ALIGN: multi-level system approach for healthy lifestyles – a personalised digital combined lifestyle intervention for individuals in financial distress.

Adaptation of combined Lifestyle Intervention to improve support for Groups in financial Need

Research line: Tailored Lifestyle: an integrated data-driven approach to lifestyle and living environment // Preserving Health
Funding Scheme: Health~Holland (Top Sector LSH) PPP Call 2025 – Tailored Lifestyle programme

Financial insecurity can negatively affect health and well-being. Chronic stress can reduce decision-making capacity and self-efficacy, making it harder to adopt and sustain healthier lifestyle behaviours. This can create a downward spiral, as poor health can also increase financial difficulties through higher healthcare costs and reduced work capacity.

Combined Lifestyle Interventions (CLIs) provide structured support for sustainable behaviour change, but participation among people in financial distress is low and drop-out rates are high, partly because existing programmes are not designed with their specific circumstances and needs in mind. ALIGN addresses this gap by co-creating, evaluating, and optimising an adapted digital CLI that integrates lifestyle and financial support and is embedded in the local environment.

Objectives and Route to Impact

Objectives

• Co-create, evaluate, and optimise an adapted digital CLI for individuals in financial distress, integrating lifestyle and financial support.
• Identify user profiles (personas) and tailoring strategies that improve uptake, engagement, and sustainment among the target group.
• Assess feasibility, acceptability, engagement, and contextual fit, and translate findings into a scaling blueprint for municipalities and health systems.

Route to impact

In the short term, ALIGN aims to make healthy behaviour change more achievable and engaging for people experiencing financial distress by providing support that fits a limited budget and real-life constraints. In the longer term, the project aims to help prevent non-communicable diseases, improve quality of life, and reduce health inequalities by ensuring that digitally supported prevention also works for financially vulnerable groups. The project explicitly aims to produce a transferable scaling blueprint that municipalities can use to implement an integrated model combining financial and lifestyle support.

Work Packages and Deliverables

Work Packages

• WP1 – Context: map key system dynamics linking financial distress and lifestyle support, and co-create a shared integration vision.
• WP2 – Tailoring: develop personas and tailoring variables using data insights and participatory input from people in financial distress.
• WP3 – Development: build and iterate mock-ups and a functional tailored digital CLI prototype.
• WP4 – Evaluation & scale-up: test prototypes and evaluate what works for whom in which contexts; translate findings into a scaling blueprint.
• WP5 – Management: coordination, participation board, and FAIR data management.

Key deliverables

• Systems map and shared vision for integrated lifestyle + financial support.
• Personas and tailoring design (user needs, barriers, and content modules).
• Mock-ups and a tested digital CLI prototype.
• Evaluation report and a practical scaling blueprint for municipalities and health systems.

Contribution to Collaboration

ALIGN is explicitly set up as a cross-domain collaboration that connects the health domain and the social/financial domain. The project structurally embeds a participation board with experts by experience to guide all phases and ensure alignment with lived realities. The consortium combines academic expertise (systems thinking, behaviour change, participatory methods), public health and municipal prevention practice, local implementation capacity, and private-sector expertise in digital CLI development—so that the adapted intervention is both scientifically grounded and practically adoptable.

Team

• Ayla Schwarz — Wageningen University & Research
• Monique Simons — Wageningen University & Research
• Annemien Haveman — Wageningen University & Research
• Jantien van Berkel — Utrecht University
• Rahul Gannamani — Ancora Health B.V.
• Ellen van Dongen — GGD Noord- en Oost-Gelderland
• Marije Idzerda — GGD Noord- en Oost-Gelderland
• Kitty Glazenburg — Sportservice Apeldoorn