Work package (WP) 1 coordinated activities as per Description of Action administratively and financially. During the project 66 bi-monthly and 7 full consortium meetings were held. All milestones were achieved and deliverables submitted on time. WP2 co-designed the HNM, meeting the needs of organizations, healthcare professionals and PEH through a systematic scoping review. Following, 69 interviews with PEH and healthcare professionals were done to explore healthcare needs and barriers for PEH accessing cancer prevention services across all 4 countries (Austria, Greece, Spain, UK), and co-adaptation focus group discussions with 56 participants were done to define HNM parameters. WP3 implemented the HNM in partner countries, preceded by capacity building. Based on pilot implementation plans, the implementation started in 06/2022 and finished in 12/2023. Overall, 20 HNs received training and provided participants with a range of services. By the end, 169 individual cancer screenings had been done. As part of feasibility analysis, WP3 reported major barriers to be systemic: inability to include PEH with no active health insurance, system fragmentation and discrimination. Individual barriers included competing needs (immediate help during acute homelessness vs. future cancer prevention). WP4 used a mixed-methods approach to conduct a formative and summative evaluation of the HNM. Questionnaires were used at 3 time points: baseline, 6 weeks, and study exit. Questionnaires and qualitative interviews were also done with the HNs and focus groups with 86 healthcare professionals involved in the implementation. Results showed improvement in quality of life, empowerment, interpersonal communication, and an increase in use of cancer preventive services. Results of the cost-utility analysis demonstrated a positive impact on quality-adjusted life years across pilot sites. Using CFIR and RE-AIM frameworks, we demonstrated the HNM to be effective form PEH’s and professionals’ perspective and multi-adaptable. WP5 used systematic reviews and Delphi methodology to define standards for the Integrated Cancer Care Pathways for PEH. The pathways were internally and externally validated and created a set of policy recommendations for national and EU adoption of the HNM. Communication in WP6 promoted societal knowledge on health inequalities to illustrate the barriers PEH face in accessing cancer prevention by creating online information outlets, scientific symposia, and events at the European Parliament. Overall, consortium members participated at 45 conferences and led 14 dedicated workshops/webinars, 6 articles and 4 research abstracts were published in peer-reviewed journals. One of the abstracts was voted best at the 2022 European Cancer Summit. WP7 and WP8 ensured all activities complied with national and international ethics and data protection regulations, with no issues being reported.
