Ioannis Ioakeimidis

MELIORA Consortium will jointly work with local actors at different levels for the realization of eight (8) in total tailor-made lifestyle intervention and behavioural modification studies, including Artificial intelligence and digital tools, to promote sustainable behavioural changes among three target populations: i) healthy women at risk of developing breast cancer, ii) breast cancer patients and iii) breast cancer survivors. The studies will take place across 4 different European countries (Greece, Sweden, Spain and Lithuania) and 6 piloting centres targeting 2000 women in urban and rural areas including participants throughout the socioeconomic spectrum. Primary health care centres, hospitals or patients’/survivors’ organisations will be used as entry points to the community. The goal of the MELIORA Virtual Coach interventions is to evaluate its effectiveness, through assessing the effect of multiple individual and contextual factors to the uptake and sustainability of behavioural changes. At the same time, identification of specific bottlenecks and barriers that prevent the uptake of sustainable behavioural change will support the development of approaches on how to best reach and involve disadvantaged socio-economic population groups, vulnerable groups, and people living in rural areas, and will provide best practices for behavioural intervention uptake and scale-up. Regular monitoring will be ongoing during the implementation to allow corrective actions and ensure effective adaptation and uptake. Based on the study outcomes, the health economic evaluation and budget impact analysis, and data deriving from the scalability assessment, national and European stakeholders will be invited to evaluate, through workshops, the potential for adoption of the MELIORA Virtual Coach Interventions in other regions or countries in Europe. This action is part of the Cancer Mission cluster of projects on “Prevention & early detection (behavioural change).

BETTER4U aims at the identification and personalized management of all weight gain determinants to battle the increasingly rising numbers of overweight/obesity, via homogenous, globally adaptable and practically assessed public health initiatives and key interventions. Building on previous key projects and biobanks, the project will focus on the hitherto neglected impact of the polygenic background of weight gain on the effectiveness of lifestyle interventions for weight management in people with overweight/obesity. BETTER4U aims to probe into the global obesity challenge, study the problem and offer solutions in a tangible realistic way with the assistance of modern AI technologies and the contribution of experts around the world. BETTER4U will be realized through the following objectives: 1. To comprehensively understand and decipher genetics, metabolomics, microbiota, socio-economic, geographical, cultural and lifestyle features linked to weight gain throughout the life course, via meta-analyses (BETTER4U data from >50 studies, >1 million individuals) and extensive literature meta-review. 2.To develop the BETTER4U intervention methodology for weight gain prevention, based on a causal AI model of obesity determinants and a pilot study in 7 European countries. 3.To deploy technology-assisted, real-time monitoring tools to measure detailed behavioral indicators and their relation to the environmental context. 4.To evaluate the efficacy of the novel BETTER4U intervention methodology in a controlled, randomized clinical trial, based on individually-tailored recommendations for lifestyle change. 5.To maximize transferability and applicability of the BETTER4U intervention methodology by identifying implementation barriers and facilitators, as well as to evaluate implementation outcomes in both participants and stakeholders. 6. To develop and disseminate the BETTER4Uobesity prevention intervention methodology guidelines using a people-centred, sustainable care approach.

PREVENT improves upscaling of primary interventions for weight control management during childhood and adolescence to reduce cancer risks in adulthood. This relies on current evidence that relates excess body weight with increased cancer risk. Towards this end, PREVENT applies a series of implementation research actions in the following directions. First, it identifies barriers to current interventions and policies preventing them from upscaling to different geographical, socio-economic, and cultural settings. Then, it introduces new multi-actor and context-aware interventions along with new user engagement strategies to face the current upscaling bottlenecks

multi-actor in the sense that they target different types of users (e.g. students, family, educators, policymakers) and context-aware in the sense that PREVENT interventions are tailored to the specific implementation places (class, canteen, sports fields, labs, outside school). The PREVENT new policies are adapted, piloted, and scaled up within the schools’ communities of three European countries facing different epidemiological settings on childhood obesity, geographic, socio-economic and cultural attributes. The pilots are designed to be holistic end-to-end ecosystems, including users, medical professionals, policymakers, public authorities, and civil communities. They focus on the whole school communities of Greece, Sweden, and Spain-Catalonia, that is, PREVENT outreach to more than 3.3 million students, required for guideline provisioning, large-scale implementation, multi-parameter assessment, and scaling-up. Co-creation, active behavioral change, self-evaluation through user empowerment, motivational interviewing, social innovation, digital-assistive engagement, health apps, and multi-domain assessment are implementation research aspects of PREVENT to advance user acceptability and compatibility with existing policies, and thus improve sustainability and upscaling. This action is part of the Cancer Mission cluster of projects on ""Prevention and Early Detection".

During the last decades, overweight & obesity rates have reached epidemic proportions across EU. Prevalence in childhood is particularly alarming, resulting in psychological impacts & increased risks for NCDs. However, although obesity-related research has provided interesting results, several issues arise due to the lack of meta-reviews & the nature of data collected. To address this, Bio-Streams aims on supporting the optimal use (and re-use) of health data (e.g. biological, demographic, epigenetic, etc.) to generate metadata/knowledge and provide new evidences, methodologies & tools for: a) creating and deploying the Bio-Streams Biobank that will act as a scientific platform for research in obesity and better diagnostic and therapeutic approaches

b) understanding the transition from metabolically healthy to unhealthy, preventing under age obesity

c) designing better strategies to educate & empower young citizens for weight self-management

d) coordinating authorities & policy makers to develop cross-sectoral solutions for health promotion & under age obesity prevention. Specifically, Bio-Streams delivers a dedicated under age obesity biobank providing real-world health data (including biospecimens, anthropometrics, behavioural and cost data) from retrospective and prospective sources, while taking into account efficient data harmonisation and standardisation principles, transforming data valorisation towards under age obesity prevention and future research. Moreover, the Bio-Streams framework for data handling, provides robust and transparent methodologies for operational procedures (data infrastructures), analysis and reporting (via meta-reviews and AI-based Apps/components, evaluated via 12 multi-site pilots (7 clinical and 5 schools)), citizen awareness and lifestyle alteration, delivering obesity prevention guidelines, knowledge generation while fostering considerable opportunities for regional and national health authorities/policymakers.

Since the Green Revolution (1960s), industrial farming has become common place, successfully producing bulk quantities of food commodities for much of the world. However, the environmental and climate impacts of this approach are now being revealed, among which soil degradation, biodiversity loss, global warming and freshwater scarcity. Additionally, the current food system (fs) does not provide a robust approach to effective distribution and nutritional wellbeing, particularly as the world population continues to grow. To support a fundamental shift in our FS, it is essential to engage & educate youngsters about the connection between food and environment. Therefore, educating teachers and subsequently students about stateof-the-art policies, strategies & approaches towards a sustainable fs (SFS) is an issue of major importance. Following the echo from the European Green Deal (EU 2019) which recognises the key role of schools to engage with the wider community on the changes needed for a successful transition to become climate neutral by 2050, the FoodSHIFT Pathways aims to stimulate innovative thinking as a key to unlocking strategies that can develop a SFS. To achieve this aim, the proposed project is going to deploy an approach that could as reference point for future-oriented curricula that better meet the current environmental challenges. More specifically the project will a) enhance the co-creation of innovation & knowledge in FS and related bio-value chains, b) develop a roadmap for FS change and c) induce a paradigm shift from a linear to a cyclical approach of learning. The core outcome will be a series of practices enriched with interactive digital resources, the FoodSHIFT Pathways focusing on describing the status & presenting future-thinking approaches to SFS. Using interactive videos & digital storytelling techniques these practices will be treated as case studies for the schools to explore. Through the provision of a training programme for a transition to more SFS the project is expected to generate new knowledge needed for similar achievements beyond the specific cases as well as develop teachers/students’ SC. The approach moves beyond a country-specific curriculum and aims at guiding curriculum innovation. The project will demonstrate how schools can be transformed to hubs of innovation for their local communities in the fs sector acting as change agents. Based on initial scenarios that will be developed by the team, teachers & students will co-develop their own projects enriched with external expertise. Such an approach holds a great potential as a) teachers & students are developing content that is meaningful for them and b) enables schools and their communities to participate in high quality projects in both curricular and extracurricular contexts (formal, non- formal & informal education). The project will contribute to behavioural changes for individual preferences, consumption habits & and lifestyles of students & beyond