Il processo co-creativo dell'Atlante Aria e Salute: coinvolgimento degli stakeholder e degli utenti nella definizione dei bisogni informativi e comunicativi.

OBJECTIVES: to describe the co-creation process adopted to define the content and communication approaches of the Air and Health Atlas. DESIGN: a two-phase co-creation process using qualitative research methods: focus groups and interviews. The first phase explored users' information needs; the second evaluated content and communication strategies through discussion of an advanced prototype of the Atlas. SETTING AND PARTICIPANTS: the ATLAS is a project promoted by the Italian Ministry of Health, aimed at integrating air quality data and health outcomes into an interactive tool to support decision-makers, technical experts, and citizens. Focus groups and interviews were conducted in Emilia-Romagna Region (Northern Italy). Stakeholders from the environmental and health sectors (technical experts, health professionals, decision-makers) were involved and selected through a stakeholder mapping instrument ('thermometer tool'). MAIN OUTCOME MEASURES: information needs regarding the relationship between air quality and health, communication preferences, comprehensibility and interpretability of data and maps, perception of communication risks, and evaluation of the Atlas prototype. RESULTS: thematic analysis identified four thematic areas: 1. awareness and knowledge; 2. behaviours and lifestyles; 3. information dissemination; 4. geographic scale of reference. A widespread difficulty emerged, particularly among non-experts, in understanding scientific data and linking pollutant exposure to health effects. Stakeholders highlighted the need for clear information on health impacts, future scenarios, and avoidable deaths under different hypothetical scenarios. The importance of emphasising the co-benefits of mitigation actions (reduction of air pollution and climate impact, promotion of physical activity, and healthy diets) was stressed, while avoiding alarmist approaches. The need for accessible language, easily interpretable maps, and supporting methodological explanations was also underlined, without differentiating navigation between technical users and citizens. The prototype was considered highly informative, but potentially prone to misinterpretation in the absence of adequate interpretative tools. CONCLUSIONS: systematic stakeholder involvement helped shape the content and communication choices of the Atlas, highlighting the need to balance scientific rigour and accessibility. The co-creation approach emerges as an effective strategy to improve transparency, comprehensibility, and trust in scientific information supporting public health decision-making.