Report by Lauren Tuchman
CHRODIS PLUS (CHRODIS+), is a three year initiative that began in 2017 and will conclude in 2020. It is funded by the European Commission and participating partner organizations, and was established under the Third Health Program (2014-2020) to work to support member states to “alleviate the burden of chronic diseases.” There are 42 partners, 21 EU countries represented, all working together to share knowledge, collaborate, and implement projects and initiatives to reduce the occurrence and severity of chronic disease.
May 14-15, 2019 marked the second annual Chrodis+ conference in Budapest. Full agenda, list of speakers, and individual presentations can be found here: http://chrodis.eu/event/budapest-conference/
While world statistics and data on non-communicable and chronic diseases continually indicate the vastness and scope of people/nations affected by such problems, it is nonetheless a positive feeling to be involved in conferences such as Chrodis+, where people from many countries work together to combine ideas, approaches, and set goals with a large emphasis on ‘prevention’ and preventative measures to help make steps towards a healthier and less-disease-filled future.
As a strong representative of Complimentary and Alternative Medicine and Traditional Medicine, ANMEs presence at this conference was impactful since the basis of our traditional and natural methods promotes the idea of prevention (rather than curative therapy). Or, in the cases where illness is already present, our approach places emphasis on measures that can help prevent worsening of disease in the future, and help move the trajectory of healing towards one that involves more natural and self-healing methods.
I found it important to see the large collaboration here between government members, health organizations, educational institutes, and scientists because it was clear that we were all interested to learn from one another, to hear more about studies being carried out, and to come up with goals that effect people as quickly as possible. I found it important to see that there was consensus on the benefit of creating best practices, on modeling nations and health-care plans after these practices (where appropriate), and designating money in budgets specifically for the purpose of seeing that these plans/practices are implemented and documented. It is necessary for learning and research purposes, but also to make sure the people who need help receive the help, and that it is not just theoretical solutions being discussed but, rather, actual, practical, and real-time help and solutions. Integration is key — between national policies and healthcare systems, as well as in individual and smaller communities and regions/areas. Feedback and innovation are also very important to track the evolution of plans and progress, and to uncover where more attention or resources should be directed.
- Renata Pap, head of the department representing Ildikó Horváth, Minister for Health, Hungarian Ministry, pointed out that there is a dilemma on how to provide healthier lifestyle. She asked: Should it be an individual approach or a community approach? Both have advantages and drawbacks.
- Ildikó Horváth, State Minister for Health, Hungarian Ministry of Human Capacities, stressed the importance of being innovative.
- Wojciech Kalamarz, Head of Unit for Health Determinants and International Relations, DG SANTE, European Commission, stated that approximately: 72 million men and 82 million women report having non-communicable diseases. He said that the commission is founding “best practices,” and that participation and work with Chrodis helps better develop these “good practices,” which can then be used from one country to another.
KEY OBJECTIVES OF CHRODIS+:
- Rokas Navickas, CHRODIS+ Scientific Coordinator, introduced his vision of CHRODIS+, discussing the 21 countries involved, 42 beneficiaries and the 3 year initiative. He stated that he believes: Europe has never been more fragile than now.
- To understand and observe where good practices can be found and to then model the present practices after this. Secondly, to apply these practices in other settings.
- To understand the importance of having: “outcome improvements” — to continually register and track the improvements, and to follow and make sure improvements continue.
PLENARY PRESENTATIONS: THEORY TO IMPLEMENTATION IN CHRODIS+: Discussions on: ‘High-level implementation of tools, models and best practices.’
- Matilde Leonardi, The Foundation of the Carlo Besta Neurological Institute, Milan, Italy, discussed: “The role of employment for people with chronic diseases.” She believes that Europe should push a similar effort that 22 other international countries are presently pushing, which involves workplace health promotion
- Jelka Zaletel, National Institute of Public Health of Slovenia, discussed: “Rolling out CHRODIS+ results on national scale - The experience in Slovenia.” Zaletel stated that adaption of healthcare system to population needs is imperative and being reflected in the national healthcare plan 2016-2025.
- Graziano Onder, Catholic University of the Sacred Heart, Rome, Italy, discussed: “Wide scale implementation of the Multi-morbidity Care Model: What? How? Why?” Onder spoke about how the ‘multi-morbidity’ care model is no longer only on paper, and he outlined implementation steps as follows:
- Understanding target, understand disease patterns, individual diseases, combination of diseases.
- Outline where there are areas of low socioeconomic status.
- Additionally, have a deep understanding of the target and a proper, well-defined scope of reach.
- Andrew Barnfield, EuroHealthNet and Nella Savolainen, National Institute for Health and Welfare, Finland, both spoke about: “Promoting children’s health with Chrodis Plus: stories from three projects”: Both Barnfield and Savolainen believe in the necessity of proper prevention, and in making changes before problems. Examples of this from the first stage of projects is: J.O.G.G, (implemented in Iceland) related to healthy food choices. And, Toybox, (a kindergarten—based intervention) focusing on the promotion water consumption/enough water for a daily requirement/intake. Barnfield and Savolainen also discussed the best type of implementation, saying that there are: Structured implementation strategies, expert support, site visits, communication, and that they have learned that there should be a separate or at least well-defined budget specifically for implementation.
- Esteban de Manuel, Kronikgune Research Centre on chronic diseases, Spain, discussed: Implementation strategy for CHRODIS+ projects. He stated that all methodology is based on collaboration of stakeholders. Furthermore, there is ‘structured methodology.’ Within this, he stated that he believes the most important part is local implementation of working groups, and that these local groups can analyze areas that they find to be most relevant. This can then be applied to the big picture. He also commented on the limited timeline of Chrodis+ (even though it is 3 years, he believed this nonetheless to be somewhat short). He stated that this only allowed for one cycle of center implementation. He also commented on the importance of reporting —that it is not a managerial task and, rather, that that learning requires structured reporting.
- Iñaki Imaz-Iglesia, Institute of Health Carlos III, Spain, discussed: “Long term and sustainable scenarios of implementation of good practices in chronic diseases in Europe.” He stated that the goal has been to work on the integration of national policies and the practice of sustainability—which extends to a governing board and includes policy dialogue, analysis for consensus statements. Thus far, there is now a governing board, 5 national policy dialogues, two workshops, an interim report, and linkage with a steering group that can guide the future policy dialogue.
Conference Day 2 was opened by Ingrid Keller, DG SANTÉ, discussing Best Practice Portals, and followed by smaller group roundtable discussions on Chrodis+ topics:
- Ingrid Keller, DG SANTÉ, discussed that CHRODIS was responsible for collecting ‘best practices’ and putting them online. She said that after this, it is vital for follow-up for “action-transfer.” She said that the DG SANTÉ asked member states to follow-up and to work to incorporate these components together to provide information for the entire project. She also said that DG SANTÉ had asked member states for input to identify which best practice they would like to transfer to their home country [i.e. Member States collectively chose: 2018: nutrition & physical activity, 2019: mental health].
- Portal is open! Stakeholders can submit! And there is often a lot of collaboration with colleagues from research programs
- ESF+ is the budget/name for next seven years in the commission (for the Health Program)
Plenary Closing Session [Included roundtable wrap-up (posters from roundtables are available online under ‘Agenda’ on website)]:
- Sabine Vuik, Health Policy Analyst , OECD action to support CHRODIS+ discussed: “Cost-effectiveness and assisting transferability of pilots.” She stated that from using data from pilot sites, the impact of upscaling or transfer can be estimated. Therefore, work can be achieved on scale-up goals. She also made the case for “investing in prevention.”
- Eeva Rantala, nutritionist, gave nice conference concluding remarks saying it is important to know when, where, and with whom is it hardest to resist temptation. Knowing this can help one stick their prevention goals. Helpful ideas for prevention, especially regarding food and intake are: making shopping lists, keep healthy options at home, making conscious decisions, making smaller portion choices. Her presentation is available here: http://chrodis.eu/wp-content/uploads/2019/06/be-the-choice-architect-of-your-own-life_chrodiswebsite_20190602.pdf