Francesca Pennucci | Scuola Superiore Sant'Anna (original) (raw)

Books by Francesca Pennucci

Mefop, 2018

Il presente lavoro di ricerca si propone di analizzare gli scenari futuri di azione dei Fondi San... more Il presente lavoro di ricerca si propone di analizzare gli scenari futuri di azione dei Fondi Sanitari Integrativi (Fsi), tenendo conto sia dell’opinione dei diversi portatori di interesse, sia dei cittadini italiani; intende altresì valutare, dato il quadro normativo italiano, possibili ambiti di sinergia con il Sistema Sanitario Nazionale (Ssn), con l’obiettivo di individuare strategie di incremento del valore aggiunto complessivamente prodotto con le risorse della collettività.

_________________________________________________________________________ Stampato nel mese di ma... more _________________________________________________________________________ Stampato nel mese di maggio 2017 presso la Tipografia Campano snc -Ghezzano (PI) Indice Premesse 6 Gli obiettivi del progetto beFood 10 I temi affrontati 12 La metodologia "mixed" 16 Indagine Campionaria 16 Campione 17 Questionario 17 La webAPP 22 Coinvolgimento diretto degli studenti e studio delle interazioni tra pari 24 Competizione collaborativa: elementi di gamification 26 La comunicazione 30 Fasi del progetto 32 La progettazione di beFood 32 La settimana di formazione-informazione degli studenti in Alternanza 33 Utilizzo estensivo degli strumenti di indagine da parte dei ragazzi in Alternanza 37 I risultati dell'indagine campionaria 42 Le abitudini alimentari 44 L'attività sportiva e attività fisica 59 I profili beFood 64 Scelte consapevoli? Etichette, fonti informative, influenze e consigli 66 Risultati qualitativi del progetto beFood 74 Impatto sugli studenti di Alternanza Scuola-Lavoro 74 Creare "salute" intorno agli studenti in Alternanza 81 Considerazioni conclusive 86 Gruppo di ricerca e lavoro 90 Ringraziamenti 94 Bibliograf ia 96 Sitograf ia 99 PREMESSE GLI OBIETTIVI DEL PROGETTO BEFOOD LA METODOLOGIA "MIXED" Provincia Popolazione 16-17 anni nella Regione Toscana al 1° gennaio 2016 Campione rappresentativo (p=0.05, d=0.04) Massa Carrara anni e campione rappresentativo per provincia Scenario Sei al supermarket per comprarti qualcosa per la colazione. Cosa sceglieresti? Alternativa 1 Delle merendine, confezionate in un incarto brillante e colorato, con su scritto che contengono vitamine.

Papers by Francesca Pennucci

International Journal of Integrated Care, Dec 27, 2023

Management decision, Jan 26, 2024

European journal of public health, Oct 1, 2022

During the last years, organizational models to assist women during pregnancy have changed. The p... more During the last years, organizational models to assist women during pregnancy have changed. The physiological management of low-risk pregnancy is gaining momentum thanks to increased available evidence. Therefore, a need to assess women's acceptance of these new proposals is emerging. This study aims to explore women's preferences during pregnancy and childbirth. We enrolled women from the continuously active survey on the maternity pathway in Tuscany, Italy. We designed Two Discrete Choice Experiments (DCE) and administered them through web-based surveys. We sought to catch women's preferences on health professionals to be involved, team-based or exclusive assistance, the physical proximity of healthcare services, and cost per service. We also explored women's decision-making autonomy and pain management during labour and childbirth. Additionally, we investigated women's information needs on the physiological model of low-risk pregnancy management through qualitative methods. Mixed logit models on the DCEs results show that women prefer being assisted during pregnancy and childbirth by healthcare services that are free of charge, easily accessible from a geographic point of view, and provided by a gynaecologist. The interaction effects reveal statistically significant differences for some sociodemographic variables of respondents and maternity pathway attributes. Besides, qualitative analyses highlight that women are interested in the physiological management of low-risk pregnancy according to their level of knowledge, confidence and safety feelings, and beliefs concerning non-medicalization and autonomy. The main findings of this study point out several implications for policy and managerial practice to effectively implement the physiological model of low-risk pregnancy management. Key messages: This study proves that costs, travel distance, and type of health professional are the main determinants of women's elicited preferences during pregnancy and childbirth. Policymakers and healthcare managers should consider these findings in organizing and providing maternal and childbirth health services to foster the physiological management of low-risk pregnancies.

2023 IEEE Symposium on Computers and Communications (ISCC)

Global Fashion Management Conference

BMC Health Services Research

Background Worldwide healthcare systems face challenges in assessing and monitoring chronic care ... more Background Worldwide healthcare systems face challenges in assessing and monitoring chronic care pathways and, even more, the value generated for patients. Patient-reported outcomes measures (PROMs) represent a valid Real-World Evidence (RWE) source to fully assess health systems’ performance in managing chronic care pathways. Methods The originality of the study consists in the chance of adopting PROMs, as a longitudinal assessment tool for continuous monitoring of patients’ adherence to therapies and self-care behavior recommendations in clinical practice and as a chance to provide policy makers insights to improve chronic pathways adopting a patient perspective. The focus was on PROMs of patients with chronic heart failure (CHF) collected in the Gabriele Monasterio Tuscan Foundation (FTGM), a tertiary referral CHF centre in Pisa, Italy. During the hospital stay, CHF patients were enrolled and received a link (via SMS or email) to access to the first questionnaire. Follow-up quest...

The International Journal of Health Planning and Management

International Journal of Integrated Care

International Journal of Environmental Research and Public Health, Sep 20, 2020

Health Policy, 2021

INTRODUCTION The incidence of overweight among youth in Western Countries requires the implementa... more INTRODUCTION The incidence of overweight among youth in Western Countries requires the implementation of initiatives to promote healthy lifestyles. Although under particular conditions obesity is not preventable, drawing attention on factors affecting teenagers' preferences can ameliorate the efficacy of public interventions designed for health promotion. METHODS This study aims at eliciting teenagers' food preferences through a discrete choice experiment, conducted in Tuscany using a webAPP survey, with the participation of more than 4,700 teenagers. Respondents expressed their preferences for breakfast food based on three attributes: food quality, packaging and claim. The survey also collected information on respondents' socio-demographic characteristics, social influence and media use for food information. RESULTS Teenagers' preferences for healthy foods seem positively related with their own level of food literacy. The tendency of respondents to read labels and nutritional facts is positively associated with preferences for healthier foods. Peers' influence is not significant, while family influence has a positive impact on teenagers' healthy choices. Internet usage is associated with unhealthy choices with a healthy aspect. CONCLUSION The results can be useful in defining effective actions for the promotion of healthy behaviors among teenagers, either in communication and awareness campaigns or in education and activation initiatives, with respect to the reading and interpretation of nutritional facts and labels, the role of family and friends, and the use of media.

Abitudini e preferenze alimentari, così come attività fisica e sportiva, sono temi fondamentali n... more Abitudini e preferenze alimentari, così come attività fisica e sportiva, sono temi fondamentali nell’ambito della prevenzione della salute, che oggi risulta sempre più centrale per l’implementazione di politiche pubbliche mirate alla riduzione di fenomeni quali l’obesità e la sedentarietà e delle patologie conseguenti. Il paradigma adottato nelle politiche di prevenzione e promozione della salute è stato caratterizzato per lo più da azioni verticali e unidirezionali, basate su processi di informazione spesso con impatto assai limitato sui comportamenti dell’utenza. Processi di comunicazione-azione efficaci sono invece quelli che permettono un percorso di apprendimento tale da determinare cambiamenti nei comportamenti e l’assunzione di responsabilità individuali e collettive rispetto agli obiettivi di salute. ‘beFood’ è un progetto di ricerca-azione implementato in Toscana per testare un nuovo modello educativo-partecipativo con l’obiettivo di mettere gli stessi adolescenti in condizione di diventare fruitori e divulgatori del messaggio di salute e non semplici destinatari di un intervento di promozione. Il progetto ha visto partecipare un gruppo di studenti liceali (n = 49) di 10 scuole secondarie toscane coinvolti in un percorso di Alternanza scuola-lavoro avviato a novembre 2016 e conclusosi a maggio 2017. Le modalità innovative nel promuovere il messaggio di salute sono state caratterizzate dal coinvolgimento degli studenti per la progettazione e conduzione di un’iniziativa di promozione della salute che includeva un’indagine campionaria volta a rilevare abitudini e preferenze in ambito alimentare e di attività fisica dei loro coetanei. Durante la rilevazione, gli studenti stessi hanno promosso l’adozione di corretti stili di vita nei confronti di più di 5000 persone. Questa esperienza ha permesso così di indagare le potenzialità dei processi di influenza peer-to-peer e l’utilizzo di linguaggi e tecnologie digitali nel diffondere contenuti di salute alla popolazione di riferimento, ottenendo dei risultati preliminari sulle potenzialità di questo approccio nelle politiche di promozione della salute. Inoltre l’indagine campionaria ha permesso di rilevare le abitudini degli adolescenti toscani evidenziando aspetti su cui impostare il lavoro futuro. Daily choices and personal preferences regarding food habits and physical activity are critical topics in health prevention. Health prevention is the first place for the implementation of public policies that aim at tackling obesity and physical inactivity that are some of the most relevant risk factors for chronic diseases, such as diabetes or complex mental diseases related to eating disorders. Generally, health promotion interventions are delivered in a top-down process with targets seen as passive receivers with a limited impact on their behaviors. Active communication processes are instead more effective to foster a learning path that lead to a behavioral change and stimulate people in taking on individual and collective responsibility towards health outcomes. ‘beFood’ is an action research project implemented in Tuscany as a new training and communication method with the aim of making adolescents receivers and messengers of the health contents. A group of Tuscan students (n = 49) from ten high school institutes was involved in this initiative as a part of their mandatory work-related learning pathway called Alternanza scuola-lavoro (a young apprenticeship program) from November 2016 to May 2017. The main objective of the project was to test the effectiveness of innovative strategies in promoting healthy lifestyles. In particular, the project aimed at shifting the participants’ role from passive receivers to active messengers by engaging them in the design phase and the conduction of a digital technology-based survey. They collected data on the habits and the preferences of their peers about food and physical activity by spreading a questionnaire including the healthy message to more than 5,000 respondents. During the whole process, it was possible to investigate the potential influence of peer-to-peer processes and the impact of customized languages and new technologies in spreading health promotional messages to the population target.

Micro & Macro Marketing, 2019

The Journal of Entrepreneurial and Organizational Diversity, 2021

A growing interest in healthcare, and particularly in the management of social and healthcare ser... more A growing interest in healthcare, and particularly in the management of social and healthcare services, is currently emerging in both academic and applied fields. More in general, the societal and economical changes of the last decades are increasingly questioning the available models applied in the structuring and administering of public services as well as their effectiveness and efficiency in addressing the needs of the populations. Great importance has been given to new paradigms such as New Public Governance (NPG), collaborative governance and co-production, but there is still a need to clarify the definition and description of the application of these models and to study their outputs and outcomes. This is a book review of the volume entitled Co-production and Japanese Healthcare, by Victor Pestoff, which contains several theoretical and empirical inputs that can foster research and awareness on the evolution of public services and on new governance opportunities, with particular attention to the different actors involved and their potential roles in building innovative responses to the emerging social and health needs of populations around the world. Healthcare systems should not only achieve efficiency and effectiveness. The proposal here is to shift the focus towards more socially oriented approaches that allow to mobilize resources from individuals and communities.

BMJ Open, 2021

IntroductionScholars, healthcare practitioners and policymakers have increasingly focused their a... more IntroductionScholars, healthcare practitioners and policymakers have increasingly focused their attention on patient-centredness. Patient-reported metrics support patient-driven improvement actions in healthcare systems. Despite the great interest, patient-reported outcome measures (PROMs) are still not extensively collected in many countries and not integrated with the collection of patient-reported experience measures (PREMs). This protocol describes the methodology behind an innovative observatory implemented in Tuscany, Italy, aiming at continuously and longitudinally collecting PROMs and PREMs for elective hip and knee total replacement.Methods and analysisThe Observatory is digital. Enrolled patients are invited via SMS or email to online questionnaires, which include the Oxford Hip Score or the Oxford Knee Score. Data are real-time reported to healthcare professionals and managers in a raw format, anonymised and aggregated on a web platform. The data will be used to investiga...

International Journal of Environmental Research and Public Health, 2020

Co-production is an approach to designing, delivering, and evaluating public services through str... more Co-production is an approach to designing, delivering, and evaluating public services through strict collaboration among professionals and the people using services with an equal and reciprocal relationship. Health promotion initiatives that include education services rarely use the co-production approach. Nevertheless, the value of co-production is widely recognized, although it is considered a normative good, and scarce and mixed evidence is available in literature. The purpose of this paper is to provide evidence supporting the hypothesis that a co-production approach, applied to an intervention for preventing obesity, can be effective and efficient. To this end, an evaluation of the processes, outputs meant as intermediate results, and behavioral and economic outcomes of a public health-promotion initiative co-produced and co-delivered with adolescents (beFood) was conducted. Mixed methods were used, including field-observations, two self-reported questionnaires, and an opportun...

BMJ Open, 2020

ObjectivesTo evaluate the feasibility of a digital and continuous collection and reporting of pat... more ObjectivesTo evaluate the feasibility of a digital and continuous collection and reporting of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) for chronic heart failure (CHF).DesignA single-site pilot study was settled for evaluating the feasibility of the intervention, both using qualitative and quantitative data (ie, workshop, surveys).SettingThe pilot has been implemented in a Tuscan specialised hospital (Italy).Participants162 patients were involved. Inclusion criteria were: a previous diagnosis of HF, age ≥18 years, absence of cognitive impairment or active tumours, ability to provide informed consent to study participation.InterventionThe continuous collection and reporting of PROMs and PREMs has been designed and implemented in 2018. PREMs questionnaires for patients were developed, while Kansas City Cardiomyopathy Questionnaire-12 was used for assessing PROMs. Questionnaires are administered at specific time points: discharge; 30 day...

Mefop, 2018

Il presente lavoro di ricerca si propone di analizzare gli scenari futuri di azione dei Fondi San... more Il presente lavoro di ricerca si propone di analizzare gli scenari futuri di azione dei Fondi Sanitari Integrativi (Fsi), tenendo conto sia dell’opinione dei diversi portatori di interesse, sia dei cittadini italiani; intende altresì valutare, dato il quadro normativo italiano, possibili ambiti di sinergia con il Sistema Sanitario Nazionale (Ssn), con l’obiettivo di individuare strategie di incremento del valore aggiunto complessivamente prodotto con le risorse della collettività.

_________________________________________________________________________ Stampato nel mese di ma... more _________________________________________________________________________ Stampato nel mese di maggio 2017 presso la Tipografia Campano snc -Ghezzano (PI) Indice Premesse 6 Gli obiettivi del progetto beFood 10 I temi affrontati 12 La metodologia "mixed" 16 Indagine Campionaria 16 Campione 17 Questionario 17 La webAPP 22 Coinvolgimento diretto degli studenti e studio delle interazioni tra pari 24 Competizione collaborativa: elementi di gamification 26 La comunicazione 30 Fasi del progetto 32 La progettazione di beFood 32 La settimana di formazione-informazione degli studenti in Alternanza 33 Utilizzo estensivo degli strumenti di indagine da parte dei ragazzi in Alternanza 37 I risultati dell'indagine campionaria 42 Le abitudini alimentari 44 L'attività sportiva e attività fisica 59 I profili beFood 64 Scelte consapevoli? Etichette, fonti informative, influenze e consigli 66 Risultati qualitativi del progetto beFood 74 Impatto sugli studenti di Alternanza Scuola-Lavoro 74 Creare "salute" intorno agli studenti in Alternanza 81 Considerazioni conclusive 86 Gruppo di ricerca e lavoro 90 Ringraziamenti 94 Bibliograf ia 96 Sitograf ia 99 PREMESSE GLI OBIETTIVI DEL PROGETTO BEFOOD LA METODOLOGIA "MIXED" Provincia Popolazione 16-17 anni nella Regione Toscana al 1° gennaio 2016 Campione rappresentativo (p=0.05, d=0.04) Massa Carrara anni e campione rappresentativo per provincia Scenario Sei al supermarket per comprarti qualcosa per la colazione. Cosa sceglieresti? Alternativa 1 Delle merendine, confezionate in un incarto brillante e colorato, con su scritto che contengono vitamine.

International Journal of Integrated Care, Dec 27, 2023

Management decision, Jan 26, 2024

European journal of public health, Oct 1, 2022

During the last years, organizational models to assist women during pregnancy have changed. The p... more During the last years, organizational models to assist women during pregnancy have changed. The physiological management of low-risk pregnancy is gaining momentum thanks to increased available evidence. Therefore, a need to assess women's acceptance of these new proposals is emerging. This study aims to explore women's preferences during pregnancy and childbirth. We enrolled women from the continuously active survey on the maternity pathway in Tuscany, Italy. We designed Two Discrete Choice Experiments (DCE) and administered them through web-based surveys. We sought to catch women's preferences on health professionals to be involved, team-based or exclusive assistance, the physical proximity of healthcare services, and cost per service. We also explored women's decision-making autonomy and pain management during labour and childbirth. Additionally, we investigated women's information needs on the physiological model of low-risk pregnancy management through qualitative methods. Mixed logit models on the DCEs results show that women prefer being assisted during pregnancy and childbirth by healthcare services that are free of charge, easily accessible from a geographic point of view, and provided by a gynaecologist. The interaction effects reveal statistically significant differences for some sociodemographic variables of respondents and maternity pathway attributes. Besides, qualitative analyses highlight that women are interested in the physiological management of low-risk pregnancy according to their level of knowledge, confidence and safety feelings, and beliefs concerning non-medicalization and autonomy. The main findings of this study point out several implications for policy and managerial practice to effectively implement the physiological model of low-risk pregnancy management. Key messages: This study proves that costs, travel distance, and type of health professional are the main determinants of women's elicited preferences during pregnancy and childbirth. Policymakers and healthcare managers should consider these findings in organizing and providing maternal and childbirth health services to foster the physiological management of low-risk pregnancies.

2023 IEEE Symposium on Computers and Communications (ISCC)

Global Fashion Management Conference

BMC Health Services Research

Background Worldwide healthcare systems face challenges in assessing and monitoring chronic care ... more Background Worldwide healthcare systems face challenges in assessing and monitoring chronic care pathways and, even more, the value generated for patients. Patient-reported outcomes measures (PROMs) represent a valid Real-World Evidence (RWE) source to fully assess health systems’ performance in managing chronic care pathways. Methods The originality of the study consists in the chance of adopting PROMs, as a longitudinal assessment tool for continuous monitoring of patients’ adherence to therapies and self-care behavior recommendations in clinical practice and as a chance to provide policy makers insights to improve chronic pathways adopting a patient perspective. The focus was on PROMs of patients with chronic heart failure (CHF) collected in the Gabriele Monasterio Tuscan Foundation (FTGM), a tertiary referral CHF centre in Pisa, Italy. During the hospital stay, CHF patients were enrolled and received a link (via SMS or email) to access to the first questionnaire. Follow-up quest...

The International Journal of Health Planning and Management

International Journal of Integrated Care

International Journal of Environmental Research and Public Health, Sep 20, 2020

Health Policy, 2021

INTRODUCTION The incidence of overweight among youth in Western Countries requires the implementa... more INTRODUCTION The incidence of overweight among youth in Western Countries requires the implementation of initiatives to promote healthy lifestyles. Although under particular conditions obesity is not preventable, drawing attention on factors affecting teenagers' preferences can ameliorate the efficacy of public interventions designed for health promotion. METHODS This study aims at eliciting teenagers' food preferences through a discrete choice experiment, conducted in Tuscany using a webAPP survey, with the participation of more than 4,700 teenagers. Respondents expressed their preferences for breakfast food based on three attributes: food quality, packaging and claim. The survey also collected information on respondents' socio-demographic characteristics, social influence and media use for food information. RESULTS Teenagers' preferences for healthy foods seem positively related with their own level of food literacy. The tendency of respondents to read labels and nutritional facts is positively associated with preferences for healthier foods. Peers' influence is not significant, while family influence has a positive impact on teenagers' healthy choices. Internet usage is associated with unhealthy choices with a healthy aspect. CONCLUSION The results can be useful in defining effective actions for the promotion of healthy behaviors among teenagers, either in communication and awareness campaigns or in education and activation initiatives, with respect to the reading and interpretation of nutritional facts and labels, the role of family and friends, and the use of media.

Abitudini e preferenze alimentari, così come attività fisica e sportiva, sono temi fondamentali n... more Abitudini e preferenze alimentari, così come attività fisica e sportiva, sono temi fondamentali nell’ambito della prevenzione della salute, che oggi risulta sempre più centrale per l’implementazione di politiche pubbliche mirate alla riduzione di fenomeni quali l’obesità e la sedentarietà e delle patologie conseguenti. Il paradigma adottato nelle politiche di prevenzione e promozione della salute è stato caratterizzato per lo più da azioni verticali e unidirezionali, basate su processi di informazione spesso con impatto assai limitato sui comportamenti dell’utenza. Processi di comunicazione-azione efficaci sono invece quelli che permettono un percorso di apprendimento tale da determinare cambiamenti nei comportamenti e l’assunzione di responsabilità individuali e collettive rispetto agli obiettivi di salute. ‘beFood’ è un progetto di ricerca-azione implementato in Toscana per testare un nuovo modello educativo-partecipativo con l’obiettivo di mettere gli stessi adolescenti in condizione di diventare fruitori e divulgatori del messaggio di salute e non semplici destinatari di un intervento di promozione. Il progetto ha visto partecipare un gruppo di studenti liceali (n = 49) di 10 scuole secondarie toscane coinvolti in un percorso di Alternanza scuola-lavoro avviato a novembre 2016 e conclusosi a maggio 2017. Le modalità innovative nel promuovere il messaggio di salute sono state caratterizzate dal coinvolgimento degli studenti per la progettazione e conduzione di un’iniziativa di promozione della salute che includeva un’indagine campionaria volta a rilevare abitudini e preferenze in ambito alimentare e di attività fisica dei loro coetanei. Durante la rilevazione, gli studenti stessi hanno promosso l’adozione di corretti stili di vita nei confronti di più di 5000 persone. Questa esperienza ha permesso così di indagare le potenzialità dei processi di influenza peer-to-peer e l’utilizzo di linguaggi e tecnologie digitali nel diffondere contenuti di salute alla popolazione di riferimento, ottenendo dei risultati preliminari sulle potenzialità di questo approccio nelle politiche di promozione della salute. Inoltre l’indagine campionaria ha permesso di rilevare le abitudini degli adolescenti toscani evidenziando aspetti su cui impostare il lavoro futuro. Daily choices and personal preferences regarding food habits and physical activity are critical topics in health prevention. Health prevention is the first place for the implementation of public policies that aim at tackling obesity and physical inactivity that are some of the most relevant risk factors for chronic diseases, such as diabetes or complex mental diseases related to eating disorders. Generally, health promotion interventions are delivered in a top-down process with targets seen as passive receivers with a limited impact on their behaviors. Active communication processes are instead more effective to foster a learning path that lead to a behavioral change and stimulate people in taking on individual and collective responsibility towards health outcomes. ‘beFood’ is an action research project implemented in Tuscany as a new training and communication method with the aim of making adolescents receivers and messengers of the health contents. A group of Tuscan students (n = 49) from ten high school institutes was involved in this initiative as a part of their mandatory work-related learning pathway called Alternanza scuola-lavoro (a young apprenticeship program) from November 2016 to May 2017. The main objective of the project was to test the effectiveness of innovative strategies in promoting healthy lifestyles. In particular, the project aimed at shifting the participants’ role from passive receivers to active messengers by engaging them in the design phase and the conduction of a digital technology-based survey. They collected data on the habits and the preferences of their peers about food and physical activity by spreading a questionnaire including the healthy message to more than 5,000 respondents. During the whole process, it was possible to investigate the potential influence of peer-to-peer processes and the impact of customized languages and new technologies in spreading health promotional messages to the population target.

Micro & Macro Marketing, 2019

The Journal of Entrepreneurial and Organizational Diversity, 2021

A growing interest in healthcare, and particularly in the management of social and healthcare ser... more A growing interest in healthcare, and particularly in the management of social and healthcare services, is currently emerging in both academic and applied fields. More in general, the societal and economical changes of the last decades are increasingly questioning the available models applied in the structuring and administering of public services as well as their effectiveness and efficiency in addressing the needs of the populations. Great importance has been given to new paradigms such as New Public Governance (NPG), collaborative governance and co-production, but there is still a need to clarify the definition and description of the application of these models and to study their outputs and outcomes. This is a book review of the volume entitled Co-production and Japanese Healthcare, by Victor Pestoff, which contains several theoretical and empirical inputs that can foster research and awareness on the evolution of public services and on new governance opportunities, with particular attention to the different actors involved and their potential roles in building innovative responses to the emerging social and health needs of populations around the world. Healthcare systems should not only achieve efficiency and effectiveness. The proposal here is to shift the focus towards more socially oriented approaches that allow to mobilize resources from individuals and communities.

BMJ Open, 2021

IntroductionScholars, healthcare practitioners and policymakers have increasingly focused their a... more IntroductionScholars, healthcare practitioners and policymakers have increasingly focused their attention on patient-centredness. Patient-reported metrics support patient-driven improvement actions in healthcare systems. Despite the great interest, patient-reported outcome measures (PROMs) are still not extensively collected in many countries and not integrated with the collection of patient-reported experience measures (PREMs). This protocol describes the methodology behind an innovative observatory implemented in Tuscany, Italy, aiming at continuously and longitudinally collecting PROMs and PREMs for elective hip and knee total replacement.Methods and analysisThe Observatory is digital. Enrolled patients are invited via SMS or email to online questionnaires, which include the Oxford Hip Score or the Oxford Knee Score. Data are real-time reported to healthcare professionals and managers in a raw format, anonymised and aggregated on a web platform. The data will be used to investiga...

International Journal of Environmental Research and Public Health, 2020

Co-production is an approach to designing, delivering, and evaluating public services through str... more Co-production is an approach to designing, delivering, and evaluating public services through strict collaboration among professionals and the people using services with an equal and reciprocal relationship. Health promotion initiatives that include education services rarely use the co-production approach. Nevertheless, the value of co-production is widely recognized, although it is considered a normative good, and scarce and mixed evidence is available in literature. The purpose of this paper is to provide evidence supporting the hypothesis that a co-production approach, applied to an intervention for preventing obesity, can be effective and efficient. To this end, an evaluation of the processes, outputs meant as intermediate results, and behavioral and economic outcomes of a public health-promotion initiative co-produced and co-delivered with adolescents (beFood) was conducted. Mixed methods were used, including field-observations, two self-reported questionnaires, and an opportun...

BMJ Open, 2020

ObjectivesTo evaluate the feasibility of a digital and continuous collection and reporting of pat... more ObjectivesTo evaluate the feasibility of a digital and continuous collection and reporting of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) for chronic heart failure (CHF).DesignA single-site pilot study was settled for evaluating the feasibility of the intervention, both using qualitative and quantitative data (ie, workshop, surveys).SettingThe pilot has been implemented in a Tuscan specialised hospital (Italy).Participants162 patients were involved. Inclusion criteria were: a previous diagnosis of HF, age ≥18 years, absence of cognitive impairment or active tumours, ability to provide informed consent to study participation.InterventionThe continuous collection and reporting of PROMs and PREMs has been designed and implemented in 2018. PREMs questionnaires for patients were developed, while Kansas City Cardiomyopathy Questionnaire-12 was used for assessing PROMs. Questionnaires are administered at specific time points: discharge; 30 day...

The International Journal of Health Planning and Management, 2019

Conference: XV SIM Conference - I PERCORSI IDENTITARI NEL MARKETING, 2018

The identity of public institutions is nowadays undermined by negative media campaign and societa... more The identity of public institutions is nowadays undermined by negative media campaign and societal changes leading to a greater individual autonomy in searching for information without looking at their sources’ reliability. Identity and trust are linked concepts and the relationship management practices put in place by the public institutions influence the both of them. The health systems need to work in managing the relation with people in order to have an impact on their trust level and re-value the health system’s identity. This work aims at exploring which could be the elements to work on in addressing this challenge, considering both the context and the users behaviors and expectations. To this end, a multilevel ordinal logistic regression model was performed on data based on an Italian sample of 1478 respondents. Results confirm that the experience with high specialized services (like outpatient and diagnostic services) are fundamental to build institutional trust, while living a bad experience with healthcare services loose a large amount of trust in the system shaming on it for the bad experience. To re-build the trust relationship between individuals and the health system should continuously work on the performance and on the quality of the users’ experience.