWjVHSUpSDUHUjDIIURQWHUOHVWUDXPDWLVPHVHWOHVPDODGLHVFKURQLTXHV,O HVW QRWp TXH FH WUDYDLO GRLW rWUH IDFLOLWp GDQV OH FDGUH VFRODLUH IDPLOLDO professionnelHWFRPPXQDXWDLUH Réseau européen pour la promotion de la santé au travail (ENHWP) : HQFRXUDJHOHVERQQHVSUDWLTXHVHQPDWLqUHGHSURPRWLRQGHODVDQWpHQPLOLHXGH WUDYDLO ,OGpILQLWODSURPRWLRQGHODVDQWpVXUOHOLHXGHWUDYDLOFRPPH©OHVHIIRUWV FRQMXJXpV GHV HPSOR\HXUV GHV VDODULpV HW GH OD VRFLpWp HQ WDQW TXH WHOOH SRXU DPpOLRUHUODVDQWpHWOHELHQrWUHGHVSHUVRQQHVGDQVOHFDGUHGXWUDYDLO » /H UpVHDX HXURSpHQ SRXU OD SURPRWLRQ GH OD VDQWp DX WUDYDLO (1+:3 D pODERUp GHV FULWqUHV GH ERQQHV SUDWLTXHV GDQV FH GRPDLQH ,O FRRUGRQQH O pFKDQJH G LQIRUPDWLRQV HW OD GLIIXVLRQ G H[HPSOHV GH ERQQHV SUDWLTXHV HQ (XURSH ,O D SXEOLp pODERUp XQ JXLGH YLVDQW j SURPRXYRLU OD TXDOLWp GH YLH DX WUDYDLO GHV SHUVRQQHVDWWHLQWHVGHPDODGLHVFKURQLTXHV /H (1+:3 D pJDOHPHQW ODQFp XQH FDPSDJQH HXURSpHQQH 0RYH HXURSH

(111) SRXU SURPRXYRLU GHV PRGHV GH YLH VDLQ HQ PLOLHX GH WUDYDLO HQ PHWWDQW O DFFHQW VXU TXDWUH WKqPHV l'activité physique SUpYHQWLRQ GX WDEDJLVPH O DOLPHQWDWLRQVDLQHODVDQWpPHQWDOH2QUHWURXYHOHVGHVSULQFLSDOHVFDXVHVGH PDODGLHV FDUGLRYDVFXODLUHV ILJXUDQW VXU OH VLWH GH O¶206 WDEDJLVPH PDQTXH G¶H[HUFLFH SK\VLTXH XQH PDXYDLVH DOLPHQWDWLRQ 4XDQW j OD VDQWp PHQWDOH HOOH UHQYRLHQRWDPPHQWDXVWUHVVGRQWOHVOLHQVDYHFFHUWDLQHV0&9RQWpWpVRXOLJQpV . .

(112) . 7. Coûts de la sédentarité - Bénéfices des programmes de Promotion de la Santé sur le Lieu de Travail (Q O¶206 D pSLQJOp OD VpGHQWDULWp FRPPH TXDWULqPH IDFWHXU GH ULVTXH GH GpFqV /HV SUREOqPHV GH VDQWp HQJHQGUpV SDU OH PDQTXH G DFWLYLWp SK\VLTXH JpQqUHQW GHV FRWV pFRQRPLTXHV GLUHFWV HW LQGLUHFWV LPSRUWDQWV HQ UDLVRQ GH O DXJPHQWDWLRQGHVIUDLVGHVDQWpGHO DOORQJHPHQWGHVFRQJpVGHPDODGLHHWGX QRPEUH DFFUX GH GpFqV SUpPDWXUpV /H YLHLOOLVVHPHQW GH OD SRSXODWLRQ HXURSpHQQH UHQIRUFH FHWWH WHQGDQFH $X QRPEUH GHV EpQpILFHV TXH OD VRFLpWp HXURSpHQQHSHXWUHWLUHUGHODSUDWLTXHG DFWLYLWpVSK\VLTXHVHWVSRUWLYHVQHILJXUH SDVVHXOHPHQWO¶DPpOLRUDWLRQGHODVDQWpHWGHODFRQGLWLRQSK\VLTXHTXLSHUPHW HQWUH DXWUHV GH GLVSRVHU GH WUDYDLOOHXUV HQ ERQQH VDQWp HW SOXV SURGXFWLIV HOOH IDYRULVH DXVVL XQH DPpOLRUDWLRQ GHV FRPSpWHQFHV HW XQH SOXV JUDQGH LQWpJUDWLRQ GHVVRFLpWpV x ,QFLGHQFHpFRQRPLTXH 2XWUHVHVHIIHWVQRFLIVVXUOHSODQGHODPRUWDOLWpGHODPRUELGLWpHWGHODTXDOLWp GHODYLHO¶LQDFWLYLWpDGHVFRWVILQDQFLHUVpOHYpVGDQVWRXVOHVSD\VGHO¶8( 3DU H[HPSOH OHV FRWV DQQXHOV HQ $QJOHWHUUH GpSHQVHV GH VDQWp FRQJpV GH PDODGLHHWSHUWHVGHUHYHQXVGXHVjXQGpFqVSUpPDWXUpRQWpWpHVWLPpVHQWUH HW PLOOLDUGV G¶HXURV &HV FKLIIUHV H[FOXHQW OHV FRQVpTXHQFHV GH O¶LQDFWLYLWp SK\VLTXHVXUOHVXUSRLGVHWO¶REpVLWpGRQWOHFRWJOREDOSRXUUDLWDWWHLQGUHMXVTX¶j PLOOLDUGVG¶HXURVSDUDQ 'H PrPH VHORQ XQH pWXGH VXLVVH OHV FRWV GH WUDLWHPHQW GLUHFWV GH O¶LQDFWLYLWp SK\VLTXHV¶pOqYHUDLHQWjPLOOLDUGG¶HXURV 6LO¶RQVHIRQGHVXUFHVGHX[pWXGHVLOSHXWrWUHHVWLPpTXHO¶LQDFWLYLWpSK\VLTXH FRWHjXQSD\VHQYLURQ150 à 300 euros par habitant par an8QHDXJPHQWDWLRQ GX QLYHDX DFWXHO GH O¶DFWLYLWp SRXUUDLW UpGXLUH VHQVLEOHPHQW OHV FRWV TXH GRLW VXSSRUWHUODVRFLpWpPDLVPrPHXQHVWDELOLVDWLRQGHFHQLYHDXSHXWHQWUDvQHUGHV pFRQRPLHV 3DU H[HPSOH VHORQ O¶pWXGH VXLVVH VXVPHQWLRQQpH O¶pFRQRPLH GH FRWVGHWUDLWHPHQWGLUHFWVTXLUpVXOWHGHO¶DFWLYLWpSK\VLTXHV¶pOqYHjHQYLURQ PLOOLDUGG¶HXURV .

(113) x (IIHWVVRFLDX[SRVLWLIV 8QHYLHDFWLYHSHUPHWG¶DYRLUGHVFRQWDFWVDYHFOHVDXWUHVODFRPPXQDXWpHWOH FDGUH GH YLH (Q SDUWLFXOLHU OH VSRUW HW OHV ORLVLUV DFWLIVIDYRULVHQWO¶DFTXLVLWLRQ GH QRXYHOOHVFRPSpWHQFHVHWODUHQFRQWUHG¶DXWUHVSHUVRQQHV /H OLHX GH WUDYDLO SHUPHW GH IRXUQLU XQ VRXWLHQ VRFLDO j XQH YLH DFWLYH HQ FUpDQW SRXUOHVFROOqJXHVGHWUDYDLOGHVSRVVLELOLWpVG¶rWUHDFWLIHQVHPEOHORUVGHVSDXVHV HWDSUqVO¶KRUDLUHGHWUDYDLO /¶H[LVWHQFHGHGLVSRVLWLIVG¶LQFLWDWLRQjODSUDWLTXHG¶DFWLYLWpSK\VLTXHjGHVILQVGH VDQWpHWELHQrWUHGHVVDODULpVSHXWFRQWULEXHUjYpKLFXOHUXQHLPDJHSRVLWLYHGH O¶HQWUHSULVH x 5HWRXUVXULQYHVWLVVHPHQWVGHVHQWUHSULVHVTXLDGKqUHQWDX[36/7 /H%,7 %XUHDXLQWHUQDWLRQDOGXWUDYDLO

(114) GDQVOHSURJUDPPH62/9( SURJUDPPH pGXFDWLIGHVWLQpVDX[5+V\QGLFDWVDVVRFLDWLRQVG¶HPSOR\HXUVHWSURIHVVLRQQHOV GHV 667