NEWSLETTER
First edition - June, 2023
Welcome to DigiCare4You!
Type 2 diabetes (T2D) and hypertension (HTN) represent an enormous burden in Europe for individuals and the society at large. It is also a burden forecast to increase over coming years, reflecting the threatening increase in the prevalence of childhood and adolescents’ diabetes as well as the ageing of the population and many other modifiable and non-modifiable risk factors.
Prevention strategies have, to date, failed to stem the tide of diabetes and HTN, with key barriers for the implementation and sustainability of such strategies including the absence of strong political commitment, the insufficient and ineffective financial, human and technical resource utilisations, as well as the lack of multiple stakeholder involvement and patient representation in plan development and implementation.
It is clear that a full overhaul of heath/social care is needed to address these barriers, consider individuals, families and communities’ needs and preferences, and integrate strategies that can effectively utilise family, community, and service system resources for intervention implementation and health-behaviour practice support.
This is why I am delighted to introduce the DigiCare4You project, which aims to improve the early prevention and management of T2D and HTN by firstly, building on an existing procedure for children’s periodic growth assessment to systematically identify people already living with, or at risk, of diabetes and HTN and secondly, developing a person-centred, community-supported solution, underpinned by digital tools, to prevent the development of these conditions and/or improve their management.
This first newsletter provides an overview of the project and its progress to date, which hopefully will help pave the way for an improvement in the quality of life and health outcomes of people living with, or at risk of developing diabetes and HTN. I hope you find it of interest.
– Prof. Yannis Manios, Project Coordinator
ABOUT THE PROJECT
What is DigiCare4You?
DigiCare4You is a Horizon2020 project which aims to improve the early prevention and management of T2D and HTN via a community-based, person-centred solution, integrating both social and healthcare systems, supported by the use of digital tools.
Why DigiCare4You?
T2D and HTN represent a major burden on individuals and society. Currently 537 m people worldwide live with diabetes (61m in Europe). Without urgent action, this number is forecast to rise to 643 m by 2030 (67m in Europe) and so will the cost burden on society. Additionally, 1.23 billion people live with hypertension.
HTN is approximately twice as prevalent in people living with diabetes compared to the general population. A staggering 75% of diabetes costs relate to often-preventable complications. Early screening and a focus on preventative measures is key to tackling these conditions.
What is DigiCare4You's goal?
The goal of this intervention is not only to improve the health status of the users, but also to empower the entire family in adopting a healthy lifestyle. To this end, schools and communities will also be actively engaged to promote health literacy, well-being and support lifestyle changes creating a more supportive social and physical environment for the entire community.
As a large part of the healthcare costs associated to T2D and HTN complications can be preventable, early screening will benefit and alleviate saturated healthcare systems.
How is the project conducted?
An implementation study is being conducted, targeting more than 10,000 families in two middle-income countries (Albania and Bulgaria) and two high-income countries (Greece and Spain).
The children's periodic growth assessment is combined with the identification of parents/ caregivers at high risk for T2D, by screening parents/ caregivers via a non-invasive self-reported digital screening tool. Those identified at high risk for T2D/HTN are being referred for glycaemia testing and blood pressure (BP) measurements at local community health centres.
Parents/caregivers confirmed to have pre-diabetes or diabetes (and possibly high BP) are invited to join a mHealth self-management intervention coordinated by the community healthcare workforce.
PROJECT STRUCTURE
How is the project structured?
DigiCare4You is organised around nine Work Packages and is deployed in three phases:
Phase 1:
Adapting the DigiCare4You solution to the local needs and contextual factors
Phase 2:
Implementing and evaluating the DigiCare4You solution
Phase 3:
Cost-effectiveness, scalability and transferability assessment of the DigiCare4You solution and capacity building to promote people-centred care in Europe
PROJECT MILESTONES
April 2021. Project kick-off Meeting
August 2021. Development of the project's communication plan, brand identity, website and content
December 2021. Establishment of the "Local Stakeholder Advisory Boards" of “implementers” and “end-users” in each country
March 2022. Establishment of the "International Stakeholder Advisory Board" & Project First Consortium meeting
September 2022. Definition of the implementation strategies to guide the adaptation and implementation of the DigiCare4You solution in each country; adapted DigiCare4You solution delivered and ready for implementation; development of the project evaluation and monitoring tools
PROJECT NEWS
Literature review on mHealth and community-based interventions for the prevention and management of Type 2 Diabetes Hypertension
News item – February 16, 2022 | Read more here
Investigators from La Trobe University, Baker Heart and Diabetes Institute, Ghent University, NYU Grossman School of Medicine and METEDA conducted a literature review on the evidence of both clinical- and cost-effectiveness of mHealth and community-based interventions for the prevention and management of T2D and HTN.
The results of this systematic review and meta-analysis have been published in two separate articles on The Lancet - Digital Health journal:
- Effectiveness, reach, uptake, and feasibility of digital health interventions for adults with type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials | Read the article here
- Effectiveness, reach, uptake, and feasibility of digital health interventions for adults with hypertension: a systematic review and meta-analysis of randomised controlled trials | Read the article here
Situation analysis to record and understand the contextual factors related to primary healthcare and community healthcare services in each country involved in the analysis
News item – February 21, 2022 | Read more here
Partners from Sant ´Anna School of Advanced Studies (SSSA) conducted a situation analysis to record and understand the contextual factors related to primary and community healthcare services in each of the four implementation countries of the DigiCare4You study (Albania, Bulgaria, Greece, and Spain).
Digital tools for the two-stage screening procedure
News item – June 21, 2022 | Read more here
Partners from the Centre for Research and Technology Hellas (CERTH) developed a web platform to be used during the two-stage screening procedure of the project. This enabled the start of the digital screening process.
mHealth applications now available for the DigiCare4You project
News item – July 12, 2022 | Read more here
Consortium partner, METEDA, developed four mHealth tools (clinical decision support platforms for HCPs and mobile applications for participants) for the intervention and monitoring process. All the mHealth applications developed by METEDA have been adapted to the local context and requirement.
DigiCare4You community-based intervention and social collaboration platform
News item – August 24, 2022 | Read more here
Partners from CERTH developed a social collaboration platform for the community-based intervention aspect of DigiCare4You. The main goal of this platform is the creation of a social and physical environment that will provide documented, reliable and useful information concerning T2D and HTN prevention, but also practical tips and guidelines on healthy and active living for all age groups.
Implementers and users' insight
News item – November 08, 2022 | Read more here
Consortium partner, SSSA, compiled the results of implementers and end users’ insight on the mHealth tools and interventions from qualitative and quantitative data sources. Implementers and end users of the DigiCare4You solution were invited to participate in focus groups and to reply to a web survey.
DigiCare4You Consortium Meetings in Athens and Zaragoza
News items – November 30/December 1, 2022 and May 8-9, 2023| Read more here and here
DigiCare4You consortium partners held their first in-person annual meeting on November 30/December 1, 2022, in Athens, where they provided updates on the work conducted over the past year in each of the nine work packages. Consortium partners met again on May 8-9, in Zaragoza and online, to review the progress achieved in recruiting study participants and developing a locally-adapted intervention, integrated in the local health system and procedures in each country.
RESOURCES
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European Public Health Week 2023: Prevention and control of chronic diseases 
The infographic is available in Albanian, Bulgarian, Greek, English and Spanish. |
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Hypertension-related resources Diabetes-related resources 
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NEXT STEPS
What is the current status and what are the next steps?
In all countries, procedures have now been established to support recruitment, assess the implementation strategy and ensure statistical power to examine study outcomes. Digital tools have also been developed, which allow for the digitalisation of the screening process, the management of diets/lifestyle changes and the monitoring by healthcare professionals of their patients.
In Greece, 10 health centres and 74 healthcare professionals are now participating in the study. In Albania, 20 schools and four healthcare centres have been enrolled in the study, with 68 healthcare professionals contributing to the implementation. In Bulgaria, 32 schools and 13 GP practices have joined the study, with a total of 51 healthcare professionals supporting the work. In Spain, 15 healthcare centres and 15 schools in Zaragoza are also participating in the study.
Collaboration platforms, tailored to the needs of each implementation country, will shortly be launched. These will support local, healthy communities and facilitate connections. Amongst others, they will allow for developing/sharing community-based events and initiatives as well as exchanging information relating to T2D and HTN. Schools will also be supported through a teacher’s guide and training sessions, with a view to creating more supportive social and physical environments.
Looking forward to the replicability and transferability of the solution, consortium partners are now busy developing tools and a prediction model to calculate the screening and intervention costs; as well as identifying scale-up indicators and adaptation strategies. These will be based on studying the mechanisms that contribute to the scalability and transferability of the solution and will support future implementation.
The study implementation is now in full-flow and early results will be reviewed during the project’s next consortium meeting, which will take place in Tirana, Albania, end of November 2023.
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