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This multicentre project aims to foster health promotion interventions and environments suitable for patients, their families, and health professionals. The strategy is based on the Health Promoting Hospitals (HPH) framework with a strong emphasis on evidence based prevention. The ultimate goal of this project is achievement of measurable improvements in population health through comprehensive promotion of healthy behaviours in diverse and complementary categories of individuals. The project would focus on vulnerable patients presenting with acute manifestation of an underlying chronic condition, and on those they have stronger bonds with. Both patients and their families are assumed—in line with theory and evidence—to feel more susceptible to illness and more open to realize,

 In summary, we feel that the rationale for implementing health promotion activities is supported by at least three factors. The increased life expectancy and prevalence of people older than 65 in Europe is likely to result in increased prevalence of preventable chronic diseases, such as diabetes and cardiovascular disorders. Second, health promotion at a hospital setting configures as an ideal system to bridge the gap between primary care services and general hospitals. Third, a considerable and diverse body of evidence supports the effectiveness of health promotion in achieving durable behaviour change which results in decreased risk for chronic medical conditions.

The strategy is based on the Health Promoting Hospitals (HPH) framework with a strong emphasis on evidence based prevention and would operate through a salutogenic approach (WHO Europe 2012) focusing on factors which support human health and well-being, and has the following specific objectives

  • Call: PJ-01-2014 «Innovation to prevent and manage chronic diseases»
  • Starting date: 1st of May 2015
  • Duration: 36 months
  • Number of partners: 5 coming from 4 EU countries
  • Coordinator: ASL Biella (Local Health Authority Biella)

Objectives (1/2)

This multicentre project aims to foster health promotion interventions and environments suitable for prevention of chronic diseases in order to:

  1. Profiling patients according to their risk factor and deliver individual counselling
  2.   Engagement of patients in interactive workshops aiming  at monitoring and changing their risk factors
  3.   Redesigning the hospital environment to be fully conducive in a health promotion perspective (e.g.           introduction of healthy food at the hospital canteen      and cafeteria)

Objectives (2/2)

  1.  creating strong liaisons with the hospital catchment area, useful to provide and maintain a suitable environment for a permanent healthy behavioural  changes among patients (within and outside the hospital)

5.  designing and availability of the protocol and reports                    encourage the promotion of hospitals embracing a comprehensive and effective health promotion approach

Emp-H partners and collaborating partners may be grouped as follows:

Consortium partners (2/2)

Local Health Authorities/Hospitals and Network of Hospitals

- ASL Biella, Italy (Coordinator)

- Hospital La Fè – Valencia, Spain (Partner)

- HPH Network (collaborating partner)

Public Universities with Competence in capacity building and evaluation of prevention and health-promotion interventions

- Università del Piemonte Orientale, Italy (Partner and WP Leader)

- Dublin University, Ireland (Partner and WP Leader)

Regional authorities and national/local associations for the prevention of chronic diseases

-              Lithuanian Sclerosis Multiple Union, Lithuania (Partner)

-              Regione Piemonte (collaborating partner), Italy

-    Fondo Edo Tempia – Biella Lotta contro i tumori (collaborating partner), Italy

-    LILT – Biella Lega Italiana per la lotta contro i tumori (collaborating partner), Italy

WP2 Dissemination and Communication

Main objectives:

This WP intends to give high visibility to the activities carried out in the project.

1)      identify the objectives and key messages, as well as the key stakeholders to be targeted by the dissemination activities throughout the project’s lifetime. Dissemination activities will be based on the results of a stakeholder analysis performed at the beginning of the project period

2) share common dissemination tools to be constantly used by the   project’s Consortium with the aim to transfer the project results to the broadest audience both at local and at European level

WP2 Dissemination and Communication

Dissemination tools

The dissemination effort will be organised along the following communication lines:

-Emp-H website, which will be a living window of the project and will be constantly updated with the latest results achieved throughout the entire lifecycle of the Project;

-Emp-H leaflets which will be produced in two versions to support the presentation of the Project in relevant conferences and fairs;

-Midterm Workshop and the Final Conference where 50-60 and 80-100 sector players respectively will be invited for a face-to-face presentation of the project results and to promote the “Emp-H model” towards other Hospitals and European regions.

-Liaison with other EU and non EU initiatives and projects such as HPH network and EIP on AHA


In particular, patients would receive:

1. environmental support for behavioural change, starting from when they enter the hospital (point i), in parallel with support in the community (point v);

2. individual counselling to change unhealthy behaviours offered during ‘Teachable moments’ (point ii), i.e., during the moments in which patients would have the greater emotional and cognitive readiness to behaviour change.

3. Interactive workshops on health related issues (such as healthy cooking and home exercise programs) which would be readily available also outside of teachable moments (point ii).

This project aims to bridge the gap between biology, psychology, and clinical medicine in the management and prevention of chronic diseases, resulting in for measurable improvements in chronic health conditions. Such benefits would have an impact on highly prevalent conditions such as cardiovascular diseases ,

Diabetes and other chronic deseases (despite not being limited to them), which would result in wide margins for health benefits throughout Europe (European Commission 2013).

This project might have at least five implication for European public health, with others that might become more obvious as the project is implemented.

First, the innovative, coherent, and integrated approach illustrated in this proposal is based on a review of the scientific literature and is expected to be highly effective in benefitting different and integrated target groups simultaneously and the community in which they live. If such effectiveness was confirmed, this project would have large implications for the European Union,in which approximately nearly 80 million people are admitted to hospitals each year for acute conditions (European Hospital and Healthcare Federation 2011)—and it appears reasonable that a similar number of relatives may access the hospital during visiting hours.

Second, this proposal would allow developing new forms of partnership between hospitals and primary care which are likely to promote an active and participatory role of all target groups involved in the project as well as the community in which they live.We expect to establish strong liaisons with the community so to provide a favourable environment for behaviour change, both within and outside the hospital. Literature provides good evidence that a comprehensive approach to health promotion is more likely to be successful compared to standalone interventions implemented in one setting.


Third, public availability of the protocol and reports would encourage the promotion of hospitals embracing a comprehensive and effective health promotion approach. In the European Union many experiences fall under the ‘Health Promotion Hospital’ label, although only a few of such experiences have been extensively documented as comprehensive multidimensional interventions. The present proposal might allow implementation of an innovative, well-documented, and generalisable intervention which could be disseminated extensively throughout European member states.

Fourth, we aim to transparently evaluate both the processes and the outcomes of this project . We feel that evidence based prevention and health promotion are two complementary approaches that can benefit from each other, and we aim to bridge the gap between them. Personalised empowerment included in selected clinical pathways more frequently accessed by at risk patients should contribute to reduce relapses and delay worsening of clinical conditions requiring hospitalization and intensive care, thus reducing healthcare costs. Promoting an active and healthy attitude in frail or aging population through the community approach can consolidate the healthy behaviours in present and following generations. A thorough evaluation would also have relevant implications for research, as so far only a few health promotion initiatives (even those within the framework of WHO/Europe Health Promoting Hospitals) have been evaluated with rigorous methodology.

Fifth, the involvement of partners with various levels of previous experience with the Health Promoting Hospitals network, based in geographically representative areas of the European Union, and having catchment areas characterised by diverse socioeconomic and demographic compositions, is expected to provide highly scalable results. The experience gained with the adaptation of the project to different contexts would be shared so to encourage replications of this project and thus benefit the largest number of hospitals within the European Union, even through existing HPH and patients networks.



To assess the impact of the counselling intervention

2. To assess the impact of interactive workshops

2.1. Proportion of patients aware of their risk factor, out of those participating to workshops (knowledge)

2.2. Proportion of patients willing to change their risk factor, out of those participating to workshops (intentions)

2.3. Proportion of patients modifying their risk factor by adopting behavioural change, out of those participating to workshops (behaviours)

3. To assess the impact of environmental intervention

3.1. Proportion of patients aware of their risk factor, out of those benefitting from hospital-based health promotion facilities (knowledge)

3.2. Proportion of patients willing to change their risk factor, out of those benefitting from hospital-based health promotion facilities (intentions)

3.3. Proportion of patients modifying their risk factor by adopting behavioural change, out of those benefitting from hospital-based health promotion facilities (behaviours)

4. To assess the impact of liaisons with the hospital catchment area

4.1. Proportion of patients aware of their risk factor, out of those benefitting from liaisons with the community (knowledge)

4.2. Proportion of patients willing to change their risk factor, out of those benefitting from liaisons with the community (intentions)

4.3. Proportion of patients modifying their risk factor by adopting behavioural change, out of those benefitting from liaisons with the community (behaviours)

Project: Heppy - Healthcare: Parents Pathways

In defining the strategies for taking care of people affected by chronic pathologies, it is assuming a growing importance the choice of combining the medical assistance provided to the patient in Hospital and the assistance at home, according to a perspective of permanent and continuous care.
Many humanities branches of studies - history, medical anthropology, sociology, and literature- help to enlarge understanding of the human experience and human cultures, including how cultures understand and deal with death, health and disease- and how cultural beliefs, biases, and needs are reflected in the structure of medical practice. Humanities, including theatre, narrative medicine1 and literature and medicine, also help to develop empathy and compassion for patients.
The humanities and arts provide insight into the human condition, suffering, personhood, our responsibility to each other, and offer a historical perspective on medical practice. Attention to literature and the arts helps to develop and nurture skills of observation, analysis, empathy, and self-reflection -- skills that are essential for humane medical care. The social sciences help us to understand how bioscience and medicine take place within cultural and social contexts and how culture interacts with the individual experience of illness and the way medicine is practiced.

In this context two approaches gain importance:
- Narrative medicine, in which the patient assume and plays an important role by providing information about himself that the professional carer can use to improve the service provided.
- “Methodology of parents’ pedagogy” that recognise to the parents a crucial role to guide the carers and the doctors in acknowledging the personal story of the patient.
The project intends provide professionals Health carers that are committed to give assistance to patients with chronic pathologies, the skills to apply the 2 above mentioned approaches so to understand the complexity of the personal story of their patient
- Develop and share, at European level, a better knowledge in a comparative perspective of the transnational state of art in the application of the concepts and methodologies of Narrative medicine, Methodology of parents’ pedagogy and their role in the concrete application of the International Classification of Functioning, Disability and Health (ICF) in the specific working environment.
- Collection of the narrative case studies making to Narrative medicine and Methodology of parents’ pedagogy in according to ICF in the database of the project
- Define and propose a common European profile of competences and skills for the professionals health carers as far of the Home assistance of patients with chronic diseases, concerning the humanising and the improving the relationship with the patient through an holistic comprehension of the personal characteristics of the patient, the parents then the relatives.
- Develop a multidisciplinary e-learning based training package aimed at teaching the application of Narrative Medicine and Methodology of parents’ pedagogy to the different professionals working in all the fields that affect and are affected in the organisation of holistic health care services: Territorial Social Services, Professional and Hospital based medical assistance, Home care assistance, Economic sustain and job counselling, Training of professionals at university level and Training of professionals care givers at post University/Vocational Training level
Professionals health carers: At least 180 Professionals health carers will directly benefit from the project results.
In each of the 6 countries at least 30 trainers will be involved for testing the training package and participating to the Virtual Community
Patients and their families: At least 50 patients, together with their families will benefit directly from the project results.
The results will be a Database collecting the e-forms that each partner will use for reviewing the main publications available addressing the 3 methodologies object of the project: Narrative medicine, Parents pedagogy and International Classification of Functioning, Disability and Health.
Each publication will be described through its bibliographical reference, an abstract and a comment of the partner.
The information will be provided in English and in the national language.
The partners will analyse through common criteria, the main experiences of health assistance, studying it from the point of view of all the actors involved: Hospital, care givers, patient and relatives.
Each case study review will be available in English and in national language.

Collection of the forms with which the partners will describe the best practices identified among the case studies analysed.
The Best practice will be identified and described by the partners according to homogeneous criteria defined by the Guidelines for identification and description of best practices.
The Best practice will be used as point of reference for developing the training course
Each National report will describe the country situation as emerged from the research carried out. Reports will be available in English and in national language.
The transnational report will summarise and compare the information of the National reports in order to highlight common tendencies and main differences.
The Report will be translated in all the languages.
The final results of the research activity will be a transnationally defined profile of the skills and knowledge that a Health carer assisting patients with disabilities and /or chronic diseases, should have in order to take into consideration and manage effectively the combination of aspects, social, economic, cultural that affect its needs. These profile will be proposed to the Health Sector community for being validated.


We are the Lithuanian Multiple Sclerosis Union (LMSU), which was founded in 2000 with the help of the Danish Multiple Sclerosis Society.
From 2002, the Organisation is a member of the European MS Platform.
From 2007 we became a member of Euro carer association.
The Organisation also is one of the initiator in the founding of the Baltic MS Alliance.
We unite appr.1000 people but represent the interests of almost 4000 affected people and are helping to solve their problems.
We co-ordinate the activities of 8 societies in the country’s largest cities and district centres.
The LMSU main Office is at A. Jaksto g. 9, Vilnius and employs 3 people: the chairman of the board, the secretary general, and the chief financial officer.
Its areas of activity include social and psychological consultation, representation of patient interests in all state institutions, and the implementation of international projects. (For more , see the projects)
Multiple sclerosis is a fundamental neurological illness with a high morbidity, especially among people at a young age of employable morbidity 20-40 years of age.
An attempt is of made to conceal the illness from not only employers but also those close to the person. Disability is rapid and severe.
Since 2000, the date of registration of its activity, LMSU has done a great deal for the benefit of patients suffering from multiple sclerosis. The Union’s activity directly affects indicators of patients’ treatment and their quality of life by means of lobbying events and meetings with local administrations. It is It is not without efforts made by the Organisation that everybody who needs pharmaceutical treatment is provided with it. The state provides 100% compensation for this treatment.
With the aim of helping to remove bureaucratic obstacles and other hindrances related to the social conditions of patients, various political and social campaigns and events were arranged over the last five years.
In other words, we are able to help people which do not require large financial recourses: e.g. the organisation of seminars, the founding of small fitness schools, the establishment of self-help groups, and, of course, providing information, education, and training to use the latest computer hardware and software.(see the projects)
We are doing a lot in fundraising for all the work currently being performed in order to improve the lives of people suffering from multiple sclerosis and to realise ideas as well as for maintaining the office and employees.
This is a public non profitable organisation. Its maintenance and its activities are supported only by the amount support and charity it receives..

Secretary General Aldona Droseikiene
Lithuanian Multiple Sclerosis Union

The Hippocrates Project

The current European social-economic situation requires individuals who work in the fields of training and in particular in the field of health training to re-consider their role, expanding the previous concept of “training for a specific role” towards a more ample and complex vision which allows for the consolidation of the ability to “manage one’s own skills” in order to respond to the continual evolution of the social-environmental factors and therefore of training needs.

In this context the following needs concerning the professional figure of the trainer emerges:
1. Ability to identify gaps in one’s knowledge with regard to Knowledge Management in the health sector
2. Ability to identify the best strategies used for Knowledge Management, in particular in the health sector
3. Acquisition of skills with regard to Knowledge Management methodology
4. Possibility of sharing one’s own understanding and training methodologies

In order to respond to these needs the project aims to:
1. Identify the knowledge gaps of trainers in the health sector with regard to Knowledge Management methodology
2. Share, by an online database, the best practice carried out by trainers with regard to Knowledge Management in the health sector
3. Provide trainers who work in the health sector with the necessary skills to manage effectively their knowledge , to allow them to update systematically their competence and if possible foreseeing the evolution of their context of reference. This will be done by means of a specific “online training path”
4. Promote the sharing of skills and experiences of trainers in the health sector at European level through an effective exchange of experience among professionals .

1. Experts in the field of training trainers in the health field, identified by the partners to fulfil needs analysis, to research best practices and to develop “the training path” package that will benefit from items made during these activities and projects. They will also be able to meet with European colleagues bearers of different experiences from theirs;

2. Trainers in the health field that will be involved in the different project phases and the first to be involved in the knowledge management process , being themselves protagonist testing the package implemented training.

The following activities will be carried out:

1. Self-Analysis of the trainers training needs to identify which skills/ Knowledge/ competence/abilities the trainers in the health field have vs. they should possess (competence gap) to effectively perform their job, considering the environment evolution which they have to integrate and assure .
2. Role competence profile, discussed and defined by some “experienced trainers focus groups” who share and compare needs, experiences, problems.
3. Creation of a database of best practice in Knowledge Management framework, to provide trainers a wide range of the existing Knowledge Management methods and tools specifically applied in health field.
4. Development and test of a training package for trainers in the health field, using all the information achieved, based upon the Knowledge Management methodology and the relevant dynamic tool which will be fulfilled, using the approved Role Profile.
5. Creation of a virtual community to share experiences, difficulties , documents, references, etc…

The main tangible result of the Hippocrates projects will be the project portal which will contain:
-the results of the needs analysis,
-the database of best practice,
-the training course on Knowledge Management method specifically designed and adapted for trainers in health field,
-the virtual community of trainers.

Promoting the Project Hippocrates. It is a non-profit agency specializing in health services. It promotes and manages the training of health personnel in collaboration with external institutions (Universities, Scientific Societies etc)
2) STATNI ZDRAVOTNI USTAV - National Institute of Public Health - Czech Republic
3) BUPNET - Training and Project Network ltd. - Germany
4) PIXEL Association - Italy
6) LIETUVOS IŠSETINES SKLEROZES SAJUNGA - Lithuanian Multiple Sclerosis Union - Lithuania
7) POLITECHNIKA KOSZALINSKA - Koszalin University of Technology - Poland