Lerești Living Lab: Personalised Prevention Rooted in Community Life

The Lerești Living Lab is a pioneering example of a personalised prevention initiative, tailoring cancer prevention to people’s lived realities, social relationships, local routines and access conditions in a rural community.

In many rural communities, prevention still reaches people too late, too generically, or not at all. The Lerești Living Lab addresses this gap by showing how personalised prevention can be designed with citizens and communities, not delivered to them from a distance. Located in northern Argeș County, Romania, in the Subcarpathian area on the left bank of the Râul Târgului, Lerești is a rural commune of three villages, with around 4,588 residents in local demographic statistics and 4,124 inhabitants recorded at the 2021 census. Its geography, dispersed settlement pattern, and rural service realities make it a strong real-world setting for prevention design and implementation.

Coordinated by the Center for Innovation in Medicine (INOMED) and developed through the 4P-CAN project under the Horizon Europe Cancer Mission, Lerești Living Lab brings together local government, the village school, a community sports association, researchers, clinicians, public health experts, social scientists, and residents to co-create more relevant approaches to personalised primary cancer prevention. Over time, the model has also evolved towards personalised cardiovascular prevention, including through the projects PERFECTO and MAYA, while keeping the same community-based methodology and implementation logic. The approach has also been promoted beyond Lerești through policy dialogues in other Argeș localities, and in January 2026 the Argeș County Council approved a partnership agreement with INOMED to initiate and implement a county-level project on cancer and cardiovascular prevention, creating a formal pathway for scale-up across the county.

What makes the initiative distinctive is that it reflects the broader understanding of personalised prevention proposed by the PROPHET (A Personalised Prevention Roadmap for Future Healthcare) project: prevention should address the onset, progression, and recurrence of disease through targeted interventions that consider not only biological information, but also environmental and behavioural characteristics and the socio-economic and cultural context of individuals, and should be timely, effective, and equitable. In Lerești, this means that prevention is not tailored only through medical or biomarker-based risk. It is also adapted to social relationships, daily routines, trust networks, mobility constraints, and the practical barriers that shape health choices in community life.

The Lerești Living Lab generates this understanding through repeated face-to-face interviews, community consultations, personal network analysis, and Net-Map exercises. These methods help identify how people receive information, who influences their decisions, what makes participation easier or harder, and where local governance bottlenecks affect prevention delivery. In Lerești personal network analysis was piloted and validated to understand community social dynamics relevant to prevention, including how networks shape behaviours such as smoking, diet, and exercise. Rather than assuming that standard messages and standard channels will work, the model creates a more realistic basis for action: the right message, through the right channel, at the right moment, from the right person.

The model is implemented in real life rather than in a controlled pilot environment. Across four panel waves between 2023 and 2025, citizens helped refine tools and activities so they remained understandable, acceptable, and feasible in a rural setting. Prevention activities were embedded in familiar spaces such as school workshops, sports events, health festivals, seminars, and community exhibitions, and linked to practical resources including medical advice, blood tests, and medical examinations. In this way, the Lerești Living Lab does not only study prevention uptake; it actively improves the local conditions that make uptake possible.

Lerești Living Lab also demonstrates how personalised prevention can strengthen equity, another core element of the PROPHET framing and wider European personalised prevention agenda. PROPHET emphasises that health systems need innovative, sustainable, and high-quality personalised strategies for chronic disease prevention, while evidence reviews in the project also stress meaningful public and patient engagement in care, research, education, and governance. In Lerești, this is especially relevant because rural populations often face limited service access, lower institutional trust, reduced mobility, and fewer opportunities to engage with preventive care. By moving prevention into everyday community spaces and designing it with local actors, the initiative reduces these barriers and makes prevention more reachable, meaningful, and actionable.

The initiative is also relevant as a model of health-system innovation infrastructure. It expands the idea of personalisation beyond genetics alone and shows how behavioural, environmental, socio-economic, cultural, and relational factors can be translated into practical prevention design. At the same time, it offers a social and community innovation infrastructure that is highly relevant for more advanced fields such as genomics, biomarker-based risk stratification, and AI-enabled prevention, because it creates the trust, participation, governance, and real-world implementation conditions that such approaches require.

This is strongly aligned with the broader agenda of the PROPHET (A Personalised Agenda and Roadmap for the Future Healthcare) project, developed as an ICPerMed Family Coordinating and Support Action. PROPHET frames personalised prevention as a field that combines biomarkers and other individual information with behavioral, environmental and contextual factors to support implementation in real healthcare systems. The Leresti Living Lab thus exemplifies how the strategic priorities of Personalised Medicine as defined by ICPerMed, EP PerMed and both the Personalised Medicine SRIA and the Personalised Prevention PROPHET SRIA can be implemented in real life settings with strong benefits for the populations.

Importantly, the Lerești Living Lab has remained active beyond the original 4P-CAN project logic, functioning as an operational platform for continued implementation, learning, and adaptation. Its core elements — community partnership, citizen involvement, adaptive fieldwork, network-informed design, practical linkage to prevention resources, and data-informed planning — are transferable to other underserved settings and to other health priorities where trust, access, continuity, and local co-ownership matter. Lerești therefore shows that personalised prevention can be both scientifically grounded and socially meaningful: not only more precise, but also more participatory, context-sensitive, scalable, and equitable.

Why it matters?

It translates personalised prevention into community practice and improves reach, relevance and trust in a rural setting.

Replicability

The model can be adapted for other underserved communities because it relies on transferable methods, local partnerships and iterative co-creation.

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