Roberto Falvo

Survey on Knowledge, Attitudes, and Training Needs of Italian Residents on Genetic Tests for Hereditary Breast and Colorectal Cancer

Objectives. The aim of the study was to assess knowledge and attitudes of medical residents working in Università Cattolica del Sacro Cuore, Rome, Italy, on genetic tests for breast and colorectal cancer. Methods. We distributed self-administered questionnaire to the residents. Logistic regression models were used to evaluate the determinants of knowledge and attitudes towards the tests. Results. Of 754 residents, 364 filled in questionnaire. Around 70% and 20% answered correctly >80% of questions on breast and colorectal cancer tests, respectively. Knowledge on tests for breast cancer was higher among residents who attended course on cancer genetic testing during graduate training (odds ratio (OR): 1.72; 95% confidence interval (CI): 1.05–2.82) and inversely associated with male gender (OR: 0.55; 95% CI: 0.35–0.87). As for colorectal cancer, residents were more knowledgeable if they attended courses on cancer genetic testing (OR: 2.08; 95% CI: 1.07–4.03) or postgraduate training courses in epidemiology and evidence-based medicine (OR: 1.95; 95% CI: 1.03–3.69). More than 70% asked for the additional training on the genetic tests for cancer during the specialization school. Conclusion. The knowledge of Italian residents on genetic tests for colorectal cancer appears to be insufficient. There is a need for additional training in this field.

Health Impact Assessment: HIA

Health impact assessment (HIA) is a combination of procedures, methods and tools used in order to evaluate the potential effects of a policy or project on the health of a population. HIA, therefore, is a multidisciplinary and comprehensive governance tool used by decision-makers in order to build a healthy public policy and reduce health inequalities .

Health promotion for older people in Portugal

In a country like Portugal where life expectancy is very high, Health Promotion for Older People (HP4OP) is a relevant issue and specific strategies are considered within priority health programmes defined at the national level by the Directorate-General of Health on behalf of the Ministry of Health. The National Health Plan 2016–2020 includes directives to facilitate health promotion and access to health and social services, as well as to reduce the burden of chronic diseases. HP4OP funds and resources derive mainly from the Ministry of Health and also from the Ministry of Labour, Solidarity and Social Security. Moreover, institutions can access European and other funds to develop projects in this field and some municipalities also finance projects and initiatives. Health plans, strategies and programmes outlined at the national level are adopted by Regional Health Administrations and the Groups of Health Centres guide implementation at the local level through dedicated units that work within the primary health care context. The integration of both social and health actions in terms of HP4OP depends on collaboration between the Ministry of Health; the Ministry of Labour, Solidarity and Social Security; municipalities; institutions in the cooperative and social sector and other stakeholders such as families, educational institutions, religious communities and health professionals. As a whole, health promotion policies for the older people in Portugal tackle the social determinants of health too. Nevertheless, a systematic approach and an integrated strategy to tackle HP4OP might constitute an important condition for the full implementation of such policies. Additionally, fragmentation of initiatives at the regional and local levels, together with other barriers to addressing health promotion activities among health professionals, might lead to the non-homogeneous implementation of interventions of HP4OP throughout the country. It is expected that many of these constraints will be overcome with the launch and implementation of the intersectoral National Strategy for the Promotion of Active Ageing from 2017.

Healthy ageing – happy ageing: Health Promotion for Older People in Italy

Health Promotion for Older People (HP4OP) is a relevant issue in Italy, one of the countries where people live the longest. Strategies, programmes and projects are set and planned at the national level, mainly by the Ministry of Health within the National Health Service, but strong competencies, funds and resources derive also from the Government, the Ministry of Labour and Social Policies and the Ministry of Internal Affairs. Moreover, European funds contribute to programmes and projects in this field. After strategic implementation at the regional level, programmes and projects are carried out at the local level under the National Health Service, mainly by the Local Health Authorities in conjunction with municipalities and other relevant stakeholders such as NGOs, the voluntary sector, families and educational and religious entities, etc. Even though Italy has been engaged in HP4OP to improve active life expectancy since 1992, a lack of planning and resources for HP4OP, policy diversification at the regional level and a prevailing interest in care-assistance rather than health promotion and prevention have prevented consistent implementation of HP4OP throughout the country.

Workplace health promotion programs in different areas of Europe

Background Aging of the workforce challenges European countries. Keeping aged workers healthy and productive, through health promotion, is a key goal of European labour policy. The aim of the present study was to collect experiences of workplace health promotion for older workers (WHPOW) conducted in 10 representative countries of Central Europe, Eastern Europe and the Mediterranean. Methods A literature review of activities of WHPOW was conducted through a comprehensive search of major scientific databases and on the website of the major European Agencies on worker health promotion. The search was restricted to papers published in English from 2000 to 2015. Companies were asked for additional documentation about WHPOW programmes in a survey conducted with SurveyMonkey. Results A total of 756 initiatives regarding WHPOW were identified. 134 of these were guidelines, regulations, or review studies. The remaining 622 activities were intervention studies performed or promoted in the workplace and targeted at older workers or at the aging of the workforce. Most of the programs were carried out in Central Europe (295, 47.4%), less in East Europe (193, 31.0%) and in Mediterranean countries (134, 21.6%). Conclusion Our study shows that there are only a limited number of WHPOW actions throughout the 10 selected European Countries. While in Central Europe widespread interest in issues of aging workforce has resulted in national policies to encourage WHPO, not all the countries of Eastern Europe are equally well equipped. Lastly, in Southern Europe health promotion activities are largely inadequate compared to needs.

The Osservasalute Health Report 2010: the contribution of a wide and independent Italian research network to decision making in healthcare

Background : The Italian Observatory Healthcare Report (IOHR - 8th edition) [1] aims to help policy makers in the process of decision making through a set of validated indicators resulting from the multidisciplinary activity of several public health experts. Its main task is to gather comparable data on the health status and the quality of health care services throughout the Italian regions. Methods : The report adopts a European approach in order to build a benchmarking activity and the selection criteria of indicators include: meaning, feasibility and quality, comparability and reliability. Each indicator is analyzed by experts in terms of meaning, pattern, validity and limits, graphic representation; recommendations are included for decision makers. A peer reviewing is performed for quality assessment. Results : The IOHR 2010 included 96 indicators, analysed by 203 authors. Through comparable regional data coming from different sources, an overview of the Italian Health System, and a gauging of the impact that different regional organizational and institutional arrangements have on the quality of health services, have been provided. Though data analysis showed a North-South gradient in the quality and the organization of health care services, nevertheless, the overall health status of Italian population is good. Risk factors, lifestyles and prevention together with geographical and social differences in health status and service access are the main priorities. Conclusions : The IOHR helps monitoring the health status in the Italian regions through specific indicators characterized by scientific strictness. It contributes to identifying the situations of excellence and disseminating public health care control tools in order to facilitate the decision making process.

Scelte di spesa e trend epidemiologici: un modello di simulazione

The Report Salute Italia 2028 aims at estimating the health needs of the Italian population by 2028 as a planning tool that can be used in the decision making process. The development of forecasts, trends and scenarios is helpful in identifying the actions to be taken with an evidence-based approach, in order to try to align the health services supply with the emerging health needs. The analysis is based on a set of indicators recognized at the national and international level. Most data derive from the Italian Observatory Healthcare Report and statistical models have been used to estimate future trends. An effort was made to develop a methodology able to link the trends emerged to the economic-financial and supply perspective. The report highlights which will be the peculiar needs of the Italian population and the main critical situations in the span time considered. Core indicators have been selected and analyzed regarding the following areas: demographic scenario, burden of disease (tumors, cardiovascular and infectious diseases, diabetes), institutional framework and health care expenditure. The financial crisis in Italy can affect substantially the crucial sector of the health care. The spending review process should avoid horizontal policies that can reduce the health expenditure in the short term, but resulting in the long term in a reduction of the health services covered and, thus, of the health status of the population.