Should I give kids money? The role of pocket money on at-risk behaviors in Italian adolescents.

BACKGROUND: Discussion on the impact of pocket money on positive behaviors is still debated. OBJECTIVE: To investigate the effect of diverse money allowance schemes on risky behaviors (smoking, alcohol, binge drinking, drug use, gambling) during adolescence. METHOD: 989 students aged 15 from Lombardy (Italy) reported information on money availability in the 2018 wave of the Health Behaviour in School-aged Children study. To analyze the relationship between money availability and risky behaviors we computed odds ratios and 95% confidence intervals through unconditional multiple logistic regression models. RESULTS: Spending more than 10€ weekly was associated with higher likelihood to smoke, binge drink or gamble. Receiving pocket money (rather than receiving money upon request) was related to higher likelihood to engage in risky behaviors. CONCLUSIONS: Pocket money may have a negative impact on adolescents, particularly with a substantial amount of money. More research is needed to understand why providing money only if needed may serve as a protective factor against risky behaviors.

Determinants of the willingness to buy products certified by omics technology: differences between regular and occasional consumers of organic food.

Consumers' demand for organic food has increased in the last years, together with a growing request for food authentication and safety. Omics technologies represent a viable analytical strategy to respond to such needs, strengthen food safety information transmission between consumers and industry, and differentiate between organic and conventional products. However, little is known about consumers' perception of such a novel certification approach. The present research ought to provide insights into the perspectives of consumers, exploring the antecedents of their intention to purchase organic vegetables certified through omics technologies and differentiating between regular and occasional consumers of organic foods. Data were collected from a representative sample of 807 Italian respondents who completed a self-report questionnaire, and Structural Equation Modeling was performed to analyze the data. Results show that several factors influence consumers' approach to omics technology, among which trust in actors in the food industry, attitudes towards the technology and environmental food concerns. In addition, the study drew attention to the differential path impacting consumers with distinct eating habits. Indeed, the degree of importance attributed to food in one's life and the interest towards innovative food are significant predictors of the intention to adopt omics technology only for people consuming organic products with higher frequency. Also, trust in industry actors follows a different path for regular and occasional organic food consumers. The present study sheds light on consumers' perspective on omics technologies, a relatively unexplored topic. Moreover, it allowed to differentiate consumers based on their organic consumption habits, which has been rarely done in previous research. The evidence collected suggests the need for tailored communication programs to stimulate the adoption of omics technologies and foster consumers' confidence in novel food technologies.

Measuring citizens' engagement during emergencies: Psychometric validation of the Public Health Engagement Scale for Emergency Settings (PHEs-E).

The Covid-19 pandemic has highlighted the importance of citizens' behaviors in the containment of the virus. Individuals might change their intention to adhere to public health prescriptions depending on various personal characteristics, including their own emotional status, which has been recognized to be a crucial psychological factor in orienting people's adherence to public health recommendation during emergency settings. In particular, it is crucial to support citizens' alliance with authorities and feeling of trust: public engagement is a concept that refers to the general involvement of citizens into public affairs which is generally considered an effective approach to enhance citizens' understanding of their crucial role in public affairs. However, so far there is no agreement on the metrics and indexes that should be used to measures public engagement during a health crisis. The aim of this paper is to validate a psychometric scale (PHEs-E), which intends to measure the readiness of individuals to adhere to the prescribed behavioral change to contain the emergency. Data were collected throughout the pandemic in Italy: in particular, five independent samples were recruited starting from March 2020 to March 2021. Results showed that the proposed measure has good psychometric characteristics. A general linear model was computed to assess the differences of public engagement across the different data points and among citizens with different sociodemographic characteristics. Correlations with other psychological constructs (i.e. Anxiety, Depression and Self-Efficacy) were also tested, showing that more engaged citizens have a lower level of anxiety and depression, and a higher self-efficacy. This study's findings indicate that individuals' characteristics may differentiate citizens' motivation to engage in public health behavioral recommendation to prevent the COVID-19 contagion. However the scale could be useful to perform a psychological monitoring of psychological readiness to engage in public health strategies to face critical events and settings.

Determinants of the Financial Contribution to the NHS: The Case of the COVID-19 Emergency in Italy.

The COVID-19 pandemic has quickly become an unprecedented challenge for many countries at a global level, requiring a significant amount of financial resources to support the National Healthcare System (NHS). In Italy, most of these resources came from the general public through tax payments and monetary donations. The present work aims to investigate the antecedents of citizens' willingness to financially support the NHS in a situation of public emergency such as the one related to the COVID-19 outbreak. It also aims to distinguish between the willingness to support the system through two different forms of financial contribution, tax payment and charitable giving. An empirical study was performed in the midst of the Italian public health emergency, while the country was reaching its contagion peak. Results showed that participants were more willing to give a financial contribution when it was framed as a one-off donation rather than as a one-off tax payment. Moreover, it was found that trust in money management was the most important factor in predicting the intention to make a financial contribution to the NHS, either through a tax payment or through charitable giving. The perceived risks with regard to the pandemic, in contrast, had no impact.

Measuring Italian citizens' engagement in the first wave of the COVID-19 pandemic containment measures: A cross-sectional study.

BACKGROUND: In January 2020, the coronavirus disease 2019 (COVID-19) started to spread in Italy. The Italian government adopted urgent measures to slow its spread. Enforcing compliance with such measures is crucial in order to enhance their effectiveness. Engaging citizens in the COVID-19 preventive process is urgent today both in Italy and around the world. However, to the best of our knowledge, no previous studies have investigated the role of health engagement in predicting citizens' compliance with health emergency containment measures. METHOD: An online survey was administered between February 28 and March 4, 2020 on a representative sample of 1000 Italians. The questionnaire included a measure of health engagement (Patient Health Engagement Scale), a 5-item Likert scale ranging from 1 to 7, resulting in 4 positions that describe the psychological readiness to be active in one's own health management, and a series of ad hoc items intended to measure citizens' perceived susceptibility and severity of the disease, orientation towards health management, trust in institutional bodies, health habits and food consumption. To investigate the relationship between health engagement and these variables, ANOVA analysis, logistic regression and contingency tables with Pearson's chi-squared analysis have been carried out. RESULTS: Less engaged people show higher levels of perceived susceptibility to the virus and severity of the disease; they are less trustful of scientific and healthcare authorities, they feel less self-effective in managing their own health-both in normal conditions and under stress-and are less prone to cooperate with healthcare professionals. Low levels of health engagement also are associated with a change in the usual purchase behavior. CONCLUSIONS: The Patient Health Engagement model (PHE) provides a useful framework for understanding how people will respond to health threats such as pandemics. Therefore, intervention studies should focus on raising their levels of engagement to increase the effectiveness of educational initiatives intended to promote preventive behaviors.

Social frame and tax compliance modulate electrophysiological and autonomic responses following tax-related decisions.

Given the intrinsic complexity of cognitive and affective processes affecting how people reason about taxes and their decisions to be compliant with such social duty, we aimed at exploring those latent processes by combining the analysis of their central and peripheral physiological correlates. We asked participants to make realistic economic decisions concerning tax-payment and manipulated the social vs. individual decisional frame. In addition, we took into account the potential role of tax-compliance trait. Thirty self-employed professionals took part in the study and completed a public good game while their autonomic (skin conductance - SC - and heart rate - HR) and neural brain (electroencephalography - EEG) activities were recorded. The analysis of physiological responses during the feedback phase - where participants could be presented or not with a fiscal audit - highlighted: (i) increased tonic SC levels and theta activity in the social condition than in the individual one; (ii) increased HR values when a fiscal audit did not take place, especially in participants who presented an enforced tax-compliance trait. Present findings support the idea that classic economic theories of tax behaviour developed under the assumption that taxpayers act as rational and individualist agents do not provide a comprehensive account for the decision-making process. They add to available evidence highlighting the contribution of psychological and social-affective variables to individuals' decision-making processes to pay or evade taxes and to their appraisal of the consequences of such choice, as suggested by the 'slippery slope' framework.

Spanish adaptation of the patient health engagement scale (S. PHE-s) in patients with cronic diseases / Adaptación española de la escala Patient Health Engagement (S. PHE-s) en pacientes con enfermedades crónicas

Background: The Patient Health Engagement scale is an instrument based on evidence about the experiences and preferences of patients with chronic diseases regarding their engagement with the treatment they receive. Aims: The main goal of this study was to adapt the Patient Health Engagement scale to the Spanish population (S.PHE-s) following the guidelines for cross-cultural adaptations. Methods: The sample comprised 413 patients with different chronic diseases. Results: The confirmatory factor analysis showed a one factor model corresponding to the structure proposed by the original authors. The factor structure was invariant by gender. Furthermore, a Rasch Model showed that the S.PHE-s was unidimensional. In addition, every polychoric correlation coefficient was higher than .60. The Ordinal Alpha of the S.PHE-s was .85. Finally, the S.PHE-s was found to be positively related to life satisfaction, positive affect, and treatment adherence and negatively correlated to negative affect, depression, and anxiety. Conclusions: In light of these results, it may be concluded that the S.PHE-s has good psychometric properties and it may be used by the Spanish-speaking scientific community to measure patient engagement (AU)

Antecedentes: la escala Patient Health Engagement es un instrumento construido en base a la experiencia y preferencias de pacientes con enfermedades crónicas en lo que respecta a su compromiso con el tratamiento que reciben. Objetivos: el objetivo del presente estudio fue adaptar al castellano la escala Patient Health Engagement (S.PHE-s) siguiendo las directrices de las adaptaciones transculturales. Método: la muestra estuvo compuesta de 413 pacientes con diferentes enfermedades crónicas. Resultados: el análisis factorial confirmatorio mostró un modelo unifactorial que correspondía a la estructura propuesta por los autores originales. La estructura factorial era invariante por género. Además, el modelo Rasch realizado puso de manifiesto la unidimensionalidad de la escala. Además, los coeficientes de correlación policóricos eran superiores a .60. El Alpha Ordinal de la escala fue de .85. Finalmente, se encontró que la S.PHE-s estaba positivamente relacionada con la satisfacción con la vida, el afecto positivo y la adherencia al tratamiento, y negativamente con el afecto negativo, la depresión y la ansiedad. Conclusiones: a la luz de estos resultados se puede concluir que la S.PHE-s tiene unas propiedades psicométricas adecuadas y que puede ser usada por la comunidad científica hispanohablante para medir el compromiso de los pacientes (AU)

Spanish adaptation of the Patient Health Engagement scale (S.PHE-s)in patients with chronic diseases.

BACKGROUND: The Patient Health Engagement scale is an instrument based on evidence about the experiences and preferences of patients with chronic diseases regarding their engagement with the treatment they receive. AIMS: The main goal of this study was to adapt the Patient Health Engagement scale to the Spanish population (S.PHE-s) following the guidelines for cross-cultural adaptations. METHODS: The sample comprised 413 patients with different chronic diseases. RESULTS: The confirmatory factor analysis showed a one factor model corresponding to the structure proposed by the original authors. The factor structure was invariant by gender. Furthermore, a Rasch Model showed that the S.PHE-s was unidimensional. In addition, every polychoric correlation coefficient was higher than .60. The Ordinal Alpha of the S.PHE-s was .85. Finally, the S.PHE-s was found to be positively related to life satisfaction, positive affect, and treatment adherence and negatively correlated to negative affect, depression, and anxiety. CONCLUSIONS: In light of these results, it may be concluded that the S.PHE-s has good psychometric properties and it may be used by the Spanish-speaking scientific community to measure patient engagement.

Giving patients a starring role in their own care: a bibliometric analysis of the on-going literature debate.

BACKGROUND: Patient-centred care has been advocated as a key component of high-quality patient care, yet its meanings and related actions have been difficult to ascertain. OBJECTIVE: To map the use of different terms related to the process of giving patients a starring role in their own care and clarify the possible boundaries between terms that are often mixed. METHODS: A literature search was conducted using different electronic databases. All records containing the search terms 'patient engagement', 'patient activation', 'patient empowerment', 'patient involvement', 'patient adherence', 'patient compliance' and 'patient participation' were collected. Identified literature was then analysed using the Statistical Package for Social Science (SPSS). The number of yearly publications, most productive countries, cross-concepts articles and various scientific fields dealing with the multidisciplinary concepts were identified. RESULTS: Overall, 58 987 papers were analysed. Correspondence analysis revealed three temporal trends. The first period (2002-2004) focused on compliance and adherence, the second period (2006-2009) focused on the relationship between participation and involvement, and the third one (2010-2013) emphasized empowerment. Patient activation and patient engagement followed the temporal development trend connected to the 'immediate future'. DISCUSSION AND CONCLUSIONS: The bibliometric trend suggests that the role of patient in the health-care system is changing. In the last years, the patient was viewed as a passive receptor of medical prescription. To date, the need to consider patients as active partners of health-care planning and delivery is growing. In particular, the term patient engagement appears promising, not only for its increasing growth of interest in the scholarly debate, but also because it offers a broader and better systemic conceptualization of the patients' role in the fruition of health care. To build a shared vocabulary of terms and concepts related to the active role of patients in the health-care process may be envisaged as the first operative step towards a concrete innovation of health-care organizations and systems.

Measuring patient activation in Italy: Translation, adaptation and validation of the Italian version of the patient activation measure 13 (PAM13-I).

BACKGROUND: The Patient Activation Measure (PAM13) is an instrument that assesses patient knowledge, skills, and confidence for disease self-management. This cross-sectional study was aimed to validate a culturally-adapted Italian Patient Activation Measure (PAM13-I) for patients with chronic conditions. METHODS: 519 chronic patients were involved in the Italian validation study and responded to PAM13-I. The PAM 13 was translated into Italian by a standardized forward-backward translation. Data quality was assessed by mean, median, item response, missing values, floor and ceiling effects, internal consistency (Cronbach's alpha and average inter-item correlation), item-rest correlations. Rasch Model and differential item functioning assessed scale properties. RESULTS: Mean PAM13-I score was 66.2. Rasch analysis showed that the PAM13-I is a good measure of patient activation. The level of internal consistency was good (α = 0.88). For all items, the distribution of answers was left-skewed, with a small floor effect (range 1.7-4.5 %) and a moderate ceiling effect (range 27.6-55.0 %). The Italian version formed a unidimensional, probabilistic Guttman-like scale explaining 41 % of the variance. CONCLUSION: The PAM13-I has been demonstrated to be a valid and reliable measure of patient activation and the present study suggests its applicability to the Italian-speaking chronic patient population. The measure has good psychometric properties and appears to be consistent with the developmental nature of the patient activation phenomenon, although it presents a different ranking order of the items comparing to the American version. PAM13-I can be a useful assessment tool to evaluate interventions aimed at improving patient engagement in healthcare and to train doctors in attuning their communication to the level of patients' activation. Future research could be conducted to further confirm the validity of the PAM13-I.

Measuring patient engagement: development and psychometric properties of the Patient Health Engagement (PHE) Scale.

Beyond the rhetorical call for increasing patients' engagement, policy makers recognize the urgency to have an evidence-based measure of patients' engagement and capture its effect when planning and implementing initiatives aimed at sustaining the engagement of consumers in their health. In this paper, authors describe the Patient Health Engagement Scale (PHE-scale), a measure of patient engagement that is grounded in rigorous conceptualization and appropriate psychometric methods. The scale was developed based on our previous conceptualization of patient engagement (the PHE-model). In particular, the items of the PHE-scale were developed based on the findings from the literature review and from interviews with chronic patients. Initial psychometric analysis was performed to pilot test a preliminary version of the items. The items were then refined and administered to a national sample of chronic patients (N = 382) to assess the measure's psychometric performance. A final phase of test-retest reliability was performed. The analysis showed that the PHE Scale has good psychometric properties with good correlation with concurrent measures and solid reliability. Having a valid and reliable measure to assess patient engagement is the first step in understanding patient engagement and its role in health care quality, outcomes, and cost containment. The PHE Scale shows a promising clinical relevance, indicating that it can be used to tailor intervention and assess changes after patient engagement interventions.

A new approach for psychological consultation: the psychologist at the chemist's.

BACKGROUND: The prevalence of mental illness and psychological suffering is greater than the availability of primary care services in Europe and, in particular, in Italy. The main barriers that hinder the access to these services are economic, the lack of proximity of services and some prejudices that may promote stigma and shame.A new mental health service, named "Psychologist in the Neighbourhood" was created to intercept unexpressed needs for psychological assistance. The service allows everyone to ask for free psychological consultation, consisting of no more than four meetings with a psychologist, in certain chemists' shops around the city of Milan. This article aims to present the service specific features of this initiative and the results of a pilot study. METHODS: Information gathered on all users included socio-demographic data, the reasons why they approached this specific service, how they learnt about it, the main presented problem and, for a random sub-group, the level of psychological well-being (as measured by the PGWBI). Socio-demographic data were compared with previously collected information about general users of psychological services. The outcome of the intervention was assessed by the clinicians. RESULTS: During the two-year project a total of 1,775 people accessed the service. Compared to traditional users of psychological services, the participants in this service were characterized by a higher presence of females, unemployed and retired people. The main factors encouraging access were proximity and the fact that the service was free of charge. Many of the users were redirected to more specific services, while for about a third of the sample the consultation cycle was sufficient to resolve the presented problem. CONCLUSIONS: The interest and participation of the population was high and this initiative intercepted an unexpressed requirement for psychological support. Free access and home proximity, were the main reasons for accessing this specific service. Subjects were mostly re-directed to appropriate services, while about a third of the sample addressed and resolved their problem with the psychologist in the chemist's shop.These encouraging results suggest the benefits of bringing psychological consultations closer to citizens, particularly to those who cannot afford it, reducing socio-economic inequalities.

An exploratory study on the Italian patients' preferences regarding how they would like to be told about their cancer.

GOAL: Major cross-cultural differences in truth-telling attitudes and practices have been demonstrated. Until recently, in Italy the doctor could conceal both diagnosis and prognosis to seriously ill patients out of beneficence. Signs of change have been reported, but the extent and way patients would be informed is still unknown. The aim of the study was to assess Italian patients' preferences regarding how they would like to be told about their cancer and its treatment. We examined the factor structure of the Measure of Patients' Preferences--Italian version (MPP-It) and whether demographical and medical variables were associated with the dimensions of patients' preferences. MATERIALS AND METHODS: Patients were invited to participate during a visit to the oncology department of the Lecco hospital (Italy) for chemotherapy or follow-up. An Italian version of the MPP-It was administered. Data were analyzed through a factor analysis. MAIN RESULTS: A total of 210 cancer patients agreed to participate. Three main factors were identified: (1) Information (Talking About the Disease). Items in this factor were concerned with the dialogue about the disease and treatment options; (2) Support (The Emotional World of the Patient). These items referred to the supportive and relational aspects of the physician-patient encounter; (3) Care (The Ideal Doctor). These items related to the patients' desires about the doctor's personal attributes. CONCLUSIONS: The first two factors, information and support, were comparable to those of similar American and Asian studies. The study suggests a cross-cultural uniformity among cancer patients who appreciate the informative and clearness of the communication aspects as being primarily important, while also giving high points to relationship aspects. The third factor appears unique to the Italian context.