"VET context In this project it has been CVET (Continuing Vocational Education and Training) that has been in focus. The definition of CVET is (according to eqavet.eu) ""Education or training after initial education and training – or after entry into working life aimed at helping individuals to:- improve or update their knowledge and/or skills;- acquire new skills for a career move or retraining;- continue their personal or professional development."" This project directly corresponds to the aims of CVETThis project has fostered excellence in the sense that healthcare professionals who have pursued high quality in their job with children born with clefts have had access to high quality work based learning giving them new tasks and competences, so as to allow them to do an even better job with those children born with cleft.EQAVET in the Netherlands have been approached by the project coordinator with a view to ensuring the training reaches, and is adopted by,relevant vocational training platforms in the Netherlands. However, because of the very specific medical nature of the project, the platforms are more likely to be in hospital environments than in training schools.Need for training programmeThere are around a million people in Europe born with a cleft. Many of these will not enjoy the same educational and employment opportunities as their peers as a result of being marginalised for looking or sounding different. If correct care is not offered in the first year of life, babies with clefts will fail to thrive and in some countries are abandoned in institutions. The 2015 report of the European Committee for Standardisation - TR 16824 – Early Care Services for Babies Born with Clefts indicated that there is a skill shortage in provision of care for cleft. This was also aknowleged at the European Parliament meeting “The challenges of health inequalities in the treatment and prevention of birth defects in Europe” in Brussels (9/10/12) and again at the European Committee for Standardisation in Brussels ‘Impact of new guidelines on the early care of babies born with cleft lip and or palate’ (21/03/2016)., Aims and objectivesThe aim of this project has been to develop a training programme for health professionals working with families with children with clefts that will equip the participants with the necessary skills to assess the infant, to determine whether there are any other associated anomalies needing specialised support and intervention, and formulate a treatment plan that allows the infant to thrive normally. It has highlighted the support needs of the child and family and provided the healthcare professionals with the tools to address these needs through patient-centred information and guidance. The developed course has 4 key modules – Understanding of cleft lip and palate; Early care focusing on diagnosis and feeding; Support and for families: Practical exercises and case histories. The course handbook spells out exactly how the course is delivered.Partners and participants By having a consortium including an expert NGO working in the specific arena of clefts, a training organisation comprising pedagogical experts in vocational training in accordance to the EQF, ECVET and EQAVET frameworks, and five hospitals routinely involved with the care of babies born with clefts (see partner organsiations, below) we have developed a functional training program.. The fact that these partners have come from diverse cultural areas has strengthened the project and made it adaptable for use in a variety of settings and contexts. The training course is in modular form and was piloted on, and promoted to, 300 health professionals and related professionals in the partners countries in order to ensure the effectiveness and cultural adaptation. In the original application we set a target of 180 to be reached by pilots and multiplier events but we well exceeded this. The modular course, handbook, national reports and promotional material are available as an open resource via the project website www.celftectp.com in 6 partner languages (BU,NL,EN, GR, LV LT and RO). ImpactThe course teaches effective care for children born with clefts from the point of diagnosis. We have been informed that the course material will now form the basis for cleft nursing education in the UK. . All partners in the project are drawing on key aspects of the programme to enrich training in their countries. Bulgaria has developed a cleft nurse network, training nurses with the material from this project. Slovenia has just let us know that they intend to use this material. We are keen to continue to promote the project and the resources we have developed. ECO Executive Director presented on the project at the US Cleft Lip and Craniofacial Congress in Arizona in April 2019 and again at the European Cleft and Craniofacial Congress in June 2019. Total audience reached by the project has been around 7500 individuals."

<< Objectives >>There are around 10 million people in Europe with a disfigurement who face enormous challenges and stigma. This project aims to improve the lives and opportunities of this group by training health professionals (HCPs) and NGOs on how these challenges can be reduced. The trainees will be given a toolkit enabling them to go out and train in the community and use adapted material directly for affected families, thus providing a cascading awareness of the dificulties and stigma faced by this group<< Implementation >>1. Development of a one-day training programme for HCPs & NGOs on (a) societal context and pressures for people affected by disfigurements (b) challenges for this group (c) effective interventions (individual; community-based; societal level) (d) basic course in social activism (e) skilling workers in the community; 2. Development of a train the trainer package to enable HCPs & NGOs to train in the community.and direct to affected families. A thorough pedagogical guide will also be included<< Results >>Development of training for health professionals and NGOs to help them understand and support the challenges faced by people with disfigurements. This knowledge is then rolled out to the community and adapted for families. The project provides slills for key workers to help people with a visible difference to gain the skills and coping strategies to deal with challenges as they occur, rather than retrospectively . Furthermore, by disseminating knowledge in the community, stigma will reduce

"It is of paramount importance to support the development of relevant and high-quality skills and competences further to strengthen key competences in VET concerning health care. European healthcare systems show significant gaps in healthcare provision (Council of Europe, 2016). At the same time, our health care system is under considerable budgetary and societal strain (European Commission, 2017). To improve our provision of care, we need to devise a more efficient and sustainable healthcare system. Then it is essential to be able to implement change and monitoring the outcomes. At the same time, numerous studies show that implementing the proposed changes in a healthcare setting remains fragmented, inconsistent, and inefficient. Hence, there is a substantial need for the development of high-quality work-based VET in the healthcare sector that facilitates the process of implementing change in an efficient and structured way and being cost-efficient. The need for ongoing training and development of health care professionals is highlighted in the Directive 2013/55/EU ""Member States shall ensure, by encouraging continuous professional development, that health professionals are able to update their knowledge… to maintain safe and effective practice"". A key priority is the need to train healthcare professionals to implement change and monitor the effect at the clinical levels. The healthcare partners from Slovenia, Greece, Estonia, Latvia, and Romania report that they do not have the resources or training to address these issues adequately and are therefore neglected. The objectives of this project were to develop, test, implement and disseminate the developed training material for healthcare managers and healthcare professionals and students. A further objective was to produce a functional training programme reflective of the sociocultural diversity across Europe. The project succeeded to make the training material accessible to a broad range of stakeholders via multi-mode delivery accessible as an open resource. The consortium consisted of public health experts in change and implementation methodology (SE) and pedagogical experts in vocational training (NO) with an NGO (NL) that incorporated the patient perspective. The hospitals (LT, EL, RO, SI, EE) generated a needs analysis of each partners' healthcare setting to achieve the best way to implement the project. The methodological approach and activities generated the following results: 1. A functional and evaluated training material that is based upon research evidence and the needs analysis. 2. The training has quickly impacted work-based CVET that enhances service provision by addressing the need to create tools for implementing and evaluating change in a structured way. 3. The pilot data of the training course showed a significant increase in learning between pre and post in 121 healthcare professionals. 4. Health care organisations have now access to continuing education and training (CVET) that will update their health professionals' knowledge in this area to maintain safe and effective practice 5. As prioritised by the European Commission, it is paramount to create a more sustainable health care system that can address that everyone has access to affordable, preventive and curative health care of good quality. This developed training course provides the tools to implement and monitor these changes for all patient groups, including those at risk for social exclusion and poverty. 6. The developed training curriculum is economically viable to implement and can reach a large group of members of health staff or NGO's. This is due to the methodological design of concrete and focused 1-day training courses that emphasise addressing knowledge and skill deficits in this area. The long-term benefits are that staff/students in the health care sector and NGOs have access via the partners a training program that will directly enhance their skillset and facilitate better health care provision for their intended target groups and in the same way make the health care system more efficient. Better implementation strategies that can ensure that improvement in health care provision will be more successful. This results in that patients will receive improved timely access to affordable, preventive and curative health care of good quality. Individuals that also belong to socially disadvantaged groups benefits since the training will address the circumstances that need to be considered when implementing change to avoid unintentional marginalisation. The project has resulted in raising a European awareness of these aspects, which adheres to the established priorities of the European Commission (European Commission Communication ""European Disability Strategy 2010-2020: A Renewed Commitment to a Barrier-Free Europe"", November 2010; European Commission Communication ""The European Platform against Poverty and Social Exclusion"", December 2010)."

In Europe it is estimated that approximately 12 million individuals have a disfigurement that results in body image dissatisfaction (BID), which is recognised as a global public health concern. Healthcare professionals (HP) across Europe commonly report caring for patients who have BID as a result of a disfiguring condition. There are many causes of disfigurement, including craniofacial conditions (e.g. cleft lip and/or palate), injury (e.g. burns and combat-related injuries), skin conditions (e.g. psoriasis) and medical treatment (e.g. following cancer or meningitis). Given their high level of contact with patients with disfiguring conditions, HP are well placed and motivated to positively address patients' BID, but many lack knowledge and confidence to do so. Research shows that giving HP simple training and access to specialist resources enables HP to take on this role. Acceptance and Commitment Therapy (ACT) offers a psychological model well suited to the needs of patients with a disfiguring condition. ACT focuses on helping patients to lead fulfilling lives and teaching them skills to manage difficult thoughts and feelings, which enhances their quality of life. The objectives of this project were to (i) develop, (ii) test (iii) implement and (iv) disseminate a training package for Health Professionals (HP), enabling them to use Acceptance and Commitment Therapy (ACT) principles to facilitate patient adjustment to a disfiguring condition. A further objective was to produce a functional training programme, reflective of the sociocultural diversity across Europe. A needs analysis of each partners' healthcare setting was carried out. The project managed to make the training material accessible to a broad range of HP and will continue to do so through multi-mode delivery. A highly experienced research team (United Kingdom, Sweden) and a knowledge mobilisation partner with extensive VET experience (Norway), along with Health Care providers (Estonia, Greece, Cyprus, Slovenia, Romania) and NGO (Netherlands) collaborated to complete the project. These partners have been selected to provide the necessary expertise and experience of the project's educational remit, and to target HP from Estonia, Greece, Cyprus, Slovenia and Romania, in order to implement the training into service provision. Project methodology and activities comprised: 1. A functional and evaluated training material that was based upon research evidence and the needs analysis from the target recipient nations. 2. The training which promptly created an impact through high quality work-based VET by addressing the need to create tools on how to address the patients with body image dissatisfaction (BID) as a result of disfiguring conditions 3. Health care organisations became able to access this open resource material and provided continuing education and training (CVET) to HP to enhance their clinical skills. 4. In line with the European Commission's priorities, the project contributed to a more sustainable health care system that safeguards access to affordable, preventive and curative health care of good quality. 5. The training proved to be economically viable to implement and at the same time able to reach a large group of members of healthcare staff, students or NGO's, as it is short and concrete. In the long-term, the training package together with its implementation plan will be updated and adapted for other partners' operational directives. The project's key products (project outline, reports, didactic guidelines, extracts from the training pack) will remain freely available online for a minimum of 5 years after funding, allowing longer-term access for HP and healthcare stakeholders. It is anticipated that the transnational networks and relationships formed through this project will also lead to new training initiatives and projects across Europe. The project resulted in raising a European awareness of these aspects, which adheres to the established priorities of the European commission (European Commission Communication 'European Disability Strategy 2010-2020: A Renewed Commitment to a Barrier-Free Europe', November 2010; European Commission Communication 'The European Platform against Poverty and Social Exclusion', December 2010).

In Europe, about 5 million live births occur each year, and it is estimated that 18% of women will develop depression during pregnancy, 13-20% of women will develop post-natal depression within the first 12 weeks of childbirth, and for 8% of women, this extends beyond the first year. Many studies have reported that negative affect and depression predict body dissatisfaction and to complicate further these relationships, poor dietary and exercise habits are also likely contributors to depression in mothers, reinforcing negative body image and poor health outcomes. At the same time, there is an established need to train healthcare professionals (HCP) and other relevant stakeholders in how to support the mental and physical wellbeing for mothers of children 0-5 years. HCP and other relevant stakeholders are well placed and motivated to address this issue positively, but many lack knowledge and confidence to do so. Research shows that providing evidence-based training and resources enables them to take on this role. By implementing an innovative approach for teaching and learning, based upon evidence-based outcomes, as well as to design continuing education and training (CVET) activities that link with the European Social Charter (ETS no.163) and the European Pillar of Social Rights (2017), will ensure a functional project. The objectives of this project are to (i) develop, (ii) test (iii) implement and (iv) disseminate the training package for HCP, enabling them to support the mental and physical wellbeing for mothers of children 0-5 years. A further objective is to produce a functional training programme, reflective of the sociocultural diversity across Europe. The project aims to make the training material accessible to a broad range of HCP and other relevant stakeholders and will do so through multi-mode delivery. In the partnership there is highly experienced researcher partners (Norway, Sweden) and knowledge mobilisation partner that has extensive VET experience (Norway), Health Care providers and other relevant stakeholders (Estonia, Greece, Romania, Serbia, Sweden, Italy, the Netherlands, and Malta) who are highly motivated to implement the training into service provision.Project methodology and activities comprise: 1. A functional and evaluated training material that is based upon research evidence and the needs analysis from the target recipient nations. 2. The training will quickly have an impact through high quality continuing vocational education and training (CVET) that enhances service provision by addressing the need to support the mental and physical wellbeing for mothers of children 0-5 years.3. Health care organisations and other relevant stakeholders will have access to this open resource material so they can provide continuing education and training (CVET) that will update their health professionals' knowledge in this area in order to maintain a safe and effective practice4. As prioritised by the European Commission, it is paramount to create a more sustainable health care system that can address that everyone has access to affordable, preventive and curative health care of good quality. 5. The training will be economically viable to implement and at the same time be able to reach a large group of members of healthcare staff, students or other relevant stakeholders. This is due to the methodological design of ​concrete and focused 1-day training course that emphasis on addressing knowledge and skill deficits in this area.6. Another significant aspect to consider is that around half of all patients in Europe cannot understand basic health care information, which indicates that health literacy is a fundamental challenge that needs to be addressed (World Health Organization, 2013). Therefore, the project will develop information material for mothers about maternal wellbeing for various societal backgrounds including mothers that have a child born with a congenital disability. Because of the issue of health illiteracy, that material will be developed at EQF level 2 for easy accessibility. In the long-term, the training package together with its implementation plan will be updated and adapted for other partners' operational directives. The project's key products will remain freely available online for a minimum of 5 years after funding, allowing longer-term access for HCP and relevant stakeholders. It is anticipated that the transnational networks and relationships formed through this project will also lead to new training initiatives and projects across Europe.The project will result in raising a European awareness of these aspects, which adheres to the established priorities of the European Commission (European Commission Communication 'European Disability Strategy 2010-2020: A Renewed Commitment to a Barrier-Free Europe', November 2010; European Commission Communication 'The European Platform against Poverty and Social Exclusion', December 2010).