Five decisive actions to transform Europe’s NCD monitoring systems: “What gets measured gets prioritised”
A new policy paper published in The Lancet Regional Health – Europe calls for decisive action to transform how Europe monitors noncommunicable diseases (NCDs). Developed jointly by Joint Action on Cardiovascular Diseases and Diabetes (JACARDI), Joint Action Prevent Non-Communicable Diseases (JA PreventNCD), and the WHO Regional Office for Europe (WHO/Europe), the paper sets out five priority actions to strengthen health monitoring systems across the region, an essential step to curb the rising burden of NCDs and mental health and ensure more effective, equitable healthcare.
The publication, titled “Strengthening non-communicable diseases monitoring systems in Europe through a multistakeholder collaborative approach: a key priority for advancing data-driven policymaking”, comes at a critical momentum after the Fourth United Nations High-Level Meeting on NCDs and Mental Health. “Europe has a unique opportunity, and responsibility, to recommit to data-driven health governance and sustained investment in resilient NCD monitoring systems”, the authors explain in the publication.
Five priorities for 2025 and beyond
The publication highlights five critical areas where action is needed to make monitoring systems stronger, fairer, and more effective. It calls for collecting data that is truly inclusive and disaggregated, so that inequalities become visible and can be addressed. It stresses the importance of solid governance, clear legal frameworks, and long-term investment to ensure that progress is sustained.
Monitoring, the authors argue, should also be embedded in real-time policymaking, so that information directly shapes decisions and drives accountability. Civil society, communities, people with lived experience, and marginalized groups should have a meaningful voice in this process, making sure that data reflects people’s lived realities. And finally, the paper points to the need for stronger collaboration across sectors, greater sharing of knowledge, and more capacity building to secure lasting impact.
“Tackling NCDs is one of five priorities of WHO/Europe’s Second European Programme of Work, co-created with 53 Member States and shaped through broad public consultations, including with health professionals, people living with NCDs and civil society. Effective action on NCDs hinges on good data. Europe can lead by example and showcase collaborative and inclusive approaches together with key stakeholders, including EU Joint Actions”, said Dr Gundo Weiler, Director of the Division of Prevention and Health Promotion at WHO Regional Office for Europe.
The challenge: gaps between commitments and reality
An estimated 80% of NCDs are considered preventable through effective public health policies and early detection strategies. These figures underscore the urgent need for a paradigm shift from a model centred on diagnostics and treatment to one rooted in prevention, health promotion, and evidence-based screening.
Despite great efforts in international commitments, progress at the national level has been inconsistent. Monitoring systems remain fragmented, overly reliant on short-term projects, or challenged by limited governance and insufficient investment. This has created a critical gap between ambitious global targets and their translation into actionable national policies.
The policy paper identifies persistent data gaps, structural weaknesses, and opportunities for innovation. It emphasizes that monitoring is not just about collecting data, it is about ensuring that information is used in real time to drive policy reform, accountability, and equity.
Lessons from Europe
The authors underline that too often, NCD monitoring efforts have been ad hoc, reliant on external funding or driven by individual champions. This has led to uneven coverage, lack of comparability between countries, and persistent blind spots when it comes to the health of groups living in vulnerable situations, such as migrants, minorities, and people with disabilities.
Without data that is disaggregated and reflects disparities, inequalities remain invisible and policies risk reinforcing exclusion. The authors argue that equity must be at the center of all future monitoring efforts.
“It is a moral and ethical imperative to advocate for and generate more inclusive data. Data should be systematically disaggregated by age, sex, gender, geography, socioeconomic status, disability, ethnic and migration background to reveal territorial disparities and enable place-based interventions”, unfolds Dr Benedetta Armocida, from the Department of Cardiovascular, Endocrine-metabolic Diseases and Aging at Istituto Superiore di Sanità-ISS, Rome (Italy) and Coordinator of JACARDI.
“We should begin to view data not merely as numbers, but as reflections of human lives and rights: each data point tells a story, and data becomes truly powerful when it shifts narratives, amplifies the voices of those too often overlooked, and holds systems accountable. Data must be observed critically and translated into policies that strengthen health systems. Without inclusive monitoring, structural inequities remain concealed, and the most vulnerable remain invisible—one data point, one life, one missed opportunity at a time”, adds Dr Armocida.
At the same time, the authors highlight successful innovations and good practices emerging from European Joint Actions, such as JACARDI and JA PreventNCD, demonstrating that progress is possible when commitments are matched by clear governance, adequate investment, and cross-sector collaboration.
“Across Europe we already see solutions that work. Joint Actions like JA PreventNCD and JACARDI help countries align methods, share tools and learn faster from each other. That is how we improve comparability between countries and make monitoring more useful for prevention and health promotion, including by showing more clearly where inequalities persist,” says Professor Knut-Inge Klepp, from the Norwegian Institute of Public Health, Oslo and Scientific Coordinator of JA PreventNCD.
“But we have to treat monitoring as core infrastructure, not an extra task. It needs stable funding, clear governance and the ability to produce data that is timely and inclusive. If monitoring depends on short-term projects or individual champions, it will remain uneven. If it is institutionalized, it can guide priorities, strengthen accountability and help sustain progress over time,” adds Klepp.
Europe has both a responsibility and an opportunity to lead the way in building stronger, more inclusive health information systems that can serve as a global benchmark. Doing so will be critical not only to reducing premature mortality from NCDs by one-third by 2030, but also to ensuring health equity and resilience in the face of future challenges. “Because what gets measured gets prioritised. What gets disaggregated gets addressed. And what gets institutionalised can be sustained”, conclude the authors.
Disclaimers
JACARDI (Grant Agreement 101126953) and JA PreventNCD (Grant Agreement 101128023) projects have received funding from the EU4Health Programme 2021-2027. Views and opinions expressed are however those of the authors only and do not necessarily reflect those of the European Union or the European Health and Digital Executive Agency (HaDEA). Neither the European Union nor the granting authority can be held responsible for them.
WHO disclaimer: The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions or policies of the institutions with which they are affiliated.
Benedetta Armocida, Hanna Tolonen, Ivo Rakovac, Beatrice Formenti, Jill Farrington, Allison Ekberg, Hector Bueno, Giovanni Capelli, Silvia Francisci, Morten S. Frydensberg, Ane Fullaondo, Linda Granlund, Yhasmine Hamu Azcarate, Torben F. Hansen, Emil Høstrup, Tomi Mäki-Opas, Luigi Palmieri, Markku Peltonen, Valentina Possenti, Marco Silano, Gundo Weiler, Kremlin Wickramasinghe, Edwin Wouters, Knut-Inge Klepp, Graziano Onder, Gauden Galea, Strengthening non-communicable diseases monitoring systems in Europe through a multistakeholder collaborative approach: a key priority for advancing data-driven policymaking, The Lancet Regional Health – Europe, Volume 61, 2026, 101553, ISSN 2666-7762, https://doi.org/10.1016/j.lanepe.2025.101553
JACARDI at the ESC Congress 2025: Advancing the integration of mental and cardiovascular health
During the ESC Congress 2025, Professor Héctor Bueno unveiled a new statement from the European Society of Cardiology on mental health and cardiovascular disease, calling for closer collaboration between cardiologists and mental health professionals. The message was clear, mental and cardiovascular health are tightly interconnected, shaping one another from onset through progression to outcomes.
The ESC Congress 2025, held in Madrid at the end of August and organized by the European Society of Cardiology, brought together global leaders in cardiovascular medicine to present the latest advances shaping the future of heart health. Among the standout contributions was the presentation of the 2025 ESC Clinical Consensus Statement on Mental Health and Cardiovascular Disease[1], delivered by Professor Héctor Bueno, co-leader of JACARDI’s working group on data; senior researcher at the Spanish National Center for Cardiovascular Research (CNIC) and cardiologist at Hospital Universitario 12 de Octubre in Madrid (Spain).
Professor Bueno, together with Professor Christi Deaton, from the University of Cambridge (UK), introduced the new ESC Clinical Consensus Statement, which calls for a fundamental change in how mental health and cardiovascular disease are understood, assessed, and addressed in clinical practice. Their message was clear: mental health and cardiovascular health are not isolated domains but deeply interconnected, with each influencing the onset, progression, and outcomes of the other.
The Consensus Statement urges healthcare systems to systematically screen for mental health symptoms during cardiovascular care, and conversely, to routinely evaluate cardiovascular risk in individuals being treated for mental health conditions. This bidirectional approach is grounded in strong evidence: poor mental health contributes to the development of cardiovascular disease, while patients with cardiovascular disease face a significantly higher risk of anxiety, depression, and other mental health challenges. When both conditions coexist, outcomes tend to worsen, underscoring the need for integrated care.
A major innovation introduced in the Statement is the creation of Psycho-Cardio Teams, multidisciplinary units in which mental health professionals, such as psychologists and psychiatrists, work alongside with cardiologists and other cardiovascular specialists. These teams aim to ensure early identification of mental health conditions, better coordination of care, and more comprehensive support for both patients and caregivers.
As Professor Bueno emphasized during his presentation: “Clinical cardiovascular practice often overlooks the impact of mental health. We need to see cardiovascular health professionals developing collaborations with mental health professionals in Psycho-Cardio Teams to help identify early mental health conditions in our patients and improve care and support for patients and their caregivers.”
Empowering patients
The proposal represents more than a structural change, it calls for a cultural shift within cardiovascular medicine. By integrating mental health into routine cardiovascular assessments, empowering patients to discuss psychological concerns openly, and acknowledging the complex interplay between emotional and physical well-being, this initiative moves toward a more person-centred model of care.
Such progress represents a significant cultural shift towards a more integrated and responsive healthcare system, with the ultimate goal of empowering patients and enhancing their quality of life. This vision aligns strongly with JACARDI’s mission to promote person-centred, prevention-oriented, and patient-empowerment models of care.
JACARDI and its growing impact on cardiovascular health in Europe
Building on this shared vision, JACARDI is actively contributing to this transformation through initiatives such as working groups focused on patients’ self-management [2] and integrated care pathways [3]. The goals of the Consensus Statement resonate strongly with JACARDI’s commitment to empowering individuals in taking an active role in managing their cardiovascular and mental health.
Professor Bueno’s leadership in this landmark ESC initiative reinforces the consortium’s dedication to advancing cardiovascular health through innovative, holistic, and patient-centred approaches. His contribution at the ESC Congress 2025 marks an important milestone in Europe’s ongoing effort to bridge the gap between mental and cardiovascular health, an effort that promises meaningful benefits for patients across the region, empowering them to openly discuss their mental health with cardiovascular professionals and increasing the likelihood that their concerns will be taken seriously.
During the ESC Congress, the European Alliance for Cardiovascular Health (EACH) also highlighted JACARDI’s role during its annual meeting held in Madrid [4]. EACH partners reviewed progress in their 2025 workplan, celebrated key advocacy achievements, and reaffirmed the importance of coordinated action to improve cardiovascular health across Europe. At the meeting, JACARDI was recognised as a strong example of effective communication and successful synergy-building among partners, illustrating how collaborative approaches can strengthen cardiovascular health initiatives at the European level.
The visible engagement of JACARDI at the ESC Congress 2025 further highlights its increasing impact on the evolution of cardiovascular care in Europe. By championing mental–cardiovascular integration, strengthening patient empowerment, and fostering collaborative care pathways, JACARDI is helping to pave the way for a more holistic, equitable and person-centred cardiovascular health ecosystem across the region.
References:
[1] Héctor Bueno, Christi Deaton, Marta Farrero, Faye Forsyth, Frieder Braunschweig, Sergio Buccheri, Simona Dragan, Sofie Gevaert, Claes Held, Donata Kurpas, Karl-Heinz Ladwig, Christos D Lionis, Angela H E M Maas, Caius Ovidiu Merșa, Richard Mindham, Susanne S Pedersen, Martina Rojnic Kuzman, Sebastian Szmit, Rod S Taylor, Izabella Uchmanowicz, Noa Vilchinsky, ESC Scientific Document Group , 2025 ESC Clinical Consensus Statement on mental health and cardiovascular disease: developed under the auspices of the ESC Clinical Practice Guidelines Committee: Developed by the task force on mental health and cardiovascular disease of the European Society of Cardiology (ESC).
Endorsed by the European Federation of Psychologists’ Associations AISBL (EFPA), the European Psychiatric Association (EPA), and the International Society of Behavioral Medicine (ISBM), European Heart Journal, Volume 46, Issue 41, 1 November 2025, Pages 4156–4225, https://doi.org/10.1093/eurheartj/ehaf191
[2] Work Package 10: Patients’ Self-management, ‘Be the master of your health’
[3] Work Package 09: Integrated care pathways, ‘Elevating pathways, enhancing Care’
A major step forward: Basque country rolls out integrated heart failure care model
A new pilot project has recently been launched in the Basque country as part of JACARDI, featuring an integrated, value-based care pathway for people with heart failure. This pilot is aligned with JACARDI’s broader mission to reduce the burden of cardiovascular disease and diabetes across Europe by strengthening coordinated care, enhancing health literacy, and scaling best practices.
Within JACARDI, Biosistemak represents the Basque country as an affiliated entity, co-leading communication and dissemination activities, supporting methodological frameworks for European pilots, contributing to health literacy initiatives, and leading the deployment of the heart failure pathway. This includes conducting a comprehensive needs assessment on the European level.
On 27 November, at the launch event organized at Cruces University Hospital in Barakaldo, Osakidetza – the public health care service of the Basque country – presented the new value-based integrated care pathway for heart failure, after two years of joint development with Biosistemak and Osakidetza’s Care Integration and Chronicity Service (SIAC). Throughout the entire development process, Biosistemak provided methodological support on pathway design, including the adaptation of care pathways and resources, the development of evaluation frameworks, the integration of technological requirements, and the preparation of awareness raising actions and training plans for professionals. The result is a comprehensive and coordinated care model that improves outcomes and quality of life for people living with heart failure while ensuring long-term sustainability.
During the event, Biosistemak researcher Yhasmine Hamu highlighted the importance of the extensive multidisciplinary collaboration behind the initiative. Over two years, professionals from family and community medicine, hospital care, nursing, pharmacy, and management collaborated to create a model that responds to real patient needs and incorporates sex- and gender-based perspectives. Presentations also highlighted innovative solutions, new corporate tools, and lessons learned on improving communication, standardising care, and defining indicators for continuous improvement.
The jointly developed pathway covers the entire care cycle for people with heart failure, from initial suspicion of the condition to hospitalisation, discharge, and ongoing follow-up in both primary and specialised settings. It is designed to align the perspectives of patients, professionals, and the general population. For patients, the model organises interventions and responsibilities in one integrated system to reduce morbidity and mortality and strengthen self-care. For professionals, it offers a clear overview of actions to be taken, decision-support tools, and a framework that promotes coordination and reduces variability. On a societal level, the model improves population health by enhancing scientific knowledge and reinforcing the sustainability of health systems.
The success of this pilot is a perfect example of how JACARDI supports Member States in adopting evidence-based and scalable care models for chronic disease management. Through its leadership in this initiative, Biosistemak contributes to strengthening integrated care and advancing cardiovascular health both within the Basque country and across Europe.
Can artificial intelligence help shape smarter cardiovascular policies across Europe?
What if policymakers across Europe had faster, clearer and more reliable data to guide decisions in cardiovascular health? Addressing that challenge, one of JACARDI’s pilot teams from CNIC presented their work at the ESC Digital & AI Summit 2025, showcasing AI innovations designed to turn evidence into actionable policy.
At the European Society of Cardiology Digital & AI Summit 2025, researchers Fatima Sanchez-Cabo, Juan Ignacio Alvarez Arenas, Daniel Jiménez Carretero, from the Computational Systems Biomedicine group at CNIC (Spanish Cardiovascular Research Center), and active members of JACARDI’s Working Group on Data Availability, Quality, Accessibility and Sharing, presented their poster: CARMINA: Optimizing low-parameter language models for high-quality cardiovascular research assistance. The work was featured in the session From bench to bedside: the potential roles of large language models in cardiovascular medicine, moderated by Professor Lis Neubeck, from Edinburgh Napier University; and Associate Professor Johan Verjans MD PhD FESC FRACP, from the University of Adelaide.
Why does this matter?
Within JACARDI’s Pilot 57, CNIC is developing EUROCARDIAB, a pioneering federated data platform integrating cardiovascular health indicators from across Europe. One of its key features is a CVD impact simulator that models how changes in risk factors could reduce event prevalence, providing policy makers with reliable, data-driven scenarios for national planning.
A dedicated web front-end will share these insights and will also host CARMINA (Cardiovascular And Research-driven Molecular Insight with Novel Assistant), an AI-powered research assistant designed to support specialized cardiovascular research. CARMINA will orchestrate the Intelligent Policy Agent (IPA), enabling autonomous trend analysis, computational modeling of interventions, and the creation of clear, actionable policy briefings for decision-makers in cardiology and diabetology.
This year’s ESC Digital & AI Summit motto, “Prepare for the next frontier in cardiovascular care”, aligns strongly with JACARDI’s overarching mission: accelerating patient outcomes and transforming clinical workflows across Europe through better data, smarter tools and more equitable care pathways.
Today, accurate, comparable and timely data on cardiovascular disease and diabetes remain limited, yet this information is essential for developing targeted policies that reduce disease burden, improve healthcare for all citizens and help close persistent inequalities.
The ESC Digital & AI Summit remains a key meeting point for global leaders, innovators and technology experts shaping the digital transformation of cardiovascular care, and pilots like this one from CNIC demonstrate how JACARDI is already turning that vision into meaningful, data-driven progress across Europe.
Slovenia’s breakthroughs in the fight against diabetes
This year’s National Diabetes Conference in Slovenia placed a strong spotlight on JACARDI and the country’s three national pilot projects addressing diabetes. These initiatives are designed to:
- Identify individuals with undiagnosed type 2 diabetes or intermediate hyperglycemia, especially among vulnerable groups who rarely access preventive services.
- Increase participation in primary-care education programs among people already diagnosed with type 2 diabetes or intermediate hyperglycemia.
- Boost attendance in the national diabetic retinopathy screening program, a crucial step in preventing diabetes-related blindness.
Slovenia is well aware of its key challenges in diabetes care and is actively addressing them through the nearly complete CARE4DIABETES project and its ongoing work within JACARDI. Both efforts are fully aligned with the country’s National Diabetes Plan, ensuring that strategic intent is translated into concrete action.
Why JACARDI matters for Slovenia
In an interview conducted during the conference, Dr Jelka Zaletel (NIJZ Slovenia) explained why JACARDI is uniquely important for the country. Slovenia knows its main barriers in managing the diabetes burden: many individuals with type 2 diabetes remain undiagnosed; those who would benefit most from preventive visits or early detection often do not enter the healthcare system; and attendance in primary-care education programs remains lower than expected.
The JACARDI pilot projects help tackle these issues head-on:
- Pilot 1: Developing new, community-based approaches to reach people unlikely to attend preventive check-ups.
- Pilot 2: Understanding and addressing why individuals with type 2 diabetes do not participate in primary-care education programs—and redesigning these programs accordingly.
- Pilot 3: Improving uptake of the national diabetic retinopathy screening program. Although 30,000 people currently attend screenings, an estimated 150,000 Slovenians live with diabetes. JACARDI helps uncover where the gaps lie and how to close them.
A fourth pilot: Strengthening cardiovascular care
These efforts are embedded in Slovenia’s National Diabetes Plan, supported by clear action plans. The National Diabetes Conference, held every November, is one such action, providing an annual moment to share progress and results from JACARDI.
Slovenia is also implementing a fourth JACARDI pilot project focused on cardiovascular health. It aims to harmonize approaches across rehabilitation centers treating patients after acute coronary events—an area where attendance is also suboptimal. This work aligns with the Ministry of Health’s decision to develop a National Strategy for Cardiovascular Health, reinforcing how JACARDI can support strategic planning beyond diabetes.
Relive the Conference
A mood video from the event captures the atmosphere at the venue. Although only speakers and roundtable participants were physically present, the online turnout was impressive, with more than 170 remote attendees.
You can also watch the full interview with Dr Jelka Zaletel, where she explores in more depth how Slovenia leverages JACARDI to address long-standing gaps in diabetes and cardiovascular care.
Socioeconomic and health disparities in adults diagnosed with type 1 diabetes mellitus before age 18
Scientific publications by JACARDI
In this post series we share the scientific publications directly linked to the JACARDI project. All publications featured in this series are authored or co-authored by JACARDI partners and reflect research and findings developed within the project framework.
We aim to showcase how evidence supports our joint mission to tackle cardiovascular diseases and diabetes across Europe.
Stay informed on how JACARDI turns evidence into action.
Keywords: public health, socioeconomic inequalities, health inequalites, type 1 diabetes mellitus, quality of life
Giulia Zamagni, Valentina Minardi, Maria Masocco, Federica Asta, Riccardo Candido, Gianluca Tornese, Giulia Bresciani, Valentina Manfredini, Elena Frattolin, Claudia Veronica Carletti, Daniela Germano, Eleonora Maurel, Luca Ronfani, Lorenzo Monasta
Abstract:
Background: Type 1 diabetes mellitus is a lifelong condition with consequences that extend well beyond glycaemic control, often impacting individuals’ socioeconomic status and overall quality of life. In Italy, the broader effects of early-onset type 1 diabetes on social and health-related outcomes have been insufficiently investigated. Therefore, this study aimed to investigate the socioeconomic impacts of type 1 diabetes among adults diagnosed with the condition before age 18.
Methods: Using data from the Italian Behavioral Risk Factor Surveillance System (PASSI) collected between 2011 and 2018 and in 2023, we analyzed key outcomes in adults aged 18–50 who were diagnosed with type 1 diabetes before age 18 and were on insulin therapy. Each case was matched by age and sex to two non-diabetic controls. Descriptive statistics and multivariable logistic regression
were used to compare key indicators.
Results: Our sample included 993 participants (331 cases and 662 controls). Cases had significantly higher odds of being unemployed [OR = 1.57 (1.20–2.07)], experiencing severe financial difficulties [OR = 1.81 (1.05–3.13)], and reporting poor self-rated health [OR = 6.64 (2.53–17.43)]. Cases also had an increased likelihood of reporting physical impairment for 1–13 days [OR = 1.91 (1.30–2.81)] and ≥14 days [OR = 2.95 (1.54–5.65)], mental health impairment for 1–13 days [OR = 2.16 (1.46–3.19)], and daily activity limitations for 1–13 days [OR = 1.73 (1.06–2.82)].
Conclusions: These findings highlight the multifaceted burden of type 1 diabetes and the need for integrated approaches to care that address not only clinical but also socioeconomic and psychosocial dimensions of the disease.
Source: https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1655035/full
Workplace Health Interventions Targeting Cardiovascular Diseases and Diabetes Mellitus for Blue-Collar Workers
Scientific publications by JACARDI
In this post series we share the scientific publications directly linked to the JACARDI project. All publications featured in this series are authored or co-authored by JACARDI partners and reflect research and findings developed within the project framework.
We aim to showcase how evidence supports our joint mission to tackle cardiovascular diseases and diabetes across Europe.
Stay informed on how JACARDI turns evidence into action.
Authors: Chiara Di Girolamo, MD, MSc, PhD; Agnieszka Lipiak, MA; Matteo Franco, MSc; Krzysztof Kaczmarek, PhD; Guillermo Barreres-Martín, MSc; Piotr Romaniuk, PhD; Carles Muñoz-Alfonso, MSc; Andrea Arroyo-Álvarez, MSc; Federica Turatto, MD; Daznia Bompart Berroterán, PhD; Ewelina Chawłowska, PhD
Abstract:
Background: Cardiometabolic diseases, such as cardiovascular diseases (CVD) and diabetes mellitus (DM), represent a global health issue, causing significant premature mortality and disability. Blue-collar workers, who often face a higher exposure to risk factors (eg, smoking, poor diet, and lack of physical activity), are particularly vulnerable to these diseases. Workplace health promotion plays a crucial role in mitigating this risk, yet the scope and the characteristics of interventions targeting this specific workforce remain unclear.
Objective: The objective of this scoping review will be to assess the extent and characteristics of workplace health promotion interventions aimed at preventing cardiometabolic diseases and their risk factors in blue-collar workers.
Methods: The review will follow the JBI methodology for scoping reviews. A search of MEDLINE, Scopus, Embase, and the Cochrane Database as well as grey literature will be conducted. The search strategy is designed to capture relevant studies published since 2014 in English, Spanish, Italian, and Polish. Eligible study designs include experimental design (eg, randomized controlled trials), observational studies (eg, longitudinal studies), qualitative research, and mixed-method approaches as well as other formats present in grey literature (eg, reports). This review will include studies focusing on health promotion interventions involving adult blue-collar workers (aged ≥18 years) currently employed, with at least 60% of participants being blue-collar employees. The interventions of interest are workplace health promotion strategies targeting CVD, DM, or their risk factors, such as hypertension, obesity, and smoking. Each paper retrieved will be screened for inclusion by at least 2 reviewers. Disagreements between the reviewers will be resolved through discussion with the other reviewers. Studies focusing on noninterventional contexts, mental health, or ergonomic safety will be excluded. Data will be extracted and analyzed using qualitative and quantitative methods, with a focus on intervention types, participant characteristics, and outcomes.
Results: The study began in March 2024 and the full scoping review report is expected to be ready in September 2025.
Conclusions: The scoping review presented in this protocol can contribute to filling the knowledge gap by mapping the current state of workplace health promotion interventions aimed at preventing CVD and DM and modifying relevant risk factors in the blue-collar workers’ group.
Five EU initiatives unite to scale health literacy action to tackle NCDs
A powerful spirit of collaboration marked this year’s European Public Health Conference held in Helsinki from 12 to 14 November: five major European projects – JACARDI, JA PreventNCD, PIA, careGIVR and PREVENTIA – jointly hosted a high-level workshop during the conference. This collaborative session demonstrated how cross-project synergy is the key to accelerating effective, inclusive health literacy strategies across the continent to curb the rising burden of non-communicable diseases (NCDs) through more accessible, inclusive and evidence-based prevention strategies.
The workshop, titled “8.H. Round table: Health Literacy in Action: Innovative and Inclusive Approaches from European Joint Initiatives”, brought together leading EU-funded initiatives involving over 100 partner institutions across 24 countries. Discussions centered on the critical challenge of reaching vulnerable groups – such as migrants, young people and populations in disadvantaged settings, who remain disproportionately affected by low health literacy and NCDs.
The session emphasized two core outcomes for participants:
• Shared approaches: Understanding how five major European projects integrate health literacy into diverse public health systems, leveraging strong equity and diversity lenses.
• Roadmap principles: Highlighting the common goals and strategies these initiatives have defined to strengthen health literacy action across different European contexts.
The JACARDI health literacy team – coordinated by Santé publique France and Biosistemak Research Institute, Basque Country, Spain – used the platform to showcase its progress in building measurable health literacy impact against cardiovascular disease (CVD) and diabetes (DM) risks and other NCDs across Europe.
The JACARDI WP6 Health Literacy team presented the extensive work completed during the first two years of the project aimed at improving health literacy and raising awareness of CVD and DM risks at both individual and societal levels. This work includes mapping existing health literacy development activities across EU countries and implementing 25 codesigned pilot projects across 13 countries.
These projects are implemented following participatory processes where key stakeholders and target groups are involved from the very beginning. Their approaches in action include applying a common framework for systematically evaluating the equity and diversity lens across pilots.
The roadmap principles guiding this work rely on a shared 12-step implementation framework, ensuring consistency across all 143 JACARDI pilots and reinforcing the integration of sustainability plans to enable future scale-up. Additionally, JACARDI assesses health literacy initiatives at multiple levels of interventions, project teams, and work packages to support continuous learning and improvement.
Through the European Public Health Conference workshop, the JACARDI team showcased its commitment to ensure health literacy initiatives reach everyone, regardless of background, language, or level of literacy. By bringing together JA PreventNCD, PIA, careGIVR, and PREVENTIA in a single collaborative session, JACARDI created a unique space to align methodologies, identify synergies, and strengthen a connected European approach to preventing non-communicable diseases (NCDs).
During the session, participants explored how projects are embedding cultural diversity into their methodologies and activities to better reach vulnerable groups and improve health equity across Europe. They also examined how inclusive health literacy strategies can support health systems in combating misinformation and disinformation, particularly in culturally and linguistically diverse communities disproportionately affected by it, and what lessons can be drawn from applying different approaches to health literacy across populations, settings, and system levels. They also discussed how this diversity can inform and strengthen national and EU-level policy.The insights generated in Helsinki will help shape the next phase of Europe’s health promotion agenda, ensuring that individuals are not only informed but empowered to understand, act, appraise, and apply health information.
JACARDI General Assembly – Madrid highlights
The JACARDI consortium gathered in Madrid for four inspiring days of exchange, collaboration, and renewed commitment to reduce the burden of cardiovascular disease and diabetes across Europe. More than 200 participants from 21 countries joined discussions on equity, gender gaps in healthcare, data systems, sustainability, and the upcoming EU Cardiovascular Health Plan.
Throughout the Assembly, partners shared early insights from JACARDI’s 143 pilot projects, offering a rich picture of progress and lessons emerging from real-world practice. Workshops and roundtables helped translate this experience into future action, reinforcing shared goals for more integrated, person-centred care. A dedicated session on the EU Cardiovascular Health Plan brought strong alignment between JACARDI’s evidence and Europe’s broader policy momentum. International contributions added valuable perspectives on monitoring systems and reducing non-communicable disease burdens.
What truly defined the event was the sense of connection: an atmosphere of openness, energy, and mutual support. As the project enters its next phase, the momentum from Madrid will continue to guide collective efforts to strengthen health systems so everyone in Europe has a fair chance at good health.
To relive the atmosphere and energy of these days, we invite you to watch our mood video capturing the unmistakable JACARDI spirit of the event.
Mitja Lainscak: My hope is that we can intervene earlier for more patients
“It’s important that the JACARDI initiative and its outcomes gain visibility within the scientific community”, stresses Mitja Lainscak, Professor of Internal Medicine at the University of Ljubljana and member of JACARDI’s Scientific Advisory Board. As a clinical practitioner and researcher, he anticipates that collaboration will be one of the most important positive outcomes of the project, along with effects going from the regional or national level to the international level.
What significance does JACARDI hold for you and your organization?
I think that the organisations involved really appreciate being part of such a large initiative, trying to bring together efforts in the field of cardiovascular medicine and diabetes and to stimulate some potential cross-talk between the partners. The consortium is hosting more than 140 pilot projects with some of them related within or across the field.
One of the main benefits of an initiative like this, is that people talk to each other and realise that they can collaborate, so that their efforts can be transferred from the regional or national level to the international level.
How do you see JACARDI’s role in tackling the increasing prevalence of cardiovascular disease and diabetes in Europe?
Our society is aging and that’s an unavoidable reality. Advances in medicine have played a significant role in this trend. In addition, improvements in detection tools and the capabilities of our healthcare system have enhanced our ability to identify patients more effectively.
I hope we will identify more people at risk, as well as those with single or multiple conditions. Early detection is crucial because it allows us to start treatment earlier in the course of the disease, rather than waiting until it has progressed and caused irreversible damage. My hope is that we can intervene earlier for more patients.
How do you think JACARDI will influence future collaboration on cardiovascular disease and diabetes prevention in Europe?
JACARDI is a Joint Action, supported by the European Union and recognised by the scientific community. In a previous newsletter, I read a message from Professor Thomas F. Lüscher, the President of European Society of Cardiology highlighting the importance of JACARDI in shaping the future of cardiovascular disease and diabetes management through collaborative, data-driven care for the benefit of patients. I believe a similar message will come from the diabetes community. So, as said previously, having like-minded experts in the same room encourages discussion and cross-fertilisation of ideas. I anticipate that participants will begin to collaborate outside of the JACARDI framework, which I see as a positive outcome.
The European Society of Cardiology and the diabetes associations are already aligned, and I believe JACARDI has a crucial role to play in promoting future collaboration.
It’s important that the JACARDI initiative and its outcomes, such as pilot results, gain visibility in the scientific community. Researchers need to present their findings at conferences and submit their work for publication. This is essential to demonstrate that the funding received has been used effectively. Ultimately, it’s important to ensure that the investments made produce tangible results.
Based on your experience as a cardiologist, what do you consider the most critical factors in improving data-driven healthcare outcomes?
This is an extremely important question. Speaking from a national perspective, as someone from Slovenia, I’d like to extend this to an international context.
I believe that the lack of IT support for collecting data is a crucial issue. Slovenia is a small country with 2 million inhabitants and 14 hospitals, but we lack a unified IT system across these institutions. Although all hospitals are publicly owned and we have a single insurance provider, we struggle to collect comprehensive epidemiological data. We have a national hospitalization database, but it doesn’t give you the granularity of patient data.
The first necessary step would be the development of IT solutions, possibly using artificial intelligence, to extract the necessary data from medical records, particularly in terms of epidemiology. In my opinion, we still lack accurate figures for many diseases, both in Slovenia and across Europe.
Without this data, we cannot fully understand the scope of the problem, making it difficult to effectively allocate resources for patient management. I believe that the JACARDI pilots will showcase best practices in addressing this epidemiological data gap.
In terms of how JACARDI’s research and initiatives could support lasting, practical changes in clinical practice across Europe, particularly in Slovenia, I anticipate that most findings will primarily reflect the pilot country’s specific context . However, some lessons can be adapted across borders. Each country involved will focus on its specific challenges, but I believe that through meetings like this, where participants are encouraged to share their work, others can identify relevant lessons.
The perspective of the Advisory Board members is crucial in this process, as we aim to integrate ideas from different work packages that may not always communicate effectively with each other. This collaboration is essential.
Dr. Mitja Lainscak is a Professor of Internal Medicine at the University of Ljubljana and conducts clinical practice and research at the Department of Internal Medicine, General Hospital Murska Sobota, Slovenia. He is the Director of the Slovenian Research Agency and his clinical and research interest is cardiovascular medicine with particular emphasis on heart failure, pharmacotherapy, and metabolism with body composition. He has published more than 170 papers and holds an Executive Committee member position at the Heart Failure Association of the ESC.
Learn more about Mitja Lainscak and his work and connect on LinkedIn.
Strengthening cardiovascular care resilience across Europe: the RESIL-Card initiative
The RESIL-Card project was launched in December 2023 due to the critical vulnerabilities in cardiovascular care delivery that were highlighted by the COVID-19 pandemic.
RESIL-Card is a 3-year EU4Health-funded initiative. It is led by We CARE, along with partners GISE (Italy), Amsterdam UMC’s Healthcare Services and Systems Research Group (The Netherlands), and CatSalut (Catalonia).
The aim of this initiative is to strengthen the resilience of European (EU) cardiovascular care systems to ensure the continuity of high-quality care during future potential crises. The project’s core focus is the development of a resilience assessment toolkit to help cardiovascular stakeholders evaluate and enhance the preparedness of their care pathways. Given the increasingly complex international context and the recent launch of crisis preparedness initiatives in Europe, RESIL-Card’s mission is deemed more relevant than ever. The project reflects a shared commitment among partners to improving cardiovascular care resilience through innovation, collaboration, and excellence.
The project is supported by major EU cardiovascular organisations and a multistakeholder Advisory Board. The work is divided into specific work packages, including an initial phase (WP1) focused on designing the toolkit, pilot testing (WP2) and dissemination (WP3).
The initial phase (WP1) involved designing the resilience assessment toolkit. Insights were gathered to characterize pandemic-related disruptions, adaptations, and innovations. The Amsterdam UMC group, leading the design work, explained that they used a “stepwise and inclusive approach” to developing an evidence-based tool, relying on lessons learned from the pandemic. This methodology included a scoping review, a survey of EU cardiologists, and focus groups with clinical, organisational, and policy experts. The first version of the RESIL-Card toolkit was released in January 2025, marking a key milestone in the project.
A Head of a Cardiology Department (Italy) who participated in a focus group reflected on the difficulty of revisiting past events but recognized their necessity: “It hasn’t been easy to relive some moments that now seem so far away, but they are what allowed us to emerge from a pandemic and will hopefully help us through any crises we may still encounter”.
Pilot testing of the RESIL-Card toolkit (WP2) is currently underway. This phase is assessing the toolkit’s functionality, usability, and real-world applicability. The workstream lead for pilot testing (CatSalut) noted that it is “notable how enthusiastic healthcare professionals are about strengthening the system, not just for individual patients, but for the benefit of the entire population”.
Dissemination efforts (WP3) throughout 2026 will promote the broad adoption and integration of the RESIL-Card toolkit into EU healthcare systems. The project anticipates amplifying its impact through collaboration with JACARDI and supporting bodies like EUPHA.
To learn more about RESIL-CARD, check the project’s news on the following platforms, Website, X, LinkedIn
Predictive medicine in action: the PROVIDE project for CVD prevention in diabetes
PROVIDE (Prediction and Prevention of Cardiovascular Diseases in Type 2 Diabetes) addresses the urgent global challenge of Cardiovascular Diseases (CVDs), which remain the leading cause of death worldwide. Specifically, people living with pre-diabetes or type 2 diabetes face a significantly higher risk of developing CVDs.
PROVIDE’s mission is to develop predictive tools and preventive strategies that assist both patients and clinicians in detecting risks early and acting before serious complications arise. By combining data science with clinical research, the project aims to change how CVD is managed in diabetes, ultimately working to reduce hospitalizations, improve quality of life, and lower healthcare costs.
The project began in November 2024 and is scheduled to run until December 2026.
PROVIDE brings together leading European experts in medicine, biomedical engineering, and digital health.
According to the project’s coordinator, Prof. Marco Giorgio Baroni (UNIVAQ), “the strength of PROVIDE lies in its interdisciplinarity, uniting clinicians, researchers, and engineers to translate complex data into practical solutions for patient care”.
The consortium has already achieved significant progress since its launch. In 2024, the project began with a series of kick-off meetings that set the foundation for the work ahead. Research protocols were defined, and efforts to harmonize clinical and digital data collection were initiated. Later that year, the PROVIDE digital platform went live, enabling the integration of multi-centre patient cohorts across Europe and supporting the release of the first cardiovascular risk-prediction algorithms.
In 2025, the project moves into its next phase, with trial expansion, cross-validation of predictive models, and the development of prevention strategies in collaboration with clinical partners. Finally, in 2026, the project will focus on validating the results at scale. This will include proposing large-scale deployment scenarios and formulating recommendations for integrating PROVIDE’s outcomes into European healthcare systems.
The project was discussed in front of a wide audience at the e-SPACE Cardio-Renal-Metabolic (CRM) live multidisciplinary conference on 5 April 2025.
Expected outcomes include a set of validated digital tools capable of identifying patients at high risk of CVD, along with personalised preventive care pathways.
The PROVIDE project collaborates with the JACARDI team in Work Package 8: Screening high-risk populations and individuals. This involves the collaborative development of standard protocols for CVD and DM risk screenings and Health Examination Surveys (HES), and sharing expertise and tools for screening.
Participants from clinical sites highlight the human dimension of the project: “For many of our patients, the fear of a heart attack or stroke is real. With PROVIDE, we can finally offer proactive monitoring rather than reactive treatment.” Experiences like this underline the importance of predictive tools and their practical impact.
PROVIDE is more than a research project, it’s a step toward smarter, preventive healthcare.
Healthcare professionals, policymakers, and citizens are invited to follow the project’s journey and engage with the results. For more information, visit the project’s website or explore tools and publications.