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Countering diet-related diseases through competitive regional food- and physical activity clusters

Final Report Summary - AFRESH (Countering diet-related diseases through competitive regional food- and physical activity clusters)

Executive Summary:
Executive Summary

The economic burden caused by a high prevalence of diet-related and inactivity related, so called non-communicable, diseases (NCDs) is immense. The epidemic proportion of NCDs is one of the single largest costs to European public health systems. It is the association of unhealthy nutrition with decreasing levels of physical activity that causes the epidemic of NCDs. AFRESH therefore aimed to develop an European Joint action plan for reducing diet- and physical inactivity-related (chronic) diseases, such as diabetes, obesity, cardiovascular diseases and various types of cancer, by designing innovative regional strategies for products and services, policy actions and research activities within the field of nutrition and physical activity.

Following this logic, the acronym “AFRESH - activity and food for regional economies supporting health" was selected. To achieve the aim of an adequate and multidisciplinary regional joint action plan at the heart of the project, a detailed work plan was followed. Firstly, existing clusters and their stakeholders were mapped and the offers, needs and demands of the regions have been evaluated. In the next step, the strengths and weaknesses and the opportunities and threats of the regional health clusters regarding the above mentioned topics were checked in workshops and study visits in the eight involved regions: Eszak-Alfold/Hungary, Flanders/Belgium, Galicia/Spain, Languedoc-Roussillon/France, Mazovia/Poland, Merseyside-Liverpool/Great Britain, Nijmegen/The Netherlands, Stuttgart Region/Germany. The results of the regional analysis led to the creation of the AFRESH joint action plan. Besides the objective of developing a multidisciplinary joint action plan and a research products and services agenda, the mentoring of less developed regions has been a crucial objective of the project to help those regions to “get on board” where the collaboration within the triple-helix is not fully developed or where parts of the triple-helix is not yet integrated. These objectives led the project consortium to search for further funding opportunities within the European framework and made them look for opportunities to finance the implementation of the joint actions through national funding streams, too. All actions of the work packages have been accompanied by dissemination and communication activities at a European and regional level to guarantee the visibility and transparency of the work done by the partners and the awareness raising of the population, the policy actors and the economy.

Project Context and Objectives:
Summary Description of the Project Context and Objectives

In the White Paper "A Strategy for Europe on Nutrition, Overweight and Obesity related health issues", COM (2007) 279 final, the European Commission has identified poor diets and low physical activity levels across the EU population as a cause of future chronic diseases, resulting in a negative life expectancy in the EU and an increasing amount of health costs. Thereby it is argued that actions should be developed including policy actors, economy and academic institutions, engaging a wide range of public and private actors. The actions should aim at a necessary link between healthy nutrition and physical activity. Especially at the regional level, the collaboration between triple-helix actors should be improved and the regional strengths should be emphasized and enhanced according to the Smart Specialization strategy of the European Union, see Communication from the Commission “Regional Policy contributing to smart growth in Europe 2020”, COM (2010) 553 final.

The economic burden caused by a high prevalence of diet-related and inactivity related, so called non-communicable, diseases (NCDs) is immense. The epidemic proportion of NCDs is the single largest costs to European public health systems. It is the association of unhealthy nutrition with decreasing levels of physical activity that causes the epidemic of NCDs. There is strong evidence showing that physical activity and healthy food have beneficial effects on the pathogenesis of all important metabolic syndrome-specific disorders (insulin resistance, type 2 diabetes, dyslipidemia, hypertension and obesity), all important heart and vascular diseases (coronary heart disease, chronic heart failure, intermittent claudication), and osteoporosis. As a result, altering nutrition and food intake and enhancing physical activity are obvious mechanisms to stop the increase of NCDs, rather than by traditional medical and pharmaceutical approaches. The adoption of unhealthy lifestyles by consumers is intimately linked with the supply of products and services by the economic system. Food production is strongly driven by consumer preferences, but trends and consumer preferences are not always in favor of healthy living. Additionally, there are substantial barriers for physical activity. Physical, economic, political, socio-cultural and environmental factors influence food intake and physical activity. Examples are food outlets, gastronomic traditions, lifestyles, working conditions, social burdens, sports infrastructures, or the “walkability” and ”bikeability” of a region.

AFRESH therefore aimed to develop a joint action plan for reducing diet- and physical inactivity-related (chronic) diseases, such as diabetes, obesity, cardiovascular diseases and various types of cancer, by designing innovative regional strategies for products and services, policy actions and research activities within the field of nutrition and physical activity. Following this logic, the acronym “AFRESH - activity and food for regional economies supporting health" was selected. To achieve the aim of an adequate and multidisciplinary regional joint action plan at the heart of the project, a detailed work plan was followed. Firstly, existing clusters and their stakeholders were mapped and the offers, needs and demands of the regions have been evaluated. In the next step, the strengths and weaknesses and the opportunities and threats of the regional health clusters regarding the above mentioned topics were checked in workshops and studies in the eight regions. The results of the regional analysis led to the creation of the AFRESH joint action plan. Besides the objective of developing a multidisciplinary joint action plan and a research products and services agenda, the mentoring of less developed regions has been a crucial objective of the project to help those regions to “get on board” where the collaboration within the triple-helix is not fully developed or where parts of the triple-helix are not yet integrated. These objectives led the project consortium to search for further funding opportunities within the European framework of funding schemes and made them search for opportunities to finance the implementation of the joint actions through national funding streams. All these actions of the work packages have been accompanied by dissemination and communication activities at the European and regional level to guarantee the visibility and transparency of the work done by the partners and the awareness raising of the population, the policy actors and the economy. Therefore dissemination actions are also crucial for the project.

The main tasks of the first project period were to develop a stakeholder map (Work Package 1) of the regional Research-Driven Clusters (RDCs), to analyze the needs and demands, and to compare the known and unknown demands at the consortium level (WP 2), to realize a SWOT and SOR analysis in the eight participating regions (WP 3) and to prepare Joint Action Plan and Business Plan (WP 4).

During the second reporting period Research and Funding Ideas (WP 6) and Product and Service Ideas (WP 7) are of central interest, while Mentoring and Change Management Toolkit (WP 8) has been started and finalized. Dissemination activities (WP 5) and project management (WP 9) have accompanied the project throughout. The AFRESH project had to revise Joint Action Plan and Business Plan until the end of the project.

Objectives of the project in detail

WP 1 should give a profound insight in the offer of research competences and infrastructures of the food RDCs and the physical activity RDCs in the partnering regions specific objectives:

1) develop a typology of food- and physical activity RDCs
2) To identify the main stakeholders in each region, through this typology
3) To describe the impact of each RDC and to compare RDCs
4) To describe the role of policy in the development of RDCs

Work Package 2 has to do an analysis of the demands and the needs for nutrition and physical activity products, effective and sustainable interventions and services in the partnering regions.

1) To generate knowledge and hypothesis for the following research priorities
2) To find common methods and instruments
3) To select research priorities

Work Package 3 should establish a set of research priorities – understood as health needs to be aimed at by mobilizing economical production factors available in the RDCs – based on the research agendas in the regions and complementarities between the partnering regions.

1) To formulate strategic objectives that should be aimed a by research priorities
2) To brainstorm on research options
3) To appraise these options against a set of criteria
4) To select a set of research priorities by using Strategic Orientation Rounds (SOR) and SWOT-analysis

Work Package 4 has to develop a Joint Action and Business Plan with a trans-national integrated research agenda.

1) To translate the research and product innovation priorities into an Joint Action Plan
2) To define the guidelines for implementation and an integrated Business Plan
3) To revise the Joint Action Plan after a first presentation by the end of the project, after the first actions have been implemented

Work Package 5 has to disseminate the project ideas and objectives and of course the results by different communication means.

1) To write a plan of the dissemination of results
2) To establish a database of relevant target groups for dissemination
3) To establish a website, public and private section; updates
4) To achieve effective knowledge transfer towards all target groups and in particular towards the business community
5) To organize scientific conferences incl. Food-Cluster Initiative meetings, hearings, presentations and press conferences

Work Package 6 has to develop measures how to realize the Joint Action Plan in the fields of research and project funding.

1) To screen for research ideas
2) To collect research ideas
3) To screen funding opportunities
4) To match funding opportunities with project ideas
5) To organize stakeholder events
6) To set up a training on research preparation

Work Package 7 has to develop measures for realizing the Joint Action Plan through cooperation with the regional economy towards future service and product ideas.

1) To collect ideas for new concepts for products and services
2) Screening of funding opportunities
3) To match potential funding opportunities with ideas
4) To organise events to bring potential partners together and to brainstorm on future strategies for product and services innovation development
5) To monitor and to describe the development of concepts for innovation

Work Package 8 has to develop a change management toolkit for regions with less experience in triple-helix networking and knowledge transfer.

1) Developing a change management toolkit for RDCs
2) Testing, refining and finalizing the toolkit
3) Improving the skills for project development

Work Package 9 is the coordination and management work package and has to lead the project from an administrative, technical and strategic point of view.

(1) To safeguard and manage a clear strategic vision throughout the project
(2) To guarantee an effective and efficient organization of the project
(3) To organize the communication between partners, with the EC and third parties

Project Results:
Description of the main S & T results/foregrounds

The main result of the AFRESH-project is a multidisciplinary joint action plan, which entitles the regions to implement tailor-made solutions for regional enterprises, public bodies, societal groups and academic institutions in the fields of Nutrition and Physical Activity. The AFRESH Project is structured into nine work packages, while two of them are dissemination and project management, the others are contributing on the way to the AFRESH Joint Action Plan.

Introduction

For developing a typology of RDCs, the stakeholders that are involved in regional clusters of physical activity and/or food concerning health, were identified and placed in a stakeholder map by beneficiary Radboud University Nijmegen Medical Centre (RUNMC) in WP 1.

University of Stuttgart (UStutt), third party related to Wirtschaftsförderung Region Stuttgart (WRS), was responsible for the analysis of needs and demands (WP 2). From that data, the consumer preferences for all participating regions were assessed. To compare offer and demand and analyze complementarities at consortium level, UStutt set up matrices for each participating RDC. Specifically, initiatives assessed in WP1 were grouped by their focus (nutrition, physical activity, people/business/knowledge), impact and their objectives listed. From WP2 latent and manifest needs and demands were included in all further activities of the project.

In the next step University of Ghent (UGent) identified the main internal strengths and weaknesses, as well as external opportunities and threats of each RDC (WP 3). For the actual SWOT, a one-day workshop was organized in each region between May 2011 and October 2011. A minimum of ten to a maximum of 15 triple-helix-stakeholders from research organizations, public authorities and enterprises were invited to this workshop. The results of the SWOT were then included in the Strategic Orientation Round (SOR, 10x10 matrix).

The Joint Action Plan (WP 4) has been elaborated under the lead of the Agropolis International (AGRO). The WP started with the organization of study visits in all eight regions. The results of the SWOT/SOR of WP 3 have been used as the starting point for WP 4. The partners agreed to have four working groups (children and young people, healthy ageing, work-site and disadvantaged) to further elaborate the JAP. For each working group the partners agreed to organize a brainstorming meeting . The results of these meetings became the basis for generating and selecting innovative research ideas and ideas for products and services.

WP 6 identified possible research funding opportunities under the lead of the Research Institute for Sport and Exercise Sciences (RISES) of Liverpool John Moores University. Some potential European funding streams were identified. Other funding opportunities will have to be identified in the future by all partners in order to implement the joint actions. This includes Horizon 2020, which has just started, now that the AFRESH project is over.

WP 7, under the lead of ANFACO CEOPESCA (ANFA), was directed at the implementation of product and service ideas of the project in regions. WP 6 and 7 helped to develop the ideas for the JAP. The consortium tried to concretize the ideas of the JAP with regional stakeholders and potential funding institutions. First follow-up proposals have been developed and submitted.

In the frame of WP 8, under the lead of INNOVA, a Change Management Toolkit was developed to help the regions with less developed clusters or less developed nutrition and physical activity collaboration to receive advice and mentoring on the necessary processes to foster highly competitive clusters with a dual approach on physical activity and nutrition. The toolkit was tested in workshops in Poland and Hungary and were finally discussed in Brussels in December 2013.

The work on the objectives of the project have been accompanied by dissemination actions (WP 5) like the launch of the website, trade fair and conference stands, leaflets in all partner languages, various press releases and other press services, by creating roll-ups and by giving lectures on the project topics. Furthermore, the management of the project (WP 9) organized the meetings of the Project Management Team and has been responsible for all administrative and organizational challenges of the project. Both WPs were led by WRS.

Overview about the project results

According to the project vision the major expected final result has been to achieve an economy-related joint health strategy using or improving the synergies of physical activity and nutrition related actions. As the project has focused on economic matters, this strategy should not solely be a public health strategy with actions only financed by public means, it should be a strategy combining all three parts of the triple-helix, public bodies, enterprises and academic institutions. We therefore expected enterprises to attribute capital towards the implementation of the joint actions because they will see the advantages of the further joint actions as we expected to participate successfully in European and national calls and funding schemes with new proposals to gain money for future projects. To realize the planned actions of the Joint Action Plan it is crucial that the suggested actions can be financed. First results show that regional enterprises are interested in financing projects of the JAP, especially in the Health@Work-sector, other results show that the ideas of the JAP has to be developed and improved with further research projects to be successful by gaining interest of the regional stakeholders.

As the AFRESH-consortium agreed in Work Package 4 (Joint Action Plan) to plan the joint activities for the following four key areas: “Children and young people”, “Healthy ageing”, “Work-site” and “Disadvantaged people”, the partners expected to gain different groups and institutions for joint future projects. With service and product ideas, with chances for policy actions, and with research strategies, the project wanted to motivate all parts of the triple-helix in the regional research-driven clusters (RDCs) for future collaboration. The White Paper on a Strategy for Europe on Nutrition, Overweight and Obesity related health issues, COM (2007) 279 final, stresses the regional and local approach. Therefore the future projects should be relevant for the regional and local sector and the partners, especially in mentored regions, should learn from the other regions and should apply together for European financial support. In the sense of the Smart Specialization strategy of the Communication from the Commission “Regional Policy contributing to smart growth in Europe 2020”, COM (2010) 553 final, the partners of the AFRESH project should focus on regional strengths and should motivate other partners from outside the consortium to join the consortium for future projects.

Finally we reached the following expected results:

1. Stakeholder Map of the participating Research-Driven Clusters including the regionaloffers
2. Analysis of the regional needs and demands
3. SWOT and SOR analysis of the participating regions
4. Joint Action Plan/Business Plan with round 30 draft and 18 final actions
5. Various dissemination actions, highlights included the Food Cluster Conferences in Gent and Brussels, the Health Connect Conference in Stuttgart, the AFRESH Closing Conference in Warsaw and the Final Stakeholder Event in Brussels.
6. The regional implementation of the research and product and service ideas of the Joint Action Plan
7. Mentoring actions and a mentoring toolkit for regions which need to be mentored
8. Socio-economic impact in the participating regions: Improved information and awareness of public and private actors, better collaboration between triple-helix actors, regional actions to decrease the amount of persons with diet- and physical-inactivity related diseases and first steps to reach long term economic success of the regional health-related industries.

The results of the Work Packages in detail

Work Package 1 Comparison RDC Offer

Different stakeholder groups and the regional stakeholders for the Afresh regions were identified.
Stakeholders that are involved in the regional clusters of physical activity and/ or food concerning health were identified through evaluation of the regional collaborative projects in healthy nutrition or physical activity. Out of these projects eight different stakeholder groups were distracted ranging from governmental institutes to knowledge institutes and health insurances.

The partners contributed to the WP as aimed in the DoW. WRS/UStutt held a meeting in Stuttgart to choose a common approach for offer and demand for WP1 and WP2 as basis for the following process. The other beneficiaries met their regional partners to discuss the following process of the WP with them.

Based on the identified stakeholders in task 1.1 and based on collaboration within innovative projects related to food or/ and physical activity stakeholder maps were drawn up for all 8 regions. These maps were made using the program Netdraw (http://www.analytictech.com/) and an Access database. RUNMC prepared a survey in three different languages. All RCPs and their regional stakeholders were asked to fill in the current regional initiatives and those who were completed in the last 5 years, using an internet based survey. Also it was asked to fill in the contact information of the project leaders of these initiatives. These initiatives consisted of regional projects, organizations or facilities that are undertaken in the different regions and focuses on food/ nutrition or/ and physical activity. To all project leaders of the initiatives in the first list a second internet based survey was send in which more detailed information on the project, the partners involved in the initiatives, duration of the project and the financial status of the project.

The consortium agreed that each partner has to list regional initiatives from the business, academia and public sectors. Besides the surveys the regional partners held stakeholder meetings in their RDCs to screen the regional initiatives and to discuss the connections between the networks and partners. Potential regional stakeholders for physical activity and diet were identified, contacted and mapped over a period of 6 months. Though many stakeholders were identified, challenges involved finding and engaging SME’s and reaching relevant organizations. Significant time was invested in personal meetings and email contact with key stakeholders about the project and in assisting them with completion of survey/typology to inform stakeholder maps.

Impact analysis through the stakeholder map was performed. RUNMC identified different impact indicators in three categories; society, knowledge and business. The impact indicators are related to the typology of the clusters performed in task 1.1. All regions collected these numbers on the impact indicators. RUNMC collected all regional data and compared these data between the clusters. For the differentiation of the stakeholders NACE-codes were used.

In the frame of WP1 identification and typology of interventions aimed at healthy eating and physical activity conducted during last 5 years were undertaken (initiative category, scope and triple helix partners of the initiative, type of intervention: physical activity, nutrition or other, main outcomes, contribution to the innovative capacity of the region, type of funding). The regional partners elaborated databases to collect information. The partners were using the Nomenclature Statistique des Activités économiques dans la Communauté Européenne (NACE) – Codes for this process. A description of the economic impact in the regions were made by the partners.

For example a database of interventions was built by WULS with support of SANTE through website’s searching, personal interviews with managerial staff in institutions and bodies and correspondence (by mail and conventional post service) for the Mazovia region. WULS identified the main stakeholders of initiatives and target population groups. The expected or achieved impact of initiatives on population’s health and physical activity were shown as well as their contribution to the regional development. The performed activities gave a profound insight in the offer of research competences and infrastructures of the Mazovia region. WRS/USTUTT, UGENT, MENS, AGRO, ANFA, RISES, INNOVA and their partners did the same for their clusters.

In order to describe the governmental influence all stakeholders but the governmental institutions were filtered from the stakeholder map. On these ‘governmental’ maps one can see where the government is linked to which initiatives and stakeholders. In addition every region analyzed regional policy-, vision- , and strategy documents and the corresponding measures and goals of governmental institutions on business development, knowledge accumulation and improving society’s health to develop the clusters on food, health and physical activity in their region. The regional contact persons (RCPs) collected these documents for the region and for every document the RCP filled in a form in table 3. Most important of this task was the comparison between document and stakeholder map. The comparison shows to what extent the policies are implemented in the region. All regions performed an analysis comparing data and the stakeholder map.

The reliable listing of existing regional initiatives, exchanges between stakeholders of the triple helix, exchanges between stakeholders from the 2 AFRESH areas (physical activity and nutrition) who did not know each other before, fruitful discussions about the mapping of stakeholders and finally an overview of the regional landscape on the AFRESH areas with the stakeholder map were the clearly significant results of work package 1. The results of WP1 were also highly relevant input for Work package 2. The amount of regional initiatives was enormous, for example in France 85 relevant initiatives for the Languedoc-Roussillon region were counted by AGRO.

Work Package 2 Comparison health need and demand

UStutt developed a concept for manifest demands: An economic approach as a theoretical framework for WP 2 was choosen, UStutt developed a standardized checklist and sent it to all RCPs to asses manifest data of all RDCs. UStutt was gathering results from participants to assess the manifest market demand for health related nutrition and physical activity topics. Each region delivered one completed checklist including all gathered data for each point of the checklist. Out of the data the consumer preferences for all participating regions were assessed.

The partners gathered the necessary available data on needs and demands in their regions. For example INNOVA as RCP of Eszak-alfold and DEB were involved in the data collection process in the fields of physical activity and nutrition in Hungary. KATKER supported INNOVA and DEB by doing this job. The data collection targeted all data available on consumer preferences by applying the proposed categories provided by UStutt.

Especially the example of Mazovia shows the process in an excellent way. The task to assess manifest needs and demands regarding nutrition and physical activity in Mazovia region was achieved using a universal questionnaire (checklist) prepared by UStutt. To fulfil three parts of the checklist secondary sources of data and information were collected for Mazovia region by WULS with support of SANTE and MODR. They provided WULS with information concerning general characteristics of Mazovia population, including personal and cultural values in the field of nutrition and PA, prevalence of diet-related diseases (part 1). To identify the needs and demands in the field of nutrition and physical activity of Mazovia population information was collected on the: healthcare institutions and medical personnel, sport and physical activity services, triple helix institutions involved in food and nutrition issues, food consumption patterns based on data from food balances and household budget surveys, with special attention regarding healthy food, food distribution channels, expenditure on food and physical activity services, consumption of physical activity oriented products and services, other aspects of life style (part 2). The barriers in context of nutrition and physical activity were presented part 3. Collected information allowed to conclude that there is a strong need to develop further healthy lifestyle programmes and initiatives targeted to selected population groups in the Mazovia region. Such activities require cooperation of main stakeholders in the food chain, including business, education, policy, especially food and nutrition policy, financial sector, as well as involvement of individual consumers.

UStutt developed a concept for latent demands. As a theoretical framework for WP 2 the economic approach was chosen. To assess latent needs and demands UStutt was using the Delphi method to analyze latent needs and demands in a 2 wave procedure through expert interviews, questionnaire and consensus conference via telephone. UStutt was gathering results from the expert interviews (1st wave; latent market demand) in the regions. Each region delivered 6 transliterated interviews in English including the triple helix as well as the physical activity and nutrition pillar. In the second wave the main statements were sent to the RCP to review and rank the main topics (2nd wave; latent market demand). Subsequently a consensus conference with all WP-leaders was done via telephone to confirm all generated and selected results.

UStutt set up tables to compare latent and manifest needs and demands (main statements of the Delphi interviews and results of the checklist). UStutt did a comparison of known and unknown demand for each region, using it for the matrix in the frame of the next task but also for the further regional plans.

To compare offer and demand and analyze complementarities at consortium level, UStutt set up matrices for each participating RDC. Included were the results of WP1 and WP2 manifesting in a comparison of RDC offer and demand. In detail the initiatives assessed in WP1 were sort by their different focuses (nutrition, physical activity, people/business/knowledge), impact and a list of their objectives. Out of WP2, latent and manifest needs and demands (main statements of the Delphi interviews and results of the checklist) were included in the analysis. For analyzing complementarities of the RDCs at consortium level, UStutt defined three cases out of the economic approach. If offer matched the demand there was a market equilibrium existing. This was defined as balance. In case the offer exceeded the demand or in inverse case, there was an imbalance manifesting in an excess supply or an excess demand. If offer correlated with demand but did not meet, it was defined as mismatch. All regions were involved in this process through reviewing their regional matrices.

WP2 has one deliverable: D2.2 “Comparison health need and demand”. Within WP2 the latent and manifest needs and demands for health related nutrition and physical activity products and services were assessed for all RDC. Concerning the manifest demand not from all regions comparable data of all points of the checklist available or were found. Therefore UStutt generated main indicators for enable a comparison between the regions. The indicators are based on the criterions comparability and availability of the data. In detail for demographic characterization, number of inhabitants, age structure, sex, income, stratification of population, education and religion could be found as main indicators for each region. Concerning the specific characterization, Body Mass Index (BMI), personal barriers for physical activity (p.a.) and volume of p.a. were selected. The manifest needs are represented by the prevalence rate of diet related and inactivity related diseases. The manifest demands include professions, institutions, programmes and environmental factors as well as consumption of products and services in terms of nutrition and p.a. For the latent demand, there were together 54 interviews from all RDCs analyzed by UStutt. There was a difference between Western and Eastern European regions noticeable. In Eastern European Regions the experts stated to have less budget available but innovative concepts in frame of dynamic countries. There was a general need to invest in lacking infrastructure. Further for nutrition and p.a. traditional values were in foreground. In Western European regions the experts stated the desire to have more budget available and better technology, therefore there was an increased demand for technological innovative products and services (ICT applications, etc.). Concerning values more fast food-and single household-culture were in foreground. For all regions price was the main motive for choosing groceries and p.a. related products and services. In frame of the next steps latent and manifest needs and demands were compared. Afterwards The aggregated demand was compared with the offer that was generated in WP1. All facets of offer and demand were subsequently compared in matrices for all regions. As main result, there were mismatches, balances or imbalances between different facets of offer and demand noticeable. The result of WP2 was therefore used as valuable input for the subsequent WP3.

Work Package 3 SWOT and SOR analysis

WP3 was the establishment of a set of research priorities – understood as health needs to be aimed at by mobilizing economical production factors available in the Research Driven Clusters – based on the research agenda in the regions and complementarities between the partnering regions. This WP had four specific objectives in order to reach the overall aim: 1) to formulate strategic objectives that should be aimed at by research priorities; 2) to brainstorm on research options; 3) To appraise these options against a set of criteria; 4) To select a set of research priorities. The work package has achieved its objectives. WP3 has 1 deliverable: D3.3 “Integrated list of regional objectives for each cluster based on the SWOT and SOR analysis”. The deliverable 3.3 was submitted in time.

A SWOT analysis identified the main internal strengths and weaknesses, as well as external opportunities and threats of each Research Driven Cluster. For the actual SWOT, a one-day workshop was organized in each region between May 2011 and October 2011. Minimum 10 to maximum 15 stakeholders from research organizations, local authorities and private sector were invited for this workshop. In order to translate the statements of the SWOT analysis into strategic objectives, every region performed a SOR (Strategic Orientation Round). While the SWOT makes a situational analysis of the RDC, the SOR is used to come to an actual strategy to achieve the vision of the RDC. The majority of the SOR outcomes presented an ‘attack’ strategy for the RDC, except for two regions who found themselves in an ‘attack’ as well as a ‘crisis’ situation. The dominant ‘attack’ strategy means that the RDCs perceive a lot of opportunities for the development of innovative products and services in the field of physical activity and food regarding their strengths. As this is AFRESH’s main goal, the attack outcome is a good outcome of the SOR.

With SWOT&SOR workshops the regions analysed their cluster with the help of UGent:

Dates of the SWOT/SOR workshops

Belgian SWOT/SOR (in Ghent) June 9, 2011
Polish SWOT/SOR (in Warsaw) June 28, 2011
Hungarian SWOT/SOR (in Debrecen) July 4, 2011
English SWOT/SOR (in Liverpool) September 13, 2011
Spanish SWOT/SOR (in Santiago de Compostela) September 21, 2011
Dutch SWOT/SOR (in Nijmegen) September 28, 2011
German SWOT/SOR (in Stuttgart) October 4, 2011
French SWOT/SOR (in Montpellier) October 26, 2011

The SWOT analysis presents for each RDC a table with 5 strength, weaknesses, opportunities and threats. It provides a structured insight on where the RDC is now (internal/external audit of the current situation). Strengths and weaknesses concerned mainly the maturity of the RDC and the partnerships within. Opportunities and threats were often referring to new technologies, existing programmes outside of the region, and the current economic situation. For all the regions the SWOT results were included in a SOR matrix in order to define the strategic objectives of the RDC.

In order to translate the statements of the SWOT analysis into strategic objectives, each RDC performed a Strategic Orientation Round (SOR). The SOR relies on the outcome of the SWOT analysis and is a planning instrument that is used to define strategic objectives through a participatory method. While the SWOT makes a situational analysis of the RDC, the SOR is used to come up with, and build consensus regarding, an actual strategy to achieve the vision of the RDC. The 5 most important Ss, Ws, Os, and Ts were included in a SOR-matrix, which was scored by each stakeholder attending the workshop. The outcome of the SOR was 4 objectives which are important, relevant and possible in the region. The regional objectives ware later compared with objectives of other partners. At the end of each SWOT/SOR workshop, a completed SOR-matrix was generated as relevant outcome. The overall dominant strategy of the SOR-matrixes was an ‘attack’. Most RDCs perceived a lot of strengths for their RDC that are suited to exploit and achieve current opportunities.

Each RDC formulated 3-4 research priorities based on the results of the SOR and SWOT.
These priorities were merged and used as input for WP4. With this information it is more convenient to develop the JAP and innovative ideas based on expertise since every RDC knows its own possible contribution better.

Work Package 4 Joint Action Plan and Business Plan

Study visits in the 8 regions have been organized by the regional partners with a follow-up by AGRO. AFRESH partners and external experts (from the other AFRESH regions) got the opportunity to gain an insight into the initiatives (projects, structures) offered in the different RDCs, as well as to discuss regional priorities and assess concrete needs. The visits consisted of a combination of visiting initiatives in the areas of nutrition and/or physical activity, involving stakeholders belonging to the 3 pillars of the triple helix. These visits enabled sharing of expertise, experiences and best practises between the different clusters. Normally round 5 to 6 initiatives or stakeholders were visited. For example during the study visit in Mazovia, organized by WULS, SANTE and MODR, there were organized five stations with the opportunity to present and then discuss with project partners 8 initiatives, guided by governmental bodies, capital authorities, university, business sector and media. The groups visiting the regional initiatives and stakeholders during all eight study visits consisted of national experts from the relevant region and the experts from the other beneficiaries and their regions. For example INNOVA took the possibility and invited 2 regional sport experts to the study visit in the Netherlands in September 2011. The visit allowed the experts to learn best practices about organizing successful clusters and sport related initiatives, which can be used in the home regions for developing the newly established Regional Sport Cluster and for the regional experts and initiatives is was the chance to discuss relevant matters with the foreign experts. As the written example shows, the other partners also did. They took part in a minimum of two foreign workshops each and they all sent their regional experts to workshops in other regions. Finally round 40 regional initiatives and stakeholders were visited by more than 50 regional or national experts and consortium partners during eight study visits. Therefore a really excellent exchange of ideas, concepts and future funding possibilities happened.

Together with the Study Visits the SWOT & SOR analysis (Work Package 3) was realized. The result was 31 regional research priorities as basis for the Joint Action Plan. Each partner or stakeholder involved in the project could express his interest in developing projects on one or several of the 31 regional research priorities defined in the course of WP3. Common interests between the regions could be identified. During a two-day workshop in December 2011 in Paris four target groups/settings were identified as being of trans-regional importancy by bringing together representatives of the eight RDCs. The four themes are the following: “Children and Young People”, “Healthy Ageing”, “Workplace” and “Disadvantaged Populations”.

According to the target groups/settings mentioned above four working groups have been constituted, by inviting interested people from the eight regions to a brainstorming workshop. Each Working Group was led by one of the AFRESH regions [Merseyside (RISES) for “children & young people”, Stuttgart (USTUTT) for “health at workplace”, Nijmegen (RUNMC) for “healthy ageing” and Languedoc-Roussillon (AGRO) for “disadvantaged populations”]. The Working Groups members met during one day in March 2012 in Paris (on 5th “children” and 6th “Disadvantaged populations”) and in Frankfurt (on 12th “workplace” and 13th “healthy ageing”) and generated during these brainstorming workshops early stage innovative research ideas and concepts for new products, services or policies. Leaders for each idea were designed among the participants, together with their corresponding “working team”.
In parallel, templates for research ideas and product ideas aiming at better defining the idea content were developed in the frame of WP6 and WP7. They were sent to the idea leaders, who had the task of filling them together with their team. Each RCP had furthermore to look in her/his region to add further partners to the teams. As result of this team effort, the ideas proposed during the brainstorming workshops have been developed and detailed, some of them have been merged or cancelled, some others developed into crosscutting ideas and concepts deemed of transversal importance for the target groups/settings. At the end, the most promising 34 ideas, seen as solutions to boost innovation in health in Europe, have been defined. An overview of these solutions proposed by the AFRESH partners and stakeholders was published in the prime version of the AFRESH JAP at the end of April 2012 (Deliverable D 4.4). With this first version of the JAP also the first version of the guidelines for implementation and the business plan have been developed and discussed with the partners of the consortium. The JAP and business plan were presented to the AFRESH partners and to members of the European Commission on May 4th, 2012 (Languedoc-Roussillon office, Brussels).

Under RISES and ANFA leadership a methodological framework was followed to further develop and consolidate the AFRESH solutions: the developed early-stage ideas were screened and evaluated by the RDCs (see also WP 6 and WP 7). This process led to the confirmation of 31 AFRESH ideas.
During the review and improvement process, it became apparent that the ideas needed to be restructured and streamlined. The Working Group leaders implemented a refinement and selection process of the AFRESH ideas based on specific criteria (see JAP final version). The selection process concluded with 18 consolidated research or product/service ideas, which are the final solutions proposed by the AFRESH partners and stakeholders. Additionally a number of horizontal themes were identified. These themes correspond to hot topics running across the AFRESH solutions and are of interest at the EU level in relation to the promotion of health and well-being for EU citizens.

The project coordination organized a meeting in Brussels on April 19, 2013 with the external funding and project management expert Jeffer London in order to discuss at the project level the way to the final JAP and for implementation and future collaboration. The JAP was also discussed during the Health Connect Conference in Stuttgart, May 7-8, 2013 with external experts and stakeholders from the clusters. The JAP was afterwards revised by AGRO with the assistance of the 3 other regions responsible of one working group (Merseyside, Stuttgart, Nijmegen), Flanders and the project coordination, based on the results coming out from the selection process and various discussions.
A short version and a complete version (with annexes) of the JAP were provided for dissemination during the final AFRESH conference in June 27-28, 2013 in Warsaw. The JAP was presented at this occasion by one of the project scientific coordinators, Xavier Gellynck. The document has been further (and will be in the future as well) used for lobbying actions in each region. It was also presented by Hans de Steur, UGent and distributed at the occasion of the AFRESH Convention in Brussels on December 4th.

Work Package 5 Knowledge Transfer and Dissemination

The website www.AFRESH-project.eu and the leaflets were established during the first reporting period. During the second reporting period the website was continuously updated, new versions of leaflets were created and printed for all partners to disseminate during workshops, meetings, trade fairs and conferences. Versions of the leaflets and screen shots of the website are attached.

A central dissemination database has been set up during the first reporting period. The database has been updated during the second reporting period until the end of the project. AFRESH consortium members and the Communication Officer Sylvia Schreiber have been present at many international, national, regional and local events, workshop and conferences, for example at the WIRE Conference, June 4-5, 2012 in Krakow, at the 1st FAB/FCI – Forum on “The Bio economy – Food, Wellbeing and Environment - Bridging science and industry by knowledge transfer” in Brussels, October 10-11, 2012, at the Health Connect Conference in Stuttgart, May 7-8, 2013, at the ISBNPA Conference in Ghent, May 22-25, 2013, at the AFRESH Closing Conference in Warsaw, June 28, 2013 and at the AFRESH High-Level Stakeholder Event in Brussels, December 4, 2013.

Communication Officer Sylvia Schreiber continued supporting the Food Cluster Initiative in the second project period intensively. She was representing FCI and AFRESH during conferences and trade fairs (see final report on all communication activities, deliverable D 5.6).

After organizing two big Food Cluster Conferences in the first reporting period in Ghent (2010) and Brussels (2011), in the second period the 1st FAB/FCI – Forum on “The Bio economy – Food, Wellbeing  and Environment - Bridging science and industry by knowledge transfer” was organized (October 10-11, 2012) and in 2013 the Health Connect Stuttgart was organized by two experts: Sylvia Schreiber (Food, Physcial Activity, Communication) and Peter Waldleitner (New Media, eHealth).

During the AFRESH Closing Conference in Warsaw, June 28, 2013 and during the Final High-Level Stakeholder Event in Brussels December 4, 2013, the members of the FCI have been invited and trained in future funding opportunities.

To raise the impact of the proposals and to work further towards their implementation, the AFRESH project organized a stakeholder event in Brussels on 4th December 2013 to which all AFRESH partners and stakeholders, among which partners from the Food Cluster Initiative, MEP Heinz Becker, European Commission, the Standing Commitee of European Doctors (CPME), the European Innovation Partnership on Active and Healthy Ageing ( IPAHA), World Health Organization (WHO), ETP Food for Life, the European Agency for Safety and Health at Work (OSHA), and other key institutions and representatives of national Health Agencies and local governments, scientists, Joint Programming Initiatives, e-health industry, health professional associations and the European Social Insurance Platform, were invited.

The following special results can be reported: the publication of new leaflets, several updates of the website, the elaboration of various dissemination materials like roll ups and give-aways and the participation in many knowledge transfer activities, such as the participation in exchanges with local stakeholders, hearings, workshops, conferences and trade fairs, the publication of articles and press releases and the participation in television and radio interviews.

Work Package 6 AFRESH ideas

Work Package was of great importance for the project because it will help to realize the actions of the Joint Action Plan by looking for relevant funding opportunities. WP 6 is working closely together with WP 4 and WP 7. There has been an intensive exchange of ideas, concepts and possible actions between these three work packages. Regular skype meetings were held among the working group leaders (RISES, RUNMC, AGRO, UStutt) and the project coordinator (WRS) to discuss activities and review progress, making strategic adjustments as necessary with the agreement of all partners at PMT-meetings.

In order to collect research ideas at the four brainstorming workshops (WP4), RISES developed an outline research proposal template to define concrete RTD project ideas. The three page template, which was issued to nominated idea leaders after the workshops, included the following fields: project information (name, target group, field, soundbite, duration, consortium etc.), rationale, objectives, innovation and excellence, deliverables, methodologies & activities, impact, strategic fit/relevance and funding/finance. A total of 18 research ideas were developed following the four brainstorming workshops.

To screen and review the AFRESH research ideas, an evaluation template was developed by RISES.

Information requests, web searches and a survey tool were used to provide an overview of research funding opportunities. Funding opportunities were screened at the:
European level by RISES, exploring funding streams such as EC department annual work programmes, relevant action plans, CORDIS, Official Journal of European Union, ERC, and utilising the Liverpool John Moores University EU Development Office. Further, each RCP was instructed to contact their respective European Research Council National Contact Points (NCPs) and Regional European Offices to explore European funding opportunities;
Local, regional and national levels by each RCP in collaboration with AFRESH partners and regional stakeholders. Funding opportunities from public (Government departments, ministries or agencies), private (companies for external R&D research grants, or investigator initiated research, or corporate social responsibility projects) and third sector (not for profit; non-governmental organisations, charities, national associations and foundations) sources, as well as philanthropists were collated using an online survey instrument.
The outcome was a list of local, regional, national and European funding opportunities, available for AFRESH partners to support the AFRESH
During the Budapest meeting, January 30-31, 2013 interested stakeholders had the chance to present possible project ideas for evaluation of an expert team. Round table discussions were held at the Stuttgart HEALTH CONNECT conference, May 7-8, 2013 to discuss the research ideas with delegates and stakeholders. Further, WRS and UGENT organized the final high-level stakeholder event in Brussels, December 4, 2013 that aimed to build new AFRESH consortia and find new partners and stakeholders. Representatives from all regions, including mentored regions, were present at both events. Both meetings were used as a platform to lobby European member groups.
Two workshops were organized in Budapest during the project meeting January 30-31, 2013 to develop the research capacity and skills of the mentored regions and AFRESH partners, with the support of AFRESH partners from the University of Debrecen. UGENT organized a one day workshop on “Research Proposal Writing” and RISES organized a 3hr research skills workshop on “Assessment of Physical Activity and Sedentary Behaviour”.
The Research Proposal Writing workshop content involved participants developing a selection of the AFRESH research ideas using the research proposal manual that UGENT had produced. Topics covered included how to link regional policies and strategic development goals to EU policy objectives; how to conduct an effective partner search; how to build up a consortium and how to convert ideas into research proposals. The research skills workshop focused on introducing methods and instruments to assess behaviour and developing an understanding of the practical considerations of using such tools such as surveys and accelerometers. Research training workshops delivered by RISES and UGENT were attended by 19 and 26 individuals, respectively. The physical activity assessment workshop evaluation forms showed that delegates rated it 4.8 out of 5 overall, with scores of 4.8 4.6 and 4.4 out of 5 for workshop delivery, content, and hospitality, respectively. The UGENT workshop feedback was that it was extremely useful. The outcome of this workshop was feedback for the idea leaders on developing their projects and an excellent research preparation manual that was issued to all partners.
The process of listing local, regional, national and European funding streams and organisations raised awareness among the AFRESH partners of the available opportunities. In total, 93 funding opportunities were available to the AFRESH partners although it was noticeable that mentored regions and regions with significant economic challenges have limited options. The evaluation tool and review process was also informative and helped generate interesting discussions among partners about the projects to be included in the JAP. Research training workshops delivered by RISES and UGENT were reasonably well attended and content considered excellent by delegates. The UGENT research preparation manual was widely praised by partners.

Work Package 7 Concepts for products and service innovation

The main aim of WP7 is to collate the ideas for products and services generated within the AFRESH project and the different funding opportunities offered by the current economic situation. WP7 in combination with WP6 which covers ideas for research and potential plans for funding contributes in the context of the AFRESH project to improving the way in which the ideas are implemented and carrying out the JAP as result of WP 4. This means mobilising and motivating the Research Driven Clusters (RDCs) for each region so that they make a commitment to support the solutions offered by the JAP and identify possible opportunities for funding. The working structure of WP6 and WP7 can be seen in the below mentioned figure. The collection and evaluation of the ideas complete the initial objectives set for WP 4, WP6 and WP7. These ideas have been supervised and evaluated by the RDCs and external experts in order to involve and motivate regional partners and interest groups. This work flow allows regional bodies to become involved in owning and developing the JAP ideas.

The aim of this task was to evaluate the different opportunities for funding to implement the ideas for products and services developed within the framework of the AFRESH project. The opportunities for funding were studied on an EU level, as well as on national and regional/local levels.

Potential sources of funding were examined by gathering information from web searches, consulting with different persons responsible for public research and development plans on a local and regional level, talking to contact persons in private consultancies and with the help of AFRESH members and partners.

The work package clearly shows which product and service ideas are of interest for the local and regional enterprises and which are old fashioned, not very innovative or to expensive,
With the workshops the partners had the chance to present the ideas to and to discuss the ideas with stakeholders and external experts. This process was partly a painful but very helpful process. The surviving ideas are now ideas with the excellent chance to get future funding by regional stakeholders and industry.

Work Package 8 Mentoring: Change Management Toolkit for RDCs

Work package 8 aims on improving the skills and capabilities of less developed clusters or of clusters with less developed collaboration structures between the triple-helix actors in the fields of nutrition and physical activity. Therefore a Change Management Toolkit (VMT) was developed and training facilities were offered to test the CMT and to train the mentored (less developed) regions. These regions also gained improved skills for future project development and management.

The goal of the Change Management Toolkit (CMT) is to address the cluster-related problems of mentored regions, where among other problems, stakeholders work mostly fragmented, cluster management is not efficient, incentives for cooperation are generally low, etc.
CMT offers a practical tool by which the situation can be significantly improved. The most important and relevant change management strategies are revealed in the first part of CMT, where cluster managers can study the theoretical background of the toolkit.

In order to complement quantitative data received from regional surveys, INNOVA prepared a guide for RCPs to implement bilateral interviews with cluster managers, thereby ensuring qualitative data for evaluation. Cluster managers were asked about the level of cooperation among cluster members, applied change management methods, blocking factors of development, etc. Their answers shed some light on the background of some problems that derived from survey results.

In parallel with Toolkit finalization, INNOVA and WP leader was working on to find out the most efficient and cost effective method for testing the toolkit in the AFRESH regions. It is stated in the DoW that the applicability of Toolkit must be tested in the mentored regions and in developed regions as well.
In order to meet this criteria, it was agreed by the Partners that all AFRESH regions participate in the testing process thereby the toolkit will be tested both in developed and developing regions. We are strongly convinced that it can be considered as an added-value of the Toolkit as it proves its applicability in regions representing different level of development.

Testing method

Our task was to test the toolkit which was implemented on the following ways:

1.: Web-based questionnaire, which was tested in five regions (all problems and tools)
2.: Workshops which were organized in Hungary and in Warsaw (first two problems and tools from the toolkit)
3. Final bilateral merged workshop with Stuttgart Region (WRS) and Flanders (UGent), December 4, 2013

Web-based questionnaire

As work package leader we faced with the difficulties of implementation of web-based questionnaire survey because some of the selected cluster managers hadn`t the time or motivation to fill in the questionnaires. They were several times asked to fill in, but not all of them fulfilled the task in a satisfaying way.

Workshops
Number
Venue
Date
1
Debrecen (Hungary)
October 17, 2013.
2
Warsaw (Poland)
October 29, 2013
3
Szirak (Hungary)
November 14, 2013

In Hungary, INNOVA organized the CMT testing workshop in Debrecen and in Szirak. The Polish partners organized the same testing workshop in Warsaw. Hungarian and Polish partners discussed the problems and suggested solutions with the involved cluster managers and experts. The structure was the same related to each workshop: The Duration was max 2 hours involving max. 5 – 6 cluster managers.

Guided questions

It is determined by the problems. Firstly we talked about the problems itself in generally, how think the cluster managers and experts about the given problems; real problems? or not? They should have mentioned some example from their cluster life and about their solutions; how they tried to solve the given problems.

Secondly, we talked about the objectives (it is determined in the toolkit). Are they agreeing with the suggested objectives? Thirdly, we talked about the suggested tools (tool by tool) stated in the toolkit. How they think about its practicability; manageability; utility (tool by tool).

Based on testing results, INNOVA refined the toolkit part and finalized the whole CMT.

Bilateral workshops

Before the AFRESH Final Stakeholder Event which was held in Brussels on December 4, 2013 we organized a bilateral meeting together with the project coordinator (WRS) and Flanders (UGent). It was a merged workshop because the aims were the same and it was very fruitful and helpful to combine the questions and solutions from the workshops in the mentored regions (see above) with the experiences of very much experienced cluster partners like UGent or WRS. During the workshop we discussed the results of the testing procedure; the details of the prepared report related to Task 8.2 and the publishable toolkit version. The Report on the testing of the toolkit was prepared by INNOVA. The work package report was prepared by INNOVA as well.

Work Package 9 Management

Coordination prepared the Consortium Agreement, made annual schedules for each project year and discussed them with the Consortium during the last year PMT or the first PMT of the actual year.

At least two PMT-meetings were held each year. In between the PMT-meetings the WRS coordination team and both scientific coordinators (UStutt, Physical Activity, Prof. Dr. Wolfgang Schlicht, UGent, Food and Nutrition, Prof. Dr. Xavier Gellynck) take care of the monitoring of the work plan and the scientific quality of the project. The scientific coordinators and the coordination team also supervised and evaluated the process of the deliverables. The deliverables have been also checked by the coordination team and the other partners and revised by the responsible WP-leaders before uploading it to the Commission. Other documents like leaflets and dissemination material have been checked by the partners and the coordination team before the WP 5-leader printed and disseminated it. The scientific synergies coordinator (ANFA with third parties UVigo, USantiago) and the coordination team took care of the coherence of the actions of the different WPs, especially WP 4, WP 6 and WP 7.

Project coordination (WRS) has been planning, organizing and chairing the meetings of the Project Management Team (PMT). The organization of the meetings together with the regional contacts have been realized smoothly and without problems.

Pre PMT-meeting Stuttgart/Germany, September 9, 2010
PMT-meeting Debrecen/Hungary, September 29, 2010 (during the kick-off)
PMT-meeting Ghent/Belgium, December 10, 2010
PMT-meeting Nijmegen/The Netherlands, May 11-12, 2011
PMT-meeting Brussels/Belgium, October 14, 2011
PMT-meeting Brussels/Belgium, March 30, 2012 (Preparation of the mid-term report)
Extra PMT-meeting Brussels/Belgium, May 4, 2012 (Presentation of the JAP to the EC)
PMT-Meeting, Brussels/Belgium, October 11, 2012 (Finalization of WP 6, 7 and 8)
PMT-meeting Budapest/Hungary, January 30, 2013 (Funding opportunities, JAP revision and Change Management Toolkit)
PMT-meeting Brussels/Belgium, April 19, 2013 (JAP finalization and future funding opportunities)
Final PMT-meeting, Warsaw/Poland, June 27, 2013 (Prolongation, Stakeholder Event, Second Report)

During the High-Level Stakeholder Event in Brussels/Belgium, December 4, 2013 no additional PMT-meeting happened, but the consortium met to prepare the event and to sign a future collaboration declaration.

The scientific coordination of the project has been organized for each pillar, the nutrition and the physical activity pillar. For the nutrition pillar Prof. Dr. Xavier Gellynck, University of Ghent, very much experienced expert in the fields of nutrition, bioscience and economy-related issues is responsible. For the physical activity pillar Prof. Dr. Wolfgang Schlicht, University of Stuttgart, a very well-known expert in the fields of sports science, physical activity, work-site health promotion and healthy ageing it responsible. Both pillars have been interlinked by the Scientific Synergies Coordinator. For this objective of the project the Spanish partner ANFA with its Third Parties University of Vigo and University of Santiago de Compostella was responsible. The scientific coordinators and the scientific synergies coordinator or their team members (Katharina Suck, married as Katharina Denker later, Julia Thurn, both from UStutt, Hans de Steur and Carl Lachat, both from UGent or Marcos Guimarey from the Spanish cluster) visited the meetings and workshops and worked on the different scientific topics of the work packages with the partners of the project, especially during the phase of the revision of JAP and business plan and finalization of WP 6, 7 and 8.

Potential Impact:
Summary of potential impact

The European Health Strategy (White Paper “Together for Health: A Strategic Approach for the EU 2008-2013, COM (2007) 630 final) has been evaluated in August 2011. The key message from this evaluation was that European Union actions are limited in reaching the national and regional level. Therefore the collaboration of the EU with local and regional bodies, research institutions and enterprises is crucial. In this sense the project consortium expected to gain more regional and local institutions for the joint European approach by showing them the advantages of European funding opportunities, exchanging of ideas and concepts, and learning from best practice examples in other regions. This expectation was met and a high proportion of regional stakeholders have been integrated in regional stakeholder meetings or workshops and for future initiatives until the end of the project.

As a socio-economic impact the AFRESH-partners expect to reduce the amount of persons suffering from diet-related and physical-inactivity related diseases in the participating regions in the future. To reach this aim strategies for product ideas for regional enterprises have been developed. For example the work group “Healthy ageing” will discuss product ideas for the older generations under the special focus of the demographic change and concrete strategies for the enterprises for their ageing workforce. Furthermore, the relevance of the results to lifestyle behavior is of great importance to reach the people in the regions and to enable the regional enterprises to produce products or to offer service ideas which will reach the needs and demands of the population. With the final stakeholder event in Brussels, the triple-helix actors were connected, enabling them to work together in future projects.

Then exchange between the European partners was very helpful and interesting. For the future collaboration the partners signed a declaration of interest December 4, 2013 during the Final Stakeholder Event in Brussels. Some partners are still working on future proposals and will submit them in the frame of Horizon 2020 or in national or other European funding schemes.

The developed research and product ideas will be part of future projects or will be realized through regional stakeholders. For example different local enterprises are very much interested in ideas like “Sustainable Healthy Company” or “Healthy Ageing”.

Also for the mature regional clusters it was very important to realize the dual approach of AFRESH, because a lot of them worked on a single path, only for nutrition or physical activity topics, but not together.

For the future we think that the dual approach of AFRESH is of crucial socio-economic importance, because the ageing society and the demographic change need more investment in the health sector, but only concepts which are focusing on both, nutrition and physical activity will cause real success in fighting against obesity and other lifestyle-related diseases.

List of Websites:

Stuttgart Region Economic Development Corporation
Sebastian Menzel
Phone +49-711-22835875
afresh@region-stuttgart.de
www.afresh-project.eu