JACARDI as a proof-of-concept for Europe’s Safe Hearts Plan

A new commentary in the International Journal of Public Health explores how JACARDI supports the translation of Europe’s Safe Hearts Plan into practical implementation. Activities conducted across JACARDI’s portfolio of over 140 pilots are generating practical implementation evidence on how public health strategies can be translated into practical action to prevent cardiovascular disease and diabetes. The authors argue that coordinated, life course-based approaches, combining prevention, early detection and integrated care, are essential to reduce the burden of these conditions across Europe.

Cardiovascular disease remains the leading cause of premature mortality and disability in the European Union. The article, by lead author Benedetta Armocida and other contributors from the joint action, highlights that the main challenge is not the lack of strategies, but how to implement them effectively and equitably across different health systems.

The article presents JACARDI as a proof-of-concept for implementing the EU Safe Hearts Plan. A key message is that cardiovascular disease and diabetes should be addressed together using a life course approach, recognising that risk factors build up over time. Early actions, such as health literacy programmes for children and young people, can support long-term health outcomes.

Linking detection, care and everyday support

The authors highlight that screening is effective only when it is connected to follow-up care. JACARDI pilots test different approaches, including community-based screening, mobile units and digital tools linked to lifestyle support.

The commentary also emphasises integrated care and self-management. Pilot interventions like a co-designed mobile application to optimize secondary prevention in Madrid and care pathways co-developed with patients and caregivers in the Basque Country demonstrate that digital and telemedicine solutions can support continuity of care and help people manage their condition in everyday life.

Equity and data as key priorities

The article underlines the importance of strong data systems and a focus on equity. Shared data models enable better monitoring of health outcomes and differences between population groups. Inclusive, targeted approaches are needed to ensure that prevention and care reach everyone.

Overall, the commentary highlights that JACARDI provides a practical model for turning policy into action. The authors conclude that combining a life course approach, integrated care and equity-focused implementation can support long-term improvements in cardiovascular health across Europe.

Read more: Commentary on JACARDI and the Safe Hearts Plan

Publication: Closing the implementation gap: the Joint Action on Cardiovascular Diseases and Diabetes (JACARDI) as a proof-of-concept for Europe’s Safe Hearts Plan

Authors: Benedetta Armocida et al. (on behalf of the JACARDI Implementation Board)

Journal: International Journal of Public Health

Publication date: 15 June 2026

DOI: https://doi.org/10.3389/ijph.2026.1609906

Co-creating health literacy actions with migrant communities in Portugal for more equitable prevention

How can cardiovascular disease and diabetes prevention become more inclusive, accessible, and meaningful for populations experiencing vulnerabilities?

In Portugal, two pilots within JACARDI’s work package on Health Literacy are exploring how locally co-created health literacy actions can make cardiovascular disease and diabetes prevention more inclusive, accessible, and meaningful.

While each pilot addresses distinct population needs, both are guided by the Ophelia approach, Optimising Health Literacy and Access. This shared framework supports their commitment to equity-oriented prevention, locally tailored interventions, and participatory implementation.

One of the pilots, led by the NOVA National School of Public Health, focuses on migrant communities in the Lisbon Metropolitan Area. It aims to strengthen health literacy and support informed action to protect and promote health, with a particular focus on diabetes and cardiovascular disease. Special attention is given to people who may face additional barriers to health information, prevention, and care, including recent arrivals, women with caregiving responsibilities, and those less often reached by traditional health promotion initiatives.

Building and co-creating solutions with communities

The migrant-focused Portuguese pilot combines quantitative and qualitative methods with a participatory process, following key components of the Ophelia approach. During the first needs and resources assessment stage, the pilot involved more than 1,200 people, including over 1,100 migrants who completed a multilingual Health Literacy Questionnaire. Interviews and a photovoice study further explored lived experiences of health, prevention, and access to care, informing the development of 16 health literacy profiles and vignettes later used in idea-generation workshops with migrants and other stakeholders.

The workshops generated more than 70 action ideas, which were then refined through prioritisation workshops to select health literacy actions, strengthen the programme theory of change, and co-design the evaluation. 

Community engagement was built around co-creation from the outset, through a Community Board and a structured participatory process involving migrants, community organisations, health and social care professionals, researchers, decision-makers, and local stakeholders. The project placed particular emphasis on safe participatory spaces, supported by flexible scheduling, multilingual facilitation, child-friendly arrangements, and emotional support mechanisms. Migrant informal leaders were also trained as peer experts to co-facilitate sessions, helping to build trust and strengthen community capacity for sustained engagement beyond the project.

Testing culturally adapted health literacy actions

Following the co-design phase, the pilot moved into implementation across community organisations, with Health Links sessions adapted at the start of each group to reflect participants’ needs, priorities, and everyday contexts. To date, more than 100 migrant participants from 18 countries of origin have taken part in sessions covering communication with healthcare professionals, navigation of the Portuguese National Health System, understanding health information, healthy nutrition, physical activity, and cardiovascular disease and diabetes prevention.

The sessions combined practical learning, peer exchange, culturally adapted examples, and community participation to strengthen health literacy as a shared responsibility between individuals, communities, and services. Activities included role plays with health professionals, games on misinformation and reliable health information, tailored nutrition activities based on participants’ cultural food practices, and outdoor physical activity sessions in public parks.

The pilot evaluation used a mixed-methods approach, combining baseline and post-intervention data with qualitative feedback from participants, facilitators, and partner institutions. Preliminary results show strong participation, high acceptability, feasibility, perceived usefulness, and improvements in health literacy and behaviour change. Participants particularly valued the practical and culturally relevant content. 

From implementation to sustainability

Recently, the Portuguese teams welcomed colleagues from JACARDI’s Sustainability team for a joint working visit focused on long-term sustainability, transferability, and the integration of pilot activities into existing health and community systems. The visit included meetings with both pilot teams and visits to implementation settings, enabling direct exchange with participants, researchers, facilitators, community stakeholders, and participating institutions.

Discussions explored how co-creation practices, community ownership, and peer involvement can support continuity beyond project funding. The visit also highlighted reflective implementation practices already emerging within the pilots, including continuous adaptation based on participant feedback, collaboration with organisations and services, and multilingual and culturally sensitive facilitation strategies.

“The project has shown us that meaningful prevention cannot be designed far from people’s realities. Co-creation with migrant communities was not an accessory component, it became the foundation for building trust, relevance, and sustainability,” said Maria João Marques, researcher at NOVA and JACARDI Portugal scientific coordinator.

This focus on sustainability is also informing broader work at national level. Building on the lessons emerging from the Portuguese pilots, a national methodological roadmap is currently being developed in Portugal by the Directorate-General of Health (DGS), NOVA, and the Portuguese Diabetes Association (APDP), to support the implementation of health literacy actions across Local Health Units. The roadmap aims to facilitate the future adaptation, replication, and sustainability of community-based approaches.

In January 2026, interim findings from the JACARDI pilots in Portugal were presented during a national webinar on co-creation and health literacy. The event gathered more than 200 participants from health, policy, academic, and community sectors, strengthening dialogue around prevention, diabetes care, and culturally responsive health literacy interventions.

For those involved, the pilot has also created a different kind of experience. As Cadi Chengelam, one of the participants in the migrant-focused health literacy activities, reflected: “For the first time, I felt that people listened to our difficulties and adapted the sessions to our culture and daily life. It did not feel like receiving instructions, it felt like building solutions together.”

In the coming months, the teams will continue refining materials, analysing evaluation findings, and exploring opportunities for long-term integration within healthcare and community settings.

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.