About This Handbook
This is an evidence-based handbook, the guidance presented here is grounded in the real implementation experience of five countries and in the measurable outcomes generated during the pilot phase. To fully understand and apply the model correctly, this handbook should be read together with the Movement Pills Toolkit, the Action Plan, and the Capacity Building materials. These complementary documents provide operational tools, training frameworks and planning instruments that complete the implementation architecture
Movement Pills promotes physical activity as a form of preventive medicine by distributing free access to sport and exercise through trusted community channels, particularly pharmacies and health professionals.
The initial methodology was first developed in 2010 in Bologna as a local pilot initiative In 2022, it evolved into a national project implemented across Italy by UISP Aps In 2024, it was further expanded into an international project and piloted in five countries: Italy, Bulgaria, Estonia, Greece and Poland
This handbook consolidates the knowledge, operational insights and implementation lessons generated through that five-country experience into a single, structured and transferable reference framework
The handbook is relevant to:
Sport and physical activity organisations, including grassroots associations, sport clubs and national federations, that are looking for a structured, evidence-based approach to engage inactive or under-served populations through the application of the initial methodology
Public health organisations and healthcare institutions, such as pharmacies, GP networks and hospital foundations, that aim to implement social prescribing initiatives, promote physical activity or strengthen preventive health programmes in alignment with the principles of the initial methodology.
Regional and local authorities responsible for public health, social inclusion or community sport, who require a tested, evidence-based model derived from the initial methodology that can be institutionally supported, integrated into local policy frameworks or co-financed NGOs and civil society organisations active in fields such as social inclusion, ageing, workplace well-being or community development, that intend to embed structured physical activity promotion within their existing services by adopting the framework of the initial methodology
What This Handbook Is Not
It is not a rigid script, the Movement Pills model is designed to be adapted, in fact, the pilot demonstrated that rigid application of the initial model in different cultural or institutional contexts produces poor results What this handbook provides is a principled framework: the core elements that must be preserved in any implementation, alongside the flexibility to shape everything else around your local reality.
This handbook gives you the map The journey still requires your commitment
How It Is Structured
The handbook follows the logical sequence of a Movement Pills implementation, from conceptual foundations through to sustainability Each chapter addresses a distinct phase or dimension of the work You can read it cover to cover or use specific chapters as standalone references depending on your needs.
Throughout the text you will encounter three types of clearly marked boxes:
INITIAL METHODOLOGY
Grey background
COUNTRY
EXAMPLES
Coloured background per country
RECOMMENDATIONS
Red header
The core model as designed by UISP in Italy These boxes present the standard approach that was tested and validated in the original pilot They describe what the methodology recommends
Real stories from the four partner countries Each bubble is labelled with a flag and a topic so you can find relevant examples quickly Some contain direct quotes from partner reports; others describe specific decisions made during implementation
Cross-cutting lessons that apply regardless of country context, and specific recommendations derived from the consolidated evidence of all five pilots. These are the things worth writing on a wall before you start planning.
1. Foundations of the Movement Pills Model
The Movement Pills methodology is built on a deceptively simple premise: physical activity is as essential to health as any prescription medicine, and should be made available with the same institutional weight, accessibility, and trust This chapter outlines the conceptual foundations, key principles, and quality standards recommended for consistent application across all implementations
INITIAL METHODOLOGY
Movement Pills was designed by UISP Bologna (Italy) in response to growing rates of physical inactivity across Italian adult populations The core concept frames exercise as 'medicine', distributed through trusted health channels (primarily pharmacies) as a free, one-month voucher for structured physical activities The model was designed to engage adults who would never choose to go to a gym by addressing both economic and psychological barriers, tackling not only financial constraints but also resistance to change and sedentary routines
1.1 The Problem This Model Addresses
Physical inactivity is the fourth leading risk factor for global mortality (WHO). In Europe, approximately one quarter of adults do not meet the European Commission's and the World Health Organisation’s Regional Office for Europe recommendation on promoting HEPA across sectors
Traditional sport promotion initiatives fail to reach the most vulnerable groups: lower socioeconomic populations, older adults, people with chronic conditions, and those with long histories of negative sport experiences.
The Leaflet
1.2 Core Principles
The following ten principles define the Movement Pills model. They are operational commitments, not abstract values.
1. Accessibility
Participation is free or genuinely affordable Facilities are reachable Sessions fit around work and family. Psychological barriers, gym intimidation, fear of judgment, are proactively addressed in communication and session design.
2 Inclusiveness and Equity
Activities must suit different fitness levels and health conditions Additional support is provided to those facing greater barriers
3. Health-Oriented and Preventive Approach
Physical activity is promoted as a preventive measure complementing (not replacing) medical treatment The model reinforces preventive healthcare at community level by connecting sport and health sectors
4. Partnership-Based Implementation
Shared responsibility across health institutions, sport organisations, public authorities and civil society is essential. Clear roles, formal agreements, and regular coordination are required.
5. Quality and Safety
Qualified instructors, structured sessions, and risk assessment procedures are non-negotiable Participant limitations must be respected and training intensity adapted accordingly
6. Participant-Centred Approach
Participants shape their own activity pathways Feedback opportunities, individual support, and recognition of achievements build ownership and reduce drop-out.
7 Evidence-Based and Reflective Practice
Systematic data collection and honest evaluation inform continuous improvement Findings are shared across the partnership network
8. Sustainability and Long-Term Impact
The free trial is the entry point, not the destination. Gradual transition to self-managed activity and long-term partnerships are built into the model from day one.
BULGARIA Core Principles in Practice
The medical-first approach pushed all ten principles to their limit simultaneously Reaching diabetic and obese patients (Accessibility + Inclusiveness) required deep clinical trust-building Endocrinologists initially feared liability for exercise injuries, so the team produced a validated low-impact curriculum and conducted on-site safety visits before a single patient was referred (Quality + Safety) The result: a genuinely health-oriented, partnership-based implementation, but one that required 200 hours of project management and 400 hours of coordination before the first session ran "Once doctors knew their patients would be safe and not intimidated, they were willing to partner with us "
Estonia's experience illustrated what happens when Principle 4 (Partnership-Based Implementation) cannot be established at scale As a smaller, less well-known organisation, Firmasport found that cold outreach to sport facilities produced almost no results, even when the offer was genuinely attractive
306 outreach attempts across three cities resulted in just 15 recruited facilities
Zero facilities were recruited in Pärnu despite 75 attempts
"It is not possible to just leave the pill boxes somewhere without permission And because it is a pilot project, we cannot give examples of results from our own context, only Italian ones, which do not convince partners here, as the culture is very different "
ESTONIA The Credibility Challenge
2. The Initial Methodology and National Adaptations
This chapter presents the Movement Pills model as initially designed in Italy, then shows, country by country, how each partner adapted it Understanding both the initial design and the adaptations is essential for any new implementing organisation: you need to know what is fixed and what is flexible.
2A. The Initial Italian Model (UISP Aps)
INITIAL METHODOLOGY — Distribution
INITIAL METHODOLOGY — Activity Provision
In Italy, Movement Pills boxes are distributed primarily through pharmacies. Pharmacists are trained to introduce the project to all pharmacy visitors, with a special focus on individuals with chronic health conditions and to proactively hand over the box, not as a leaflet left on a counter, but as an active, personal offer linked to the customer's health situation This 'active dispensing' method leverages the pharmacist's trusted authority to frame physical activity as a genuine health intervention
INITIAL METHODOLOGY — Registration
UISP coordinates a large network of grassroots sport associations that pre-exist the Movement Pills project In the Italian pilot, 370 associations offered 1 200 distinct activity types across gym-based, outdoor, and water-based settings, from fitness and yoga to Nordic walking, Venetian rowing, and age-specific aqua gymnastics This variety ensures that participants can find something that suits their interests, fitness level, and schedule
Participants access activities through a leaflet included in the box, which lists all affiliated associations along with their schedules and contact information. Registration is handled by each association. A baseline questionnaire is completed prior to the first session, and a final questionnaire is administered after the one-month period
INITIAL METHODOLOGY — Scale
The Italian model operated at significant scale: 31 Local UISP committees, 364 Italian Municipalities engaged, 480 000 boxes distributed, 2 457 pharmacies involved This scale is made possible by the existence of UISP's pre-built national network
2B. National Adaptations
Each of the four pilot partner countries adapted the model significantly Some adaptations were planned; others emerged in response to unexpected local conditions All produced valuable learning
BULGARIA The Medical Prescription Model
Bulgaria made the most radical adaptation of the original Italian model by embedding Movement Pills inside the clinical referral system Rather than relying on general pharmacy traffic, the team recruited GPs and endocrinologists as formal 'prescribers', specifically targeting patients with Type 2 Diabetes and clinical obesity
KEY ADAPTATIONS:
Distribution channel: GPs and endocrinologists referred specific patients; pharmacies served as collection points, reinforcing the clinical framing
Target group: Adults aged 35–65 with diagnosed or high-risk metabolic conditions, far more defined than Italy's broad community reach
Activity design: All classes modified for obesity and diabetes (functional group fitness, yoga, aerobics, strength training) A nutrition coach delivered group health seminars alongside physical sessions
Trainer preparation: Extensive, trainers briefed on hypoglycaemia recognition, exercise modification for clinical groups, and escalation procedures
Liability management: A validated low-impact curriculum was produced and shared with referring doctors; site safety visits were conducted
WHY THIS WORKED: The 'prescription' framing resonated deeply with the medical culture of the region and with patients who needed authoritative encouragement to view exercise as treatment Gym facilities responded positively when framed as 'community health partners' gaining access to a hidden demographic
BULGARIA Unexpected Pivot: Reaching Teachers
During digital monitoring of Facebook campaigns, the team noticed unexpectedly high engagement from educators and school staff a group not initially targeted
Cross-referencing with an earlier EU survey showing 80%+ of regional teachers identified critical need for physical activity due to occupational stress, the team dynamically expanded its target to include the education sector.
"We tailored specific messaging to educators, presenting Movement Pills not just as a health tool, but as an intervention for occupational well-being."
This data-driven pivot is now recommended as a best practice for all future implementations: monitor your digital channels weekly and be prepared to adapt.
GREECE The Stadium Distribution Model
Greece made the most structurally different adaptation: rather than using pharmacies or community centres as distribution points, Olympiacos distributed all 29,586 boxes (99% of allocation, the highest rate of any country) at sport events
KEY ADAPTATIONS:
Distribution channel: Home matches and events of Olympiacos (football, basketball, volleyball) including Euroleague and Champions League games Collaboration with the Hellenic Athletics Federation enabled distribution at a major Piraeus road running event
Target group: Broad, fans of all ages attending events, with additional outreach to universities and students to extend reach beyond stadium audiences
Activity provision: All delivered exclusively through Olympiacos SFP Sport Academies (tennis, beach volleyball, boxing, fencing, swimming, sailing, SUP, track and field). Internal coordination between club departments ensured consistency
What was not adapted: No healthcare sector involvement (no pharmacies, no GPs). The model relied entirely on the institutional brand and community trust of Olympiacos
CHALLENGE: Some older adults perceived the physical activity box as actual medication and required additional explanation Digital registration via QR codes was also problematic for older adults, the team responded by increasing on-site human support at distribution points
GREECE — Scheduling as a Retention Tool
Participant drop-off in Greece was primarily driven by scheduling mismatches, training sessions did not align with when participants were actually available
The team's solution was immediate and practical: new training groups were created and morning weekday sessions were added, making full use of Olympiacos's available facilities
"Some participants withdrew due to difficulty accessing facilities because of long travel distances We responded by participating in smaller-scale matches and local activities to bring the project geographically closer to participants "
319 participants engaged in activities; 39 (12%) continued with paid participation after the trial
ESTONIA The Personal Network Model (and its limits)
Estonia produced the most candid and instructive account of what happens when the model meets an unsupportive institutional environment Firmasport's experience is essential reading for any smaller organisation considering implementation KEY ADAPTATIONS:
Distribution channels: Schools, company offices, a clinic, and member organisations, not pharmacies (cultural and regulatory barriers made pharmacy engagement impractical)
Activity provision: Heavy emphasis on free outdoor and community activities (nature trails, disc golf, orienteering, running groups) alongside gym-based Pilates, yoga, jiu-jitsu and Firmasport's own fitness challenges
Registration: Rather than directing participants to the main project website, the team created a Linktree enabling them to manage and update their own activity listings independently
ESTONIA What Estonia Recommends for Future Implementers
Despite the distribution challenges, Estonia's team produced some of the pilot's most honest and transferable lessons: "The project should be led by a well-known or even governmental organisation to gain stakeholder and media attention"
POLAND — The Community Hub Model
Poland adapted the model by replacing pharmacies entirely with community institutions: cultural centres, libraries, senior centres, kindergartens, restaurants, and local information hubs The logic was that these are the spaces where different demographic groups already gather, trust the staff, and are receptive to new initiatives
KEY ADAPTATIONS:
Distribution: Boxes placed at reception desks, in activity rooms, and rotated between spaces in facilities with limited room Facility managers and staff were briefed to actively introduce the boxes to users
Activity provision: 3 clubs, 12 activity types including gym fitness, Pilates, yoga, walking, running, cycling, and swimming, well-balanced and accessible
Partner engagement: Trainers who co-created the programme acted as its primary ambassadors Their existing relationships with target communities were more effective than any formal marketing
Promotion: Dedicated website with schedules and online registration, supported by social media from trainers and partner institutions, local press announcements, posters, and neighbourhood council channels
CHALLENGE: Formal approval processes for cooperation agreements with public institutions caused delays Solution: start approval processes 6–8 weeks before planned distribution and maintain proactive follow-up with decision-makers
POLAND Voice from a Participant
The Poland report includes a direct testimonial that captures what the model is designed to achieve: "Good morning I'd also like to say that Ms Dorota's classes are great (I can compare) I'd love to attend your paid classes "
This participant, who had evidently attended multiple different fitness providers and found Movement Pills better, represents the 19% who went on to continue with paid participation. 80 participants engaged in Poland; 15 (19%) continued after the trial.
2C. Relevant Data
Element
Distribution channel 438 pharmacies + 74 GPs
GPs, endocrinologists, pharmacies (active dispensing)
Primary target group General adult community
Diabetic / obese patients (35–65)
Sport events (stadium, Euroleague, athletics)
Healthcare integration Deep (core model)
Deepest of all countries
Sport fans + students (broad)
Offices, schools, clinic, member orgs
Cultural centres, libraries, senior centres, kindergarten s
Working adults, educators Mixed community (all ages)
None (brandbased trust) Minimal Minimal
Sport clubs / providers 140 associations, 39 activity types
3 clubs, 6 types (clinical focus)
Olympiacos academies only, 9 types
8 clubs, 10 types (outdoor focus)
3 clubs, 12 types (balanced)
Key innovation Model origin; pharmacy network Clinical referral stream; educator pivot
megadistribution
workaround; outdoor offer Community hub network; trainer as ambassador
3. Planning and Preparation
The quality of the planning phase sets the upper limit for implementation success Investing in structured preparation consistently results in smoother execution
INITIAL METHODOLOGY — Planning Framework
UISP's planning process is part of an advocacy strategy to promote Health Enhancing Physical Activity following the six phases: (1) Needs Analysis, (2) Partnership Development, (3) Programme Preparation, (4) Distribution and Engagement, (5) Activity Implementation, (6) Monitoring and Improvement Each phase informs the next, creating a continuous learning cycle Needs analysis in Italy draws on local administrations health data, UISP's existing association network intelligence, and direct community consultation
3.1 Local Context Analysis
Before designing anything, understand where you are working Map population groups with low physical activity levels, audit cultural attitudes toward exercise and 'free offers', identify existing sport and wellness provision, and assess the institutional landscape.
BULGARIA Needs Analysis: Starting from Clinical Data
BG Be Active began by identifying the specific health burden of their pilot region: high prevalence of Type 2 Diabetes and clinical obesity in Plovdiv and surrounding areas This epidemiological framing shaped every subsequent decision, who to target, which healthcare partners to approach, how to design activities, and how to address trainer liability concerns
"We decided to include GPs and endocrinologists specifically because of the high prevalence of Type 2 Diabetes and obesity in the region This medical-first approach ensured that Movement Pills were treated by patients as a necessary health intervention rather than a novelty "
ESTONIA — Needs Analysis: Facing Cultural Barriers Early
Firmasport's pre-pilot assessment identified a critical cultural barrier early: in Estonia, 'there is no free lunch' The expectation that everything has a price and that giving services away requires special justification is deeply ingrained This meant that the standard Italian value proposition 'offer free activities in exchange for community visibility' was simply not compelling in the Estonian context
Recognising this in the planning phase did not eliminate the problem, but it allowed the team to calibrate expectations and focus resources on personal relationship activation rather than broad outreach
3.2 Defining Realistic Objectives
Set objectives according to your actual capacity. The pilot revealed gaps between planned and actual distribution in some countries. Work backward from your desired impact to establish realistic targets:
Approximately 50% of distributed boxes are expected to be collected by interested recipients
About 50% of those who take a box are expected to register for an activity
Around 20% of participants are expected to continue with paid participation after the trial
GREECE — Setting Targets Around Events
Olympiacos set a single clear objective: distribute as many boxes as possible through existing home events By anchoring distribution to stadium attendance figures (Euroleague games regularly draw 10,000+ spectators), the team could predict volume with confidence 29,586 boxes were distributed from a 30,000 allocation, a 99% rate achieved through pure logistical excellence and the strength of an existing event infrastructure
The lesson: if you have a reliable high-footfall channel, design your target around it, do not set a target and then search for a channel
4. Building Effective Partnerships
Partnership quality was the single strongest predictor of implementation success across all five pilot countries
INITIAL METHODOLO
GY — The Italian Partnership Ecosystem In Italy, UISP operates a pre-existing national network of affiliated sport associations These associations are accustomed to coordinated national campaigns, familiar with UISP's quality standards, and motivated by a shared social mission The 'partnership development' phase for UISP is therefore largely an activation exercise, reaching into an existing network, rather than a recruitment exercise
4.1 The Partnership Ecosystem
Effective implementation depends on a well-functioning ecosystem, consider these as the loadbearing pillars
Healthcare actors Distribution, referral, credibility, participant motivation
Sport facilities and trainers
Public authorities
Activity delivery, participant onboarding, retention
Institutional credibility, facility access, communication channels
Patient safety assured; reduced admin burden; alignment with preventive health outcomes
New demographic access; visibility; social mission; potential for paid membership conversion
Community health outcomes; local visibility; alignment with health strategies
Community organisations Distribution, target group access, trusted communication Service to existing users; cobranding; low additional workload
BULGARIA Winning Over Sport Facilities
BG Be Active's most effective engagement strategy was what they called the 'Shared Value Proposition': presenting Movement Pills as a genuine opportunity for gyms to access a demographic they had never previously reached, sedentary adults with metabolic conditions who, once their health improved, had strong motivation to become long-term members
"The most effective strategy was appealing to clubs' desire for prestige and social contribution By framing the project as a 'big project' with high social value, we successfully motivated facilities to join They saw a clear benefit in being publicly associated with a widely recognised initiative that directly supports at-risk patients "
Trainers also reported unexpected professional satisfaction: "Several noted that helping 'patients' improve their health metrics was more motivating than standard fitness training "
POLAND
The Trainer-as-Ambassador Model
Swim for a Dream built their partnership strategy around trusted trainers who already had strong relationships with the communities they served Rather than approaching facilities as an unknown external organisation, the team asked trainers to introduce the initiative to their existing clients and networks
This produced faster buy-in, lower administrative friction, and higher participant confidence, because the Movement Pills offer was introduced by someone participants already knew Supporting tactics included: co-branding (logos on materials, social media mentions), sharing concrete engagement data from early-adopter facilities, and keeping the cooperation model deliberately simple and low-effort for venues
5. Activity Design
The activity programme is the heart of Movement Pills Box distribution brings people to the door; compelling, accessible, and safe activities keep them engaged and create lasting behavioural change
INITIAL METHODOLO
GY — Activity
Design
Principles
Italy's activity offer reflects UISP's founding philosophy of 'sport for all': non-competitive, inclusive, accessible across fitness levels and age groups The Italian model prioritises breadth to maximise the likelihood that any participant will find something appealing
Intensity is progressive Formats are welcoming rather than performance-oriented Outdoor and water activities are included alongside gym-based options to remove the psychological barrier of entering a traditional fitness environment.
BULGARIA Activity Design for Clinical Populations
Bulgaria's activity programme was the most clinically adapted of all pilot countries Every session was modified for participants with obesity and Type 2 Diabetes:
All exercises low-impact and progressively intensified
Trainers briefed to recognise and respond to hypoglycaemia
Group fitness, yoga, aerobics, kettlebell, and functional classes no high-intensity formats
A nutrition coach delivered a group seminar on healthy eating and metabolic health alongside the physical programme
Social atmosphere deliberately cultivated: trainers created non-intimidating environments to ensure retention among participants with long histories of inactivity
RECOMMENDATION FROM BULGARIA: Create a formal 'Medical Fitness' certification or quality seal for trainers working with diabetes and obesity This would significantly accelerate GP trust and referral rates in any future clinical implementation
GREECE Using Existing Academy Infrastructure
Greece delivered all activities exclusively through Olympiacos SFP Sport Academies, an existing highquality infrastructure with trained coaches, established safety protocols, and a wide facility network in Piraeus
9 activity types were offered: boxing, kick boxing, fencing, walking, track and field, tennis, beach volleyball, swimming, sailing and SUP
This 'single provider' model ensured consistency and quality but created a scheduling bottleneck When participants' availability did not match facility schedules, the team's response was fast and effective: new groups were created, morning weekday slots were added, and smaller local venues were activated to reduce travel barriers
"All physical activities were delivered exclusively by Olympiacos SFP through its academies, ensuring consistency, high quality standards, and strong participant trust "
ESTONIA Outdoor and Free Activities as a Workaround
When indoor sport facilities proved difficult to recruit, Estonia expanded its activity offer to include activities that require no facility agreement: nature trails, disc golf parks, orienteering routes, and running groups
These free, outdoor activities allowed FirmaSport to provide a credible and varied activity offer despite a limited partner base
8 clubs contributed 10 activity types in total: Pilates, yoga, jiu-jitsu, Firmasport's own fitness challenges, walking, running, orienteering, nature trails, disc golf, and running groups
LESSON: If indoor facility recruitment is proving slow, launch with outdoor and community-based activities immediately This maintains momentum, gives participants something to engage with, and creates proof points for approaching reluctant indoor facilities
Poland achieved one of the most balanced activity mix: 12 types across gym (fitness, Pilates, yoga, martial arts, flexibility), outdoor (walking, running, cycling), and water (swimming) settings
With only 3 sport clubs, this breadth reflects deliberate programming rather than a large provider network
The team focused on types that were genuinely accessible to their mixed-age, community-centre-based target group
Senior centres reported particularly strong turnout and engagement, validating the choice of inclusive, low-intensity indoor formats for older participants
6. The Distribution System
The Movement Pills box is simultaneously a physical object, a symbolic gesture, a communications tool, and a psychological trigger. The distribution system is what connects all of them. Getting it right determines who receives the box, what they understand about it, and whether they act on it
The defining feature of the Italian distribution model is what the project team calls “active dispensing ” Rather than simply leaving boxes on shelves for customers to find, pharmacists are trained to present the project to every pharmacy visitor They also identify customers with chronic conditions who are collecting prescriptions and personally hand them the box, framing it as a health tool tailored to their specific situation, carrying the same authority as medication.
BULGARIA Active Dispensing in Practice
In Bulgaria, boxes were actively dispensed: pharmacists and medical staff received specific training to identify patients purchasing medication for chronic conditions (such as diabetes or hypertension) and personally provide them with a Movement Pills box, not as a promotional leaflet, but as a validated health tool
"Instead of passive placement, we implemented an 'active dispensing' method: pharmacists and medical staff were trained to identify patients purchasing medication for chronic conditions and personally hand them a Movement Pills box This validated the intervention as a legitimate health tool "
One mid-course adjustment: direct GP referrals were slower than expected due to consultation time limits
The team shifted a higher volume of stock to pharmacy counters, where staff had more time to explain the project, resulting in faster uptake.
GREECE Event-Based Mass Distribution
Greece demonstrated that high-volume distribution is achievable without a pharmacy network, if you have a large, trusted event infrastructure Key elements of the Greek distribution model: Information stands at every home Olympiacos match and major sport event
Promotional staff (4 people, part-time during events) dedicated to participant outreach and on-the-spot explanation
Collaboration with the Hellenic Athletics Federation for distribution at a Piraeus road running event, extending reach beyond Olympiacos's own fan base
CHALLENGE: The box design was occasionally mistaken for actual medication by older participants The team responded with additional on-site signage and verbal explanation from promotional staff
POLAND — Community Hub Distribution
Poland's distribution model relied on facility managers to place boxes in visible, high-traffic locations within their institutions, reception desks, activity rooms, notice boards Where space was limited, boxes were rotated between rooms to ensure visibility
The key to making this work: facility staff were briefed and personally motivated to champion the initiative to their users Without this human element, community hub placement risks becoming passive placement, a box on a shelf that nobody notices
LOGISTICAL CHALLENGE: Several public institutions required formal approval before boxes could be placed on their premises Starting this approval process 6–8 weeks in advance is now recommended as standard practice
ESTONIA The Linktree Solution
Estonia's most practical and transferable innovation was replacing the main project website with a Linktree as the primary activity listing tool
The original project website required multiple clicks to reach relevant information, could not be updated by local partners, and was in English, all significant barriers for Estonian participants
The Linktree allowed the Estonia team to add, remove, and update activity offers themselves at any time, without waiting for central project support.
"The offers for free activities should be listed on paper inside the actual MP box, not only online."
7. Communication and Promotion
Promotion of Movement Pills serves two distinct purposes: reaching potential participants, and maintaining the commitment of distribution and activity partners These require different messages and different channels.
INITIAL METHODOLO
GY — Italian Communicati on Strategy
UISP's communication model integrates three layers: (1) institutional endorsement from municipalities and health authorities; (2) professional referral via healthcare channels; (3) community-level promotion through local associations' existing networks. The combination of top-down institutional credibility and bottom-up grassroots activation is what makes the Italian model particularly effective at reaching people who would ignore standard advertising
BULGARIA — Three-Channel Communication Strategy
Bulgaria used a three-channel approach that proved highly effective: OFFLINE (primary): Face-to-face briefings with healthcare professionals This channel was the most effective for reaching the target clinical group because participants received the recommendation from an authority figure they trusted
DIGITAL: Targeted Facebook and Instagram campaigns for the 35–65 age group in the pilot region, sharing participant success stories, and explaining the 'PILLS' concept
INSTITUTIONAL: Official endorsement and promotion through the Municipalities of Plovdiv and Markovo, providing institutional validation and reaching citizens through municipal channels
UNEXPECTED INSIGHT: Facebook monitoring revealed high engagement from educators, leading to a successful mid-campaign expansion of the target group to include teachers as a distinct segment
GREECE — Event Presence as Primary Communication
For Greece, sport events were not just distribution channels, they were the primary communication channel Face-to-face interaction at Olympiacos events allowed promotional staff to explain the concept immediately, answer questions on the spot, and sign participants up in real time
"Direct engagement during sport events proved to be the most effective communication channel, as it enabled immediate interaction with citizens, on-the-spot information provision and direct registration of interested participants "
When face-to-face was not possible due to geography (many fans live far from Piraeus facilities), the team pivoted to outreach at local universities, reaching a younger, geographically distributed audience through a trusted institutional channel
ESTONIA What Did Not Work and Why
Estonia used social media, a webpage, and newsletters to member companies The most successful channel was direct email There was no media interest
"The only partners we got were through our personal contacts, and it is not sustainable this way "
Three systemic barriers undermined broader communication success:
Low organisational name recognition meant press and media did not engage
The project website was not user-friendly, not locally editable, and not in Estonian
Cultural scepticism toward free offers meant digital promotion generated curiosity but not commitment LESSON FOR FUTURE IMPLEMENTERS: Invest in your own digital infrastructure from the outset. A locally editable, locally translated, simple activity listing page is more valuable than sophisticated marketing if partners and participants cannot navigate to what they need.
POLAND — Multi-Channel Local Promotion
Poland used the most diverse channel mix of all pilot countries:
Direct meetings with facility managers and target groups
Social media promotion via project trainers and partner institutions (leveraging their existing followers)
Local press announcements and articles
Posters and leaflets in community centres, libraries, and neighbourhood council boards
Promotion in internal brochures of partner institutions
The team noted that information spread most effectively within and among the partner facilities' existing communities, confirming that trusted intermediaries outperform direct-to-public advertising for this type of initiative
