{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:01:42Z","timestamp":1790686902704,"version":"4.1.0"},"reference-count":42,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"unspecified","delay-in-days":271,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Prim Health Care Res Dev"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1463423626101777_as1\">\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>This study examines how community participation and empowerment processes are shaped and fostered in practice in the context of community health centres (CHCs) in Emilia-Romagna, Italy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1463423626101777_as2\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>European health care systems are encouraged to make their primary health care more people centred. With the introduction of CHCs, Italy is promoting this development. In this context, community participation and empowerment represent important features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1463423626101777_as3\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This qualitative study draws on the experiences of practitioners and stakeholders working in the field of community participation and empowerment in CHCs. We conducted 19 in-depth interviews and our interviewees provided descriptions from 14 good-practice CHCs. The examples were organized according to different levels of participation, thus highlighting four themes: a) connecting with the community by informing, meeting, and proposing activities; b) consulting with the community to identify its needs; c) collaborating with the community (including prior consultation); and d) the community as the leader of the process.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1463423626101777_as4\">\n                    <jats:title>Findings:<\/jats:title>\n                    <jats:p>In terms of the four themes and the extent of involvement, we identified a variety of processes aimed at supporting community participation and empowerment and provided various examples. We described the different goals of community participation\u00a0and empowerment (e.g., the appropriateness, accessibility and visibility of CHC services; improved health; the mobilization of community resources; the construction of supportive networks; and the creation of spaces for capacity-building), the interviewees\u2019 reported potential benefits; the community participation methods used (e.g., world caf\u00e9s, workshops) and the different target groups addressed (e.g., specific disadvantaged groups or entire local community).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1463423626101777","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:35:06Z","timestamp":1790685306000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["How are community participation and empowerment processes shaped and fostered in practice in community health centres in Emilia-Romagna, Italy? A qualitative study"],"prefix":"10.1017","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5362-1463","authenticated-orcid":false,"given":"Daniela Rosalba","family":"Luisi","sequence":"first","affiliation":[{"name":"Bielefeld University, School of Public Health"},{"name":"University of Applied Sciences and Arts of Southern Switzerland (SUPSI)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1034-2373","authenticated-orcid":false,"given":"Kerstin","family":"H\u00e4mel","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03prydq77","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Vienna, Department of Nursing Science"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"S1463423626101777_ref5","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-017-4958-4"},{"key":"S1463423626101777_ref33","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czu076"},{"key":"S1463423626101777_ref19","unstructured":"Ministero della Salute (2007) Decreto ministeriale 10 Luglio 2007. Progetti attuativi del Piano sanitario nazionale - Linee guida per l\u2019accesso al cofinanziamento alle regioni e alle province autonome di Trento e Bolzano. Legge n. 296\/2006. Available at https:\/\/www.gazzettaufficiale.it\/atto\/serie_generale\/caricaDettaglioAtto\/originario?atto.dataPubblicazioneGazzetta=2007-10-10&atto.codiceRedazionale=07A08580&elenco30giorni=false (accessed 18 April 2020)."},{"key":"S1463423626101777_ref31","unstructured":"Regione Emilia-Romagna (2010) Deliberazione della Giunta Regionale n.291\/2010, 8 febbraio 2010. Casa della Salute: indicazioni regionali per la realizzazione e l\u2019organizzazione funzionale. Bollettino Ufficiale della Regione Emilia-Romagna, BURERT n.48\/2010. Available at https:\/\/bur.regione.emilia-romagna.it\/dettaglio-inserzione?i=5c2bc156a94f4aabe27f7e1a9d0bcbb7 (accessed 25 February 2026)."},{"key":"S1463423626101777_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2020.11.007"},{"key":"S1463423626101777_ref27","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4419-5921-8_10"},{"key":"S1463423626101777_ref11","doi-asserted-by":"publisher","DOI":"10.48291\/SISA.66.1.2"},{"key":"S1463423626101777_ref22","doi-asserted-by":"publisher","DOI":"10.1017\/9781108855464"},{"key":"S1463423626101777_ref37","unstructured":"Turco, L (2006) Un New Deal della Salute Linee del programma di Governo per la promozione ed equit\u00e0 della salute dei cittadini. Available at https:\/\/www.salute.gov.it\/imgs\/C_17_pubblicazioni_530_allegato.pdf (accessed 25 February 2026)."},{"key":"S1463423626101777_ref42","first-page":"35","volume-title":"Partizipative Qualit\u00e4tsentwicklung in der Gesundheitsf\u00f6rderung und Pr\u00e4vention","author":"Wright","year":"2010"},{"key":"S1463423626101777_ref7","unstructured":"De Belvis, AG , Meregaglia, M , Morsella, A , Adduci, A , Perilli, A , Cascini, F , Solipaca, A , Fattore, G , Ricciardi, W , D\u2019Agostino, M , Maresso, A and Scarpetti, G (2024) Italy: Health System Summary, 2024. Copenhagen: European Observatory on Health Systems and Policies, WHO Regional Office for Europe."},{"key":"S1463423626101777_ref3","unstructured":"Agenzia Nazionale per i Servizi Sanitari Regionali (2025) Report nazionale di sintesi dei risultati del monitoraggio dm 77\/2022 I semestre 2025. Available at https:\/\/www.agenas.gov.it\/images\/2025\/dm77\/Report_Nazionale_DM77_I_semestre_2025.pdf (accessed 12 February 2026)."},{"key":"S1463423626101777_ref28","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/daaa133"},{"key":"S1463423626101777_ref14","volume-title":"Community Building: Logiche e Strumenti di Management: Comunit\u00e0, Reti Sociali e Salute","author":"Longo","year":"2021"},{"key":"S1463423626101777_ref32","unstructured":"Regione Emilia-Romagna (2016) Deliberazione della Giunta Regionale n.2128\/2016, 5 dicembre 2016, Case della Salute: indicazioni regionali per il coordinamento e lo sviluppo delle comunit\u00e0 di professionisti e della medicina d\u2019iniziativa, Bollettino Ufficiale della Regione Emilia-Romagna, BURERT n.388\/2016. Available at https:\/\/bur.regione.emilia-romagna.it\/dettaglio-inserzione?i=fe9badc5637d40b286a2268e7214e44f (accessed 25 February 2026)."},{"key":"S1463423626101777_ref23","doi-asserted-by":"publisher","DOI":"10.3310\/phr01040"},{"key":"S1463423626101777_ref30","volume-title":"Implementing the Primary Health Care Approach: A Primer","author":"Rajan","year":"2024"},{"key":"S1463423626101777_ref41","first-page":"91","volume-title":"Handbuch Partizipation und Gesundheit","author":"Wright","year":"2012"},{"key":"S1463423626101777_ref25","doi-asserted-by":"publisher","DOI":"10.1002\/hpm.3553"},{"key":"S1463423626101777_ref38","unstructured":"World Health Organisation (1978) Primary Health Care: Report of the International Conference on Primary Health Care, Alma-Ata, USSR, 6-12 September 1978. Geneva: World Health Organisation."},{"key":"S1463423626101777_ref2","unstructured":"Agenzia Nazionale per i Servizi Sanitari Regionali (2024) Linee di indirizzo per l\u2019attuazione del modello organizzativo delle Case della Comunit\u00e0 hub . Available at https:\/\/www.agenas.gov.it\/images\/agenas\/PNRR\/Linee_di_indirizzo_CdC.pdf (accessed 27 September 2024)."},{"key":"S1463423626101777_ref24","volume-title":"Qualitative Evaluation and Research Methods","author":"Patton","year":"1990"},{"key":"S1463423626101777_ref4","doi-asserted-by":"publisher","DOI":"10.1080\/01944366908977225"},{"key":"S1463423626101777_ref17","doi-asserted-by":"publisher","DOI":"10.1201\/9781351017190-28"},{"key":"S1463423626101777_ref34","first-page":"3","volume-title":"Implementing the Primary Health Care Approach: A Primer","author":"Rouleau","year":"2024"},{"key":"S1463423626101777_ref8","doi-asserted-by":"publisher","DOI":"10.1017\/9781108855464.008"},{"key":"S1463423626101777_ref35","doi-asserted-by":"publisher","DOI":"10.1080\/17538068.2021.1935569"},{"key":"S1463423626101777_ref40","unstructured":"World Health Organisation Regional Office for Europe (2021) European Programme of Work 2020-2025: United Action for Better Health . Available at https:\/\/iris.who.int\/handle\/10665\/339209 (accessed 1 April 2025)."},{"key":"S1463423626101777_ref20","unstructured":"Ministero della Salute (2022) Decreto ministeriale 23 Maggio 2022, n.77. Regolamento recante la definizione di modelli e standard per lo sviluppo dell\u2019assistenza territoriale nel Servizio sanitario nazionale. (22G00085). Available at https:\/\/www.gazzettaufficiale.it\/eli\/gu\/2022\/06\/22\/144\/sg\/pdf (accessed 12 February 2026)."},{"key":"S1463423626101777_ref6","unstructured":"Conferenza delle regioni e delle province autonome (2025) Linee di indirizzo per l\u2019attivit\u00e0 oraria da rendere da parte dei medici del ruolo unico di assistenza primaria nelle case della comunit\u00e0 25\/117\/CR05a\/C7. Available at https:\/\/www.regioni.it\/download\/news\/662272\/ (accessed 25 February 2026)."},{"key":"S1463423626101777_ref29","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.311.6996.42"},{"key":"S1463423626101777_ref39","unstructured":"World Health Organisation and United Nations Children\u2019s Fund (2018) A Vision for Primary Health Care in the 21st Century. Towards Universal Health Coverage and the Sustainable Development Goals. Geneva: World Health Organisation."},{"key":"S1463423626101777_ref12","doi-asserted-by":"publisher","DOI":"10.4135\/9781036212940"},{"key":"S1463423626101777_ref18","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-322-93270-9_3"},{"key":"S1463423626101777_ref10","doi-asserted-by":"publisher","DOI":"10.1111\/jan.14955"},{"key":"S1463423626101777_ref36","unstructured":"Struttura Interregionale Sanitari Convenzionati (2025) Accordo collettivo nazionale per la disciplina dei rapporti con i medici di medicina generale ai sensi dell\u2019art. 8 del d.lgs. n. 502 del 1992 e successive modificazioni ed integrazioni \u2013 triennio 2022-2024. Available at https:\/\/www.sisac.info\/anteprimaNewsHome.do?tipo=WEB&idArea=201011221610481056&idNews=20260115131705797&tit=&cat=&ddal=&dal=03\/03\/2026 (accessed 03 March 2026)."},{"key":"S1463423626101777_ref1","unstructured":"Agenzia Nazionale per i Servizi Sanitari Regionali (2023) Documento di indirizzo contenente indicazioni per la promozione della partecipazione\/co-produzione dei pazienti, dei cittadini e della comunit\u00e0 nell\u2019ambito delle Case della Comunit\u00e0. Available at https:\/\/data.agenas.it\/web\/documenti\/01_Documento_di_Indirizzo_partecipazione_co-produzione_CdC_Dic.2023.pdf (accessed 16 Febuary 2026)."},{"key":"S1463423626101777_ref26","doi-asserted-by":"publisher","DOI":"10.1111\/hsc.13528"},{"key":"S1463423626101777_ref13","unstructured":"Labonte, RN (1993) Health Promotion and Empowerment: Practice Frameworks. Toronto: University of Toronto Centre for Health Promotion and ParticipACTION."},{"key":"S1463423626101777_ref9","doi-asserted-by":"publisher","DOI":"10.1108\/IJSSP-03-2023-0081"},{"key":"S1463423626101777_ref16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0310137"},{"key":"S1463423626101777_ref21","doi-asserted-by":"publisher","DOI":"10.1007\/s11553-009-0180-2"}],"container-title":["Primary Health Care Research &amp; Development"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1463423626101777","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:35:12Z","timestamp":1790685312000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1463423626101777\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":42,"alternative-id":["S1463423626101777"],"URL":"https:\/\/doi.org\/10.1017\/s1463423626101777","relation":{},"ISSN":["1463-4236","1477-1128"],"issn-type":[{"value":"1463-4236","type":"print"},{"value":"1477-1128","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e111"}}