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The project’s objectives focus is on prevention of diabetes and CVDs

  • By improving health literacy.
  • Informing on unhealthy lifestyle factors.
  • Offering tangible solutions for the adoption of healthy lifestyles.
  • Raising awareness on early detection approaches.
  • By even providing tools for self-monitoring of the health status.

What is PreAct ?

Cardiovascular diseases (CVDs) are the leading cause of death globally, taking more than 17.9 million lives each year (WHO, 2021), while within the EU 37% of all deaths in 2017 were attributed to CVDs (OECD, 2020). On the other hand, worldwide about 463 million people live with type 2 diabetes (T2D) (Roth et al., 2018) and in Europe, the number of adults diagnosed with diabetes has almost doubled over the last decade (Healthier Together, 2022). As it has been reported, CVDs and diabetes often go hand in hand (Centers for Disease Control and Prevention, 2022). For this reason, it becomes even more concerning that “the high prevalence of T2D worldwide continues to rise, even in developed European regions, and, despite significant investments in clinical care, research, and public health interventions, there appears to be no sign of a reduction in the rate of increase” (Khan et al., 2020). Moreover, T2D is now also more frequently diagnosed at younger ages, and even in children, which relates to increased overweight and physical inactivity among children, adolescents and young adults (Healthier Together, 2022).

According to OECD, on average in OECD countries, obesity (a well-recognized risk factor for the development of T2D and CVDs) will be responsible for 70% of all treatment costs for diabetes and 23% of treatment costs for CVDs. In its member countries, about one-third (32.1%) of individuals perform insufficient amounts of physical activity, whereas this value is higher in EU28 (33.1%) (OECD, 2019).

Additionally, the WHO European Region has the highest rates of smoking (WHO, 2014) and the highest proportion of drinkers (WHO, 2022a). In general, more disadvantaged groups, including the less educated and low-income individuals, are less likely to achieve sufficient levels of physical activity or have a healthy diet and they are more likely to be obese (OECD, 2019), they have higher rates of smoking (WHO, 2014) and they present elevated health risks from alcohol consumption in comparison with wealthier drinkers (WHO, 2022a). When considering “large inequalities in life expectancy exist between socioeconomic groups within and between EU countries” the challenge of reducing the prevalence of CVDs and T2D becomes even greater (Healthier Together, 2022).

On top of this, “since the outbreak of the COVID-19 pandemic, the challenge for countries to effectively prevent Non-Communicable Diseases (NCDs) has become even bigger: COVID-19 has disproportionately impacted people at risk of NCDs, among others, with a rise in unhealthy (such as malnutrition and lack of physical activity). Also, due to COVID19, the diagnosis of NCDs was forcibly postponed. The pandemic further magnified persistent inequalities in health outcomes and health determinants, both within and across countries.

Additionally, Russia’s invasion in Ukraine, which resulted in refugees arriving from Ukraine to find shelter in EU countries for a short or longer period, will also inevitably increase the burden of NCDs (Healthier Together, 2022).

On the other hand, “the COVID-19 crisis led to the accelerated introduction of some new technology by both national authorities and citizens. For instance, there has been a significant rise in the use of tele-medicine in healthcare settings and this could prove to be beneficial for the prevention and treatment of NCDs” (Healthier Together, 2022). And, most importantly, behavioural lifestyle interventions that target the four main modifiable risk factors that count for most of the burden of NCDs, i.e., lack of physical activity, poor diets, tobacco, and alcohol, have proven effective to control diabetes and reduce the risk of CVDs and this is a major opportunity that must be exploited.

Considering the above, the “PREACT” project addresses the action EU4Health Program (EU4H) in order to improve public health in the Union through disease prevention and health promotion, as well as international health initiatives and cooperations. PREACT responds to the scope and the general objectives of the call by aiming to improve and foster health in the Union and to reduce the burden of CVDs and diabetes, and related risk factors, by supporting health promotion and disease prevention, by fostering healthy lifestyles, and by reducing health inequalities.

Offering Updated Information and Raising Awareness

8

Courses

12+

Partners

36

Months

We Address different groups in general population from diverse environments.

We focus on offering updated information and raising awareness of diabetes and CVDs in easily comprehensible, non-verbal ways / animated videos, offering ways of self-monitoring one’s health status, emphasizing the importance of screening programs.

Educational Material for All

Train the Trainers

JSTE Educational Material

Checkup App

Purpose and Use

This questionnaire is intended for the initial screening of adults. The responses lead to a recommended care pathway: emergency assistance, cardiac evaluation, testing for diabetes, or preventive assessment by a general practitioner or internal medicine physician.

Instructions for Completion

  • Answer based on what is happening now or what has happened recently, as specified in each question.
  • Select one response in each row. If you are unsure, select Do not know.
  • Do not use the total number of positive responses as a diagnosis.
  • If an emergency symptom is present, stop completing the questionnaire and seek immediate assistance.

Completion Details

Participant code  __________________________________________________________

Date  __________________________________________________________

Age  __________________________________________________________

Optional sex or gender  __________________________________________________________

Completed by  □ participant    □ healthcare professional    □ other

Important Limitation

The absence of symptoms does not exclude cardiovascular disease or diabetes. FINDRISC and SCORE2 must be used in their original forms, in the appropriate age groups, and by a person who understands their limitations. This questionnaire does not create a new validated numerical score.

Love & Check Yourself

Love & Check Yourself

We focus on offering updated information and raising awareness of diabetes and CVDs in easily comprehensible, non-verbal ways / animated videos, offering ways of self-monitoring one’s health status, emphasizing the importance of screening programs.

Cardiometabolic Risk Initial Screening Questionnaire

17%

Section A Emergency Warning Signs

Complete this section first. If you answer Yes to any question and the symptom is occurring now, call 112 or go immediately to an Emergency Department.

A1 - Do you currently have pain, pressure, heaviness, or tightness in your chest??? *
A2 - Does the chest pain spread to your arm, back, neck, or jaw, or is it accompanied by cold sweating or nausea? *
A3 - Do you have severe or sudden shortness of breath? *
A4 - Have you fainted, or do you feel that you may faint, together with chest pain or marked palpitations? *
A5 - Have you suddenly developed drooping on one side of the face, weakness in one arm, or difficulty speaking? *
A6 - Do you have intense thirst and very frequent urination together with vomiting, abdominal pain, deep rapid breathing, drowsiness, or confusion? *

Section B Symptoms Requiring Cardiac Evaluation 

Consider the past four weeks unless the question states otherwise. 

B1 - Do you experience pressure, heaviness, or discomfort in your chest when walking quickly, climbing stairs, or exercising? *
B2 - Do you become more short of breath than you did previously during everyday activities? *
B3 - Do you experience recurrent forceful or irregular heartbeats that last longer than a few minutes? *
B4 - Are the palpitations accompanied by dizziness, shortness of breath, chest pain, or a feeling that you may faint? *
B5 - Have you fainted during exercise or immediately afterward? *
B6 - Have you developed new swelling in your legs, or do you need more pillows because you have difficulty breathing when lying down? *
B7 - Has your ability to walk or exercise decreased noticeably without a clear reason? *
B8 - Have you been diagnosed with heart disease, an arrhythmia, or heart failure? *

Section C Symptoms Requiring Diabetes Testing 

Consider whether the following symptoms appeared recently or have become more pronounced. 

C1 - Are you noticeably thirstier than usual? *
C2 - Do you urinate more frequently, especially during the night? *
C3 - Have you lost weight without trying? *
C4 - Do you experience persistent tiredness or weakness without an obvious cause? *
C5 - Do you experience blurred vision that recurs or persists? *
C6 - Do you have wounds that heal slowly or recurrent infections? *
C7 - Do you have numbness, burning, or a wound on your feet that is not improving? *
C8 - Have you previously been told that you had high blood glucose, prediabetes, or gestational diabetes? *

Section D Cardiometabolic Risk Factors

The following information helps a healthcare professional decide whether preventive assessment is needed. These items are not scored automatically in this tool. 

D1 - Do you currently smoke, or did you stop smoking recently? *
D2 - Have you been told that you have high blood pressure, or do you take medicine for it? *
D3 - Have you been told that you have high cholesterol or triglycerides? *
D4 - Do you have excess body weight or an increased waist circumference? *
D5 - Are you physically active for less than about 30 minutes on most days? *
D6 - Do you eat vegetables, fruit, or other fibre-rich foods less than daily? *
D7 - Does a parent, brother, or sister have diabetes mellitus? *
D8 - Has a close relative developed cardiovascular disease at a relatively young age? *
D9 - Do you have chronic kidney disease, sleep apnoea, or another chronic condition that affects cardiovascular risk? *
D10 - Has it been more than two years since your last blood pressure, glucose, and lipid assessment? *
Completed by *

References

American Diabetes Association Professional Practice Committee. (2026). 2. Diagnosis and classification of diabetes: Standards of Care in Diabetes 2026. Diabetes Care, 49(Supplement 1), S27–S49. https://doi.org/10.2337/dc26-S002

Byrne, R. A., Rossello, X., Coughlan, J. J., et al. (2023). 2023 ESC Guidelines for the management of acute coronary syndromes. European Heart Journal, 44(38), 3720–3826. https://doi.org/10.1093/eurheartj/ehad191

European Commission. (n.d.). Single European emergency number 112. https://europa.eu/youreurope/citizens/travel/security-and-emergencies/emergency/index_en.htm

Lindström, J., & Tuomilehto, J. (2003). The diabetes risk score: A practical tool to predict type 2 diabetes risk. Diabetes Care, 26(3), 725–731. https://doi.org/10.2337/diacare.26.3.725

Marx, N., Federici, M., Schütt, K., et al. (2023). 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes. European Heart Journal, 44(39), 4043–4140. https://doi.org/10.1093/eurheartj/ehad192

National Institute for Health and Care Excellence. (2010). Recent onset chest pain of suspected cardiac origin: Assessment and diagnosis (Clinical Guideline CG95). https://www.nice.org.uk/guidance/cg95

SCORE2 Working Group and ESC Cardiovascular Risk Collaboration. (2021). SCORE2 risk prediction algorithms: New models to estimate 10 year risk of cardiovascular disease in Europe. European Heart Journal, 42(25), 2439–2454. https://doi.org/10.1093/eurheartj/ehab309

Visseren, F. L. J., Mach, F., Smulders, Y. M., et al. (2021). 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. European Heart Journal, 42(34), 3227–3337. https://doi.org/10.1093/eurheartj/ehab484

World Health Organization. (2020). HEARTS technical package for cardiovascular disease management in primary health care: Risk based CVD management. World Health Organization. https://www.who.int/publications/i/item/9789240001367

The App is available cross-platform for higher compatibility.

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Animation Series
PREACT

8 Episodes raising awareness for health issues

Employing engaging non-verbal communication in the educational material is expected to massively enhance the greater promotion of the information regarding health and disease prevention eliminating language barriers, and with the aid of technology (digital tools) it is expected to have an impact on populations of different groups, different abilities/disabilities.