YOUNG50 - effectiveness of the Italian CARDIO50 best practice transferred to other EU Member States
Authors: Boccuzzo G , Silan M , Michieletto A , Rovai E , Tamang M E , Bressan V , Golin P , Benacchio L 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): European Health and Digital Executive Agency (HaDEA) - funded under the European Union’s Health Programme (2014-2020).

Introduction
Young50 is a European project that aims to promote the prevention of cardiovascular diseases by transferring the Italian CARDIO50 screening model within the Member States of the EU. The programme provides for the measurement of lifestyles and cardiovascular risk parameters of 50-year-olds, in order to support them towards appropriate prevention and diagnostic-therapeutic pathways.

Purpose
The aim of the work is to illustrate the project and the main evidence that emerged in terms of appropriateness of the approach used and evidence on the effectiveness of the protocol.

Data and methods
The population of interest consisted of a sample of cohorts of 50-year-olds residing in the test catchment area between 2008 and 2019. Subjects with diagnosed clinical conditions were excluded. Invitations were sent to 30,132 subjects; of these, 56.6% (17,044) participated. Participants were categorised into 4 different cardiovascular risk groups (A, B, C, D): A: normal cardiovascular risk parameters and healthy lifestyles; B: normal parameters but unhealthy lifestyles; C: parameters outside the standard; D: subjects already in therapy. Subjects belonging to B were interviewed and counselling was carried out based on the subject's behavioural risk factors. These factors were: diet, alcohol, physical activity, smoking, BMI, and abdominal circumference. After the counselling intervention (T0), most of the subjects were invited to return after a period of between 6 months and a year (T1), in which the condition of the subject was re-evaluated compared with the first interview.

Results
47% of participants belonged to group B (7,967); 4,876 were invited to T1. Among them, 43% adhered to follow-up (2,098). Of the remaining participants, 19% belonged to group A (24% women, 13% men; 26% graduates, 12.6% elementary school qualifications), 25% to C (16% women, 26% men), and 9% to D.
Among the participants in B at T0, 34% presented unhealthy diet, 10% alcohol overconsumption, 30% lack of physical activity, 52% a high BMI, 65% abdominal circumference above the norm.
At follow-up, 68.2% of the participants remained in B, 15.4% improved passing into A (19.7% women, 10.2% men; 21.6% graduates, 11.3% elementary school), whereas 16.2% worsened to C or D.
The most significant improvements were observed within the group that remained in B: 52% improved diet (13% worsened), 40.1% alcohol (2.6%), 53.7% physical activity (30%), smoking 18.8% (1.1%).

Conclusions
Significant improvements were observed at the end of the programme in the reduction of behavioural risk factors. Both the participation rate and the initial conditions were better for women and more highly educated subjects.
These results suggest the effectiveness of the programme, which needs to be even more personalised with respect to the profile of the person, who, depending on their characteristics, is more or less sensitive to the initiative.