Engaging the public in surveillance: building a platform to monitor preventive behaviours

Abstract While behavioural factors are recognized as key to managing outbreaks, few public health systems have established tools to monitor these responses over time. Existing approaches are often reactive or limited, making tracking difficult. To address this gap, the University of Pisa developed a digital platform to support participatory monitoring of preventive behaviours through periodic data collection. The digital platform architecture integrates secure user identification, socio-demographic profiling, and modular questionnaires adapted to different epidemic phases. These assess behaviours, attitudes, and perceptions related to vaccination, preventive actions (e.g. removing still water to prevent mosquito breeding), social interactions, and trust in health information. A key feature is the integration of a Community Advisory Board (CAB), led by the civil society organization “Cittadinanzattiva”. The CAB supports testing of accessibility features and platform functionalities, validates questionnaires and ensures cultural and linguistic adaptation. It co-develops outreach strategies and helps identify participation barriers-particularly for people with chronic conditions and social vulnerabilities. This participatory approach strengthens acceptability and equity from the outset. Participants can visualise their own response history, receive tailored feedback, and access health promotion content through multiple channels. Core functionalities of the platform are based on a dynamic configuration system that allows segmentation of users by behaviour, demographics, or health status, enabling the delivery of tailored questionnaires or messages and subgroup analysis. The platform will be piloted during upcoming influenza and dengue surveillance phases. By embedding citizens in the production of public health intelligence, the BEHAVE-MOD platform offers an adaptive, scalable, equity-sensitive tool for behaviour-informed outbreak preparedness and response.