A major new European study is set to trial AI-powered health tools that could transform how we detect and prevent chronic disease in children and teenagers, helping to curb one of the world’s biggest public health threats, non-communicable diseases (NCDs).
Funded by the European Union’s Horizon Europe programme, the €8 million SmartCHANGE programme is developing advanced, explainable AI technologies to identify early health risks and promote behaviour change in young people. While cardiometabolic risk calculators are commonly used for adults, no equivalent tool currently exists for children and adolescents.
Clinicians often have to rely on basic indicators like BMI or subjective judgment to assess which young people may be at risk, a method that often misses underlying issues. SmartCHANGE aims to fill this critical gap by developing the first AI-supported risk prediction tool specifically designed for ages 5 to 19, giving healthcare professionals a more accurate, evidence-based way to guide early intervention.
Over the next year, feasibility studies focused on children and adolescents will begin in Portugal, the Netherlands, Finland, Slovenia, and Taiwan, testing SmartCHANGE’s mobile and web-based tools in real-world school and community healthcare settings.
“We know that many long-term health conditions like heart disease and type 2 diabetes have their roots in childhood,” says project coordinator Dr Mitja Luštrek, Head of the Department of Intelligent Systems at the Jožef Stefan Institute (Slovenia). “With SmartCHANGE, we’re building tools that predict risk, while actually enabling children, families, and professionals to do something about it – early, ethically, and effectively.”
Despite growing awareness, non-communicable diseases (NCDs) remain the world’s leading cause of death and healthcare expense, accounting for nearly 70% of all global deaths. Many of these illnesses, from cardiovascular disease to obesity-related complications, can be prevented through early intervention and healthier habits.
SmartCHANGE seeks to address this challenge by harnessing artificial intelligence (AI) not as a diagnostic black box, but as a transparent decision-support tool – tailored for families, schools, and frontline healthcare professionals.
At the heart of SmartCHANGE are two digital applications:
- HappyPlant – a gamified mobile app for children, teens, and families, designed to support healthier habits at home and on the move.
- A companion web app for healthcare professionals (HCPs), offering explainable AI-generated risk insights and tools to monitor and guide behaviour change interventions.
The SmartCHANGE system also explores the use of federated learning, a privacy-preserving approach where AI models are trained across decentralised servers without needing to pool sensitive data in one central location. Instead of transferring personal health data, only anonymous model updates are shared between sites. This method helps protect user privacy and supports compliance with strict data protection standards, especially important when working with children and families.
Meanwhile, explainable AI (XAI) techniques are used to ensure that the system’s predictions can be interpreted by healthcare professionals and developers, helping them understand how decisions are made, identify potential biases, and build trust in the technology.
Between October 2025 and the Summer of 2026, feasibility studies will assess how SmartCHANGE tools can be deployed across five very different healthcare environments:
- Portugal: Family-centred care via paediatricians and GPs, with children aged 6-10 and their parents.
- Netherlands: School-based public health service targeting youth aged 11 to 14.
- Finland: School nurses are conducting health assessments for students aged 11 and 14.
- Slovenia: The study will target children aged 6-10 through community-based integrated care, using the country’s existing MySLOfit platform.
- Taiwan: A parallel study to test the system’s transferability beyond Europe, mirroring Portugal’s family-focused model.
Each site has involved around 100 families and up to 10 healthcare professionals. A pilot study was completed between April and June 2025, providing valuable feedback on feasibility and usability. The project has now entered its full one-year implementation phase, which runs from September 2025 to June 2026.
Unlike many tech pilots that remain trapped in academic silos, SmartCHANGE is designed with real-world scalability in mind. Insights from the studies will be used to refine the tools, inform international implementation strategies, and support wider EU and global efforts around youth health, digital well-being, and AI governance.
The project aligns directly with UN Sustainable Development Goal 3 (Good Health and Well-being). It offers a model for responsible innovation in AI, where the focus is not only on what technology can do, but what it should do.
“What makes SmartCHANGE different is its commitment to trust, transparency, and impact. We’re building an ecosystem of support that empowers young people to take charge of their own health, with the right tools and guidance,” Dr Luštrek said.
SmartCHANGE brings together a diverse consortium of 13 partners across Europe and Asia, combining world-class expertise in healthcare, artificial intelligence, behavioural science, ethics, and communication. The project is coordinated by the Jožef Stefan Institute (Slovenia). It includes leading clinical and research institutions such as the University of Ljubljana, University of Porto, Amsterdam UMC, JAMK University of Applied Sciences, and Taipei Medical University.
Technical development is driven by Connectedcare Services BV, Engineering Group, University of Piraeus Research Centre, TU Eindhoven, and Università della Svizzera italiana, while Vrije Universiteit Brussel ensures strong oversight of ethical, legal, and privacy aspects. Trust-IT Services leads communication, dissemination, and stakeholder engagement. Together, this international team is building a trusted, inclusive digital health ecosystem to support healthier futures for children around the world.
