Progressi delle Aziende Sanitarie (PASSI) – Italy
In 2006, the Center for Disease Control and Prevention at the Italian Ministry of Health (MoH) entrusted the Italian National Health Institute (Istituto Superiore di Sanità, ISS) with the task of developing a system for continuous surveillance over the adult population (Rapporti ISTISAN 2007). In that year, the Italian Ministry of Health (MoH) in order to improve and support the public health of the country, funded the National Center for Epidemiology, Surveillance and Health Promotion (CNESPS) to develop ongoing surveillance of behavioral risk factors and preventive measures included in the National Prevention Plan over the adult population in Italy (Baldissera 2007).
The National Center for Epidemiology, Surveillance and Health Promotion (CNESPS) is one of the seven National Centers of the Istituto Superiore di Sanità (ISS), and is organized in 9 Units (e.g., the Communicable Disease Epidemiology Unit) plus the Statistics, Training, and Communication Offices (EpiSouth 2008).
The Istituto Superiore di Sanità (ISS) is the leading technical and scientific public body of the Italian National Health Service. Its activities include research, control, training and consultation in the interest of public health protection. This Institute is divided in seven Departments and seven National Centers (NCs). The NCs are technical scientific structures which carry on research, control, training activities and consultation, also involving different departments within the ISS, and play a coordinating role with institutions outside the ISS (EpiSouth 2008).
In 2006, the National Center for Disease Prevention and Control (CCM) funded the ISS to develop an ongoing surveillance system to collect, analyze, and disseminate data related to behavior risk factors and prevention health measures over the Italian population. This project was called PASSI (Progressi delle Aziende Sanitarie) the Italian Behavior Risk Factor Surveillance system.
Prior to PASSI, in 2005-2006 the National Institute of Health (Istituto Superiore di Sanità -ISS) in cooperation with the Italian regions conducted two cross-sectional pilot surveys to demonstrate the feasibility of having an ongoing telephone survey surveillance system that provide local and regional data for public health interventions in the Italian Health System. They tested surveillance questionnaires, sampling methods and design, protocols for gathering data, data analysis, and implementation; for the future implementation of a surveillance system. Based on results obtained from these pilot studies and the necessity to promote healthy lifestyles and implementation of preventive measures in Italy, in 2006 PASSI, the Italian Behavior Risk Factor Surveillance system, was launched as an experimental approach useful in the behavioral risk factor surveillance, and monitoring of programs for the prevention of chronic diseases.
The main objective of PASSI is to estimate the frequency and evolution of behavioral risk factors for health and the diffusion of preventative measures, over-time. Production and dissemination of information relevant to public health professionals and community are PASSI’s priority goals (Massimo 2007). This surveillance system was adopted on all the 21 administrative Italian regions where they were agreed to participate. The Italian regions comprises one or up to 22 local health units (LHU) which offer preventive medical services for populations ranging from 40,000 to over a million. Actually, PASSI is focused on Italy’s 180 Local Health Units (LHU) being a national system with a local implementation.