CAUTION: This message came from outside Imperial. Do not click links or open attachments unless you recognise the sender and were expecting this email. Dear Franco, Thank you for your message. Please find below a description of the TUTCH approach and its implementation, as requested. We hope this provides a clear overview for the application, and we are of course happy to further refine or expand any part if needed. Do not hesitate to reach out if you have any questions or would like us to adjust the text to better fit the proposal. Looking forward to your feedback. Best regards, Robert TUTCH Approach – Implementation Overview The TUTCH (Teens Understanding and Taking Control of Health) approach, developed by the CHOICE Foundation in Sweden, is a structured health literacy programme targeting adolescents aged 12–18, as well as young adults up to 25. Its primary objective is to enhance knowledge and awareness of the effects of alcohol, tobacco, and other drugs, while strengthening young people’s decision-making capacities, critical thinking, and resilience. The programme is delivered through an interactive, peer-to-peer model in which trained medical students and medical doctors facilitate classroom-based sessions. It combines evidence-based health education with participatory methods, including group discussions, scenario-based exercises, and learning materials. This approach fosters engagement and encourages active reflection, while maintaining a structured pedagogical framework that can be adapted to different cultural and educational contexts. A key feature of the TUTCH approach is its emphasis on high-quality implementation. Initial training is delivered on-site by certified CHOICE trainers in each participating country. This ensures consistency, methodological integrity, and a strong foundation for local delivery from the outset. Facilitators are certified following completion of the training and supervised initial sessions. Quality assurance is maintained through standardized curricula, detailed implementation guidelines, and continuous support from CHOICE. To enable sustainable scale-up, a train-the-trainer model may be introduced at a later stage, allowing selected local coordinators to support ongoing delivery. However, CHOICE retains responsibility for initial training and certification to safeguard fidelity to the core methodology. For international implementation, TUTCH places strong emphasis on co-creation with local stakeholders, including youth organisations, schools, and public health institutions. This collaborative process ensures cultural relevance and contextual adaptation, while preserving the programme’s core content, structure, and educational principles. - Vänliga hälsningar Robert Åkesson CEO Insamlingsstiftelsen Choice Tfn: +46 (0)70 795 71 98 robert@stiftelsenchoice.se<mailto:robert@stiftelsenchoice.se> www.stiftelsenchoice.se<http://www.stiftelsenchoice.se> [cid:C4995F53-B406-4C21-A75A-ACC341D6699A] 1 april 2026, 09:50 centraleuropeisk sommartid, skrev Sassi, Franco <f.sassi@imperial.ac.uk>: Dear Robert, Thank you for your prompt reply. Giulia will contact you about the administrative requirements for joining the proposal. I would like you/your team to define the aspects you have mentioned at the end of your last message (highlighted below), because you know better how your approach can or should be implemented. We will need a few paragraphs of text for the application (between half a page and one page maximum) describing the TUTCH approach you have developed and how it is typically implemented. Can someone in your team provide this, please? It would be great if we could receive it by early next week. We will get back to you with a budget proposal as soon as we have completed a draft budget for the whole project. Thank you. Franco From: Robert Åkesson <robert@stiftelsenchoice.se> Sent: 01 April 2026 08:30 To: Sassi, Franco <f.sassi@imperial.ac.uk> Cc: Olney, Jack J <jack.olney@imperial.ac.uk>; info@stiftelsenchoice.se; zhealth-mgmt <zhealth-mgmt@imperial.ac.uk> Subject: [Z-health-Mgmt] Re: Possible involvement in EU grant proposal CAUTION: This message came from outside Imperial. Do not click links or open attachments unless you recognise the sender and were expecting this email. Dear Franco, Thank you for your clear and helpful response. The proposed scope sounds well aligned with our way of working, and we are happy to move forward. We would be glad to contribute to the programme design, co-lead the co-creation and adaptation process, and develop and deliver the training for medical students in the three countries. Given the scale, we would recommend including a structured approach to training, certification, and quality assurance to ensure consistency and impact across contexts. A train-the-trainer model could also be valuable to support scalability. As we move ahead, it would be great to align on the level of involvement in co-creation, the format of the training, and expectations around follow-up and quality assurance. We would also appreciate clarification on whether the training is expected to be delivered on-site in each country, digitally, or through a hybrid format. We look forward to the next administrative steps. Best regards, Robert - Vänliga hälsningar Robert Åkesson CEO Insamlingsstiftelsen Choice Tfn: +46 (0)70 795 71 98 robert@stiftelsenchoice.se<mailto:robert@stiftelsenchoice.se> www.stiftelsenchoice.se<http://www.stiftelsenchoice.se> [cid:image001.png@01DCC1BC.77CA95D0] 31 mars 2026, 19:07 centraleuropeisk sommartid, skrev Sassi, Franco <f.sassi@imperial.ac.uk<mailto:f.sassi@imperial.ac.uk>>: Dear Robert, Thank you for your reply. I will try to answer your questions as follows, but of course I am open to your suggestions if you think the activities should be organised diffently: 1. the expected scale of training activities across countries, We will be implementing the intervention packages (for the age groups 12-18 and 19-25,respectively) in three countries each. I expect the TUTCH approach to be more suitable for the younger age group (12-18). If this is correct, it means that medical students will need to be trained in three countries. We expect interventions to take place at the regional, rather than national level. As a rule of thumb at this stage (we are still planning the details) I would assume that the health literacy programme will be delivered to around 50 secondary school classes in each of the three implementing countries over the course of one academic year. 1. the level of involvement in co-creation and adaptation processes, We would expect the CHOICE Foundation to be actively involved in the co-creation and cultural adaptation process. You will probably co-lead it with the public health institutes that will be leading the implementation in the three countries. 1. and whether our role is primarily focused on training and methodology, rather than direct delivery to student groups. I assume the medical students who will deliver the health literacy programme to student groups will have to be recruited locally, in the respective countries (please, let me know If you have a different view). If this is correct, the role of your organisation would be focused on the design of the programme and training of the medical students. When you are ready to move forward with the admin steps, Giulia Cali from the proposal management team will contact you to provide a list of what we need you to provide at this stage. Best, Franco From: Robert Åkesson <robert@stiftelsenchoice.se<mailto:robert@stiftelsenchoice.se>> Sent: 31 March 2026 13:25 To: Sassi, Franco <f.sassi@imperial.ac.uk<mailto:f.sassi@imperial.ac.uk>> Cc: Olney, Jack J <jack.olney@imperial.ac.uk<mailto:jack.olney@imperial.ac.uk>>; info@stiftelsenchoice.se<mailto:info@stiftelsenchoice.se>; zhealth-mgmt <zhealth-mgmt@imperial.ac.uk<mailto:zhealth-mgmt@imperial.ac.uk>> Subject: Re: RE: RE: Possible involvement in EU grant proposal CAUTION: This message came from outside Imperial. Do not click links or open attachments unless you recognise the sender and were expecting this email. Dear Franco, Thank you for your message, and for sharing the intervention packages – this is a very strong and well thought-through proposal. We are pleased to see that TUTCH is included as a best practice within the health literacy component. From our side, we would be very interested in participating in the project. Based on the materials, we understand our role primarily as contributing to the design of the health literacy component and training the medical students (or other facilitators) who will deliver the sessions in each country. Our experience is that maintaining quality and impact requires a structured approach to training, certification, and follow-up, especially when the model is implemented across different contexts. We would therefore be keen to contribute with a more comprehensive implementation framework, including training, certification of facilitators, and elements of quality assurance, while working closely with local partners on adaptation. Before proceeding with the administrative steps, it would be helpful for us to clarify a few points to ensure a realistic scope and level of involvement: • the expected scale of training activities across countries, • the level of involvement in co-creation and adaptation processes, • and whether our role is primarily focused on training and methodology, rather than direct delivery to student groups. We would be happy to discuss this further in a short call. Looking forward to hearing from you. Best regards, Robert - Vänliga hälsningar Robert Åkesson CEO Insamlingsstiftelsen Choice Tfn: +46 (0)70 795 71 98 robert@stiftelsenchoice.se<mailto:robert@stiftelsenchoice.se> www.stiftelsenchoice.se<http://www.stiftelsenchoice.se> [cid:image001.png@01DCC1BC.77CA95D0] 27 mars 2026, 14:51 centraleuropeisk normaltid, skrev Sassi, Franco <f.sassi@imperial.ac.uk<mailto:f.sassi@imperial.ac.uk>>: Dear Robert, I apologise for the delay in getting back to you on the EU proposal. We have been very busy developing aspects of the proposal, and I have been delayed in relaying more information to you. You will find two documents attached to this message, which describe the components of the two intervention packages we are planning to implement as part of the project, aimed at the age groups 12-18, and 19-25, respectively. Our plan is to implement each package in three countries, so with 6 implementing countries in total. At the moment, it looks like the countries will be Norway, Spain, Slovenia, Germany, North Macedonia, Ukraine, and possibly UK. The first component of each intervention package, as you will see, is a “Health and digital literacy” education programme. The exact content of these programmes will be the result of co-creation with youth organisations and local stakeholders, but we would like to structure the health literacy component around your intervention model. We would ask you to help us design those health literacy programmes and to train the medical students who will be delivering the programmes. I assume this will require a certain degree of language and cultural adaptation, relative to the model you are applying in the Swedish context, but you will be working closely with country partners in this adaptation work, so you will be well supported. At the end of the project, you will have a fully exportable model that can be adapted for implementation in more countries. If you are happy to proceed on this basis, I suggest we go ahead with the administrative formalities involved in joining the EU grant proposal. I am including the proposal management team in this email, so that they can follow up with you on what’s needed from the CHOICE Foundation at this stage to make you a partner in the proposal. We will need to quantify the time commitment of the CHOICE Foundation’s staff, so that we can assign a budget to your organisation in the project. I look forward to hearing further from you. Franco From: Robert Åkesson <robert@stiftelsenchoice.se<mailto:robert@stiftelsenchoice.se>> Sent: 17 March 2026 13:27 To: Sassi, Franco <f.sassi@imperial.ac.uk<mailto:f.sassi@imperial.ac.uk>> Cc: Olney, Jack J <jack.olney@imperial.ac.uk<mailto:jack.olney@imperial.ac.uk>> Subject: Re: RE: Possible involvement in EU grant proposal CAUTION: This message came from outside Imperial. Do not click links or open attachments unless you recognise the sender and were expecting this email. Add sender to Safe Senders List<https://support.microsoft.com/en-gb/office/add-recipients-to-the-safe-senders-list-in-outlook-be1baea0-beab-4a30-b968-9004332336ce#picktab=classic_outlook> Dear Franco, Thank you for the detailed explanation – this is very helpful and the proposal sounds both important and well aligned with our work. The focus on early adolescence and health literacy, as well as the involvement of medical students, seems like a particularly strong approach and a good fit with what we do at CHOICE Foundation. I would be very interested to learn more about the planned intervention package and how you envision our role in shaping the training and delivery. It would also be helpful, when possible, to understand the expected level of involvement and timeline for partners at this stage of the proposal. I look forward to your follow-up message. Best regards, Robert - Vänliga hälsningar Robert Åkesson CEO Insamlingsstiftelsen Choice Tfn: +46 (0)70 795 71 98 robert@stiftelsenchoice.se<mailto:robert@stiftelsenchoice.se> www.stiftelsenchoice.se<http://www.stiftelsenchoice.se> [cid:image001.png@01DCC1BC.77CA95D0] 17 mars 2026, 13:10 centraleuropeisk normaltid, skrev Sassi, Franco <f.sassi@imperial.ac.uk<mailto:f.sassi@imperial.ac.uk>>: Dear Robert, Thank you for your prompt and interested reply. Let me answer first your two specific questions. We are working on a proposal that will be submitted to the European Commission (DG Research) on 16th April, so this is not yet approved or funded. We are still in the process of shaping it up. On your other question, we would include the CHOICE Foundation as a partner receiving funding from the EU, like all partners in the project. Let me try to provide additional information on the scope of the proposal in this message. I will then follow up later today or tomorrow with a more comprehensive description of the intervention package in which we would like your Foundation to contribute. The proposal is focused on three key health areas that are strongly associated with young people's behaviours (age 12-25, this is prescribed by the EU call). The three areas are obesity and metabolic health; mental health; and addictions (broadly covering, alcohol, tobacco, substance use, gambling, screen addictions etc.). We are breaking up the prescribed age range into two key transitions, one in the earlier age range (12-18) from early to late adolescence, and the second in the later age range (19-25), from school to tertiary education or work. We would see your involvement mainly in the earlier age range, if the information I have on your approach is accurate. For each of these transitions, we are developing a multi-component intervention package that covers multiple dimensions related with behaviour and habit formation in young people. In the adolescence age range, we envisage the intervention package to be implemented in secondary schools, covering the following four domains: (a) health and digital literacy; (b) self-management of digital media use; (c) healthy school environments and nudges; and (d) provision of resources and services. Your approach would fit within the first domain, as a way of improving children’s health literacy in the three health areas mentioned above. We are exploring the possibility to work with EMSA, the European Medical Students’ Association, who may be able to help us deploy the intervention in at least three countries (Norway and Spain would be two of them, we are currently selecting a third one), but we would be counting on your organisation’s experience to support the design of the training of medical students and the organisations of the format and contents of the sessions to be delivered in schools. As I mentioned, I will follow up with more details about the intervention package and the current structure of the proposal and partners in a separate email. Franco From: Robert Åkesson <robert@stiftelsenchoice.se<mailto:robert@stiftelsenchoice.se>> Sent: 17 March 2026 06:48 To: Sassi, Franco <f.sassi@imperial.ac.uk<mailto:f.sassi@imperial.ac.uk>> Cc: Olney, Jack J <jack.olney@imperial.ac.uk<mailto:jack.olney@imperial.ac.uk>> Subject: Re: Possible involvement in EU grant proposal CAUTION: This message came from outside Imperial. Do not click links or open attachments unless you recognise the sender and were expecting this email. Dear Franco, Thank you for your kind email and for reaching out. We are pleased to hear about your proposal, and the CHOICE Foundation is indeed interested in exploring the possibility of contributing to this project. Before proceeding further, I would appreciate receiving some additional details about the proposal, particularly regarding the overall scope, planned interventions, and the expected role of CHOICE Foundation. I also have a couple of initial questions: • Would participation in the project require any financial contribution from our side? • Has the proposal already been submitted or approved, or is it still under development? I look forward to learning more and continuing the discussion. Kind regards, Robert - Vänliga hälsningar Robert Åkesson CEO Insamlingsstiftelsen Choice Tfn: +46 (0)70 795 71 98 robert@stiftelsenchoice.se<mailto:robert@stiftelsenchoice.se> www.stiftelsenchoice.se<http://www.stiftelsenchoice.se> [cid:image001.png@01DCC1BC.77CA95D0] 16 mars 2026, 14:00 centraleuropeisk normaltid, skrev Sassi, Franco <f.sassi@imperial.ac.uk<mailto:f.sassi@imperial.ac.uk>>: Dear Robert, I am following up on a contact that my colleague Jack Olney established with you over the past weekend. I am leading the development of a grant proposal under a current EU Horizon programme call on Behavioural interventions for the prevention of non-communicable diseases in young people. I have recently come across the work of the CHOICE Foundation, and I find it very interesting and potentially a great fit for our proposal. I wonder if you would consider a collaboration on this proposal. This would involve exporting your intervention model to at least three European countries (at the moment we are not planning interventions specifically in Sweden) and supporting implementation in those countries. In each of the countries in which we intend to implement interventions, we are partnering with the relevant National Public Health Institutes, and we have the support of the European Office of the WHO. If you have an interest in exploring this opportunity, I would be happy to provide further details about the proposal and to discuss a possible role for the CHOICE Foundation. I look forward to hearing from you. Franco Franco Sassi PhD Chair in International Health Policy and Economics Director, Centre for Health Economics and Policy Innovation (CHEPI) Imperial Business School London SW7 2AZ United Kingdom Email: f.sassi@imperial.ac.uk<mailto:f.sassi@imperial.ac.uk> Tel: +44(0)207 594 9157
