Kyriakos Souliotis - Faculty of Social and Political Sciences, University of Peloponnese, Corinth, Greece
Eirini Agapidaki - Faculty of Social and Political Sciences, University of Peloponnese, Corinth, Greece
Lily Evangelia Peppou - Community Mental Health Centre, University Mental Health Research Institute, Athens, Greece
Chara Tzavara - Faculty of Social and Political Sciences, University of Peloponnese, Corinth, Greece
Dimitrios Varvaras - Department of Surgery, University of Rome Tor Vergata, Rome, Italy
Oreste Claudio Buonomo - Department of Surgery, University of Rome Tor Vergata, Rome, Italy
Dominique Debiais - Europa Donna France, Paris, France
Stanimir Hasurdjiev - Bulgarian National Patients’ Organization, Sofia, Bulgaria
Francois Sarkozy - FSNB Health & Care, Paris, France

Background Even though there are many patient organizations across Europe, their role in impacting health policy decisions and reforms has not been well documented. In line with this, the present study endeavours to fill this gap in the international literature. To this end, it aims to validate further a previously developed instrument (the Health Democracy Index - HDI) measuring patient organization participation in health policy decision-making. In addition, by utilizing this tool, it aims to provide a snapshot of the degree and impact of cancer patient organization (CPO) participation in Italy and France.    Methods A convenient sample of ۱۸۸ members of CPOs participated in the study (۹۵ respondents from ۱۰ CPOs in Italy and ۹۳ from ۱۲ CPOs in France). Participants completed online a self-reported questionnaire, encompassing the ۹-item index and questions enquiring about the type and impact of participation in various facets of health policy decisionmaking. The psychometric properties of the scale were explored by performing factor analysis (construct validity) and by computing Cronbach α (internal consistency).   Results Findings indicate that the index has good internal consistency and the construct it taps is unidimensional. The degree and impact of CPO participation in health policy decision-making were found to be low in both countries; however in Italy they were comparatively lower than in France.   Conclusion In conclusion, the HDI can be effectively used in international policy and research contexts. CPOs participation is low in Italy and France and concerted efforts should be made on upgrading their role in health policy decision-making.

Patient Participation, Health Policy Decision-Making, Cancer Patient Organizations (CPOs), Scale, Development