Periodic Reporting for period 1 - MELIORA (Multimodal Engagement and sustainable Lifestyle Interventions Optimizing breast cancer Risk reduction supported by Artificial intelligence)
Berichtszeitraum: 2024-01-01 bis 2025-06-30
MELIORA is an EU-funded initiative dedicated to transforming breast cancer risk reduction through innovative preventing strategies. Breast cancer (BC) remains the most commonly diagnosed cancer in women across Europe. Although diet, physical activity, and alcohol consumption are recognised as modifiable risk factors, uptake of preventive behaviours remains low, especially among disadvantaged populations. MELIORA tackles this challenge through the development of an AI-supported, context-aware digital health intervention tailored to three key groups: i) healthy women at risk of developing BC, ii) BC patients, and iii) BC survivors. Implemented in urban and rural areas across Greece, Sweden, Spain, and Lithuania, the project targets 2,080 women in total through six pilot sites. MELIORA delivers personalised interventions via a Virtual Coach (VC), designed to support behaviour change by addressing individual needs and broader social, cultural, and environmental factors.
The project’s objectives are to:
1. Identify individual and systemic factors influencing BC-related lifestyle behaviours.
2. Design and develop a digital tailor-made intervention grounded in behavioural science (COM-B model).
3. Implement and evaluate the intervention through eight cluster randomised studies.
4. Assess feasibility, acceptability, cost-effectiveness, and scalability.
5. Engage stakeholders to facilitate long-term adoption and integration into policy frameworks.
The project’s objectives are to:
1. Identify individual and systemic factors influencing BC-related lifestyle behaviours.
2. Design and develop a digital tailor-made intervention grounded in behavioural science (COM-B model).
3. Implement and evaluate the intervention through eight cluster randomised studies.
4. Assess feasibility, acceptability, cost-effectiveness, and scalability.
5. Engage stakeholders to facilitate long-term adoption and integration into policy frameworks.
In the first project period, MELIORA carried out extensive activities under multiple work packages. Under WP3, three literature reviews were completed and a contextual analysis conducted in the four implementation countries. Participatory workshops involving patients, survivors, healthcare professionals, community actors, and policymakers were held to identify barriers and facilitators to behaviour change. Additionally, a comprehensive set of 27 evidence-based implementation strategies was developed to support the successful adaptation and delivery of the MELIORA solution across the four implementation countries. The design of the pilot study was led by WP4, including the creation of content focused on physical activity, structured around the COM-B model and behaviour change techniques like goal setting and self-monitoring. Materials were reviewed, translated into four languages, and underwent user testing. Standard operating procedures (SOPs) for participant recruitment, BMI measurement, app usage, and assessment protocols were also documented to ensure harmonised execution across study sites. WP5 focused on the technical development of the MELIORA application system, including the architecture and specifications of the Virtual Coach Intervention. Meanwhile, preparatory work for cost-effectiveness and scalability assessments were initiated under WP6. The MAFEIP tool was selected for economic modelling, and a Scalability Assessment Methodology and Scoring (SAMS) system was drafted based on cross-country data. Preparations for implementation of the main intervention under WP7 advanced through finalisation of the study design, stratified randomisation methodology, and completion of the tools for process and impact evaluation.
MELIORA advances the state of the art in breast cancer prevention by integrating AI-supported, context-sensitive digital tools and behaviour science, to deliver personalised interventions. Unlike existing technologies that typically support post-diagnosis symptoms management or life quality improvement of survivors, MELIORA proactively reaches out to all women, including at-risk population both in urban and underserved, rural areas—while accounting for structural, personal, and sociocultural barriers. The system is designed to support personalised behavioural guidance that considers individual context and adapts recommendations to user preferences, behaviours, and environmental conditions. MELIORA’s approach acknowledges that sustainable behaviour change requires more than knowledge—it depends on motivation, capability, opportunity, and consistent support. At the same time, MELIORA envisions positive ripple effects across generations by influencing health behaviours in mother-daughter dyads. This broader potential aligns with prevention efforts targeting behavioural risk factors during critical developmental windows.