Table Of Content OSTERREICHISCHE AGENTUR FUR GESUNDHEIT UND ERNAHRUNGSSICHERHEIT GMBH.. 23

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1 Table Of Content Joint Action on Nutrition and Physical Activity... 5 Summary... 6 Work Package Coordination and Management Dissemination activities Evaluation Evidence (Economic rationale for action on childhood obesity) Nutritional information monitoring and food reformulation prompting Healthy environments by integrated approaches Early interventions Coordinator, Leader contact and partners INSTITUT NATIONAL DE LA RECHERCHE AGRONOMIQUE INSTITUT NATIONAL DE LA RECHERCHE AGRONOMIQUE INSTITUT NATIONAL DE LA RECHERCHE AGRONOMIQUE BUNDESMINISTERIUM FUER GESUNDHEIT BUNDESMINISTERIUM FUER GESUNDHEIT OSTERREICHISCHE AGENTUR FUR GESUNDHEIT UND ERNAHRUNGSSICHERHEIT GMBH.. 23 OSTERREICHISCHE AGENTUR FUR GESUNDHEIT UND ERNAHRUNGSSICHERHEIT GMBH.. 23 OSTERREICHISCHE AGENTUR FUR GESUNDHEIT UND ERNAHRUNGSSICHERHEIT GMBH.. 23 OSTERREICHISCHE AGENTUR FUR GESUNDHEIT UND ERNAHRUNGSSICHERHEIT GMBH.. 23 OSTERREICHISCHE AGENTUR FUR GESUNDHEIT UND ERNAHRUNGSSICHERHEIT GMBH.. 23 SERVICE PUBLIC FEDERAL SANTE PUBLIQUE, SECURITE DE LA CHAINE ALIMENTAIRE ET ENVIRONNEMENT INSTITUT SCIENTIFIQUE DE SANTE PUBLIQUE INSTITUT SCIENTIFIQUE DE SANTE PUBLIQUE SCIENSANO SCIENSANO NATSIONALEN CENTAR PO OBSHTESTVENO ZDRAVE I ANALIZI MINISTERSTVO NA ZDRAVEOPAZVANETO BOLNITZA LOZENETZ BOLNITZA LOZENETZ HRVATSKI ZAVOD ZA JAVNO ZDRAVSTVO HRVATSKI ZAVOD ZA JAVNO ZDRAVSTVO HRVATSKI ZAVOD ZA JAVNO ZDRAVSTVO HRVATSKI ZAVOD ZA JAVNO ZDRAVSTVO HRVATSKI ZAVOD ZA ZDRAVSTVENO OSIGURANJE HRVATSKI ZAVOD ZA ZDRAVSTVENO OSIGURANJE HRVATSKI ZAVOD ZA ZDRAVSTVENO OSIGURANJE STATNI ZDRAVOTNI USTAV TERVISE ARENGU INSTITUUT TERVISE ARENGU INSTITUUT TERVEYDEN JA HYVINVOINNIN LAITOS TERVEYDEN JA HYVINVOINNIN LAITOS TERVEYDEN JA HYVINVOINNIN LAITOS FRIEDRICH-ALEXANDER-UNIVERSITAET ERLANGEN NUERNBERG Page 1/51

2 FRIEDRICH-ALEXANDER-UNIVERSITAET ERLANGEN NUERNBERG FRIEDRICH-ALEXANDER-UNIVERSITAET ERLANGEN NUERNBERG FRIEDRICH-ALEXANDER-UNIVERSITAET ERLANGEN NUERNBERG DEUTSCHE GESELLSCHAFT FUR ERNAHRUNG E.V DEUTSCHE GESELLSCHAFT FUR ERNAHRUNG E.V AID INFODIENST ERNAHRUNG, LANDWIRTSCHAFT, VERBRAUCHERSCHUTZ EV AID INFODIENST ERNAHRUNG, LANDWIRTSCHAFT, VERBRAUCHERSCHUTZ EV Alexander Technological Educational Institute of Thessaloniki (TECHNOLOGIKO EKPAIDEFTIKO IDRYMA THESSALONIKIS) Alexander Technological Educational Institute of Thessaloniki (TECHNOLOGIKO EKPAIDEFTIKO IDRYMA THESSALONIKIS) ARISTOTELIO PANEPISTIMIO THESSALONIKIS ARISTOTELIO PANEPISTIMIO THESSALONIKIS ARISTOTELIO PANEPISTIMIO THESSALONIKIS ORSZAGOS GYOGYSZERESZETI ES ELELMEZES-EGESZSEGUGYI INTEZET ORSZAGOS GYOGYSZERESZETI ES ELELMEZES-EGESZSEGUGYI INTEZET ORSZAGOS GYOGYSZERESZETI ES ELELMEZES-EGESZSEGUGYI INTEZET ORSZAGOS GYOGYSZERESZETI ES ELELMEZES-EGESZSEGUGYI INTEZET ORSZAGOS GYOGYSZERESZETI ES ELELMEZES-EGESZSEGUGYI INTEZET NEMZETI EGESZSEGFEJLESZTESI INTEZET INSTITUTE OF PUBLIC HEALTH IN IRELAND LIMITED INSTITUTE OF PUBLIC HEALTH IN IRELAND LIMITED INSTITUTE OF PUBLIC HEALTH IN IRELAND LIMITED INSTITUTE OF PUBLIC HEALTH IN IRELAND LIMITED INSTITUTE OF PUBLIC HEALTH IN IRELAND LIMITED UNIVERSITY COLLEGE CORK - NATIONAL UNIVERSITY OF IRELAND, CORK UNIVERSITY COLLEGE CORK - NATIONAL UNIVERSITY OF IRELAND, CORK MINISTERO DELLA SALUTE ISTITUTO SUPERIORE DI SANITA ISTITUTO SUPERIORE DI SANITA ISTITUTO SUPERIORE DI SANITA SLIMIBU PROFILAKSES UN KONTROLES CENTRS SLIMIBU PROFILAKSES UN KONTROLES CENTRS SLIMIBU PROFILAKSES UN KONTROLES CENTRS SLIMIBU PROFILAKSES UN KONTROLES CENTRS SVEIKATOS MOKYMO IR LIGU PREVENCIJOS CENTRAS VI MINISTERE DE LA SANTE LIGUE LUXEMBOURGEOISE DE PREVENTION ET D'ACTION MEDICO-SOCIALES Ministry for Health - Government of Malta Ministry for Health - Government of Malta Ministry for Health - Government of Malta HELSEDIREKTORATE HELSEDIREKTORATE HELSEDIREKTORATE HELSEDIREKTORATE HELSEDIREKTORATE HELSEDIREKTORATE HELSEDIREKTORATE Page 2/51

3 SLASKI UNIWERSYTET MEDYCZNY W KATOWICACH SLASKI UNIWERSYTET MEDYCZNY W KATOWICACH MINISTERIO DA SAUDE - REPUBLICA PORTUGUESA MINISTERIO DA SAUDE - REPUBLICA PORTUGUESA MINISTERIO DA SAUDE - REPUBLICA PORTUGUESA INSTITUTUL PENTRU OCROTIREA MAMEI SI COPILULUI ALFRED RUSESCU INSTITUTUL PENTRU OCROTIREA MAMEI SI COPILULUI ALFRED RUSESCU INSTITUTUL PENTRU OCROTIREA MAMEI SI COPILULUI ALFRED RUSESCU UNIVERSITATEA BABES BOLYAI URAD VEREJNEHO ZDRAVOTNICTVA SLOVENSKEJ REPUBLIKY URAD VEREJNEHO ZDRAVOTNICTVA SLOVENSKEJ REPUBLIKY URAD VEREJNEHO ZDRAVOTNICTVA SLOVENSKEJ REPUBLIKY NACIONALNI INSTITUT ZA JAVNO ZDRAVJE NACIONALNI INSTITUT ZA JAVNO ZDRAVJE NACIONALNI INSTITUT ZA JAVNO ZDRAVJE NACIONALNI INSTITUT ZA JAVNO ZDRAVJE AGENCIA ESPANOLA DE CONSUMO, SEGURIDAD ALIMENTARIA Y NUTRICION AGENCIA ESPANOLA DE CONSUMO, SEGURIDAD ALIMENTARIA Y NUTRICION AGENCIA ESPANOLA DE CONSUMO, SEGURIDAD ALIMENTARIA Y NUTRICION AGENCIA ESPANOLA DE CONSUMO, SEGURIDAD ALIMENTARIA Y NUTRICION AGENCIA ESPANOLA DE CONSUMO, SEGURIDAD ALIMENTARIA Y NUTRICION MINISTERE DES AFFAIRES SOCIALES ET DE LA SANTE MINISTRY OF HUMAN CAPACITIES MINISTRY OF HUMAN CAPACITIES Outputs Newsletter n Newsletter n Newsletter n Newsletter n Newsletter n Newsletter n Layman version of the final report Final report Dissemination plan (4th version) Position paper Interim evaluation report n Yearly evaluation report n Final evaluation report Report on country-specific prevalence and impact studies Report on country-specific costing studies Report on country-specific forecasting studies Briefing for EU ministers Best practices inventory and guidelines for improving the collection and use (both by stakeholders and by consumers) of nutritional food information Pilot study and identification of participants in a monitoring network Final report of the existing model good practices Final Guidance document on the integrated approach and its potentials Web-based toolbox for program planners and decision makers Page 3/51

4 Report on conditions for successful implementation and transferability of actions Document which summarises models and recommends actions to be developed further Final report including information/data on national policies and activities in each MS Publishable Final evaluation report The lifetime impacts and costs of childhood obesity : Ireland, Romania, Slovenia, Greece The lifetime impacts and costs of childhood obesity : Italy, Croatia, Portugal Interim report Dissemination plan (3rd version) Yearly evaluation report n Report of case studies in Member States Dissemination plan (2nd version) Evidence paper and study protocols Interim evaluation report n Definition and criteria for good practices Dissemination Plan (1st version) Descriptive working paper defining good models for multi-component interventions Quality manual (QM) Website Leaflet Evaluation methodology and plan Page 4/51

5 Joint Action on Nutrition and Physical Activity JA GPSD [705038] START DATE: 01/09/2015 END DATE: 30/11/2017 DURATION: 27 month(s) CURRENT STATUS: Finalised PROGRAMME TITLE: 3rd Health Programme ( ) PROGRAMME PRIORITY: - CALL: Grants for actions co-financed with Member State authorities 2014 (Joint Actions) TOPIC: Nutrition and physical activity Joint Action EC CONTRIBUTION: EUR KEYWORDS: Adolescents, Adolescents, Children, Children, Economic Cost, Empowering Families, Healthier Environments, Healthy Diet, Healthy Start, Nutrition, Nutrition, Nutritional Information, Obesity, Obesity, Overweight, Physical Activity, Physical Activity, Policy Page 5/51

6 PORTFOLIO: Nutrition, Nutrition and physical activity, Physical Activity SUMMARY Project abstract In all EU Member states (MS), the high level of overweight and obesity in children and adolescents is of particular concern. In the EU, around 1 in 3 children 6-9 years old were overweight or obese in 2010, a sharp rise in prevalence despite numerous MS or EU initiatives.physical inactivity and poor diet from birth (and even in utero) are important determinants of adiposity leading to overweight and obesity. They are also independently associated with various non-communicable disease risk factors leading to the main pathologies European populations are suffering from, including detrimental psychosocial outcomes. Overweight and obesity represent an economic burden with up to 7% of EU health budgets spent each year directly on diseases linked to obesity, with more indirect costs resulting from lost productivity. Nutritional problems and physical inactivity need to be addressed in an integrated way so as to promote healthier environments, to make the healthy option the easiest option and to inform and empower families.within the general frame of the EU Action plan on childhood obesity , the JA s general objective is to contribute to halting the rise in overweight and obesity in children and adolescents by Through the, identification, selection and sharing of best data and practices within the 25 countries involved, the JA will allow for : to advocate based on an estimation and forecast of economic cost of overweight and obesity; to improve the implementation of integrated interventions to promote nutrition and physical activity for pregnant women, families with young children; to improve actions within school settings; and to increase the use of nutritional information on foods by public health authorities, stakeholders and families for nutrition policy purposes. The JA will reinforce the links between national nutrition and physical activity policies initiated by the EU Strategy on nutrition, overweight and obesity-related health issues. Summary of context, overal objectives,strategic, relevance and contribution of the action In all EU Member states (MS), the high level of overweight and obesity in children and adolescents is of particular concern. In the EU, around 1 in 3 children 6-9 years old were overweight or obese in 2010, a sharp rise in prevalence despite numerous MS or EU initiatives. Physical inactivity and poor diet from birth (and even in utero) are important determinants of adiposity leading to overweight and obesity. They are also independently associated with various non-communicable disease risk factors leading to the main pathologies European populations are suffering from, including detrimental psychosocial outcomes. Social inequalities in Nutrition and Physical activity remain a main challenge for the different national nutrition policies. Overweight and obesity represent an economic burden with up to 7% of EU health budgets spent each year directly on diseases linked to obesity, with Page 6/51

7 more indirect costs resulting from lost productivity. Nutritional problems and physical inactivity need to be addressed in an integrated way so as to promote healthier environments, to make the healthy option the easiest option and to inform and empower families. Within the general frame of the EU Action plan on childhood obesity , the Joint action s (JA) general objective is to contribute to halting the rise in overweight and obesity in children and adolescents by Through the identification, selection and sharing of best data and practices within the 26 countries involved, the JA allows: to advocate based on an estimation and forecast of economic cost of overweight and obesity; to improve the implementation of integrated interventions to promote nutrition and physical activity for pregnant women, families with young children; to improve actions within school settings; and to increase the use of nutritional information on foods by public health authorities, stakeholders and families for nutrition policy purposes. The JA reinforces the links between national nutrition and physical activity policies initiated by the EU Strategy on nutrition, overweight and obesity-related health issues. Methods and means The Joint action (JA) consortium has 39 associated partners from 24 European countries and involves also an important number of collaborating stakeholders. In total, all but 3 (Denmark, The Netherlands, United Kingdom), i.e. 25 of the 28 EU MS, as well as Norway, participate in the JA. The consortium contains broad and diverse expertise relevant to carrying out the JA with success as the partners are all key actors in the European and national health and/or nutrition and physical activity programmes. The JA offers a unique opportunity to share and analyse practices and to discuss recommendations on best practices in the many different fields necessary to improve the situation of childhood overweight and obesity. From this coordinated work, a harmonised and integrated approach to address this major public health challenge is developed. This work aims to improve the concrete practical coordination based on a networking of European nutrition and physical activity policies allowing as far as possible a harmonisation of strategies and actions. Different types of actions are implemented in the Joint Action: The use of economic evaluation of the cost of children obesity to encourage public action, The sharing of specific tools to promote the improvement of the nutritional quality of foods and the consumer information at national level, The identification and sharing of integrated actions at local or national level for diet and physical activity, with children (from in utero to the end of school age) as a target, families and professionals as main actors of the actions, and pre-school and school settings as the main place to act. To ensure the success and efficiency of the JA, close links with high-level policy makers and other stakeholders in the field of nutrition and physical Page 7/51

8 activities is implemented through the active involvement of the collaborating stakeholders, and beyond, through the JA s dissemination activities. Work performed during the reportingperiod The started on 1st September A Public Launch Event was organised on 28th September 2015 in Luxembourg and gathered around 50 participants from the JANPA partners' organisations, EC institutions, WHO and stakeholders. The kick-off meeting took place on September 2015 and was attended by representatives from 32 of 39 associated partners and 3 collaborating partners. The WP1 team managed all contractual, financial and administrative aspects of the project. WP1 established the management structure, defined the JA rules and procedures and elaborated the JANPA templates. A JA Quality Manual was established and disseminated to all partners. WP1 ensured the communication with the EC and managed unforeseen events (preparation and submission of 5 amendments to the JANPA Grant Agreement). WP1 also conducted internal technical and financial reporting approximately every six months and issued the corresponding internal reports. Templates for the two periodic reports to be submitted to Chafea were prepared to help partners to complete the reporting. The periodic technical and financial reports were then compiled and submitted to Chafea. WP1 prepared the JA s General Assembly held of September 2016 in Berlin and organised 14 steering committee meetings (conference calls or faceto-face meetings). All deliverables produced by the other WP were reviewed, commented and validated before submission to Chafea. The JANPA Position paper and the Layman version of the Final report were prepared in close collaboration with the WP2 team and with contributions from WP leaders and. The WP2 team defined JANPA s dissemination strategy and created the relevant communication tools: the visual identity, a website, an information leaflet, a poster and a tweeter as well as a Facebook account. It established and continuously updated a dissemination plan. With the contributions of all partners, WP2 leader compiled and analysed a list of stakeholders identified at country and EU levels in order to disseminate results and relevant information about JANPA in each MS and to establish contacts with other research projects at regional/national and European level. Six newsletters were produced and reached approximately stakeholders. The WP2 team together with the WP leaders prepared factsheets of the JANPA main deliverables and disseminated them at the JANPA final conference and through the different JANPA dissemination channels. A Layman version of the Final report (a brochure of 16 pages) was prepared in November 2017 and described the Page 8/51

9 main results of JANPA. The JANPA Position paper was established together with all WP leaders and contained recommendations for the implementation of the JANPA results. The WP2 supported the Coordinator to prepare and promote the JANPA final conference (information shared through the dissemination channels, printed materials provided; ). The WP3 team established the Evaluation plan, including the identification of 3 external experts to support the WP3 team, the Coordinator and the WP leaders in their activities. Two interim evaluation reports and two yearly evaluation reports were produced. The WP3 also prepared a final evaluation report and its layman version. The JANPA evaluation was implemented through several on-line questionnaires (for the WP leaders, the JANPA partners, the stakeholders ), through evaluation forms completed by the external evaluators and through five meetings (face-to-face or conference calls). The WP4 Irish team submitted four academic systematic reviews of the international literature for publication in peer-reviewed journals which cover prevalence of childhood obesity and overweight, childhood impacts of childhood obesity and overweight, adult impacts of childhood obesity and overweight and the lifetime costs of childhood obesity. In late 2015 / early 2016, the WP4 lead team conducted an -based Local Mate The main output achieved so far and their potential impact and use by target group (including benefits) Summary of the main outputs (Technical activities) The WP4 team worked on the deliverable 4.1 Evidence paper and study protocols which was submitted. The Evidence paper covers prevalence of childhood obesity, health and other impacts of this condition, healthcare and other costs, taking into account the availability and quality of data in the EU MS. It summarizes four International systematic reviews ( Irish studies ). WP4 members have also worked on the Study Protocols which identify the most appropriate methodology and modelling approach based on existing work and models; they have been tested in the scope of the Irish studies. The Deliverables 4.6 and Lifetime Impacts & Costs of Childhood Obesity Overweight in Europe: Part 1: Modelling methodology; Data requirements; Results for the Republic of Ireland & Northern Ireland and 4.7 Part 2: Data & Data Documentation; Challenges & Lessons; Future Developments were produced. They gave results for 2 countries (Ireland and Northern Ireland) and produced the data necessary to get results for the other countries (except Page 9/51

10 Portugal). To achieve this objective, it is necessary to improve the tools and to make them largely available. Links with OECD which is working on the economy of obesity will allow in a near future to include the JANPA WP4 work in a global view. Participating countries of WP5 collected information on existing monitoring systems of nutritional information and their use by nutritional policy managers. Countries also collected available data on the use and understanding of food information by families. In 3 countries where a pilot study took place - data were collected on the nutritional composition of two categories of food (breakfast cereals and sugary beverages) and were put into a harmonised database. The feasibility of such a system was already demonstrated in France ( Oqali ), and was tested in Romania and Austria. The main conclusion of the first part of the work (D5.1) is that a combination of different types of policy actions is necessary in order to improve the quality of the diet at the population level: information and education to increase the interest for nutrition, actions on the food environment in order to make the good choices easier, simplified food labelling systems to empower the families and give them the possibility to make the right choice when shopping, and food reformulation to improve the quality of the food supply. The main conclusions of the second part of the work (D5.2) is that: (i) a monitoring tool managed by public authorities and fed by industry is necessary to qualify the nutritional quality of the food offer and to follow up the impact of the nutrition policies deployed, and (ii) that it is absolutely necessary to work at the brand and at the country level because the offer varies depending of the country, but also because the composition of the products can be different from one country to another. Such a tool, based on the Oqali model, could easily be implemented in other European countries. The WP6 team conducted desk research on existing definitions in health promotion and set up a working definition and criteria for good practices. WP6 worked on the collection and analysis of the collected good practices regarding integrated approaches in kindergartens and schools; 37 good practices were collected from 15 countries and all 13 WP6 members countries were sent country context forms to be completed. WP6 members also worked on assessing the existing capacities and resources for the prevention of childhood obesity; 187 web-based questionnaires from 13 countries were completed and 16 interviews were conducted. The final D6.2 Compendium of Good Practices in Creating Healthier Environments in Pre-Schools and Schools brings together diverse practices from 16 countries which were collected in a standardized way. It offers information on 39 different good practices, with the objective of making both a Achieved outcomes compared to the expected outcomes Page 10/51

11 The outcomes have been achieved as planned though with some delays in the submission of some deliverables. Due to external constraints, the WP4 results were delayed and need a further development after the end of JANPA. However, the implemented methodology proved to be efficient. Dissemination and evaluation activitiescarried out so far and their major results Dissemination activities WP2 Information about JANPA and its outputs have been largely disseminated both at national level and European level. The main target groups, including EC institutions (in particular DG SANTE), international organisations, topic-related projects, public national, regional and local authorities, educational body and schools, health communities, universities, NGOs, foundations, food economic actors etc., have been reached through both offline and online communication means. Most countries participating in the Joint Action have created a specific section on their organisation s website or have disseminated information about JANPA through their newsletters or their websites. As of October 2017, JANPA Twitter s account has 251 followers and views, the Facebook account has been liked by people and has reached people or institutions so far. The information leaflet has been translated in the languages of the partners for a total of 19 languages. The main JANPA Deliverables, the Position paper and the Layman report have been printed and disseminated during the JANPA Final conference, as well as on the JANPA website. Factsheets of the main deliverables have also been prepared and disseminated through printed copies and the electronic channels. Six newsletters were prepared and sent to around stakeholders working on local, regional, national and European levels. Also, JANPA has been presented in many conferences and meetings both at national and European levels (some of them are presented on the JANPA website). Evaluation activities WP3 In the beginning of JANPA, the evaluation activities have helped defining and setting up an evaluation mechanism as well as a relevant evaluation methodology for JANPA s activities. Two interim evaluation reports (for internal use) have been issued in March 2016 and in June 2017 and gave an overview of the work achieved. The reports provided recommendations for WP leaders and the project s partners in order to implement their future activities as initially expected. In addition, two yearly evaluation reports were prepared in the end of the first and the second year of the JA and included the evaluation of the three external evaluators, selected in the beginning of JANPA. In the end of JANPA, the Evaluation team prepared a final evaluation report on the basis of an on-line questionnaire sent to the JANPA stakeholders and aiming to evaluate the impact of the JA. A layman version of the final evaluation report is also available. The global final evaluation of JANPA shows a high level of achievement of the Page 11/51

12 various ambitious objectives given. It shows also that the many partners of JANPA in the participating countries were satisfied with the process. JANPA achieved its overall purpose. Finally, JANPA early assessment of impacts was positive: there were some cases of changes in policies, institutions, and regulations where positive JANPA impact was identified. Page 12/51

13 Work package Work Package 1: Coordination and Management Start month: 1 End month: 27 Work Package Leader: ANSES Efficient consortium management and coordination of the different WPs is fundamental for the success of the JA. This includes stimulating effective exchange of information among all partners, management, coordination, budget management, guidance, leading meetings and interacting on the JA s behalf with the EC, Chafea and other external bodies. This WP will be responsible for delivering the JA expected outputs within the agreed time scale and resources and will ensure their quality and the impact of the activities in accordance with the JA objectives. Also, WP1 will deal with any legal issues, especially regarding IPR management. Finally, this WP will be responsible for collecting and compiling the technical and financial periodic reports, as well as the final report ensuring timely submission to Chafea. WP1 is led by the Administrative coordinator ANSES together with the Technical Coordinator DGS FR. All partners are involved, namely in reporting and attending meetings. Task 1.1: Overall contractual, financial and administrative management (Task leader: ANSES) Sub-task 1.1: General administrative management and coordination (Sub-task leader: ANSES) For a detailed overview of the JA management structure and organisation, monitoring mechanisms and financial management description, please refer to section 9. ANSES, as coordinator, will be in charge of the management of the JA, reporting to the EC and partners and allocating the resources. It is responsible for defining the decision-making framework, administrative and financial coordination, preparing financial reports and communicating with the Commission, organising General Assembly meetings, and, in case of conflict, implementing actions for conflict resolution. Sub-task 1.1.2: Knowledge management (Sub-task leader: ANSES) The objective of this task is to implement the IPR policy and to ensure effective knowledge management (mutual access right to knowledge of the others participants when necessary for the execution of the JA). Knowledge and IPR management processes will be specified in the Consortium Agreement (CA). The CA will be drafted by ANSES prior to the start of the JA detailing all aspects concerning the management and reporting, conflict resolution and IPR-related matters. The CA will be agreed and signed by all Consortium members. Any issue regarding conflicts and IPR protection that cannot be settled bilaterally between partners within WPs will be resolved by the Steering Committee (SC) according to the procedures described in the CA. A model of Confidentiality Agreement will also be prepared by the Coordinator to be Page 13/51

14 signed by Collaborating stakeholders or External experts, when necessary. Task 1.2: Technical coordination (Task leader: DGS FR) The technical coordinator, DGS FR, will ensure the implementation and the monitoring of the technical part of the JA. It will deal with the: - Assessment of the results with regards to the stated objectives - Coordination of activities within and between WPs - Monitoring the conformity of the deliverables with the assigned objectives - Preparation and submission to the EC of periodic and final technical reports based on reports and supporting documents provided by the WP Leaders - Preparation and submission to the Steering Committee of an internal interim technical and financial report every six months, aiming to assess any scientific or financial deviation compared to the plan and take appropriate correcting measures (together with ANSES) - Communication among participants, WP leaders and JA coordinating team, with respect to the timely delivery of milestones and deliverables - Submission of the JA Deliverables to Chafea, after prior validation by the Steering Committee. Task 1.3 Quality Assurance scheme (Task leader: ANSES) A quality manual will be prepared and provided to the partners. This manual will provide tools and templates for the reports and different tables and forms that will have to be completed by the partn Work Package 2: Dissemination activities Start month: 1 End month: 27 Work Package Leader: ISS Task 2.1 Dissemination Plan A detailed dissemination plan will identify goals, including the description of the dissemination strategy, timeline, appropriate methods and tools, taking into account the European and national target of the dissemination. Besides the implementation of the website, the dissemination activities of the partners could include the participation in events of EU interest and other activities in order to disseminate the results of the JA. The Dissemination Plan will be updated about every 8 months. SubTask Visual identity of JA The JA will follow the corporate communication policy of the EU, but the JA needs to be clearly identified. For this reason, a visual identity will be defined, and it will be used in all publications related to the JA (website, reports, presentations, etc.); through the visual identity the activities and results of JA will easily be recognised. The visual identity will be officially adopted after approval by all partners. SubTask Tools Moreover WP2 will also be responsible for the preparation of a set of standardised tools to be used when disseminating the JA results (technical reports/deliverables coversheet; slide scheme to be used in event s presentations). Also, we will produce a set of basic slides on the JA that will be updated on regular basis. SubTask Stakeholders analysis Page 14/51

15 Stakeholder analysis is the first step to define the dissemination strategy. In order to enlarge the network for the dissemination, all the partners will be invited to identify interesting stakeholders in each MS and to establish contacts also with other research projects both at regional, national and European level. Moreover, all the partners will be requested to circulate the products within their institutions and collect the feedback (comments, suggestions) received from the addressees. In close cooperation with WP3 leader, WP2 partners will identify a pool of stakeholders at MS and EU level in order to create a Network that will support the dissemination and the evaluation WPs. Task 2.2 Project and develop website The main tool supporting the routine dissemination of the results will be the JA website. The website, set up in the early phase of the JA and targeted to the general public, professionals and policy makers, will provide information on the JA, updates on progress and results. The aim of this website will be to highlight the objectives of the JA and will include the most important outputs (methodologies, results, presentations, reports and recommendations) as soon as they are produced. The website will establish an open channel with stakeholders asking for suggestions and feedback. The website will follow all the communication recommendations (clarity of language for both experts and the general public, transparency, interaction with different parts of society, pictures, videos, infographs, etc.) and will use an open access resource. In order to ensure the flexibility of the content and a prompt reaction to the input from the other partners and stakeholders, the website will be built and managed by the WP2 staff. The portal will have innovative aspects, such as web 2.0 tools, (link to social networks, web-tv, podcast, newsletter, etc.). The Web strategy also provides a dedicated YouTube channel and ongoing activity on social networks. Web products (tools and database, etc.) of the other WPs will be linked to the JA web site. The website will be a work in progress, and in continual development during the whole project life. Considering the objectives, the web portal will be developed in two phases, the first with descriptive purposes, the second considering the results and the materials produced. The private area on the website will be used to support internal communication and to gather and share resources, deliverables and products useful for all the partners. The website will remain available for at least two years after the end of the project. To provide c Work Package 3: Evaluation Start month: 1 End month: 27 Work Package Leader: ATEITH Task 3.1 Evaluation strategy : The overall evaluation methodology and strategy will be developed at the early stages of the project. This plan will specify the necessary procedures and standards for the implementation, monitoring and evaluation of the project. SubTask Overview and finalization of the methodology and indicators (from Page 15/51

16 M1 to M3) Detailed description of methodology for a multirater evaluation methodology for all WPs will be developed in collaboration with each WP leader. Methodology, processes, steps and templates both for the peer review as well as for the selfassessment will be developed. Appropriate output and outcome indicators for measuring the progress as well as establishing success of the project will be finalised through the use of the SMART methodology. An evaluation plan will be drafted, describing major deadlines, steps and procedures necessary for the overall evaluation of the JA. All necessary supportive material (e.g. templates, questionnaires) will also be finalized. JA partners will be invited to answer one on-line questionnaire regarding risks and special features of their tasks in each WP. SubTask Compilation of list of external experts and selection of 3 experts. (from M1 to M3) Compilation of a list of experts from academia, national and international authorities who could contribute as external independent evaluators concerning the evaluation of the scientific results of the WPs. Respective job profiles (including skills, references, academic and scientific credits, previous experience in evaluation schemes etc) will be developed. Input from all partners and the EU will be utilized for the compilation of the list. Selection through an open and transparent procedure of three experts will be carried out. Task 3.2 Overall Evaluation of the project SubTask Systematic appraisal of the timeliness, the quality of the action and its effects. (from M3 to M27) A) Every 12 months (M13, M25) a systematic appraisal of the timeliness, the quality of the action (e.g., whether the action outcomes are useful and meet the user needs), and its effects (e.g., whether the action achieved its objectives and had an impact on the target group) will be carried out, with suggestions for corrective actions if necessary. These reports will help: Design/acquire appropriate tools to support the measures and information collection and define the baseline measurement reference point Carry out the assessment Update if needed the indicators, methodology and corresponding tools Refine the evaluation process and plan, based on the results already obtained. At M13 and M25, JA partners will be invited to fill one on-line questionnaires, and provide -if needed- additional information and supportive material to the WP3 Leader. The external experts will contribute to both Yearly reports through teleconferences. B) Two interim evaluation reports (M7, M19) will also be organized in the course of the JA. Interim reports will focus on the conduction of self-assessment process among coordinators, WP leaders (concerning possible risks, threats or corrective actions) and internal reviews by coordinator and WP leaders (concerning the cohesion of WP objectives and policy priorities). JA WP Leaders will be invited to fill 2 on-line questionnaires, before the interim reports, concerning the course of the each WP work, the conduction of a self-assessment process and internal review of JA progress overall. SubTask Final evaluation report (from M25 to M27) Page 16/51

17 An overall evaluation and synopsis of the WP achievements will be carried out. Emphasis will be given to identification of useful lessons (best practices and innovations developed, possible operational or organisational problems or difficulties faced) learnt for all stakeholders in order to support: a) collective memory of DG SANTE and CHAFEA concerning next policy initiatives, projects and programs, b) capacity building of respective par Work Package 4: Evidence (Economic rationale for action on childhood obesity) Start month: 1 End month: 24 Work Package Leader: IPH IRL 2.1. BACKGROUND Recently, Safefood published a study of the cost of adult obesity in the Republic of Ireland and Northern Ireland undertaken by a research consortium led by UCC- CHDR. In a related study carried out by the consortium, the Foresight obesity model, developed by UKHF, was used to explore the health and economic implications of projected increases in adult obesity in Ireland. Safefood is funding an Irish childhood obesity costing study, expected to commence in April 2015 and be completed in 12 months. In 2013 WHO (Europe) published nutrition, physical activity and obesity profiles for the 53 Member States. Adult (20+ year olds) prevalence data was based on WHO GHO figures. Adolescent prevalence data (10-19 year olds) was based on WHO (Europe) Health Behaviours of School-aged Children (HBSC) data; NUIG - IRL manages that study in the Republic of Ireland. Childhood (5 9 year olds) was based on WHO (Europe) Childhood Obesity Surveillance Initiative (COSI) data; NNSC - IRL manages the COSI study in the Republic of Ireland. In a related study, the Foresight obesity model was used to explore the burden of adult obesity-related diseases (CHD, stroke, type 2 diabetes and seven cancers) in the 53 countries of the WHO (Europe) region. The EConDA Project ( co-ordinated by UKHF, is currently using a consensus micro-simulation modelling approach based on the Foresight obesity model to look at cost effectiveness of obesity and tobacco interventions on cardiovascular disease, diabetes, respiratory diseases in eight EU countries: Bulgaria, Finland, Greece, Lithuania, the Netherlands, Poland, Portugal, and the United Kingdom. These studies provide useful background materials. Work Package 4 will extend the adult costing studies to childhood obesity by adapting their modeling techniques the estimation of current and future effects and costs of childhood obesity. By supplementing the chief data sources used in the WHO (Europe) s nutrition, physical activity and obesity profiles, the Work Package will provide more indepth data about childhood obesity in participating EU MSs. In EU MS participating in advanced studies (see below), Work Package 4 will provide details of costs to individuals and families as well as costs to public finances. In each participating EU MS we will explore the feasibility of estimating costs in vulnerable groups at risk of Page 17/51

18 health inequalities. Process documentation and costing templates arising from Work Package 4 can be used by non-participating EU MSs who wish to use their own national data obtain initial costings at a later date OUTLINE OF THE WORK PACKAGE We propose to conduct basic studies in three EU MS (Croatia, Italy and Portugal) and advanced studies in Ireland and three other EU MS (Greece, Romania and Slovenia). Participating EU MS include countries with relatively complete and less complete data and will cover some of the diversity in the populations and circumstances nations in EU MSs. The table below describes the differences between basic and advanced studies. BASIC STUDIES ADVANCED STUDIES Focus on core standardised / intercountry comparable data Also include their advanced country-specific data Major clinical conditions only Wider range of clinical conditions Health impacts only Also include other impacts Inputting of (adjusted) data from proxy countries More complex data imputation methods involving country-specific data The JRC as a Collaborating Partner will provide support to WP TASKS Work Package 4 will involve five tasks: Task 4.1: Establishing an International Scientific Advisory Group (Milestone D4.1) In M1 an expert International Scientific Advisory Group (ISAG) will be established to guide scientific aspects of WP4. Task 4.2: Producing an Evidence Paper and Study Protocols (Deliverable D4.1) We will review published literature and materials gathered in projects such as the ECo Work Package 5: Nutritional information monitoring and food reformulation prompting Start month: 1 End month: 24 Work Package Leader: ANSES Note: Tasks 5.1, 5.2 and 5.3 will inventory the results of large EU projects and networks, such as INFORMAS (the International Network for Food and Obesity / Non-communicable Diseases Research, Monitoring and Action Support), or SALUX (a European network to follow-up the reformulation of manufactured foods in terms of the reduction of the levels of fat, saturated and trans fat, salt and sugar).. Task 5.1: Identification of available food information Compare and benchmark, within and between all the nine countries participating in the WP, the nutritional information provided on labels of purchased foods (specially food products for children like breakfast cereals) according to the EU legislation (EC 1169/2011) and available for the families: food content, portion size, food labelling Page 18/51

19 Task 5.2: Analysis of uses of food information for nutrition policy Compare and benchmark within and between countries how this information provided on labels is used for the nutritional policy (i.e.: for reformulation by the industry and retailers, for information of public health professionals who are in contact with families, for information, education and increasing awarenesscampaigns, how it is read by citizens, other). Task 5.3: Analysis of uses of food information by families Inventory of use and understanding of this food information by families, according to their socio-economic status, in order to propose recommendations on how to reduce health inequalities through policy development and action in the area of food information. Task 5.4: Pilot studies implementation : nutritional composition comparison and monitoring network 1. Based on the French approach ( Oqali, the nutrition section of the French Observatory of Food Quality), implement a pilot study (with report) in Austria and Romania: collect the nutritional information provided on labels (EC 1169/2011), on selected manufactured foods, harmonize the analysis and presentation of this nutrition labelling data, test the use of this information for the different aims and stakeholders (public health professionals, consumer and family associations, industry members and retailers). 2. Present nutritional composition comparisons especially on fat, saturated fats, salt and sugar content. Identify best reformulations and promote possible improvements on some food categories to manufacturers. By food categories, establish nutritional composition cartographies. Thus each manufacturer can identify the positioning of their own products and characterise them in terms of sugar, salt or fat content, in order to incite them to reformulate their products to reach the best reformulation product, as identified in the inter-country comparisons and cartographies. 3. Constitute a network of monitoring systems of nutritional information, with the objective of capacity building in this area, among relevant stakeholders. Implementing this data collection and nutritional information comparisons among EU Member states, will make possible to: - estimate the nutritional composition variability - identify the best reformulations products - analyse the possible level of improvement of the food nutritional quality - encourage food reformulations - build a European monitoring network Three levels of participation (and associated approximate workload in terms of person-months): - Basic level (2 PM): o Check at own national level the food nutritional information systems identified by the WP leader (Task 5.1) o Report if this food information is used for public health nutrition policy and how (Tasks 5.2 and 5.3) o Read/check the guideline report and participate in the meetings Page 19/51

20 - Pilot study (6 PM + 2 PM of basic level) Gather food product information (especially nutritional information provided on labels) for food consumed by families (breakfast cereals, soft drinks, ) - maximum 50 products Summarize the information to show the variability of nutrient content and so possible imp Work Package 6: Healthy environments by integrated approaches Start month: 1 End month: 24 Work Package Leader: OGYEI General description of the work: There is a clear need for establishing a good governance and for effective integrated national interventions addressing the increasing trend of childhood obesity. Therefore, WP6 aims to collect and critically examine existing good practices of MSs based on a standardized protocol. Existing capacities will be assessed by web-based questionnaires and by personal interviews with key informants. The work will focus on action areas and activities defined in the EU AP and will be resulted in a state-of-the-art guidance and a web-based toolbox for programme planners and decision makers on how to design and implement effective measures that are in line with the identified needs, opportunities and resources. The social inequality aspect will be part of the analysis As a Collaborating Partner, JRC plans to provide support to a number of WP6 activities. Task 6.1: Set up a definition and criteria for good practices (from M1 to M3; duration 3 months) The aim of the first task is to develop good practice criteria in relation to childhood obesity prevention. In this context, special attention will be given to the importance of considering not only the evidence-base, ethical aspects, effectiveness, monitoring and evaluation, but also the issues of sustainability and inequalities in health. The criteria will be applied to identify good practices in Task Desk research on existing definitions for good practices in health promotion (M2) - Set up a definition and criteria within the context of WP6 (M3, D6.1) Task 6.2: Collection and overview of integrated approaches in kindergartens and schools (from M3 to M20; duration 17 months) This task concerns the collection and analysis of existing policy approaches and national level programmes, projects, initiatives and interventions designed to improve nutrition and/or physical activity or prevent childhood obesity in kindergartens and schools. - Set up a collection protocol for MSs (M5) - Collection of good practices by the 15 WP6 partners (M9) - Analysis of the collected examples with a particular focus on common Page 20/51

21 characteristics, facilitators and barriers as well as on similarities and differences between MSs and the potential impact of cultural, social and political context in which the collected GPs were planned and implemented (M15) - Draft and final report on good practices including specific recommendations for the guidance document (M20, D6.2) Task 6.3: Capacity assessment(from M3 to M20; duration 17 months) The objective of this task is to obtain an overview of existing capacities and resources for the prevention of childhood obesity in the WP6 partner countries. Each of the WP6 partners will conduct web-based surveys, while the advanced level partners will organize personnel interviews. Participants will be selected from leading organisations (representatives of organisations) and policy sectors (policymakers) relevant to the prevention of childhood obesity. Besides, some interviews with European bodies representing children/parents/teachers will carry on to better identify their needs and points of view. - Set up a web-based questionnaire and a protocol for the interviews with key informants (M5) - Stakeholder identification (involving different sectors and different levels) from the Stakeholder Pool identified within WP2 - Implementation of the web-based surveys and personal key informant interviews focusing on goals, opportunities, resources, capacities, functions, collaborations, barriers, enablers and challenges (M9) - Analysis of the collected data (M15) - Set up recommendations for the guidance document (M20) Task 6.4: Guidance on Healthy environments by integrated approaches (from M18 to M24; duration 6 months) This task will summarize the findings and create a state-of-the-art guidance and a web-based toolbox for programme planners and decision makers. The web-based toolbox will be a part of the common JANPA website, but also ef Work Package 7: Early interventions Start month: 1 End month: 24 Work Package Leader: THL Task 7.1. Description of policies and interventions on nutrition and physical activity (from M1 to M4, duration 4 months) List, compare and benchmark, within and between countries participating in the WP7 the policies and actions of nutrition and physical activity that are specifically targeted for pregnant mothers and families with small children. Review and mapout the specifically nutrition and physical activity-oriented actions and interventions that are being implemented by both government and non-governmental organizations. Collect examples on policy/national actions, implementation guidelines, follow up practices. WP7 partners need to set up definition, criteria and work plan for WP7. Selection of activities from each member states for further description and/or analysis ( zero- Page 21/51