The Communicative-Relational Operating Model of the Italian National Institute of Health for an Effective Telephone Intervention in Public Health, Structured on Basic Counselling Skills.

Introduction: Communication has a crucial role in public health, because it becomes an essential component of prevention; it is also a proactive tool in health promotion. From a planning perspective, it is appropriate to use communication means that can help the bidirectional communication process, such as face-to-face communication and telephone communication. Materials and methods: In relation to this, the Italian National Institute of Health has developed the "Modello Operativo Comunicativo-Relazionale" (the "Communicative-Relational Operating Model"). It is based on the fundamental skills of the counselling, this gives a protocol to the health professionals that is replicable and organized and it allows health professionals to carry out a telephone communication that is efficient with the user through technical-scientific and communication-relational skills. The goal is to answer in a customized way to the various users' health needs. The Operating Model was created by experts of the National AIDS and Sexually Transmitted Infections Helpline of the Operational Unit of Psycho-Socio-Behavioural Research, Communication, Training, of the Infectious Diseases Department. Later, the Operating Model was proposed to the experts of the Helplines in the National Centre on Addictions and Doping and the National Helpline of the National Centre for Rare Diseases in the National Institute of Health that integrated this method into their telephone approach. Results: The Operating Model illustrated above was applied to several helplines of the National Institute of Health as an example of correct scientific information, updated and customized on sexual transmitted infections, addictions and rare diseases. Conclusions: This article aims to illustrate the Operating Model, the theoretical prerequisites that subtend it and its possible application in the different public health structures that use the telephone for a profes-sional relationship with their users.

[The characteristics of the use and the levels of diffusion of nonconventional medicine]. / Caratteristiche d'uso e livelli di diffusione della medicina non convenzionale.

The national trends of the utilisation of non conventional therapies suggest that an increasing number of patients employ remedies that are outside the mainstream of what has been defined as conventional western medicine. The extent to which these practices have clinical efficacy according to biomedical criteria is a matter of ongoing debate. It may be that independent of any such efficacy, the attraction of alternative medicine is related to the power of its underline shared beliefs and cultural assumptions. The fundamental premises are an advocacy of nature, vitalism, "science" and spirituality. For patients, who choose alternative medicine, the most important reason to abandon conventional therapies could be to move from the sterile "high-tech" realm of official medicine to a more intimate "high-touch" intervention offered by non-physicians.

[A proposal for training in integrated counseling]. / Proposta di un percorso formativo sul counselling integrato.

The relationship between socio-health care workers and individuals seeking help has traditionally considered the individual seeking help as a "case" rather than an "individual". To change this attitude, counselling professionals must focus their attention on the individual's personality, through individualised interventions focussing on the "here and now", with the goal of overcoming any feelings of unease that the individual may have and of ultimately resolving the problem at hand. For this change to occur, knowledge and practical experience ("to know" and "to know how") are fundamental, but they do not suffice: reception, listening, empathy and relational skills ("to know how to be") must be given equal importance in the culture and training of the socio-health care worker. At present, to ensure that existing services and the interventions conducted are efficient and effective, it is fundamental to integrate the normal training and updating activities of socio-health care workers with training in integrated counselling and for improving the specific communication skills and strategies necessary in creating a "help relationship". The present document describes a proposal for organising courses on integrated counselling for socio-health workers.

[The replication of the educational activities of a course developed by the National Training Program for social health workers for controlling HIV infection]. / Replicazione dell'attività formativa di un corso previsto dal Piano nazionale di formazione per operatori socio-sanitari per la lotta alle infezioni da HIV.

A course for regional trainers was organized by the Working Group for HIV training (PFH) and held in Rome. This course has motivated the participants and has given them the ability to organize similar training activities at local level. The training methodology, the evaluation methods and the objectives used in the course are described. An investigation has been carried out by the Working Group of PFH to evaluate the training activity of the participants at the regional level. The results show that 17 out of the 25 participants have been able to organize a total number of 53 peripheral courses and train 2144 health workers. The training methodology and the evaluation method utilized at the different local levels have followed the ones used in the central course.