INTRODUCTION:
Insufficient levels of physical activity (PA) continue to be a serious public health problem worldwide. In Gipuzkoa, a territory-wide innovative initiative based on a systemic approach was developed to tackle inactivity: the Physical Activity Guidance Service (PAGS), which connects PA, health, and community resources. Methos: Since 2016, the PAGS service has expanded from 2 to 35 municipalities across the territory. The service integrates referrals from primary care professionals, local PA resources, and personalized counseling. A standardized 5-step protocol (0–4) is used, and participant follow-up is conducted using the IPAQ questionnaire. Descriptive statistical data from 1709 participants were analysed.

RESULTS:
Ninety-five percent of users were referred from the Public Health Service, and 66% were women. At baseline, 27% of participants were classified as physically active, increasing to 52% after a two-month follow-up. Improvements were observed in motivation, interests, and regular PA. Key success factors included intersectoral collaboration, personalized plans, and the activation of municipal sports networks as critical leverage points. Furthermore, municipalities with PAGS services demonstrated greater effectiveness in developing PA policies for inactive populations and in coordinating with other sectors (e.g., equality, social services, mobility).

CONCLUSIONS:
The PAGS initiative demonstrates that a localized and systemic approach can be used to promote PA in a scalable and sustainable manner. It connects primary care, municipal policies, and community services, fostering an integrated public health approach.