Empowering vulnerable urban populations to reduce NCD risk: The HORUS pilot study in Rijeka, Croatia

Abstract Non-communicable diseases (NCDs), including type II diabetes and cardiovascular conditions, are the leading cause of preventable morbidity and mortality globally, with disproportionate impact on vulnerable populations. The Horizon Europe HORUS project (GA No. 101136516) seeks to reduce this burden by promoting healthy urban environments and lifestyles through co-designed, evidence-based interventions. In Rijeka, Croatia, one of three European pilot sites, the real-life interventions will be implemented targeting 300 adults aged 18+ from vulnerable populations, equally divided into intervention and control groups. Using a longitudinal pre- vs. post-intervention design, participants are recruited from four neighbourhoods identified through the ‘Barometer of Health of the Residents of Rijeka’ and spatial-temporal health determinants analysis. The intervention is grounded in the Transtheoretical Model of Behaviour Change and supported by motivational interviewing and an ICT solution (Wakamola app). Based on baseline assessments and interviews, participants are guided through one of four pathways-physical activity, nutrition, interviwellbeing, or health literacy-tailored to their individual needs. Pilot preparation included ethical approvals, stakeholder engagement, and cross-sectoral collaboration. The intervention phase, launched in July 2025, is being delivered in community settings with support from public health professionals, digital tools, and local partners. Preliminary findings suggest strong community interest and engagement, underscoring the need for inclusive, accessible urban health strategies. The Rijeka pilot will provide actionable insights to inform urban policy aimed at fostering healthier, more equitable, and sustainable cities across Europe. Key messages • Findings from the intervention will contribute evidence on the integration of spatial health data, behavioural theory, and ICT tools in real-world urban health research and policy translation. • The use of neighbourhood-level health data and spatial-temporal analysis provides a novel, context-sensitive approach to designing equitable and relevant public health interventions.