Abstract Atrial fibrillation (AF) is the most common arrhythmia in older adults and often coexists with other chronic conditions, exacerbating physical and cognitive decline and contributing to frailty. The interplay between frailty and comorbidity in AF remains underexplored, particularly regarding quality of life (QoL), health management, and outcome prioritization. Within the AFFIRMO project, this study investigated the experiences of older adults with AF and at least one chronic condition via an online survey. Frailty was assessed using the FRAIL questionnaire, and participants were grouped by frailty status and number of comorbidities. Health-related quality of life (HRQoL) was measured using the EQ-5D-3L and Visual Analogue Scale (VAS). Challenges in health management and prioritized outcomes were also explored. We included 659 participants (median age 72 years, 52.8% female). Those with pre-frailty or frailty and ≥ 3 comorbidities reported the poorest HRQoL. Comorbidity, particularly combined with frailty, was associated with health management difficulties, including healthcare visits, polypharmacy, and mobility limitations. Across all groups, maintaining independence and improving QoL were prioritized outcomes. Pain relief was especially important for those with higher comorbidities. In older adults with AF, comorbidity and frailty significantly affect QoL and health burden. Tailored, patient-centred care strategies and routine assessment of frailty and comorbidity are essential to improve care coordination and outcomes.

Engagement as a concept can explain why Digital Health Interventions (DHIs) produce individual variance in outcomes, and sometimes limited effectiveness, especially in practice. However, previous literature on engagement across different domains (e.g., Psychology, Implementation Science, Human-Computer Interaction) yields disparate conceptualizations, research methods, design strategies, and measurement methods. Therefore, this workshop aims to: bring together a diverse group of researchers within the field of DHIs with an interest in engagement; provide an overview of how engagement has been used, in terms of concept, measures, and strategies; work towards a shared understanding of how engagement, with its diverse measures and strategies, can be leveraged to inform the design, development, and evaluation of meaningful DHIs. We welcome submissions either as a description of a use case that includes: how engagement was defined, measured, designed for by our participants, as well as their lessons learned; or as a short position paper describing their interest in the topic, future plans for measuring/designing for engagement, and current challenges. Our post-workshop plans aim to draw from this transdisciplinary collaboration to document lessons learned on how to employ engagement in DHI development, research and design.

Background Although international guidelines provide recommendations for screening and monitoring of early-stage type 1 diabetes (T1D), navigating the care pathway can still be difficult for individuals, caregivers, and healthcare professionals (HCPs). These challenges are exacerbated by variations in healthcare systems, gaps in communication, and limited psychosocial support.Aims This manuscript aims to bridge the gap between theory and clinical practice and present practical, stage-specific recommendations for early-stage T1D care in pediatric and adult populations.Materials and Methods This article was informed by a structured literature review, qualitative interviews with HCPs in the UK, Germany, France, Italy, and Spain, and multidisciplinary expert input from the CARE-T1D working group. The group comprised six pediatric and six adult endocrinologists, and two psychologists from the EU, UK, and US.Results, Discussion and Conclusion Here we present proposed care pathways for pediatric and adult early-stage T1D, integrating recommendations for clear communication, care coordination, and psychosocial support throughout. This manuscript is intended to support the standardization of early-stage T1D detection and monitoring, thereby contributing to improved outcomes, including reducing the incidence of diabetic ketoacidosis (DKA) and hospitalization at stage 3 T1D diagnosis.

Gambling disorder is a growing public health concern, exacerbated by the rapid expansion of online gambling. Prevention is key to supporting individuals from developing or exacerbating risky conducts. This study presents a multidisciplinary project across psychology and computational linguistics. The project aimed at developing a predictive system for detecting linguistic markers of problematic gambling behaviours in customer-operator chats from Sisal, a major Italian gambling company. The objective is to support staff in promptly recognizing at-risk individuals and providing timely assistance. The research was conducted in two phases. First, a qualitative analysis of Italian conversations on the online support centre chat identified linguistic and discursive markers of risk. These insights informed the training of a supervised binary classification model. In the second phase, the system was refined through dataset expansion, manual coding carried out by psychologists, and the introduction of a four-level risk classification. Markers were grouped into macro-categories and weighted according to emotional intensity and frequency before being integrated into the predictive model. Findings showed that combining linguistic analysis with psychological expertise can effectively enhance the early detection of problematic gambling behaviours. The research highlighted the potential of text mining as a tool for prevention and person-centred interventions in gambling disorder.

Protein consumption is essential for healthy ageing, yet many older adults fail to meet recommended levels. Protein-enriched foods have been proposed as an intermediate solution between habitual diets and oral supplements; however, their acceptance among older adults remains inconsistent. This systematic review synthesizes factors influencing the acceptance of protein-enriched foods among adults aged 65 years and older.Following PRISMA guidelines, 14 peer-reviewed studies were analyzed using a multilevel framework encompassing product-related, individual, and sociocultural determinants. Influencing factors were classified as barriers, facilitators, neutral, or debated variables and synthesized according to their frequency and explanatory emphasis across analytical levels.Across 43 identified determinants, acceptance was primarily constrained at the microlevel: when taste, texture, or ease of consumption were compromised, protein-enriched foods were generally rejected. On the meso-level, psychological and social factors, including familiarity, perceived health relevance, and professional endorsement helped to foster acceptance, once sensory and physiological requirements were met. Lastly, on the macro-level sociocultural factors shaped legitimacy and trust but exerted limited influence in the absence of satisfactory functional acceptability.Overall, acceptance of protein-enriched foods in later life emerges as a hierarchically structured, multilevel process in which product characteristics and consumer physiology delimit choice, while psychological and sociocultural factors condition openness, relevance, and sustained adoption. Designing protein-enriched foods that feel familiar, enjoyable, and worth eating may therefore be as critical as their nutritional potential for supporting everyday eating in older age.

The prevalence of obesity and non-communicable diseases is progressively increasing worldwide. To address this problem, in 2011, the European Commission declared its intention to adopt a common front-of-pack label (FOPL) to inform European consumers and enable them to choose nutritionally appropriate foods. Therefore, the aim of this study is to evaluate the effectiveness of two labels officially adopted by European countries.The study was designed as a randomized-controlled trial, consisting of three conditions: use of Nutri-Score label vs. use of Battery label vs. no label (control condition). 1900 Italian adult participants were asked to use for one month a mobile application to visualize food label information and orient their food choices. Adherence to the Mediterranean diet and nutrition knowledge were assessed before and after the intervention.Data showed low use of labels: more than 6 out of 10 consumers never used them during the 30-day intervention period. The ANOVA test showed no statistically significant differences among groups for adherence to the Mediterranean diet and nutrition knowledge before and after the intervention, as well as after a difference-in-difference regression analysis. Moreover, self-assessed nutrition knowledge and individual diet quality were overestimated by 3.9% and 17.6%, respectively.FOPLs showed no effectiveness in influencing participants' eating pattern. Future research should explore if the reasons that prevented Italian consumers from using FOPLs are consumer-related (i.e., nutrition knowledge and diet quality overestimations), label-related (i.e., complexity or extreme simplification in information), or related to other contributing factors (i.e., time available for food shopping, economic aspects).

AimPatient engagement is increasingly recognized as a key determinant of adolescents’ adaptation to chronic illness; however, developmentally sensitive measures capturing engagement trajectories in youth remain scarce. Although the Patient Health Engagement Scale (PHE-s®) has demonstrated robust psychometric properties in Turkish adult populations, its applicability to adolescents has not yet been examined. The objective of this study was to examine its psychometric properties among adolescents with chronic diseases in a Turkish inpatient sample.MethodsA cross-sectional psychometric validation study was conducted with 200 adolescents aged 12–19 years hospitalized for chronic conditions in a tertiary pediatric hospital in Türkiye. The PHE-s® was evaluated using a multi-method approach integrating Rasch Partial Credit Modeling, categorical principal component analysis, and confirmatory factor analysis. Internal consistency, test–retest reliability, and differential item functioning across demographic and clinical subgroups were examined. Concurrent validity was assessed through associations with the Child Attitude Toward Illness Scale (CATIS).ResultsAnalyses supported a unidimensional structure of the adolescent PHE-s®, with strong item loadings and acceptable model fit across analytic approaches. The scale demonstrated high internal consistency (ordinal α = 0.90) and excellent one-week test–retest reliability (ICC = 0.98). Measurement invariance was largely supported across sex, education level, and follow-up attendance, with limited differential item functioning observed by age and medical-device dependence. Patient engagement was moderately and negatively associated with illness attitudes (ρ = −0.53, p < 0.001), indicating that higher engagement corresponds to more positive illness appraisals while reflecting a related but distinct construct.ConclusionThe Turkish PHE-s® is a reliable and valid instrument for assessing psychological engagement trajectories among adolescents with chronic diseases in inpatient settings.

Gambling increasingly occurs across multiple access environments, yet research has often treated online and offline gambling as interchangeable modes of access rather than as distinct patterns of behavioural engagement. The present study examined whether gambling channel engagement was associated with type of game, financial literacy dimensions, financial anxiety, and national context. The study included 2,000 adult gamblers recruited in Italy (n = 1,000) and the United Kingdom (n = 1,000). Gambling channel was classified as offline-only, online-only, or mixed-channel engagement. A sequential multinomial logistic modelling strategy examined the contribution of gambling type and country, followed by Financial Knowledge, Financial Behaviour, Financial Attitudes, and Financial Anxiety. Country-specific models, formal interaction tests, demographic and socioeconomic adjustment, and non-parametric bootstrap analyses were also conducted. Gambling type was the strongest predictor of channel engagement. Strategic gambling and participation across multiple gambling-type categories were consistently associated with online and mixed-channel gambling relative to offline gambling. Financial Knowledge independently predicted both online and mixed-channel engagement, whereas Financial Behaviour, Financial Attitudes, and Financial Anxiety were not significant after adjustment for gambling type and country. UK participants had higher odds of online and mixed-channel gambling than Italian participants. Country-specific analyses showed that Financial Knowledge predicted online gambling in both countries and mixed-channel gambling in the UK. Formal interaction testing indicated that the association between Financial Knowledge and mixed-channel gambling was significantly stronger in the UK than in Italy. The findings suggest that gambling channel engagement reflects broader patterns of behavioural diversification rather than a simple preference for a particular mode of access. Financial Knowledge may be associated with participation across more complex and flexible gambling environments, although its role appears to vary across national contexts.

Antimicrobial stewardship (AMS) interventions aim to optimise prescribing practices and tackle antimicrobial resistance. Since 2019, the Centers for Disease Control and Prevention (CDC) have included education as a core element of AMS programmes. This narrative review synthesises recent evidence (2019-2025) on educational interventions targeting healthcare professionals to improve antibiotic use. A systematic search across databases identified 78 eligible studies conducted in different countries and clinical settings. Most interventions (N = 58) focused on clinical knowledge transfer, such as appropriate antibiotic selection, treatment duration, and guidelines adherence. Only a minority (N = 20) addressed psycho-social and behavioural aspects, including communication with patients or shared decision-making. This gap was reflected in the profile of education providers, primarily clinical experts such as infectious disease specialists or pharmacists, and in the limited use of behavioural or theoretical frameworks. Educational strategies frequently included traditional training sessions and audit and feedback. Although several studies reported improvements in prescribing behaviours, long-term sustainability and implementation fidelity were rarely assessed. Despite increasing recognition of the role of behavioural and psycho-social factors in shaping prescribing practices, these dimensions remain largely absent from educational content. To foster sustainable change, future AMS programmes should adopt theory-informed designs, incorporate psycho-social and behavioural dimensions. Strengthening these aspects is essential to support healthcare professionals in navigating the complex realities of prescribing decisions and to achieve long-term reductions in inappropriate antibiotic use.

BackgroundCardiovascular diseases (CVD) remain the leading cause of mortality and disability worldwide. In Italy, individuals at very high cardiovascular risk may encounter fragmented care pathways and territorially uneven access to preventive, specialist, and post-discharge services. Although patient engagement is recognized as a key determinant of long-term outcomes, limited qualitative evidence is available on how it develops across the cardiovascular care pathway.ObjectiveThis thematic analysis explored how patient engagement is experienced across the cardiovascular care pathway among individuals at very high cardiovascular risk in Italy, with particular attention to psychosocial, relational, and organizational factors.MethodsA qualitative descriptive analysis using five participatory workshops was conducted with 24 patients and 5 caregivers across four Italian regions. Audio-recorded sessions were transcribed verbatim and analyzed thematically through an iterative hybrid inductive-deductive process, in addiction structured observational notes were recorded by the research team during workshops. The Patient Health Engagement (PHE) Model was used as an interpretive lens for higher-order analysis.ResultsFour phases across the cardiovascular care pathway were examined: diagnosis, hospital management, post-discharge, and adaptation to post-event life. Across these phases, engagement emerged as a dynamic process shaped by emotional disruption, therapeutic understanding, communication quality, and continuity of care. The transition from hospital to home was the most fragile phase, characterized by insufficient guidance, limited psychological support, and fragmented follow-up. Participants also described territorially situated differences in access to specialist referral, rehabilitation, and supportive services. Cross-cutting themes included inadequate doctor-patient communication, limited psychosocial support, caregiver burden, and the supportive role of patient associations.ConclusionsPatient engagement in cardiovascular care is co-produced by individual, relational, and organizational factors. Strengthening discharge preparation, follow-up continuity, psychosocial support, and equitable access to rehabilitation may help sustain engagement over time. Future research should examine engagement trajectories longitudinally and investigate caregiver perspectives more systematically.

Food systems have a significant impact on environmental sustainability, underscoring the need for innovative technologies to support more sustainable agricultural methods. However, the adoption of these technologies hinges on consumer acceptance, making the analysis of consumer perceptions essential. This study examines consumer acceptance of three sustainable food technologies, namely upcycling technologies, biostimulants, and artificial intelligence (AI), in agriculture through a cross-sectional online survey involving 2416 Italian adults representative of the population. It explores participants' knowledge, consumers' beliefs, and purchase intentions regarding these technologies and the novel foods treated with them. Findings indicate limited consumer knowledge, with AI applied in agriculture being relatively better known but perceived as less natural and riskier. Upcycled foods, while seen as sustainable, are associated with low levels of pleasantness. Biostimulants occupy a middle ground, being perceived as more innovative than Upcycling Technology but less artificial, risky, and reassuring compared to AI. Notably, the observed differences between technologies are small, despite statistical significance. Psychological and attitudinal factors, such as variety-seeking in food choices, food technology neophobia and food involvement, have a stronger association with purchase intentions than socio-demographic variables. Trust in actors within the agribusiness system, knowledge of new technologies, and consumers' beliefs about new foods are also positively associated with the purchase intention of foods treated with these technologies. The study emphasizes the importance of tailored communication strategies to overcome barriers, highlighting sustainability and quality while addressing perceived risks and unconscious fears. These insights are critical for advancing the adoption of innovative and sustainable food technologies in agriculture.

Background The AFFIRMO trial aimed to evaluate the efficacy of a mobile-health (mHealth) structured intervention adapting the Atrial Fibrillation Better Care (ABC) pathway, combining the comprehensive geriatric assessment (CGA), to enhance guideline-directed, holistic AF management and reduce the risk of clinical outcomes in older patients with atrial fibrillation (AF) and multimorbidity. Methods In a multicentre, open-label, cluster-randomised study conducted in six European countries, clusters were allocated to usual care or intervention (iABC system) (ClinicalTrials.gov NCT06775028, https://clinicaltrials.gov/study/NCT06775028). In usual care clusters, patients were managed according to clinical guidelines. Findings We enrolled 1260 patients (mean [SD] age 74 [6] years; 44.4% (560/1260) female; median CHA2DS2-VASc 4 [IQR 3–5]), with 634 (50.3%) assigned to intervention and 626 (49.7%) to usual care. Overall, 41.0% (517/1260) had >2 comorbidities, with a high prevalence of anticoagulation (1226, 97.3%) and guideline-recommended therapies. CGA in the intervention arm documented a highly preserved function. The primary endpoint of all-cause unplanned hospitalisation occurred in 108 (17.1%) and 114 (18.2%) patients in the intervention and usual care groups [adjusted OR 0.95, 95% CI 0.61–1.49; p = 0.84]. Use of the AFFIRMO Mobile App was suboptimal, with 68.5% (433/632) of patients using it for only one-third of the observation time. Interpretation In a setting of high baseline guideline adherence and low event rates, the iABC system did not reduce unplanned hospitalisations compared with usual care. These findings suggest no incremental benefit of mHealth integrated care interventions when applied to optimally managed populations, particularly in the context of suboptimal intervention uptake. Funding European Union's Horizon 2020 Research and Innovation Program (grant agreement 899871).

INTRODUCTION:Atrial fibrillation (AF) is the most common arrhythmia in older people, with an increasing prevalence of various geriatric conditions, such as multimorbidity, and frailty. A contemporary integrated approach is effective in reducing the risk of clinical adverse events, particularly when streamlined through the application of the Atrial Fibrillation Better Care (ABC) pathway, as proven in 2 non-European trials. METHODS:The atrial fibrillation integrated approach in frail, multimorbid and polymedicated older people (AFFIRMO) trial, a European multicenter, open-label, cluster-randomized study, will examine whether a mobile-health integrated care approach based on the ABC pathway combined with a multidimensional Comprehensive Geriatric Assessment (CGA) can reduce the 12-month risk of unplanned all-cause hospitalizations in patients with AF ≥65 years with ≥1 concomitant chronic condition(s). RESULTS:The AFFIRMO trial enrolled 1,260 patients with AF (mean age 74 [SD 6] years; 44.4% female) across 6 European countries (Bulgaria, Denmark, Italy, Romania, Serbia, and Spain). At baseline, the median (IQR) CHA2DS2-VASc score was 4 (3-5), and the median (IQR) HAS-BLED score was 1 (1-2). Hypertension was reported in 992 (78.7%) patients, and diabetes mellitus in 369 (29.3%) patients. Among the enrolled patients, 507 (40.5%) were prefrail, and 171 (13.7%) were frail. Oral anticoagulants (OACs) were prescribed for 1,225 (97.2%) patients, with 1,149 (91.2%) patients receiving non-VKAs oral anticoagulants (NOACs). Follow-up is ongoing and planned to be completed in January 2026. CONCLUSIONS:The AFFIRMO trial will provide evidence on the efficacy of the ABC pathway in conjunction with the CGA approach in reducing the risk of unplanned all-cause hospitalizations and other clinical adverse events in older, multimorbid patients with AF. REGISTRATION:ClinicalTrials.gov identifier: NCT06775028.

Genome-editing (GE) techniques are gaining relevance in the agri-food system for their potential to enhance crop resilience and sustainability, raising questions about consumer acceptance and responsible innovation. Understanding public willingness to buy (WTB) GE foods is therefore essential. While trust in science is often cited as a key driver, its effects are not straightforward. This study examines mechanisms linking trust in science to WTB GE foods, testing the mediating role of attitudes and the moderating role of perceived literacy. A cross-sectional online survey was conducted with a representative sample of Italian adults. Using structural equation modelling, we tested three models: a mediation model, a model including a direct path between trust and WTB, and a moderated model incorporating perceived literacy. Trust predicted more favourable attitudes toward GE, and attitudes were strongly associated with WTB. However, when controlling for attitudes, the direct effect of trust on WTB was negative. Perceived literacy significantly moderated this relationship: higher perceived literacy strengthened the negative trust-WTB association. Overall, generalized trust in science is not sufficient for public acceptance of GE crops and foods. Communication strategies should move beyond trust-building and foster informed, critically engaged consumers.

Abstract Background The role of nutrition in managing Inflammatory Bowel Disease (IBD) is widely discussed, yet its interplay with stress-related factors influencing eating behaviour and disease management remains complex. Stress-induced eating behaviours, such as increased comfort foods consumption, may exacerbate symptoms and hinder effective disease management, impacting clinical outcomes and quality of life. This study, part of EU-funded MiGut-Health project, assesses the relationship between stress, eating behaviours, and disease management in IBD patients, focusing on comfort food consumption, psychological food involvement, and disease-related factors, including health engagement, stool consistency, and disease activity. Methods In August 2024, a cross-sectional study was conducted applying an online survey to a cohort of 2,276 adult IBD patients across Italy. The survey included validated scales: the Patient Health Engagement Scale (PHE-s), Psychological Food Involvement Scale (PFIS), Perceived Stress Scale (PSS-10), Salzburg Stress Eating Scale, Inflammatory Bowel Disease Symptom Inventory (IBDSI-SF), and Bristol Stool Chart, along with items on Comfort Food Consumption. Data analysis involved descriptive analysis and independent samples t-test. Results Participants reported moderate perceived stress (mean=17.3 ± 7.75), with 35.5% indicating increased comfort food consumption when stressed, primarily chocolate (23.2%), sweet snacks (22.0%), and savoury snacks (21.0%). Individuals with high stress (32.6%) were more likely to consume fast food (mean=0.4 ± 0.66, p < 0.001) and sweetened beverages (mean=0.7 ± 1.21, p < 0.001). They placed greater importance on comfort food groups for managing stress (mean=2.7 ± 1.17 vs 2.5 ± 1.14, p < 0.001). Disease activity was notably higher in the high-stress group (mean=29.2 ± 15.61 vs. 16.8 ± 11.66, p < 0.001), alongside looser stool consistency (mean=4.8 ± 1.59 vs. 4.3 ± 1.45, p < 0.001). High-stress patients also demonstrated lower health engagement (mean=2.1 ± 0.68 vs. 2.6 ± 0.74, p < 0.001) and reduced psychological food involvement (mean=4.1 ± 1.17 vs. 4.4 ± 1.09, p < 0.001). Conclusion Stress significantly shapes eating behaviours and disease management in IBD patients. High stress correlates with increased comfort foods consumption, reduced psychological food involvement, and poorer disease outcomes, including heightened symptoms, looser stool consistency, and diminished health engagement. These findings highlight the complex relationship between stress and disease-related factors, suggesting the need for integrated interventions targeting stress management to improve dietary behaviours and overall disease management in IBD.

Pathological gambling poses significant global issues, leading to economic, social, and psychological consequences such as debt, family breakdowns, and mental health problems. While various risk factors for gambling addiction, including comorbid addictions, psychiatric disorders, gender, age, and easy access to gambling venues, have been well-studied, less emphasis is placed on protective factors. Strong social support and higher education are key in mitigating gambling addiction. Higher education, in particular, equips individuals with better decision-making skills and risk management strategies, reducing the likelihood of addictive behaviors. Strengthening education and social support systems is essential for preventing gambling addiction. A systematic review was conducted across Scopus, PubMed, Web of Science, and EBSCO, focusing on studies published after 2000. Peer-reviewed studies written in English that examined the relationship between financial literacy and gambling were included. Studies focusing solely on financial topics or not in English were excluded. The review follows the PROSPERO protocol. Financial literacy is linked to lower rates of pathological gambling, although its impact varies based on cultural context and gambling accessibility. From 880 papers, 8 met the inclusion criteria. Six studies confirmed a relationship between higher financial literacy and reduced gambling behavior, while two studies indicated that the significance of this relationship depended on specific financial literacy dimensions or contextual factors. This research underscores the importance of incorporating consumer education and psychological factors into future gambling addiction prevention strategies, particularly for younger gamblers.

BACKGROUND:Antimicrobial resistance (AMR) represents a growing challenge to both individual and public health, driven by the excessive and inappropriate use of antibiotics. Studies emphasize a widespread lack of knowledge regarding proper antibiotic use and the mechanisms of antibiotic resistance. This study aims to explore the relationships between citizens' health engagement and attitudes towards antibiotic consumption (Hypothesis 1, Hypothesis 2) and explores the role of orientation to health literacy as a mediator of these relationships (Hypothesis 3). METHODS:Data were collected via a questionnaire administered to a representative sample of the Italian population (N = 1016). Descriptive statistics and mediation analysis, using bootstrapping with 5000 resamples to estimate indirect effects and assess statistical significance. RESULTS:All hypotheses were confirmed. Health engagement had a significant, positive effect on orientation to health literacy, which was positively associated with attitudes towards antibiotic consumption. Moreover, orientation to health literacy fully mediated the effect of health engagement on attitudes towards antibiotic consumption. CONCLUSIONS:This study highlights the crucial role of health literacy in influencing attitudes towards appropriate antibiotic consumption. Public health interventions should not only encourage individuals to actively engage with their health, but also focus on improving their health literacy, including on specific topics such as AMR.

New Genomic Techniques (NGTs) enable precise genetic modifications and offer potential improvements in food safety and sustainability. Despite these benefits, consumer scepticism-especially in culturally rich food contexts like Italy-poses a barrier to acceptance, particularly for traditional products such as cheese. This study examines how benefit framing (health vs. sustainability) and psychosocial factors influence Italian consumers' attitudes and purchase intentions towards cheese produced with NGTs. A nationally representative sample of 1007 Italian adults participated in an online survey. Participants were randomly assigned to two framing conditions emphasizing either health-related benefits (improved safety) or sustainability-related benefits (extended shelf life) of NGT-treated cheese. Health framing generated significantly more positive attitudes and higher purchase intentions than sustainability framing. Psychosocial predictors were analysed using the Ecological Framework of food-related behaviour through multiple linear regressions, separately for the two conditions. Key predictors of purchase intention included positive attitudes towards NGT-treated cheese and low levels of food technology neophobia. Social influence positively impacted both groups, while trust in authorities was significant only under the health condition. Food variety seeking and social affirmation showed frame-specific effects. This is the first study to investigate consumer acceptance of NGTs in the context of cheese, a culturally significant food in Italy. It highlights the persuasive power of health-based framing and underscores the role of individual and social factors in shaping acceptance. The findings offer practical guidance for communication strategies aiming to promote NGT-derived foods in traditional markets.

Innovative farming practices to mitigate environmental impacts are critical. Participatory approaches, which actively involve farmers in co-developing solutions, are vital for overcoming resistance and enabling successful, context-specific agricultural innovations. This scoping review maps participatory methodologies in agricultural innovation, identifying their key characteristics and factors contributing to their success. We used PRISMA-ScR guidelines and conducted a systematic search on the databases Scopus and Web of Science, out of 807 studies published between 1994 and 2022, 34 met our criteria. Data extraction involved coding theoretical frameworks, project phases, duration, participant types, barriers, facilitators, innovations, and modes of participation into categories: contributory, collaborative, and co-created. We used Atlas.ti for coding transparency and analysis. Projects spanned 26 countries, primarily in Europe and Africa, with an average duration of 5 years. Innovative practices were grouped into the following themes: climate change, crop choice, irrigation, pest management, and technical improvements. Most projects involved farmers in defining research questions. Participants included farmers, experts, NGOs, private companies, and public organizations. Successful projects actively involve stakeholders, especially farmers, from idea generation to implementation, and benefit from strong relationships and informal, flexible interactions. Intermediaries, like extension agents, are effective in bridging gaps and fostering trust. Our review indicates the need for clearer reporting guidelines to enhance comparability and effectiveness across participatory research.