Nutrition and physical activity

Pilot projects funded by the European Parliament

 
 

A pilot project or preparatory action is an initiative of an experimental nature designed to test the feasibility and usefulness of action. It is meant to try different approaches, develop evidence-based strategies to address a problem, identify good practices, and provide policy guidance for the benefit of possible future initiatives in the area of nutrition and physical activity.

The European Commission's contracts with various contractors are based on their approaches in the chosen proposals and provide them with the necessary scope for their execution. Boards of scientific experts have been set up from a variety of disciplines for each project to provide robust guidelines for the project intervention and to validate its tools including the project websites which reflect the views of the authors and not necessarily the official opinion of the Commission.

Feel free to browse the ongoing or recently concluded projects below.

My healthy family

"My healthy family”: EU Project to encourage children, older people and pregnant women in Hungary and Poland to eat more fruit and vegetables.

The project put the family at the centre of its activities as food is very much a social activity and the family is often the birth place of healthy habits.

The idea was to get people to truly enjoy the tastes, textures and colours of fresh fruit and vegetables. This was done by distributing FREE fruit and vegetables and, with the help of well-known chefs, by providing recipes and cooking lessons (alongside information on the nutritional value of food).

More than 23 500 people took part, the equivalent of seven thousand households in four regions, Észak-Alföld and Észak-Magyarország in Hungary, Kujawsko-Pomorskie and Podkarpackie in Poland. Particular attention was given to vulnerable population groups in those regions.

Key messages of My healthy family were that fruit and vegetables are good for you, tasty, easy to prepare, and not expensive especially if bought in season.

Conclusions on the project's impact on shopping, cooking and eating habits will now support policy-making as well as further sharing and implementing of best practices in health and nutrition. Find the detailed post evaluation in section "Monitoring and evaluation".

The contractor has also summarised its approach to encouraging the target groups to increase their consumption of fruit and vegetables, to share their experience with everybody wishing to carry out similar initiatives. Their guide showcases lessons learnt throughout the different phases of the project. The dos and don'ts described range from advice on the best distribution points, best methods to register participants to ensuring the quality of fruit and vegetables as well as arranging their distribution to underlining the educational value of the project. The guide is also available in Polish and Hungarian.

The project's methodology was also assessed by an external evaluator who added her insights based on suggestions from the local partners and stakeholders.

To reach the target groups and keep them interested throughout the project was a key determinant for its success or failure.

The best way to reach young people is via committed teachers at schools who effectively helped register the kids and their families. Educational competitions for schools only work if really interesting prizes are offered e.g. vouchers for sport equipment. Teachers are always grateful for ready to use lesson plans. Electronic media with interesting, funny content also attract the attention of youngsters.

Pregnant women were the most difficult both to reach and to keep interested, in the opinion of the interlocutors as they are in the middle of rearranging their everyday lives. Facebook pages for mums or mums to be are an effective channel, so are nurses and midwives who are in direct contact. Health services (clinics, midwives associations, nurse centres) are good places to distribute the leaflets and the most effective way to register pregnant women.

The key is to offer them produce plus nutritional information conveying the message that improving their lifestyles not only benefits themselves but also their unborn or new born children. Projects are all the more effective if combined with activities such as dietary advice, basic medical examination or exercises for pregnant women.

Seniors are an excellent target group for this kind of project. Due to low household budgets, problems with transporting their purchases they do not pay enough attention to consumption of adequate amounts of fruit and vegetables, but on the other hand have more time to experiment in kitchen. They may also help to get in touch with the whole family.

They are though a tough group to recruit. Universities of the Third Age are an effective starting point as they are spread all over the country, but they rarely reach people in small towns or villages. Health services and welfare centres on the contrary are well placed to promote the project as they have contact with the poorest people, including seniors. Events are likely to attract individual seniors, far more than the internet. Seniors often do not have access, BUT this situation is changing due to the numerous programmes dedicated to people 60+ learning how to use computers and Internet.

The evaluation revealed which factors influenced how the project was perceived and its effectiveness.

The concept of distributing free parcels of produce to people of low income mistakenly led to the project being associated with food aid. This was compounded by the strong engagement of social welfare centres where more than half of the distribution points were located. Whilst their support was invaluable in the recruitment process, using more NGOs and local organisations such as schools would have put more emphasis on the educational content of the project.

Some of the partners encountered a somewhat demanding attitude in their participants claiming it was not worth the bus ticket to fetch the rather symbolic parcels which were never meant to be more than an incentive. Corrective action was taken early on. The number of distributions was reduced to increase the parcel size to almost 3kg. Distributions were combined with activities e.g. advice by nutritionists, presentation on infant first aid, cooking classes etc.

Undoubtedly, participants have changed some of their eating habits, especially children who learned the value of eating fruit and vegetables. As the perceived high price of fresh produce is a major deterrent, long term behavioural change depends typically on the income situation of the families. Unless it improves, their consumption is changing only during the intervention.

The project clearly proved that boosting fruit and vegetables consumption cannot be done by handing out produce alone, at least not on this small scale. Educational aspects and attractive events are essential to affecting behavioural change, to a far larger extent than originally planned in the 'My healthy family' project.

To promote the project, a poster, the recipe fans and teaching resource published below were produced which could serve as inspiration to your own project.

The evaluation revealed that the Teaching Resource created for lower secondary school students also proved useful to kindergarten teachers and even English teachers who would "like to benefit from such precious materials" in the future.

Due to its informative character as well as its attractive form, the Recipe Fan was highly appreciated by the local partners and by the participants (even if its impact would have been even higher if it had been available at the time of the first distribution). The need to work collaboratively with the chefs to adapt the traditional Polish and Hungarian recipes to meet with the objectives of the project was heavy on resources.

The project websites and social media presence was considered indispensable to the communication with tens of thousands of participants. Partners stated that they should have used social media even more efficiently in reaching target groups, especially pregnant women and parents.

All partners agreed that promotional items can play an important role in communicating and raising engagement of participants.

What determines the intake of fruit and vegetables? –
"My healthy family" literature review

This literature review provides an analysis of what determines the fruit and vegetables intake of children, pregnant women and older people and of how it can be improved.
In 2002, WHO reports suggested that up to 2.6 million deaths worldwide and 31% of cardiovascular diseases may be attributed to inadequate consumption of fruit and vegetables.
In most Western countries, people eat far less than the recommended amount of fruit and vegetables and studies have shown that children's intake of fruit and vegetables tracks into adolescence and is even maintained in adulthood.
Reaching out to youth, pregnant women and older people from lower socioeconomic status groups are also crucial challenges in this area.
Interventions to develop healthier food choices may improve individual preferences and often resulted in increased fruit and vegetables consumption, in the short term, but were only moderately successful in achieving a sustained consumption of adequate amounts of fruit and vegetables.

Pregnant women

They tend to eat more fruit and vegetables during their pregnancy, but not enough. To prevent deficiencies and ensure adequate neonatal growth, behaviourally-based interventions usually rely on dietary counselling. Distributing vouchers for fruit and vegetables may effectively increase their consumption in the long run.

Children and adolescents

Children's consumption of fruit and vegetables is determined by the eating habits of their parents. This influence dramatically decreases during adolescence. Interventions combining healthier food choices with physical activity as well as programmes providing respondents with individualised feedback have been particularly promising.

Older people

They are more often burdened by numerous health problems and often lack the income for healthier lifestyle choices.

Research gaps

Future longitudinal research into both personal and environmental factors (family, school, local community and national factors) should generate:

  • more information on determinants of fruit and vegetables consumption to which coming interventions should be tailored;
  • more information concerning product, consumer and environmental-related factors which determine food choices.

Efforts should be made to study, raise awareness and educate particularly vulnerable target groups such as older people, children and pregnant women.

The results of 'My healthy family' as well as 'We love eating' were presented on 16 December 2015 in Brussels. Please find here the agenda and presentations.

Monitoring and evaluation

2,257 youngsters, seniors and pregnant women in Poland and Hungary shared their understanding of the benefits of a healthy diet as well as some of their shopping, cooking and eating habits for a second time. This post evaluation survey gathered the data needed to compare to the earlier baseline allowing an assessment of the project's impact. The results are also available in Hungarian and Polish.

The project has in fact increased the consumption of fresh fruit and vegetables, but people’s cooking and eating habits are still deeply rooted in not always healthy traditions. Interventions of this kind need therefore to focus on how to turn deeply rooted habits into healthier – and tasty – culinary routines.

With most people there is still a gap between awareness, positive attitudes and day-to-day behaviour. Price is most often perceived as the impeding factor for change.

Other highlights:

  • Is eating healthy a privilege? Although participants were at the end of the project more responsive to seasonality and origin of fruit and vegetables (as opposed to price alone), the majority still considers fresh products too expensive. Nevertheless, more of their food budget is now being spent on fresh fruit and vegetables.
  • Hungarian kids already show a lot of wisdom when it comes to snacks. Fresh fruit are their preferred choice, followed by yoghurt and other milk products and fresh vegetables.
  • Combining the old with the new! “My healthy family” has significantly diversified the sources of inspiration for cooking: tradition can make room for personal creativity.
  • Pleasure matters! Not surprisingly, what food tastes and smells like is what matters the most to the foodies.

The project showed that behaviour change needs to be stimulated according to the needs of the different target audiences:

  • Pregnant women: benefit from information and personal counselling.
  • Youngsters 10-15 years: benefit from education and information to raise their awareness. Fruit seems to be more appealing to kids than vegetables, judging by their response to attempts of increasing their consumption. Therefore, special efforts should be made to promote consumption of vegetables among children.
  • People 65+ years: they are aware and willing to eat more fruit and vegetables but cannot always afford to do so. They can perhaps benefit the most from personalised advice on how to shop and cook more balanced meals on a budget.

Read about previous surveys

Monthly delights – recipe fans

Want to change your cooking habits?
Looking for a better and more colourful diet?
Like to try something new in the kitchen?

Recipes for 12 main courses plus starters and desserts, combined with free fruit and vegetables packages were meant to inspire "My healthy family" participants to try out new ways to a healthier diet.

Project ambassadors Magda Gessler and Alexandra Béres adapted some of their popular Polish and Hungarian recipes, introducing more fruit and vegetables to their countries' traditional cuisine. They took an innovative approach to show that fruit and vegetables are an essential part of many tasty, nutritious, balanced and affordable meals.

Check the "Monthly delights" to discover which fruit or vegetables could make your meals tastier than ever and let yourself and your family be encouraged to try out new dishes. Enjoy your meal!


Teaching resource

To encourage secondary school students to discuss healthy lifestyles, four specific lesson or project plans have been developed by the “My healthy family” pilot project. Teachers may use these ready-to-use guides to introduce nutrition and physical activity onto the learning schedules of 10 to 15 year olds. By navigating them, the students will at the same time be stimulated to develop interpersonal skills and learn how to cooperate. The lesson plans are also available in Hungarian and Polish.

Over 270 responses from 31 schools in Hungary were recently submitted by teams of young people answering the fruit and vegetables quiz (part of the teaching resource). Going through the quiz led many of them to surprising facts about fruit and vegetables. Some could not believe that there are as many as 7 500 varieties of apples; others were astonished to learn that lemon juice can help the cleaning around the house.

For their correct answers, and by luck of the draw, vouchers for sport equipment were won by the "Clever fruits", "Rosehip band", "Over-matured oranges", "Vitamin bombs" and "Radish" teams.

The pupils also used the interactive scenarios to explore the importance of a balanced healthy diet as well as the environmental impact of the way we eat.

In a parallel competition 69 entries (articles, posters, videos, photos, etc.) were submitted by student groups of 24 secondary schools in Poland carrying slogans like ‘Eat healthy! Be healthy!’ and ‘Eat healthy and colourful’. ‘My healthy family’ gadgets and cookbooks were won by the groups who submitted the two best artworks as well as the teacher who involved the highest number of students.
Check out the winning poster and the video of the runner up. https://youtu.be/O69fk8xKIEU

Story of the month

My healthy family tasted a rainbow of fruit and vegetables for better health

Leafy greens such as spinach and lettuce are excellent sources of folate, a B vitamin. Anthocyanins in strawberries, raspberries, red grapes act as powerful antioxidants. Orange and yellow fruit and vegetables are usually coloured by natural plant pigments called “carotenoids.” Beta-carotene in carrots and pumpkins is converted to vitamin A. Citrus fruit like oranges are an excellent source of vitamins B and C.

Participants of “My healthy family” were given information about those different groups to encourage them to eat more fruit and vegetables which offer many benefits to long term health.

Why not turn your 5 a day into a veritable rainbow!

Read other stories of the month


Launch events

"The "My Healthy Family" project simultaneously kicked off across 4 European regions with launch events in Rzeszów (capital of the region of Podkarpackie), Toruń (capital of the region of Kujawsko-Pomorskie) in Poland as well as Debrecen (capital of the Hungarian region of Észak-Alföld) and Miskolc (in the Hungarian region of Észak- Magyarország)."

Useful links:

We love eating

“We Love Eating”: Project to promote healthy lifestyles across Europe

This European initiative took a fun and upbeat approach to healthy eating focusing on 6 messages
Enjoy shopping for a healthy meal
Enjoy cooking
Enjoy eating together
Enjoy drinking water
Enjoy colourful fruits & vegetables
Enjoy physical exercise

The project targeted children, pregnant women and older people who are in key life stages where good nutrition is particularly important.

We Love Eating encouraged conscious eating and focusing on the pleasure food brings through tools such as games, recipes, leaflets, posters and its website. It also promoted more physical activity in daily life, offering realistic ways to adopt a healthier and more active lifestyle.

Conclusions on the project's impact on participant's lifestyle choices will now support policy-making as well as further sharing and implementing of best practices in health and nutrition. Find the detailed post evaluation in section "Monitoring and evaluation".

The contractor has also summarised the lessons learnt from its approach to encourage the target groups to improve their diets and engage in regular physical activity, to share their experience with everybody wishing to carry out similar initiatives. Their guide showcases the dos and don'ts ranging from where to find partners to set up a community based project, which activities worked well for which target group to success or failure of its tools.
It also includes hands on suggestions from the partners and stakeholders:

  • Timing
    Allow enough time for your project for behavioural changes to take place; one year might not be long enough.
  • Local influences and co-creation
    Clearly identify the different ethnic and socio-economic groups you will target and adjust the materials and activities to avoid language and cultural barriers, especially with certain disadvantaged groups like ethnic minorities and migrants. Stakeholders are keen on co creating the materials.
  • Collaboration, not competition! Reach target groups by going to where they are rather than expecting them to come to the project. Map existing local initiatives, projects and networks related to promoting healthy diets and regular physical activity in your city to take advantage of the possible synergies and ensure there is no overlap.
  • Focus on one or two target groups and messages
    Several cities struggled with the diversity of the messages and target groups, some stakeholders found the project a little too ambitious. By dividing resources over target groups and messages it seemed that less impactful. Keep key messages simple and do not communicate them all at once. Instead, focus activities and communication on one or two messages at a time.
  • Activities are key, they were the ideal way to connect to the target groups and convey the messages. Take care to develop activities that your target groups truly want and need.
  • Create a Facebook page especially for pregnant and breastfeeding women.
    Maintaining contact with pregnant women can prove more difficult – especially once they’ve had their babies. One way to keep in touch with them is by starting a Facebook group. Ideal, especially for new mothers who are craving contact with other mums but struggle to find the time to go to social events. Make a special effort to keep the page updated and engage women in online dialogue as well as in real activities.
  • To be able to evaluate your work and the results, gather statistically representative groups that agree to take part in the pre- and post-evaluation. The sample size always needs to be realistic and above all proportionate to the cities’ population size.

A variety of posters, publications and games in multiple languages which could serve as inspiration to your own project may be downloaded here.

Sustainability and transferability

'We Love Eating' in Catalonia – Pilot project once again proves its transferability

Enthusiasm certainly paid for the Spanish city of Granollers and in turn the EU-funded 'We Love Eating' (WLE) project. Starting in 2017, the Catalan public health authorities will include WLE in the framework of their public health plan. As a result, the project will be replicated in the neighbouring municipalities of Canovelles and Les Franqueses del Vallès.

This does not come as much of a surprise, given the broad range of successful activities organised in Granollers. More than 30 events and activities, ranging from a review of school canteen menus to the promotion of healthy walking trails, took place in the last quarter of 2015 alone. Similar activities and a range of new ones will be implemented starting next year.

This adds to WLE's previous achievements ensuring its transferability and sustainability:

  • The city of Raalte (neighbouring Dutch WLE pilot city Deventer) will use the WLE approach to create their own healthy activities for children, seniors and disadvantaged groups;
  • The French city of Roncq managed to integrate WLE messages and activities into the ‘Vivons en Forme’ (VIF)  programme at national level.

Read other stories


Monitoring and evaluation

2,158 children, their parents, older people and pregnant women in the 7 European citiesdescribed their behaviour, awareness of the benefits of a healthy diet, and intentions towards physical activity at the end of the project. More than half of them knew the 'We Love Eating' project was an initiative of the European Union. The project's leaflet turned out to be the most successful tool attracting all target groups.

Almost 600 had already participated in earlier surveys, making it possible to verify if and how the intervention actually changed their behaviour. The awareness of aspects of a healthily lifestyle increased in almost all target groups. Positive trends can be observed, most evident in older people. Seniors have the best intentions towards all aspects of healthy living.

  • More seniors are now eating fruit and vegetables daily or drink water more than 3 times a day. Older people believe that drinking water will have a positive effect on their health.
  • Parents are more aware that their children enjoy eating healthily. Fewer young children eat vegetables less than twice a week or drink water less than once a day.
  • Fewer youngsters, 10-15 y., eat fruit less than twice a week. They intend to share more meals with their family or friends.
  • Pregnant women are more aware that it is good for their unborn child if they enjoy eating balanced, home-cooked meals with fruit and vegetables, and are physically active.
  • "We Love Eating" triggered 3 out of 4 pregnant women to think about their lifestyle, though their actual behaviour still remained largely unaffected. On this point, it could be noted that intentions are largely determined by perceptions. This means that some respondents may (erroneously) consider their lifestyle to already be healthy, therefore seeing no special need for increased efforts to change it.

So even if the ideal lifestyle has not yet been fully achieved, it may be on its way – or just around the corner – thanks to this project.

The results of 'We love eating' as well as 'My healthy family' were presented on 16 December 2015 in Brussels. Please find here the agenda and presentations.

Read about previous surveys


Launch events

In a colourful, happy and intergenerational atmosphere, seven cities across Europe - Banská Bystrica (Slovakia), Bradford (United Kingdom), Cluj-Napoca (Romania), Deventer (The Netherlands), Granollers (Spain), Poznán (Poland) and Roncq (France) – celebrated simultaneously the official launch of the We Love Eating pilot project, aiming to show citizens how enjoyable and healthy eating can be.


Useful links:
http://we-love-eating.eu/en

'Together': Project promoting healthy diets to pregnant and breastfeeding women

This European initiative promoted healthier diets and regular physical activity before, during and after pregnancy. It targeted mums and mums to be, especially from disadvantaged groups.

Facts and figures

The 'Together' pilot project potentially reached out to close to one million pregnant or breastfeeding women in

  • Prague (Czech Republic)
  • Manchester (United Kingdom)
  • Murcia (Spain)
  • Varna (Bulgaria)
  • Odense and Kolding (Denmark).

According to the monitored key performance indicators more than 8,000 participants joined over 450 of the attractive activities on offer.

Close to 2,500 women shared their eating and exercise habits, knowledge of the benefits of a healthy diet for mother and child as well as their intentions towards adopting a healthy lifestyle in two separate surveys. Read about the achieved behaviour changes in chapter 'Monitoring and evaluation'.

With over 11,500 visitors the website proved to be a successful project tool. With 6,000 fans and 965,404 users who saw some of their content, the facebook pages had by far the most impressive reach. The peer support 400 women offered each other in the privacy of closed facebook groups must also not be underestimated especially not for women from vulnerable groups as well as young or isolated mothers.

12,600 leaflets and 1,250 posters raised awareness of the project. 250 handbooks with instructions for the local promoting groups and 5,100 cotton bags filled with useful information and small gifts such as fridge magnets also contributed to its success.

The women collaborated with doctors, experts and NGOs to design and test the best communication and educational approaches for different settings. Good ideas will now be identified to be replicated in other European cities and regions.

The project began by assessing the scientific basis on

  • nutritional intake and habits of pregnant and breastfeeding women and the effects of a healthy diet on both mother and child;
  • best practices in communicating with pregnant and breastfeeding women, including from disadvantaged backgrounds

Four priority areas for action were identified:

  • Avocate
    Promote healthier lifestyles among pregnant and breastfeeding women, with a focus on a balanced diet and regular physical activity
  • Educate
    Help women manage pregnancy related weight gain and loss; raise awareness on the benefits of maintaining exclusive breastfeeding for at least six months
  • Mediate
    Help women make the most of advice from health professionals
  • Enable
    Make healthier lifestyles easier to choose and more equally accessible.

The project's messages revolved around major healthy lifestyle topics:

  • It's the right moment to change for a healthier life
  • By taking care of yourself, you're taking care of your baby
  • Adopt healthy lifestyle by:
    • Learning together
    • Moving together
    • Shopping together
    • Cooking together
    • Eating together
  • Don't be afraid to ask
  • You're not alone
  • Participate in our activities

Lessons learnt

The contractor has summarised the lessons learnt from its approach to encourage the women to improve their diets and engage in regular physical activity, to share its experience with everybody wishing to carry out similar initiatives. Their guide showcases the dos and don'ts ranging from where to find partners to set up a community based project, which activities worked well in which city to success or failure of its tools.

It also includes feedback from the local partners adding their insights on project implementation and development, intended to help others avoid some of the difficulties they encountered:

  • Allow for enough time for behavioural changes to take place and be observed. One year is the minimum, but longer is even better.
  • Develop synergies with and build upon existing local initiatives, services and projects. Find out who can best reach pregnant and breastfeeding women. The success of the project will depend largely on getting interest groups to take ownership and get fully involved in carrying out activities. Take the project where the women are going anyway rather than expect them to find it elsewhere. Working with existing networks is also a way of ensuring the sustainability of the project.
  • Motivate and train local coordinators and partners, the project stands or falls with their enthusiasm.
  • Clearly identify the different ethnic and socio-economic groups and adapt information materials, events and activities to their specific needs e.g. serve foods they are familiar with, check if they are comfortable exercising in public, etc. Linguistic and cultural barriers of e.g. ethnic minorities and migrants must also be taken into account. Thinking of these factors from the beginning will greatly improve the project's chances to make a difference.
  • Activities are the key to involving the women and getting the messages across, but only if the project offers activities they truly want and need.
  • Create a Facebook page for the interested women who can be challenging to engage with on a regular basis. Especially new mothers are busy but also crave interaction with other mums. A Facebook page allows them to connect with their peers at the moments when it is convenient. Update the page as well as your website regularly with relevant information and activities and engage women in online dialogue as well as in real activities.
  • Monitor the project from the beginning to evaluate the results later on and to ensure the most accurate findings. With pregnant and breastfeeding women it is challenging to gather statistically representative groups that agree to take part in the monitoring and evaluation for the necessary length of time. Social media are ideal to maintain regular contact.

Monitoring and evaluation

'Together' made healthier lifestyles easier to choose

New mums in 6 European cities described their behaviour, awareness of the benefits and intentions towards adopting a healthy lifestyle for a second time at the end of the 'Together' project. All 531 women were already interviewed at the onset of the project when most of them were still pregnant, making it possible to verify if and how the intervention actually changed their lifestyle.

The project stimulated more than half of the women to eat more home-cooked meals, drink more water and eat more fruit and vegetables. They also intend to keep up or increase their regular physical activity.

  • 64% are drinking more water.
  • 58% are eating more home-cooked meals.
  • 53% are eating more fruit and vegetables.
  • 50% are avoiding energy drinks.

After the project, women felt better informed about a healthy lifestyle (eating habits, physical activity) and even the women who were already well informed, confirmed that 'Together' motivated them to actually apply the tips they received.

Women do everything they can to safeguard their baby's health, even more so once the bundle of joy has arrived (81% compared to 77% when they were pregnant). The best intentions on breastfeeding though suffer a reality check once the baby is there with 24% of new mothers opting out of solely breastfeeding.

Activities were key, the highest number of women (24%) found out about the project whilst participating in those, followed by social media which unexpectedly did not surpass traditional leaflets in reaching women (22% each). For women from disadvantaged backgrounds social media worked even less well (11%). Two out of three women knew the 'Together' project was an initiative of the European Union

Read about previous results

Celebrating 'Together' making a difference to lifestyles of mums across Europe

On 5 October 2016 mums and organisers alike celebrated simultaneously the official final events of this EU-funded project for pregnant women and breastfeeding mothers in their cities.

Their hard work over the last two years resulted not only in healthier lifestyles for many participants across Europe but also in ongoing programmes for maternal and child health e.g. in Murcia. Mayor José Ballesta announced he will continue 'Together' workshops, built directly upon the key messages and methodology.

Begoña Merino Merino, head of health promotion in the Spanish Ministry of Health, Social Affairs and Equality, recognised the relevance of the 'Together' methodology to the current national health strategy. She declared that her ministry plans to disseminate the 'Together' approach nationwide as a good practice in health promotion and disease prevention.

Women have become more aware that what is healthy for them is also healthy for their children” was one of the main conclusions highlighted at the closing conference of ‘Together’ in Odense.

Read about previous stories

Health communication in a nutshell

These are the key points of the literature review.

Knowledge is not enough

Although knowledge alone is not a magic wand capable of improving health outcomes, enhanced health literacy (especially of vulnerable populations) improves the capacity to access, understand and use the information which in turn might improve the health.

What do women really want?

Women want to make changes to their diets in pregnancy, the health of the child being the key motivator, but are not always sure how to do it in often limited available time. Therefore, information should clearly be portrayed in terms of the perceived benefits of a healthy diet for mother and child.
Unfortunately, the information they receive is frequently conflicting, and this causes many women to follow the wrong advice or just give up on changing their behaviour at all. For instance, many believe that home-cooked meals are necessarily more expensive. Overcoming this mind-set may play a key role in helping some of them improve the way they and their families eat.
In fact, successful health communication for women has the potential to change the lifestyle of entire families as women are not only the primary target group of the intervention but often the ones who do most of the shopping and cooking.

Women desire clearly defined goals, hence behaviour change techniques e.g. goal setting, self-monitoring (food diaries) and feedback should be considered.
During and after pregnancy many women desire interaction with and support from other women. Interventions that are able to offer a social element along with a health-related benefit are likely to have extra appeal.
Oral delivery, meaning personal “word-of-mouth” is liked better than written materials, receiving information in groups is favoured over individual counselling, preferably on family or community level. Community-based interventions should count on the skills and knowledge that already exists in the community, e.g. by encouraging networks of people who can support each other.

How to get the message across?

When designing messages, one must take into account the incentives and barriers associated with both the ‘problematic behaviour’ and the ‘desired behaviour’. A person's day-to-day real-life experiences, including, for instance, their minority status, or socially disadvantaged position, or cultural and religious beliefs, etc., influence the decisions they take.
The use of pictures and visual aids has been proven effective in communicating medical risk information to immigrant populations.
The channel can be as important as the message, indeed, no matter how true your message is, it is wasted if it doesn’t arrive to its target. Youth are currently more likely to tweet; but 25-35 year old women will often post on Facebook, daily. As a high percentage of pregnant and breastfeeding women desire group interaction but lack the time to participate, becoming part of a social media group can serve a similar supportive purpose.
Social media can indeed incorporate high quality content from existing projects of local, regional or national governments to leverage existing public health resources. Cross-linking and reverse traffic flow can improve our own project’s visibility.
Interactive web-based systems can also be effective in reaching women who do not have the time for frequent meetings, appointments or activities. Furthermore, they can be custom-made to suit the needs of the multicultural and multilingual target groups. Mothers appreciate the notifications and interventions this kind of system is able to send using custom made triggers.
Text messaging programmes are another promising channel which has proven successful in the promotion of various health-related behaviours. Although problems related to the digital divide remain a concern, already 50% of the EU population regularly uses a smartphone and thus the potential for mobile health communications is very significant.

Useful links:

Taste booster

Infographic about the implementation of the project, click to enlarge

Pilot project summary

Fresh fruit and vegetables are essential components of a healthy diet and their regular consumption could help prevent major diseases. Eating a balanced and healthy diet is important for us and especially for pregnant women, children and older people.

In 2012, the European Commission launched the ‘Taste Booster’ pilot project to test how to best encourage these groups to eat more fresh fruit and vegetables in regions with primary household income below 50% of the EU average.

The project was carried out in Kosice and Poprad (Slovakia), Roman and Medigidia (Romania) and Lovech and Troyan (Bulgaria) and entailed a series of monthly cooking sessions. The target audiences were reached and involved in partnership with local stakeholders (schools, community centres, hospital maternity wards, etc.).

The participants prepared recipes containing fresh fruit and vegetables under the guidance of chefs and nutritionists. At the end of each session they were provided with a kit containing ingredients and recipes, allowing them to recreate the experience at home.

Between 2012 and 2014:

  • An estimated 5,000 participants were reached through almost 1,000 cooking sessions and events
  • 92% of participants declared to have eaten more fruit and vegetables since  participating in the cooking sessions
  • 97% of participants said they feel more informed about nutrition
  • 98 tons of fruit and vegetables were consumed on location and distributed for further cooking at home.

Following the successful activities of this project, its results will now support policy-making and further implementation of best practices in health and nutrition.

The contractor has summarised their approach to encouraging the target groups to increase their consumption of fruit and vegetables, to share their experience with everybody wishing to carry out similar initiatives. Their guide includes success factors and lessons learned throughout the different phases of the project. It even provides a list of utensils needed to organise a cooking session as well as a wide selection of sample dishes.

To promote the project, a poster as well as a leaflet plus a selection of recipe sheets were produced which could inspire the marketing material for your own project.

For those interested in the post evaluation, the contractor has compiled a presentation of their methodology and the conclusions from their survey on eating habits and project impact.

SciView: Gathering evidence for a healthier EU

This EU-funded preparatory action will review scientific evidence and policies to create a comprehensive evidence-base for more effective and efficient action to tackle challenges related to nutrition and physical activity and to help prevent non-communicable diseases.

The overarching goal is to contribute to the promotion of healthy diets and regular physical activity, in particular among vulnerable people and low socio-economic status groups.

The reviews will be carried out in eight areas:

  • Preconceptions and behaviours contributing to positive energy balance;
  • Health interventions effectiveness and efficiency, in the domain of nutrition and physical activity;
  • Sources of calories consumed and physical activity undertaken by EU citizens;
  • Consumption, energy intake and impact of fruit juices and of artificially and sugar sweetened beverages on health;
  • Consumption, energy intake and impact of High Fructose syrups on health;
  • Links between school and work performance and achievement, and overweight and obesity and/or inadequate physical activity;
  • Possible early warning indicators for changes in population overweight and obesity; and
  • Nutrition and physical guidelines for specific population groups.

Over its two-year duration, this project will involve:

  • Comprehensive literature reviews of published scientific and grey literature publications in the eight objective areas;
  • Interviews with experts, to test the results of the literature reviews and obtain preliminary ideas for policy recommendations;
  • Production of case studies, highlighting interesting initiatives at EU or national/local level;
  • Organisation of expert workshops, to discuss and validate the results of the literature reviews; and
  • Development of policy recommendations based on these reviews and Member State policies in the areas of nutrition and physical activity.

Eight reports as well as easy to understand brochures will be produced, one for each objective, describing the results of the scientific reviews and a set of policy recommendations.
The project began in February 2016 through a series of interviews with individuals and organisations active in the field of nutrition and physical activity, such as the World Health Organisation (WHO), the OECD, academic experts, and non-profit organisations which hold expertise within these policy areas. These insights will be used to refine the method of the subsequent stages of the project.

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