Participatory urban transformations for health prevention: school streets, placemaking, and institutional integration in national prevention planning

The Italian National Prevention Plan (NPP) 2020–2025 calls for a joint action on environmental and urban determinants of health. The recent reforms of primary health care (DM 77/2022) highlight the role of communities and Local Health Authorities in the promotion of health in everyday settings. However, practical tools which link prevention planning to small-scale urban transformations still remain poorly described. This study explores how international approaches to children’s school-travel and urban participatory practice in street design can guide the next cycle of the NPP. An extensive review of the available international grey literature and technical guidelines identified ten operational documents (toolkits, guidelines and practice-oriented reports) addressing two categories of interventions: (1) school-travel and “school streets” schemes and (2) tactical urbanism and placemaking initiatives. Each document was then evaluated using an adapted Urban HEART framework, expanded with a sixth domain, “Applicability to the Italian National Health Service”. They all scored qualitatively (1–5) across the six domains. The analysis shows consistently high scores for Health, Physical Environment, Participation and Governance, particularly with regard to school street toolkits and child-friendly street design guides. Equity and formal links to health-system planning and evaluation remain less systematically developed. Overall, findings suggest that school-travel interventions and child-centred placemaking around the schools are closely aligned with the logic and tools outlined in the NPP. These could be considered as potential prevention actions in the future NPP cycles, provided that explicit health outcomes, minimum indicators and stable intersectoral governance arrangements are co-designed with the Local Health Authorities.