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Background Childhood obesity prevention is a public health priority in industrialized countries. The Reggio Emilia Local Health Authority has implemented a program involving primary and secondary prevention as well as the care of obese children. There are many health-promoting mobile apps, but few are targeted to children and very few are sponsored by public health agencies. Objective The goal of the research was to describe the process and tools adopted to cocreate a mobile app sponsored by the Reggio Emilia Local Health Authority to be installed in parents’ phones aimed at promoting child health and preventing obesity. Methods After stakeholder mapping, a consulting committee including relevant actors, stakeholders, and users was formed. Key persons for childhood obesity prevention were interviewed, focus groups with parents and pediatricians were conducted, and community reporting storytelling was collected. The results of these activities were presented to the consulting committee in order to define the functionalities and contents of the mobile app. Results Three key trends emerged from community reporting: being active, playing, and being outdoors; time for oneself, family, and friends; and the pressures of life and work and not having time to be active and socialize. In focus groups, interviews, and labs, mothers showed a positive attitude toward using an app to manage their children's weight, while pediatricians expressed concerns that the app could increase their workload. When these findings were explored by the consulting committee, four key themes were extracted: strong relationships with peers, family members, and the community; access to safe outdoor spaces; children’s need for age-appropriate independence; and professional support should be nonjudgmental and stigma-free. It should be a dialogue that promotes family autonomy. The app functions related to these needs include the following: (1) newsletter with anticipatory guidance, recipes, and vaccination and well-child visit reminders; (2) regional map indicating where physical activity can be done; (3) information on how to manage emergencies (eg, falls, burns, fever); (4) module for reinforcing the counseling intervention conducted by pediatricians for overweight children; and (5) a function to build a balanced daily diet. Conclusions The pilot study we conducted showed that cocreation in health promotion is feasible, with the consulting committee being the key co-governance and cocreation tool. The involvement of stakeholders in this committee made it possible to expand the number of persons and institutions actively contributing to the project.

The paper illustrates an empirical research project concerning the co-creation process in Reggio Emilia’s public services and their efforts to reduce childhood obesity. The research is based on a participative evaluation research methodology. The project has been implemented within the framework of the CoSIE project, funded by the Horizon 2020 Research Program — Innovation Action. It has been led by the Local Health Unit (LHU) of Reggio Emilia, a mid-size town in north-eastern Italy, and Cup2000/Lepida, a public/private corporation delivering ICT for health service in the Emilia-Romagna Region. The empirical research has been conducted by the University of Bologna, using a mixed method multi-dimensional strategy and combining the Action-Research tradition with the approach of the Theory of Change. The theoretical framework reflects on the co-creation process, distinguishing between its different phases. In particular, it defines the co-production and the co-design phase, operationalising them with the concepts of System Integration and Social Integration. This linkage allows the analysis of the involvement of institutional stakeholders and final users in the co-creation process. Many factors including the actors’ identity, the participation modalities and the impact of each stakeholder on the service, contribute to the model of co-creation in “the shadow of institutions”, characterised by a low level of Social Integration and a high level of System Integration.

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Questo contributo riflette sulla coesione sociale, indagando i processi che ne favoriscono lo sviluppo a scala locale tramite le dimensioni di engagement collettivo e responsabilità condivisa. Il quadro concettuale viene applicato a due Social Street con una metodologia qualitativa. I risultati evidenziano la contingenza di engagement collettivo e responsabilità condivisa, la genesi di episodi di coesione sociale e l'importanza di interfacce riflessive tra gli attori comunitari e istituzionali.