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Lifestyle to improve frailty, mood, cognitive decline and quality of life in women surviving cancer or with diabetes

Survival of cancer and diabetes define two morbidities with growing prevalence and marked specificities. Gender profile affects specific areas, like breast cancer, which leaves women in a deteriorated health state and increased vulnerability. We aim at implementing healthy lifestyle, including nutrition and physical activity, to reduce the burden of frailty and of chronic diseases with strong gender profile, mainly musculoskeletal (osteoporosis) and cognitive decline, in women surviving cancer or suffering diabetes. Improvement of mood and quality of life are additional objectives. To reinforce scalability, the commitment in embedded into the CARMEN program, which provides integrated care at primary care level of the public health system. Nurses, who share with social workers first assessment and monitoring, initiate enrolment in the programme. Referral to primary care doctors or the third level specialist (gynaecologist) is done when required. Empowerment is strengthened by the use of an ICT-based program (mobile-based) and by the involvement of patients associations. Adherence in the long term and sustainability are promoted in that way. Collaborative work with other EIPAHA partners materialises in sharing of screening and monitoring tools. Further, the commitment is inserted within the Valencia reference site. Clinical and analytical data are kept in a database while serum and ADN samples are stored in bio-bank. A parallel basic and clinical research program is attached to the initiative.
Background
Geographical scope: 
Regional level
Region involved:
Countries involved:
Organisation
Organisation name: 
University of Valencia- INCLIVA
Organisation address: 
AV BLASCO IBÁÑEZ 17, 46010 Valencia, Spain.
Kind of organisation: 
Hospitals
Primary care centres
Specialised physicians
General practioners
Nurses
Research centres
Academia
NGOs
Viability
Time for deployment: 
Between one year and three years
Preparation of implementation: 
We developed a program integrating primary and specialised care, with the inclusion of physicians and nurses. Once the scheme was set up we completed a series of initiatives to make the program both scalable and evidence-based. Funds at this stage were derived from Asociación Salus Vitae and a...
Investment per citizen / service user / patient: 
Between 100 – 1.000 EUR per targeted citizen / patient
Cost calculation: 
Costs include the salaries of the intervening staff plus the medical explorations.
Evidence of practice: 
Apparent evidence. Evidence is based on qualitative success stories
Evidence creation: 
The impact of our intervention is being assessed qualitatively at the present moment. Studies are on-going in which strong clinical evidence is being assessed.
Maturity level: 
Proof of concept is available: it works in a test setting and the potential end-users are positive about the concept.
Maturity level detalis: 
The practice is well inserted within the network of the public health system, integrating primary care centres with the specialists in the third level hospital. Also, nurses are integrated with researchers and medical specialists. This warrants scalability to similar models in Europe, which is the...
Time of impact: 
Long term and sustainable impact – e.g. a long time after the pilot project ended and routine day-to-day operation began
Kind of impact: 
Better quality of life (societal)
Aspects time of impact: 
During the progression we have not been able, for obvious reasons, to detect changes in final clinical events, which require a long-term follow up and a huge number of participants. However, even with the still low numbers, we have detected improvement in psychological indicators (mood, social...
Transferability level: 
Transferability has not been considered. The innovative practice has been developed on local/regional/national level and transferability has not been considered in a systematic way
Transferability details: 
The selected option is insufficient to describe our actual status, but we do not fill up the totality of conditions of the second option. In summary, we meet the requirements for transferability because the practice evolves within the common structure of a public health system. Moreover, the...
Initiative
Type of Practice: 
Notable practice
Stakeholders concerned: 
Hospitals
Primary care centres
Specialised physicians
General practioners
Nurses
Research centres
Academia
NGOs
Regional public authorities
Local public authorities
Advocacy organisations others
Reach of initiative: 
1,000 - 9,999
Age group: 
18 – 49
50 - 64
65 - 79
Baseline information: 
Healthy ageing has specificities in women. This affects frailty, and functional decline. The cancer survivors include a concrete population that keeps growing thanks to the success of available treatments. The status of these women is severely affected in distinct functions, which create an area of...
Source of funding: 
European funding
Funding scheme: 
Health Programme