ZaPrePis

Project Description

Background

Managing chronic diseases (cardiovascular diseases, neoplasms, diabetes, chronic respiratory diseases, mental disorders, and others) represents one of the greatest health challenges of the modern healthcare systems. Chronic diseases account for the vast majority of the disease burden and premature mortality in the European region of the World Health Organization as well as in Slovenia. Their burden extends beyond the health aspect, as they have consequences for individual, society and the healthcare system as a whole. At the individual level, chronic diseases significantly reduce quality of life, as they are long-term, often progressive, and require constant adjustments to daily life; they frequently lead to reduced work capacity, increased sick leave and early exit from the labour market. At the societal level, the burden of chronic diseases manifests itself, among other things, in reduced workforce productivity and widening health inequalities, as chronic diseases disproportionately affect vulnerable population groups. At the same time, the healthcare system is under increasing pressure, as chronic diseases account for the largest share of healthcare expenditures related to hospitalizations, long-term treatment, medications, and long-term care. This is reflected in overburdened healthcare systems, longer waiting times, and increased staff workloads. Demographic changes pose an additional burden.

Therefore, managing chronic diseases requires a strategic, comprehensive, and long-term approach that includes prevention, early detection of risk factors, support for people with chronic diseases in managing their own care, and systemic solutions. In this context, improving the population’s health literacy represents a significant strategic opportunity, as it enables individuals to access, understand, evaluate, and use health information to make daily decisions aimed at maintaining or improving their health. Health literacy also facilitates more effective communication with healthcare professionals and makes it easier to navigate the healthcare system. Improving health literacy thus emerges as a key tool for managing the burden of chronic diseases at the individual, system, and societal levels, and represents a strategic opportunity for developing sustainable, accessible, and equitable preventive measures.

Improving health literacy, promoting health and implementing the integrated prevention of chronic diseases helps people to maintain and improve their health, reduce the risk of developing chronic diseases and prevent or delay the onset of chronic diseases for as long as possible. It also helps with the early detection and management of chronic diseases and ensures a better quality of life and extends health life expectancy.

Project Managing chronic diseases through the prism of health literacy – ZaPrePis Project – represents a significant step toward addressing one of the greatest public health challenges. By comprehensively integrating scientific evidence, the development of new preventive care approaches for people with chronic diseases, research on health literacy, and systemic and organizational improvements, the project promotes an approach that simultaneously addresses the needs of individuals and the capabilities of the healthcare system. By utilizing the potential of health literacy, the project combines empowering people to take active care of their own health with greater accessibility, comprehensibility, and responsiveness of preventive services, while paying special attention to vulnerable groups. In this way, it lays a solid foundation for reducing the burden of chronic diseases, improving residents’ quality of life and strengthening the quality and effectiveness of primary prevention in the long term in Slovenia.

Purpose of the project

Conducting a comprehensive evaluation of the Integrated chronic diseases prevention program for adults (Together for Health) implemented at the primary healthcare level in Slovenia and systematically updating it based on the evaluation results, completed research, and professional guidelines. The project will develop new approaches and strategies for the prevention and management of chronic diseases at the primary level, with an emphasis on strengthening adults’ general, navigational, communication, and digital health literacy. Particular emphasis will be placed on the involvement of patients, vulnerable groups, and civil society, as well as on the sustainable implementation of solution within the healthcare system.

Project objectives

The long-term goal of the project is to improve the accessibility, quality, and effectiveness of preventive care for the management of chronic diseases at the primary care level. The project aims to empower the adult population of Slovenia to take an active role in maintaining and promoting health, to improve health literacy, to reduce health inequalities, and to reduce the burden of chronic diseases in Slovenia. At the same time, the project aims to establish a comprehensive framework for monitoring the long-term effects of the revised Integrated chronic diseases prevention program for adults (Together for Health) at the population level.

Specific objectives:

• To conduct a clinical study on preventive care (preventive pathways) for patients in a Together for Health programme that is being implemented at the primary care level, with an emphasis on health literacy and health outcomes.
• To conduct an external evaluation of preventive services for adults provided by the health promotion centres.
• To improve the quality of preventive services in health promotion centres with the development, piloting and implementation of a tool for measuring patient’s experiences in health promotion centres (PREMS – Patient-Reported Experience Measures).
• To evaluate, update/develop, and digitize health education materials for patients in the field of chronic disease prevention, and upgrade the Together for Health programme’s online platform into a modern tool for providing interactive support to patients in the field of chronic disease prevention.
• To develop, pilot-test, and evaluate new preventive interventions to improve health literacy and empower people with chronic diseases;
• To conduct a national survey on health literacy among adults in Slovenia, which will enable the monitoring of trends, the identification of differences among population (sub)groups, and will serve as a basis for further planning of measures; particular emphasis will be placed on researching health literacy among vulnerable populations.
• To develop approaches to strengthen organizational health literacy, with an emphasis on improving patient orientation, information accessibility, linguistic and cultural appropriateness, and support for navigating the healthcare system.
• To prepare a proposal for a systemic overhaul of the Together for Health programme, based on the results of the evaluation, clinical studies, and research conducted, and taking into account the current needs of the population and contemporary guidelines; particular emphasis will be placed on involving users and providers on shaping the programme overhaul and ensuring its practical feasibility.

Project structure

The project is being implemented in the framework of nine Work packages 8WP). Three WP are horizontal and include Project management (WP 1), Communication and dissemination (WP 2), and Monitoring and systematic management (WP 9). The remaining six WP are content-based and include and external evaluation of preventive care interventions for adults at health promotion centres (WP 3), the conduct of a clinical study on preventive care interventions and patient pathways within the Together for Health programme (WP 4), the assessment of patient experiences at health promotion centres (WP 5), comprehensive upgrading of materials and digital support for the prevention of chronic diseases (WP 6), the development of new preventive interventions to improve health literacy among people with chronic diseases (WP 7), and research on health literacy (WP 8). Work packages are being implemented simultaneously.

WP 1 – Project management – leading and coordination of the project

WP 2 – Communication and dissemination

WP 9 – monitoring and systematic management

WP 3 – External evaluation of preventive care interventions for adults at health promotion centres

WP 4 – Clinical study of preventive services and pathways of patients in the Together for Health programme

WP 5 – Measuring patient’s experiences with health promotion centres

WP 6 – Comprehensive upgrade of materials and digital support for the prevention of chronic diseases

WP 7 – The development of preventive interventions to improve health literacy among people with chronic diseases

WP 8 – Researching health literacy of adults

Added value

Empowerment of the individual

The key added value of the project is a conceptual shift from a traditional, disease-centred approach to a holistic model that places the individual at the forefront and focuses on strengthening their health literacy, empowerment, and active role in health care. In this project, health literacy is understood not merely as an individual ability, but as the result of interactions between the individual and the healthcare system, which must be understandable, accessible, and responsive.

Together for Health programme revision based on evaluation results and research

The first comprehensive and systematic evaluation of the Integrated chronic diseases prevention program for adults (Together for Health) will be carried out within the ZaPrePis project. Based on the results of the clinical study, the external evaluation by the health promotion centres, other research, current guidelines, and the experiences of programme users and providers, we will prepare a proposal for a systemic overhaul of the Together for Health programme.

Higher quality of preventive interventions at health promotion centres

Through the development, pilot testing, and implementation of a Patient-Reported Experience Measures (PREMS) tool, the project contributes to the systematic improvement of the quality of preventive services at the health promotion centres, their responsiveness, and a better user experience.

Strengthening health literacy as a systemic capacity

The project goes beyond the individual level and makes a significant contribution to the development of organizational health literacy. By developing approaches for better patient orientation, clearer communication, linguistic and cultural appropriateness, and support in navigating the healthcare system, the project strengthens the capacity of healthcare organizations to work with diverse population groups.

Development of modern digital and communication solutions

By updating and digitising health education materials and upgrading the online Together for Health platform, the project will create modern, interactive tools for the prevention of chronic diseases, designed in accordance with the principles of health literacy.

Data on health literacy as a basis for measures

By conducting a national survey on adult health literacy, the project will provide data for monitoring trends, identifying disparities among population groups, and planning targeted public health interventions. This represents significant added value for policymakers, decision-makers, and practitioners at all levels of healthcare.

Sustainable systemic effects

The project is focused on sustainable change, as the solutions developed will not merely be pilot projects but are designed for systematic integration into existing primary healthcare structures. Establishing a framework for monitoring long-term effects enables further improvement and adjustments to the programme even after the end of the project.

Cooperation and co-creation

The project brings together researchers, healthcare professionals, users, civil society, and policymakers, and encourages the co-creation of solutions that are acceptable, feasible, and effective in practice.

Expected results and materials

• A comprehensive evaluation of the Together for Health programme, which will include data from the clinical study, the results of the external evaluation of the health promotion centres, and other research findings. Based on this, a proposal will be prepared for a systemic overhaul of the Together for Health programme, which will contribute to more effective prevention of chronic diseases at the primary care level.
• The PREMS (Patient-Reported Experience Measures) tool will be developed to measure patient experiences at the health promotion centres, which will help improve the quality, responsiveness, and user experience of preventive services at the health promotion centres.
• Revised and digitized health education materials and an upgraded online Together for Health platform that will provide users with access to clear and tailored information on the prevention of chronic diseases and help improve their health literacy.
• Develop new preventive care programmes to improve health literacy and empower people with chronic disease; these programmes will be pilot-tested and evaluated, and a proposal will be prepared for their nationwide implementation through the health promotion centres.
• Conducted National survey on adult health literacy which will enable the monitoring of trends, the identification of vulnerable groups, and provide a basis for further planning of public health measures.

The expected results will contribute to greater awareness and active participation of the population in maintaining and promoting health, strengthening health literacy at the individual, organizational, and systemic levels, and developing proposals for systemic changes that can be incorporated into national development documents. In this way, the project’s results will help reduce the burden of chronic diseases.

Duration of the project: September 1 2025 until December 31 2028

Beneficiaries: NIJZ (National Institute of Public Health) and MZ (Ministry of Health)

Funding: ZaPrePis project is being implemented in the framework of the Slovenia’s EU Cohesion Policy Programme 2021–2027, Policy Objective 4 “A more social and inclusive Europe implementing the European Pillar of Social Rights”, priority task 7 “Long-term care and health and social inclusion”, specific objective ESO4.11 “Enhancing the equal and timely access to quality, sustainable and affordable services, including services that promote the access to housing and person-centred care including healthcare; modernising social protection systems, including promoting access to social protection, with a particular focus on children and disadvantaged groups; improving accessibility including for persons with disabilities, effectiveness and resilience of healthcare systems and long-term care services”. The investment is co-funded by the EU form the European Social Fund Plus and the Budget of the Republic of Slovenia, as a national contribution. The total value of the project is 5,542,439.00 EUR, of which EU contribution is 3,435,604.00 EUR.