Following the interviews of Lithuania and Romania, Marie Louyot, YOUNG50 project leader at Luxembourg Institute of Health, and Fabrice Mouche, YOUNG50 coordinator at Ministry of Health – Directorate of Health replied to the 3 questions presented by ProMIS regarding the Luxembourg approach in Young50
Present your Young50 prevention programme results adapted in your country. Which are the main finding and lessons learn to give evidence?
Luxembourg participated in the “Stay Healthy – Cardiovascular Risk Prevention – YOUNG50” project funded by the European Union health program (2014-2020) from 2019 to 2023.
The project was conducted as a collaboration between the Directorate of Health and the Luxembourg Institute of Health (LIH), from September 2021 to May 2023 in the form of a pilot project.
In order to engage general practitioners (GPs), the project was promoted to several medical associations. After a call for participation to GPs by the Directorate of Health, 15 doctors showed an interest and were trained for the project. 9 GPs finally confirmed their involvement and recruited YOUNG50 participants. The number of participants eligible by each doctor varied greatly, from 1 to 22 participants.
Of the 71 people invited to participate in the study, 47 participated in the initial study visit (consent, online questionnaire and consultation with the doctor), i.e. a good participation rate of 66%. Among them, 40 (85%) were classified as having risky lifestyle habits and are concerned by the follow-up visit. The most common risk factors were the consumption of less than 5 fruits and vegetables per day (31 participants) and insufficient physical activity (31 participants). One participant withdrew consent during the study.
Participants and GPs were contacted to assess their satisfaction for this first stage of the study. 20 participants (43%) answered the satisfaction questionnaire. The responses were all predominantly positive. 7 doctors participated in the satisfaction interview following the initial consultations. All responded positively to the question “Would you recommend this program to other general practitioners?”.
The 40 “at risk” participants were invited for a face-to-face workshop on diet and physical activity. The workshop got a 10% participation rate but 100% of satisfaction. Follow-up visits will take place from March 2023. The YOUNG50 project made it possible to test the tools developed as well as the procedures for selecting, inviting participants, screening and planning workshops.
Due to the short remaining time when we were able to actually start YOUNG50 in Luxembourg, the number of participants included is limited. However, the adherence rate is good with 66%. A high percentage of participants was concerned by at least one cardiovascular risk factor, suggesting the importance and usefulness of this type of prevention program. The first satisfaction results from GPs and participants are encouraging.
Which have been the problems incurred, the criticalities and the mitigations actions undertaken by your organisation?
A change of Principal Investigator at Directorate of Health caused a delay for the beginning of project activities in Luxembourg. In 2021, a collaboration between the Directorate of Health and the LIH was set up to gather the competences and finally launch the project.
The COVID-19 crisis had an important impact on the project: The Directorate of Health and the GPs were totally focused on it. Moreover, the participants were not receptive to other health issues.
We interacted with several GPs organizations to reach doctors and to call for volunteer GPs. A cardiologist supported the project among organizations and GPs. Adherence of GPs to the program was unfortunately low. We provided them a constant support to complete all the screening activities.
As participation of GPs and participants is voluntary, the attractiveness of the offer is of course essential. All communication supports were designed to reach and match the correct target. All material for GPs were translated in French, English and German. All material for participants were translated in French, English, German and Portuguese.
The direct involvement of Directorate of Health and the UE grant was a proof of seriousness of the project for GPs and participants.
Adherence of participants was quite good but needed several reminders for the screening questionnaire and appointment. Adherence to the workshop was low even with several reminders and several dates proposed.
The regulatory procedures needed for the project delayed the beginning of the screening activities.
Networks were used to create the prevention tool presenting the programs available in Luxembourg to give specific assistance to participants (programs for smoking cessation, nutrition, physical activity…).
How do you plan to integrate the Young50 experience and approach into your policy and sustainability plans?
YOUNG50 is already part of the Luxembourg Cardio-Neuro-Vascular National Plan (PN-MCNV). The Ministry and the Directorate of Health have decided to officially launch the PN-MCNV during the second semester of 2023.
We recently had several meetings to evaluate the next steps:
- Continuation/extension of the programme and of the collaboration between the Directorate of Health and the LIH:
- Increase the number of GPs and participants
- Refine statistical analysis results
- Conversion of the programme to a national screening
- and/or develop screening for risk factors and Cardio-Neuro-Vascular diseases with actors and tools different from those of Young50