20% of Italians do not receive any screening invitations. And among the citizens who are involved, one-third have trouble participating in the checkups, and one-fifth give up prevention due to conflicting schedules, waiting lists, and logistical challenges with our National Health Service. Six out of ten individuals are enabled to conduct prevention tests. This is the conclusion drawn from the Patient Engagement Barometer, the first national poll of Italians' perceptions of active participation in their treatment route conducted by Helaglobe. According to the study, 87% of citizens have never participated in hospital or health-care quality surveys, or in specific working groups to create and enhance these services. This compares to 35% who found it difficult or extremely difficult to schedule exams or visits. Even at the level of individual health professionals, this lack of participation is reflected, with 22% of patients claiming that their doctor never involves them in health decisions and 40% who are involved only occasionally, despite the fact that almost all citizens want to participate and be engaged in the choices while respecting the decisions made by health professionals.