# Unfolding Success Factors and Barriers in Adapting Slovenia’s Health Promotion Centre Model to Bergamo Province: A PIET-T Feasibility Assessment with Time-Dependent Care Implications

## TL;DR

This study assesses how to adapt Slovenia's successful health promotion model to Bergamo, Italy, by identifying key factors and barriers for a feasible implementation.

## Contribution

The study provides a tailored feasibility assessment of adapting Slovenia's Health Promotion Centre model to Bergamo using the PIET-T framework.

## Key findings

- Eight key elements define Slovenia's Health Promotion Centre model, including governance, financing, and integration with primary care.
- Bergamo requires adaptation in financing, coordination, workforce capacity, and digital integration to adopt the Slovenian model.
- The model's adaptation could improve timely risk-factor management for time-dependent health conditions like cardiovascular events.

## Abstract

Background/Objectives: Health Promotion Centres (HPCs) in Slovenia represent a European best practice for integrated prevention and health promotion. This study explores the feasibility of adapting the Slovenian HPC model to Bergamo Province, Lombardy, considering local population needs and health system characteristics. Methods: We conducted a qualitative feasibility and policy analysis based primarily on documentary review, complemented by a webinar, a study visit to Slovenia, and expert consultations (conducted in two group discussions) with professionals from ATS (Agenzia Tutela della Salute) Bergamo and local ASST (Azienda Socio-Sanitaria Territoriale) providers. Data were analysed using the PIET-T framework (Population–Intervention–Environment–Transfer). Results: Eight key elements define the Slovenian model: (1) governance and stewardship; (2) structural financing; (3) standardized service portfolio; (4) systematic preventive referrals; (5) integration with primary care and screening; (6) multidisciplinary teams with codified training; (7) community outreach and equity orientation; and (8) information systems and reporting. While Bergamo shares similar demographic and epidemiological profiles, differences in behavioral risk factors, project-based financing, fragmented initiatives, and limited digital integration necessitate adaptation. The comparative assessment highlighted key areas requiring contextual adaptation, including financing mechanisms, organisational coordination, workforce capacity, digital interoperability, and approaches to equity. Conclusions: The Slovenian HPC experience demonstrates the potential of integrated, community-based health promotion. Its adaptation to Lombardy appears feasible if core components are preserved and tailored to local governance, population, and health system conditions. These organisational features may be particularly relevant for time-dependent conditions, such as acute cardiovascular and cerebrovascular events, by potentially supporting more timely risk-factor management and coordination across diagnostic and emergency pathways. Rather than a blueprint for reform, this experience offers useful insights to reinforce prevention and health promotion within the ongoing territorial care reform in Lombardy.