"Leo&Giulia standing for public health": an animated series to promote the values of public health among school-aged children. Best practices and field-trial protocol.

Background: The "Leo&Giulia standing for public health" project is an innovative digital health education model targeting primary school children. The project, developed during the COVID-19 pandemic, aims to educate primary school-aged children about public health issues through an animated cartoon series. It highlights the importance of early-life health promotion and the potential role of educational settings in shaping health behaviours. Study design: A 2-year school-based cluster-randomized controlled community trial will be conducted among 8-10-year-old pupils in the province of Pavia, Northern Italy. Methods: The intervention group will receive an educational programme via a new episode of "Leo&Giulia" animated series, focusing on smoking prevention. The study will assess changes in knowledge, attitudes towards smoking, and communication about smoking risks among peers and parents. The trial involves baseline and follow-up assessments through questionnaires targeting both children and parents. Results (expected): We assume that children in the intervention group will demonstrate increased knowledge and awareness of smoking-related health risks and develop negative attitudes towards tobacco use compared to the control group. Enhanced communication about tobacco harms among peers and between children and parents, as well as increased parental involvement in anti-smoking socialization practices, are expected secondary outcomes. Discussion and Conclusions: "Leo&Giulia" integrates health education into the school curriculum, leveraging the appeal of animated content to engage children in public health topics. The project is expected to contribute to the field of health education by demonstrating the effectiveness of digital health interventions in childhood, foreseeing potential long-term impacts on health behaviors and in shaping future public health strategies.

Investigating Eating Habits of Children Aged between 6 Months and 3 Years in the Provinces of Modena and Reggio Emilia: Is Our Kids' Diet Sustainable for Their and the Planet's Health?

A healthy and balanced diet is crucial for children's well-being and aids in preventing diet-related illnesses. Furthermore, unhealthy dietary habits indirectly impact children's health, as the food industry stands as one of the primary drivers of climate change. Evidence shows the Mediterranean diet is sustainable for both children's and the planet's health. The aim of this cross-sectional study was to evaluate the eating habits of children aged between 6 months and 3 years, in the province of Modena and Reggio Emilia, in Italy, along with their adherence to the guidelines for a healthy diet, and examine the role of pediatricians in promoting knowledge about nutrition and sustainability. In our sample (218 children), most children exceeded the recommended meat and cheese intake, while consuming insufficient amounts of vegetables, fruit, and legumes. Vegetable and fruit consumption declined with the increase in age category while eating sweets, soft drinks, and processed food increased. Incorporating school meals' data into this analysis, we observed a modification in dietary compliance, characterized by an increase in meat and cheese consumption, alongside improvements in the intake of vegetables, fruits, fish, eggs, and legumes. This study suggests that supporting an integrated approach that combines social and educational initiatives is crucial. Future research should prioritize fostering sustainable eating habits within communities to facilitate dietary habits' transformation and encourage healthier lifestyles.

Vaccination strategies for high-risk and fragile populations in Lombardy (Italy): a region-wide assessment of hospital-based models and best practices.

Background: Subjects with selected underlying medical conditions are at higher risk of infection and severe outcomes from vaccines preventable diseases. While most countries adopt life-course approaches to vaccination, high-risk group immunization programmes could maximize individual protection, while contributing to population health. The COVID-19 pandemic stimulated the planning and implementation of successful hospital-based high-risk groups' immunization models. However, in Italy, high-risk subjects' vaccine coverage is not actively monitored at the national or regional level, nor shared guidelines exist yet on hospital-based immunization programmes. Study Design: The study reports findings from a region-wide assessment of the availability, characteristics, and setting-specific features of hospital-based immunization programmes for high-risk subjects in the Lombardy region. Methods: Fondazione The Bridge a not-for-profit organization based in Milan, in collaboration with the Prevention Unit of the Lombardy Region Directorate for Welfare, and the University of Pavia coordinated a project aimed at bringing together regional health institutions, key stakeholders, academic experts, scientific societies and patients' associations to assess high-risk subjects' barriers to vaccine uptake and inform preventive programmes and policies. In this context, we designed and implemented a survey to systematically map the existence and characteristics of hospital-based immunization programmes targeting high-risk subjects. The survey was proposed to all 115 hospital medical directions of the Lombardy region. Results: We collected data from 97 hospital medical directions, with a response rate of 85%. Among respondents, 24% were publi-cly managed hospitals, 17% were Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) and 59% accredited private hospitals. Overall, 51.5% facilities in the Lombardy Region reported to actively administer vaccines to high-risk subjects in hospital settings, the prevalence being 89.6% in public hospitals. Among hospitals where vaccines are actively administered, 46% reported to have centralized vaccines ambulatory clinics, while 54% reported to administer vaccines in the context of inpa-tient care, within clinical wards. In 14% of hospitals vaccination counselling is carried out at the hospital level, while patients are referred to community services for the vaccine administration, 58% have established clinical pathways and formalized internal procedures to integrate vaccine prevention within the clinical care. Conclusions: Half of hospital facilities in the Lombardy Region administer vaccines to high-risk patients. Hospital-based im-munization models vary widely by vaccines programmes, organizational aspects, vaccines procurement and workforce involved. Identifying best practices and effective models can help tackle current challenges and improve immunization coverage for at-risk groups.

Efficacy and Safety of Endovascular Fenestrated and Branched Grafts Versus Open Surgery in Thoracoabdominal Aortic Aneurysm Repair: An Updated Systematic Review, Meta-analysis, and Meta-regression.

OBJECTIVE: To provide an updated systematic review and meta-analysis with meta-regression of efficacy and safety of fenestrated/branched endovascular repair of thoracoabdominal aortic aneurysms (TAAAs) compared with open repair. BACKGROUND: Endovascular repair of TAAAs may be a promising alternative to open surgery by reducing invasiveness and expanding the eligible population, but evidence remains limited. METHODS: We applied "Prepared Items for Systematic Reviews and Meta-analysis" guidelines to retrieve, quantitatively pool, and critically evaluate the efficacy and safety (including 30-day mortality, reintervention, spinal cord injury [SCI], and renal injury) of both approaches. Original studies were retrieved from PubMed, Embase, and Cochrane Library until April 20, 2022, excluding papers reporting <10 patients. Pooled proportions and means were determined using a random-effect model. Heterogeneity between studies was evaluated with I2 statistics. RESULTS: Sixty-four studies met the predefined inclusion criteria. Endovascular cohort patients were older and had higher rates of comorbidities. Endovascular repair was associated with similar proportions of mortality (0.07, 95% confidence intervals [CI]: 0.06-0.08) compared with open repair (0.09, 95% CI: 0.08-0.12; P = 0.22), higher proportions of reintervention (0.19, 95% CI: 0.13-0.26 vs 0.06, 95% CI: 0.04-0.10; P < 0.01), similar proportions of transient SCI (0.07, 95% CI: 0.05-0.09 vs 0.06, 95% CI: 0.05-0.08; P = 0.28), lower proportions of permanent SCI (0.04, 95% CI: 0.03-0.05 vs 0.06, 95% CI: 0.05-0.07; P < 0.01), and renal injury (0.08, 95% CI: 0.06-0.10 vs 0.13, 95% CI: 0.09-0.17; P = 0.02). Results were affected by high heterogeneity and potential publication bias. CONCLUSIONS: Despite these limitations and the lack of randomized trials, this meta-analysis suggests that endovascular TAAA repair could be a safer alternative to the open approach.

The key role of public health in renovating Italian biomedical doctoral programs.

Background: A key renovation of doctoral programs is currently ongoing in Italy. Public health and its competencies may play a pivotal role in high-level training to scientific research, including interdisciplinary and methodological abilities. Methods: As a case study, we used the ongoing renovation of the Clinical and Experimental Medicine doctoral program at the University of Modena and Reggio Emilia. We focused on how the program is designed to meet national requirements as well as students' needs, thus improving educational standards for scientific research in the biomedical field, and on the specific contribution of public health and epidemiology in such an effort. Results: The renovation process of doctoral programs in Italy, with specific reference to the biomedical field, focuses on epidemiologic-statistical methodology, ethics, language and communication skills, and open science from an interdisciplinary and international perspective. In the specific context of the doctoral program assessed in the study and from a broader perspective, public health appears to play a key role, taking advantage of most recent methodological advancements, and contributing to the renovation of the learning process and its systematic quality monitoring. Conclusions: From a comparative assessment of this case study and Italian legislation, the key role of public health has emerged in the renovation process of doctoral programs in the biomedical field.

Health and social home services among community-dwelling older people during COVID-19: Results from the cross-sectional LOST in Lombardia project.

BACKGROUND: Few studies have focused on changes in health and social services access due to the COVID-19 pandemic. We aimed to describe changes in the use of selected health and social home services due to the pandemic and to investigate potential associated factors, including socio-demographic characteristics, number of chronic diseases and mental health indicators, among older Italian individuals. METHODS: We analysed data from the LOST in Lombardia cross-sectional study conducted in November 2020 on a large representative sample of 4400 individuals aged ⩾65 years. To identify potential factors associated with the increased use of three selected health and social home services, we estimated odds ratios (OR) and confidence intervals (CI) using multivariable logistic regression models. RESULTS: Compared to the year before, 5.0% of older adults increased help from domestic workers (vs. 6.9% reducing) during the pandemic, 4.4% increased help from non-familiar caregivers (vs. 1.3% decreasing) and 4.7% increased medical home visits (vs. 1.0% decreasing). An increase in the use of these services was more frequent among participants with co-morbidities (p for trend <0.001), especially with diabetes (for caregivers: OR=12.2, 95% CI 6.0-24.8), and worse mental health (for caregivers and for those with a GAD-2 score ⩾3 vs. <3: OR=10.6, 95% CI 5.8-19.4). Conversely, people living in more crowded households less frequently increased health and social services use during the pandemic. CONCLUSIONS: Our results should inform targeted interventions for the identified vulnerable groups to close the gap in health and social inequities.

Vaccine Mandates in the COVID-19 Era: Changing Paradigm or Public Health Opportunity? Comment on "Convergence on Coercion: Functional and Political Pressures as Drivers of Global Childhood Vaccine Mandates".

The debate around vaccine mandates has flourished over the last decade, with several countries introducing or extending mandatory childhood vaccinations. In a recent study, Attwell and Hannah explore how functional and political pressures added to public health threats in selected countries, motivating governments to increase the coerciveness of their childhood vaccine regimes. In this commentary, we reflect on whether such model applies to the coronavirus disease 2019 (COVID-19) case and how the pandemic has re-shuffled the deck around vaccine mandates. We identify COVID-19 immunisation policies' distinctive aspects as we make the case of countries implementing mass immunisation programmes while relying on digital COVID-19 certificates as an indirect form of mandate to increase vaccine uptake. We conclude by acknowledging that different forms of mandatory vaccination might serve as a shortcut to protect population health in times of emergency, underlining, however, that the ultimate public health goal is to promote voluntary, informed, and responsible adherence to preventive behaviours.

Grandparenting during pandemic times: pros and cons for mental health.

BACKGROUND: The COVID-19 pandemic and associated lockdown measures posed an unprecedented challenge to the crucial role of grandparenting in family-oriented cultures, such as Italy. Reduced contact with grandchildren during this period potentially threatened grandparents' mental health and well-being. METHODS: We analysed data from the LOckdown and lifeSTyles in Lombardia cross-sectional study conducted in November 2020. The study included a representative sample of 4400 older adults from Lombardy, Italy, of which 1289 provided childcare to their grandchildren. RESULTS: A decrease in self-reported grandparenting was associated with an increased likelihood of experiencing depressive symptoms among grandparents (OR 1.50, 95% CI 1.01-2.24). Conversely, an increase in grandparenting was linked to poorer sleep quality (OR 11.67, 95% CI 5.88-23.17) and reduced sleep quantity (OR 2.53, 95% CI 1.45-4.41). CONCLUSIONS: Despite the barriers posed by the pandemic, grandparenting played a beneficial role in maintaining the mental health and well-being of older adults. However, it is crucial to recognise specific vulnerabilities, such as gender, feelings of hopelessness and overcrowding, which can have detrimental effects during and beyond emergency situations. Careful attention to these factors is essential for developing targeted support systems and interventions aimed at safeguarding the mental health of older adults and enhancing their resilience in crises.

Transition to retirement impact on smoking habit: results from a longitudinal analysis within the Survey of Health, Ageing and Retirement in Europe (SHARE) project.

BACKGROUND: In an ageing society, retirement impacts on behavioural risk factors and health outcomes should be carefully assessed. Scant evidence exists from longitudinal studies on the short- and long-term consequences of the transition to retirement on smoking habit. METHODS: We conducted a longitudinal study based on the Survey of Health, Ageing and Retirement in Europe (SHARE) data from 27 European countries plus Israel collected in 2004-2020. To estimate relative risks (RR) and corresponding 95% confidence intervals (CI) for smoking status and intensity at seven time periods before and after retirement, we fitted adjusted generalised estimating equation (GEE) models for repeated measures. RESULTS: We selected a cohort of 8998 individuals employed at baseline and retired at follow-up (median follow-up time: 9 years; maximum: 16 years). As compared to the year of retirement, the RR of smoking was 1.59 (95% CI 1.44-1.76) at 10 years or more before retirement, 1.35 (95% CI 1.25-1.46) from 5 to 9 years before retirement, and 1.18 (95% CI 1.10-1.27) from 1 to 4 years before retirement. Smoking steadily decreased after retirement, being 0.94 (95% CI 0.87-1.01) from 1 to 4 years after retirement, 0.76 (95% CI 0.69-0.84) from 5 to 9 years, and 0.58 (95% CI 0.46-0.74) 10 years or more after retirement. In smokers, the estimated number of cigarettes smoked/day decreased from about 27 cigarettes/day at 10 years or more before retirement to 9 cigarettes/day at 10 years or more after retirement (p trend < 0.001). CONCLUSION: Longitudinal data suggest that lifestyles might favourably change with retirement. Further studies are needed to direct healthy ageing promotion policies better.

Older Adults' Access to Care during the COVID-19 Pandemic: Results from the LOckdown and LifeSTyles (LOST) in Lombardia Project.

The COVID-19 pandemic disproportionally affected older people in terms of clinical outcomes and care provision. We aimed to investigate older adults' changes in access to care during the pandemic and their determinants. We used data from a cross-sectional study (LOST in Lombardia) conducted in autumn 2020 on a representative sample of 4400 older adults from the most populated region in Italy. Lifestyles, mental health, and access to healthcare services before and during the pandemic were collected. To identify factors associated with care delays, reduction in emergency department (ED) access, and hospitalisations, we estimated prevalence ratios (PR) and 95% confidence intervals (CI) using multivariable log-binomial regression models. During the pandemic, compared to the year before, 21.5% of the study population increased telephone contacts with the general practitioner (GP) and 9.6% increased self-pay visits, while 22.4% decreased GP visits, 12.3% decreased outpatient visits, 9.1% decreased diagnostic exams, 7.5% decreased ED access, and 6% decreased hospitalisations. The prevalence of care delays due to patient's decision (overall 23.8%) was higher among men (PR 1.16, 95% CI 1.05-1.29), subjects aged 75 years or more (PR 1.12, 95% CI 1.00-1.25), and those with a higher economic status (p for trend < 0.001). Participants with comorbidities more frequently cancelled visits and reduced ED access or hospitalisations, while individuals with worsened mental health status reported a higher prevalence of care delays and ED access reductions. Access to care decreased in selected sub-groups of older adults during the pandemic with likely negative impacts on mortality and morbidity in the short and long run.

COVID-19 pandemic impact on people with diabetes: results from a large representative sample of Italian older adults.

AIMS: Restrictions imposed to prevent SARS-CoV-2 transmission should be weighed against consequences on vulnerable groups' health. Lifestyles and disease management of older people with diabetes might have been differentially impacted compared to non-chronic individuals. METHODS: A cross-sectional study (LOST in Lombardia) was conducted on a representative full sample of 4 400 older adults (17th-30th November 2020), collecting data on lifestyles, mental health and access to care before and during the pandemic. RESULTS: We compared 947 (51.9%) people with diabetes and 879 (48.1%) healthy subjects reporting no chronic conditions. People with diabetes reported more frequently increased physical activity (odds ratio, OR 2.65, 95% confidence internals, CI 1.69-4.13), drinks/week reduction (OR 6.27, 95%CI 3.59-10.95), increased consumption of fruit (OR 2.06, 95%CI 1.62-2.63), vegetables (OR 1.41, 95%CI 1.10-1.82), fish (OR 2.51, 95%CI 1.74-3.64) and olive oil (OR 3.54, 95%CI 2.30-5.46). People with diabetes increased telephone contacts with general practitioners (OR 3.70, 95%CI 2.83-4.83), hospitalisations (OR 9.01, 95%CI 3.96-20.51), visits and surgeries cancellations (OR 3.37, 95%CI 2.58-4.42) and treatment interruptions (OR 1.95, 95%CI 1.33-2.86). CONCLUSIONS: Pandemic adverse effects occurred but are heterogenous in a population with chronic diseases, who seized the opportunity to improve health behaviours, despite health system difficulties guaranteeing routine care, within and beyond COVID-19.

COVID-19 lockdown impact on familial relationships and mental health in a large representative sample of Italian adults.

PURPOSE: Benefits of national-level stay-at-home order imposed in Italy to prevent SARS-CoV-2 transmission need to be carefully weighed against its impact on citizens' health. In a country with a strong familial culture and where welfare relies on households, confinement drastically decreased support provided by elder relatives, which may have resulted in mental health worsening. METHODS: A web-based cross-sectional study (LOST in Italy) was conducted on a representative sample of Italian adults during lockdown (27th of April-3rd of May 2020). We asked 3156 subjects to report on reduced help in housework and childcare from retired parents to assess the impact of confinement on mental health, through validated scales before and during lockdown. RESULTS: Overall, 1484 (47.0%) subjects reported reduced housework help from parents, and 769 (64.0%, of the 1202 subjects with children) diminished babysitting support. Subjects reporting reduced housework help had worsened sleep quality (multivariate odds ratio, OR = 1.74, 95% confidence interval, CI 1.49-2.03) and quantity (OR = 1.50, 95% CI 1.28-1.76), depressive (OR = 1.32, 95% CI 1.14-1.53) and anxiety symptoms (OR = 1.53, 95% CI 1.32-1.78), compared to those reporting unreduced help. Worsening in sleep quality (OR = 2.32, 95% CI 1.76-3.05), and quantity (OR = 1.80, 95% CI 1.36-2.37), depressive (OR = 1.79, 95% CI 1.39-2.31) and anxiety symptoms (OR = 1.90, 95% CI 1.48-2.46) was also associated with reduced babysitting help. Mental health outcomes were worse in subjects with poorer housing and teleworking during lockdown. CONCLUSION: Confinement came along with reduced familial support from parents, negatively impacting household members' mental health. Our findings might inform evidence-based family and welfare policies to promote population health within and beyond pandemic times.

Adherence to the Mediterranean Diet during the COVID-19 national lockdowns: a systematic review of observational studies.

BACKGROUND AND AIM OF THE WORK: During the COVID-19 pandemic, many countries adopted restrictive measures to mitigate infection spread, which might have influenced people's lifestyle and dietary habits. We conducted a systematic review to evaluate the impact of national lockdowns on adherence to the Mediterranean Diet (MD). METHODS: Studies were identified searching Medline, Embase, Web of Science, and the Cochrane Library. Studies published until 4th May 2021 were included. We only considered studies reporting original data from quantitative analysis and assessing changes in adherence to the MD, using validated dietary scores, or in consumption of MD food items. Data extraction, pooling, and quality appraisal of included studies were conducted following the PRISMA guidelines. RESULTS: Forty-two studies were retrieved. After screening, 12 studies met inclusion criteria and were included in the review, of which 4 (33%) were longitudinal studies. Six (85.7%) of the seven studies that measured changes in MD adherence before-during lockdown reported an increase (rate of change of high-adherence to MD ranged between +3.3% and +21.9%). Evidence indicates that consumption of MD food items increased during lockdown but is heterogeneous in study design, quality, and findings. CONCLUSIONS: Our results suggest adherence to the MD during lockdown might have increased in some settings, while the determinants of such a trend are to be further explored. We raise awareness of the need to research further the impacts and long-term consequences of COVID-19 containment measures on dietary and lifestyle habits.

Safety surveillance after BNT162b2 mRNA COVID-19 vaccination: results from a cross-sectional survey among staff of a large Italian teaching hospital.

BACKGROUND AND AIM: Comirnaty® was the first COVID-19 vaccine available for the vaccination campaign of healthcare workers in Italy. With the aim of assessing vaccine safety, we conducted a cross-sectional survey administrating a voluntary-based questionnaire on adverse events following immunisation (AEFIs) in San Raffaele Hospital, Milano, Italy. METHODS: From 4th January 2021 to 27th April 2021, we collected 2,659 questionnaires (response rate: 24,5%). We analyzed data, reporting AEFIs by gender, age, self-reported severity, type, time of insurgence and duration, and estimating relative-risk ratios (RRR) and corresponding 95% confidence intervals (CI). RESULTS: The most reported symptoms were injection site pain, fatigue, headache, myalgia, chills, fever, and arthralgia. Severe systemic reactions were more frequent after receiving the second dose (RRR 6.25, 95% CI 4.57-8.55), in women (RRR 3.33, 95% CI 2.30-4.82), and less frequent in individuals aged 60 or more (RRR 0.26, 95% CI 0.14-0.49). In addition, we noted a wide range of adverse events of special interest (AESIs). CONCLUSIONS: Consistently with clinical trials and pharmacovigilance surveillance, AEFIs were frequent, but severe ones were uncommon, supporting the massive implementation of the COVID-19 vaccination campaign and providing valuable data for a risk profiling of vaccinees. (www.actabiomedica.it).

The Use of Digital Technologies to Support Vaccination Programmes in Europe: State of the Art and Best Practices from Experts' Interviews.

Digitalisation offers great potential to improve vaccine uptake, supporting the need for effective life-course immunisation services. We conducted semi-structured in-depth interviews with public health experts from 10 Western European countries (Germany, Greece, Italy, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal, and the United Kingdom) to assess the current level of digitalisation in immunisation programmes and retrieve data on interventions and best practices. Interviews were performed using an ad hoc questionnaire, piloted on a sample of national experts. We report a mixed level of digital technologies deployment within vaccination services across Europe: Some countries are currently developing eHealth strategies, while others have already put in place robust programmes. Institutional websites, educational videos, and electronic immunisation records are the most frequently adopted digital tools. Webinars and dashboards represent valuable resources to train and support healthcare professionals in immunisation services organisation. Text messages, email-based communication, and smartphone apps use is scattered across Europe. The main reported barrier to the implementation of digital-based programmes is the lack of resources and shared standards. Our study offers a comprehensive picture of the European context and shows the need for robust collaboration between states and international institutions to share best practices and inform the planning of digital intervention models with the aim of countering vaccine hesitancy and increasing vaccine uptake.

Safety and Efficacy of Spray Intranasal Live Attenuated Influenza Vaccine: Systematic Review and Meta-Analysis.

Although influenza is a major public health concern, little is known about the use of spray live attenuated influenza vaccine (LAIV) among adults. For this reason, we conducted a systematic review and meta-analysis to investigate the efficacy and safety of LAIV, especially in adults with/without clinical conditions and children <2 years, with the final aim of possibly extending the clinical indications. PubMed/MEDLINE and Scopus were the two databases consulted through February 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. A critical appraisal was conducted. Analyses were performed by using ProMeta3 software. Twenty-two studies were included, showing that LAIV was associated with a higher probability of seroconversion when compared with a placebo and considering the A/H1N1 serotype (pooled OR = 2.26 (95% CI = 1.12-4.54), p-value = 0.022; based on 488 participants, without heterogeneity (I2 = 0.0%)). The meta-analysis also confirmed no significant association with systemic adverse events. Only rhinorrhea, nasal congestion, and sore throat were significantly associated with LAIV compared to the placebo. Despite limited available evidence, LAIV has proved to be a safe and effective flu vaccination, also due to its very low invasiveness, and our review's results can be considered a starting point for guiding future research and shaping forthcoming vaccination campaigns.

Transition to retirement impact on health and lifestyle habits: analysis from a nationwide Italian cohort.

BACKGROUND: Retirement is a life-course transition likely to affect, through different mechanisms, behavioural risk factors' patterns and, ultimately, health outcomes. We assessed the impact of transitioning to retirement on lifestyle habits and perceived health status in a nationwide cohort of Italian adults. METHODS: We analysed data from a large cohort of Italian adults aged 55-70, derived from linking six waves of the Participation, Labour, Unemployment Survey (PLUS), a national survey representative of the Italian workforce population, conducted between 2010 and 2018. We estimated relative-risk ratios (RRR) of transition to retirement and their corresponding 95% confidence intervals (CIs) for selected behavioural risk factors and health outcomes using multivariable logistic regression models. We used propensity score matching (PSM) to account for potential confounders. RESULTS: We included 5169 subjects in the study population, of which 1653 retired between 2010 and 2018 (exposed, 32%). Transition to retirement was associated with a 36% increased probability of practising sports (RRR 1.36, 95% CI 1.12-1.64). No statistically significant changes were reported for smoking habit (current smoker RRR: 1.18, 95% CI 0.94-1.46) and BMI (overweight/obese RRR: 0.96, 95% CI 0.81-1.15). Overall, retiring was associated with improved self-rated health status (RRR 1.26, 95% CI 1.02-1.58). CONCLUSION: Individual data-linkage of multiple waves of the PLUS can offer great insight to inform healthy ageing policies in Italy and Europe. Transition to retirement has an independent effect on perceived health status, physical activity and selected behavioural risk factors. It should be identified as a target moment for preventive interventions, with particular reference to primary prevention so as to promote health and wellbeing in older ages.