Event: XIV National Congress of the Italian Society of Health Psychology – SIPSA

                      Location: Cagliari, 25-27 May 2023

Contribution: The engagement process and preventive decisions: subjective positions in screening practices

Authors: Daniela Lemmo, Maria Luisa Martino, Roberto Bianco, Anna Rosa Donizzetti, Daniela Caso

Abstract: Oncological screening programs allow for the early identification of disease risks, offering timely diagnoses and effective treatments. In Italy, 41% of women participate in mammographic screening and 28% in cervical screening. The epistemological framework of shared decision-making in health recognizes engagement as part of the decision-making process, although it is not superimposable on it. Indeed, engagement is a dynamic process of emotional adaptation and processing of the different positions of the subject co-authoring wellness trajectories in partnership with the healthcare system. The literature identifies 3 phases of the engagement process in health decisions: recruit (why did I get engaged?), retain (Why do I stay engaged?), and sustain (What do I need in order to keep being engaged?). The study aims to identify how women participating in breast and cervical cancer screenings give meaning to the engagement process in relation to preventive practices. Within the Miriade project, 40 semi-structured interviews were conducted. Data are analyzed using the Framework Method. The results show 4 categories for each phase of engagement. Recruit: Disease risk monitoring; Self-care mastery; Managing fear of death; By chance. Retain: Good healthcare relationship; Easy access; Recurring invitations; Informal anticipation of results. Sustain: Continuity of healthcare providers; Drivers of good practices; Personalized organization of health exams; Reduction in waiting times for results. The study of the meaning-making processes related to the relationship of women involved in screening practices with the three moments of the engagement process highlights the need for a personalization of preventive practices to be included in a procedural and relational dynamic necessary to inform different research fields in the healthcare context.