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.
