A community-based programme to reduce non-communicable disease risk among persons living in disadvantaged neighbourhoods in three European countries: protocol for a controlled trial.

BACKGROUND: Non-communicable diseases (NCDs) are the leading cause of premature death in Europe and disproportionately affect persons experiencing disadvantages (i.e., low-income populations, migrants and ethnic minorities). The Health Outcomes from Raised Urban Settings (HORUS) evaluation study aims to implement and evaluate a community-based programme, based on the social-ecological model, to reduce key modifiable NCD risk factors. The study is performed in three European cities (Rijeka, Croatia; Rotterdam, The Netherlands, and Valencia, Spain). METHODS: The HORUS programme will be evaluated using a mixed-methods, controlled study design. A total of 900 participants will be recruited: 150 in the intervention group and 150 in the control group at each study site. Self-reported data will be collected at baseline (T0) and at 9-month follow-up (T1). The primary outcome measured is change in lifestyle across four domains: diet, physical activity, alcohol consumption and smoking. In addition, implementation outcomes will be assessed, including acceptability, appropriateness, feasibility, adoption, penetration, implementation costs, and sustainability. DISCUSSION: The HORUS study will generate robust evidence on the effectiveness and implementation of community-based interventions for NCD prevention targeting disadvantaged neighbourhoods. Findings will inform the development of scalable, equity-oriented strategies to promote healthier lifestyles and reduce NCD risk factors in neighbourhoods across Europe. TRIAL REGISTRATION: ISRCTN registry number is ISRCTN11383698. Date of registration is 4/8/2025. https://www.isrctn.com/ISRCTN11383698 .