IL VOLONTARIATO NELLA GOVERNANCE DEI SERVIZI SANITARI TOSCANI: DALL'AGGREGAZIONE ALL'INTEGRAZIONE DI MODELLI SOCIALI, ORGANIZZATIVI ED INDIVIDUALI

Il Volontariato nella Governance dei Servizi Sanitari Toscani: Dall'Aggregazione all'Integrazione di Modelli Sociali, Organizzativi ed Individuali Il fenomeno del Volontariato sta ricevendo progressivamente attenzione dagli studiosi di management, con particolare riferimento al ruolo che le Organizzazioni Non-profit (NPO) svolgono nella società moderna, oltre alla modalità con cui i cittadini si impegnano attivamente nel Terzo Settore al fine di far fronte ai cosiddetti ‘fallimenti’ dello Stato (government failures) e dei mercati (business failures). La letteratura di riferimento studia come la Società Civile sia in grado di fornire efficacemente i servizi socio-umanitari, rappresentando in tal modo un importante attore sociale al pari dell’Ente Pubblico, rappresentato dalle Istituzioni Governative (GOV), e del mercato, rappresentato dalle imprese ed i business commerciali (BUS). Nella presente ricerca il fenomeno del Volontariato è concettualizzato ed analizzato empiricamente attraverso tre prospettive – macro, meso, micro – le quali corrispondono alle tre sezioni della tesi di ricerca. A tal fine, abbiamo preso in considerazione l’area geografica della Regione Toscana, che rappresenta uno standard di riferimento ed eccellenza per l’implementazione da parte delle NPO di servizi socio-sanitari, in particolare nell’ambito dell’emergenza ed urgenza (Servizio 118). Infatti, il Terzo Settore toscano ha un’antica tradizione storico-culturale sviluppatasi fin dal Medioevo – la nascita della prima associazione di Volontariato fiorentina risale al 1244 – e durante i secoli è stato in grado di contribuire in modo significativo all’evoluzione del social welfare regionale, grazie all’implementazione di servizi socio-sanitari nei confronti della propria comunità locale. Quali sono le ragioni essenziali, le caratteristiche peculiari, e le leve strategiche che permettono il successo di tale realtà filantropica regionale? Per rispondere a tale domanda, abbiamo in primo luogo analizzato l’evoluzione storica delle interazioni istituzionali tra GOV e NPO toscane. Facendo riferimento alla letteratura di partnership ed alleanze strategiche, il focus è stato sul fenomeno delle partnership sociali cross-settoriali (CSSP – Cross-Sector Social Partnership), che si riferiscono ad alleanze strategiche tra i tre attori sociali, ossia lo Stato, le imprese for-profit ed il Terzo Settore, al fine di perseguire obiettivi sociali capaci di creare valore per la comunità di riferimento e soddisfarne le esigenze. La letteratura pertinente concettualizza tale fenomeno attraverso tre fasi, denominate ‘formazione’, ‘implementazione’, ‘risultati’. Inoltre, tali fasi sono costituite da stage i quali a loro volta sono suddivisi in micro-processi. Uno dei gap della letteratura fa riferimento agli aspetti dinamici e contingentali che influenzano l’evoluzione delle CSSP in relazione a tali fasi, stage e micro-processi. Il nostro obiettivo è stato di contribuire a tale letteratura analizzando la specifica fase di ‘implementazione’ della partnership sociale cross-settoriale tra Regione Toscana e Associazioni di Volontariato, indagando l’evoluzione dei tre stage definiti ‘selezione’, ‘design’ e ‘istituzionalizzazione’. Attraverso la metodologia della ‘critical event analysis’, abbiamo analizzato archivi storici, documenti, report, norme legislative, interviste con Presidenti e Direttori delle NPO toscane e responsabili della Regione Toscana, al fine di esaminare l’evoluzione della CSSP toscana negli ultimi 35 anni, ossia dal 1978 (creazione del Sistema Sanitario Nazionale) ai giorni d’oggi (2013-2015). Per tale livello ‘macro’ di analisi, è emerso come la partnership sociale sia stata caratterizzata dal cosiddetto ‘isomorfismo coercitivo’ il quale ha imposto alle Associazioni di Volontariato di adattarsi dinamicamente al contesto ambientale di riferimento per essere in grado di rispondere a pressioni contestuali esterne. Tali fattori hanno scaturito 5 principali criticità, ossia la legittimazione, il potere, la fiducia, l’identità, l’absorptive capacity, che sono evolute dinamicamente nel corso delle interazioni storiche tra i partner regionali. Nella seconda sezione della tesi abbiamo utilizzato una prospettiva ‘meso’, in particolare l’analisi di uno specifico modello di business e governance che sempre più caratterizza le organizzazioni non- profit, ossia il modello ‘ibrido’. Tale modello fa riferimento alla compresenza di attività filantropiche/non-profit e commerciali/for-profit nella stessa organizzazione. Il fenomeno dell’ibridizzazione è sempre più un elemento significativo per le moderne realtà organizzative, poiché molte imprese sia for-profit che non-profit stanno sempre più convergendo verso un modello di ‘impresa sociale’, che sottolinea l’orientamento e l’attitudine imprenditoriale verso la responsabilità sociale delle strutture organizzative nei confronti di stakeholder e ambiente di riferimento. In particolare, tale fenomeno sta progressivamente caratterizzando le Associazioni di Volontariato toscane le quali devono organizzare innovativi modelli di business e governance al fine di essere autonome finanziariamente, divenendo così sempre più indipendenti dalle Istituzioni Governative e più sensibili ai bisogni di volontari e comunità locale. La letteratura ha individuato due tipologie di modelli ibridi, ossia il modello integrato e quello disintegrato, focalizzandosi in maniera marginale sulle possibili implicazioni manageriali. Al fine di contribuire a tale filone di letteratura, abbiamo effettuato un caso di studio multiplo analizzando tre NPO toscane ‘ibride’. Grazie alla coding analysis delle interviste semi-strutturate effettuate con i Presidenti e i manager delle Associazioni di Volontariato, è stato possibile individuare implicazioni manageriali significative per tali realtà organizzative. In primo luogo, abbiamo concettualizzato una terza tipologia di modello di business e governance ibrido, ossia il modello semi-intergrato; in secondo luogo, abbiamo individuato sei categorie concettuali emerse dall’analisi che influenzano la gestione di tali realtà, ossia legittimità interna, legittimità esterna, scambi e flussi monetari, struttura organizzativa, perdita di identità, limiti alla crescita organizzativa. I risultati dell’analisi sottolineano come il modello ibrido integrato sia caratterizzato da alti livelli di criticità in riferimento ai limiti alla crescita; il modello disintegrato dal rischio di perdita identitaria; infine, il modello semi-integrato da criticità concernenti la legittimità interna e limiti alla crescita. La terza sezione della tesi fa riferimento ad una prospettiva ‘micro’, analizzando in primo luogo il concetto socio-antropologico del dono all’interno del contesto di volontariato; in secondo luogo, indagando le motivazioni psico-socio comportamentali dei volontari, oltre che le loro attitudini ed intenzioni comportamentali. In particolare, mentre il primo capitolo della sezione fa riferimento all’analisi concettuale del dono utilizzando importanti teorie antropologiche – come la Teoria del Dono di Marcel Mauss – il secondo capitolo presenta un’analisi empirica attraverso un modello ad equazioni strutturali (SEM – structural equation modeling), in grado di analizzare simultaneamente le relazioni ipotizzate tra significative variabili latenti delle attitudini, intenzioni e comportamenti dei volontari. Abbiamo utilizzato scale di questionari convalidati in letteratura e collezionato 379 questionari completati da volontari di 20 NPO toscane. Dopo l’analisi esplorativa fattoriale delle dimensioni oggetto di analisi – motivazioni (sociale, carriera, valori, conoscenza, protezione dell’io, avanzamento dell’io), atteggiamento verso l’organizzazione, religiosità, reciprocità positiva e negativa, intenzione a donare – abbiamo costruito un modello SEM e analizzato sia gli indici di significatività (modello di misurazione) sia le relazioni ed ‘influenze’ esistenti tra variabili (modello strutturale). Le principali implicazioni manageriali fanno riferimento alla capacità del management delle NPO di analizzare e conoscere i segnali relazionali emanati dai volontari, al fine di rispondere in modo appropriato ed incentivare lo sforzo di tali preziose risorse strategiche. Infatti, i volontari non rappresentano solamente il principale ‘fornitore’ di tempo, risorse, know-how e abilità per le Associazioni di Volontariato, bensì al contempo sono i beneficiari di gratificazione, soddisfazione e spirito associazionistico ottenuti dalla partecipazione all’organizzazione. In particolare, la dimensione di reciprocità insieme all’intenzione di donare sottolineano come la relazionalità sia un elemento cruciale per la gestione delle NPO, che presuppone una profonda conoscenza dei tratti psicologici dei volontari, oltre alle loro attitudini ed intenzioni comportamentali. Tali fattori sono importanti per rendere le Associazioni di Volontariato il veicolo sociale efficace in grado di rispondere ai bisogni della comunità locale e cercare di risolvere i ‘fallimenti’ dello Stato e dei mercati, grazie in modo particolare alle loro risorse più importanti, ossia i volontari. Voluntarism in the Governance of Tuscan Socio-health services: From the Aggregation to the Integration of Social, Organizational, and Individual Models The phenomenon of voluntarism is increasingly achieving attention by management scholars, specifically focusing on the role of Non-profit Organizations (NPOs) in modern society and the way citizens actively commit themselves in the Third Sector in order to cope with government and business failures. Pertinent literature questions how the organized Civil Society successfully provides human service delivery, thus traditionally representing an important societal actor along with both the Public Entity, represented at a local level by Governmental Institutions (GOV), and the market, represented by enterprises and for-profit business (BUS). In the present thesis, such a phenomenon has been conceptually and empirically analyzed following three perspectives, namely a ‘macro’, ‘meso’, and ‘micro’ perspective, which correspond to the three sections of the research. To this purpose, we chose an emblematic geographical area, the Region of Tuscany, which represents a paradigmatic excellence and national benchmark for the provision of emergency-urgency socio-health services. Actually, the Tuscan Third Sector has a historical and long-lasting tradition that started in the medieval period, precisely 1244 in Florence, and during the Centuries has significantly contributed to the evolution of regional welfare, especially by providing socio-health services to its own local community. What are the essential reasons, peculiar characteristics, and strategic levers that allow such a regional successful philanthropic reality? To answer this question, we firstly analyzed the historical evolution of the institutional interactions between regional GOV and Tuscan NPOs. Drawing on partnership and strategic alliances literature, we focused on the notion of cross-sector social partnership (CSSP), which refers to strategic arrangements between the three societal actors, namely GOV, BUS, and NPOs, aiming at social purposes. CSSP literature conceptualizes such arrangements through a tripartite framework which is composed by three phases, namely formation, implementation, and outcome of the social partnership. Further, each phase is characterized by stages which in turn are composed by micro-processes. However, scarce attention has been given to the analysis of evolving CSSP focusing on dynamic and contingent elements influencing and affecting such arrangements. We attempted to contribute to this stream of literature by choosing the implementation stage of the CSSP between Tuscan GOV and NPOs, and its three stages, namely selection, design, and institutionalization. By using critical event analysis, we examined historical archives, documents, reports, legislative frameworks, interviews with NPOs Presidents and Directors and GOV representatives, in order to assess the evolution of the Tuscan CSSP in the last 35 years, particularly from 1978 (the creation of the Italian NHS) to the present period (years 2013-2015). At this first ‘macro’ level of analysis, it emerged how the examined Tuscan CSSP has been characterized by an institutional ‘coercive isomorphism’ which imposed NPOs to adaptively respond to external pressures. These environmental factors resulted in five main CSSP internal outputs, namely legitimacy, power, trust, identity, and absorptive capacity, which dynamically evolve throughout the historical interactions between partners. In the second section of the thesis we used a ‘meso’ perspective, particularly the analysis of a specific business and governance model which is increasingly characterizing NPOs realities, the hybrid model. Such a model refers to the implementation of both for-profit and non-profit activities within a single organization. Hybridization is actually an important element in modern organizations, mainly because many for-profit enterprises and traditional NPOs are converging toward the so-called ‘social enterprise’ model, which stresses the socially responsible entrepreneurial mindset of modern management and organizational structures. Such a phenomenon is progressively characterizing Tuscan NPOs, which have to arrange innovative forms of business model in order to be financially autonomous and thus becoming, on the one hand, more independent of regional GOV and, on the other hand, more trustworthy toward its own volunteers and local community. Pertinent literature has individuated two types of hybrid business and governance models, namely the integrated and disintegrated ones, although few attempts have provided managerial implications for such hybrid arrangements. We attempted to contribute to this stream of literature by conducting a multiple case study of three Tuscan ‘hybrid’ NPOs. Specifically, the coding analysis of semi-structured interviews with NPOs Presidents and Directors resulted in significant managerial implications for these organizations. Firstly, we conceptualized a third hybrid business and governance model, the semi- integrated one; second, we individuated six conceptual categories affecting the hybridization phenomenon – internal legitimacy, external legitimacy, monetary exchange and flows, organizational structure, loss of identity, growth constraints. Interestingly, the integrated model resulted affected by high critical levels of growth constraints; the disintegrated model by risk of loss of identity; and, finally, the semi-integrated model by internal legitimacy and growth constraints. The third and final section of the thesis builds on a ‘micro’ perspective by firstly analyzing the socio- anthropological concept of the gift and donation in the voluntary context, and secondly investigating volunteers’ motivations, attitudes, and behavioral intention to donate in order to deepen how these essential strategic resources of NPOs behave. While the first part of the section is a conceptual analysis of the notion of gift-giving building on anthropological theories (e.g. The Theory of the Gift by Marcel Mauss), the second part presents an empirical analysis using a structural equation model (SEM), which allowed to simultaneously assess the hypothesized relationships between important latent dimensions of volunteers’ behavior, intention to donate, and attitude toward the NPO. Particularly, we used validated psychological and managerial scales and collected 379 questionnaires completed by Tuscan volunteers of 20 NPOs. After an exploratory factor analysis of the analyzed latent dimensions – volunteers’ motivations (social, career, values, understanding, ego protection, ego enhancement), attitude toward charities, religiosity, positive and negative reciprocity, intention to donate – we implemented SEM procedure and evaluate both the ‘measurement’ model (fit indices) and the ‘structural’ model (hypothesized relationships) of the proposed constructs. Main managerial implications refer to the importance for NPO board to assess and understand volunteers’ relational signals, in order to appropriately respond to and incentive such crucial strategic resources of the organization. Actually, volunteers represent not only the main ‘provider’ of time, resources, know- how, and ability for NPOs, but also and at the same time the main ‘beneficiary’ of gratification and satisfaction derived from being part of a committed philanthropic association. Particularly, the reciprocal dimension of volunteers’ behavior, along with their intention to donate, stress how the relational element is important in the management of such realities, which presupposes a deep understanding of individual psychological traits, attitudes, and behavioral intention. Such elements make NPOs the effective and successful societal vehicles able to respond to community needs and to cope with government and market ‘failures’, thanks to their most precious resources, the volunteers

What sparks ethical decision making? The interplay between moral intuition and moral reasoning: lessons from the scholastic doctrine

Recent theories on cognitive science have stressed the significance of moral intuition as a counter to and complementary part of moral reasoning in decision making. Thus, the aim of this paper is to create an integrated framework that can account for both intuitive and reflective cognitive processes, in order to explore the antecedents of ethical decision making. To do that, we build on Scholasticism, an important medieval school of thought from which descends the main pillars of the modern Catholic social doctrine. Particularly, the focus will be on the scholastic concept of synderesis, which is an innate human faculty that constantly inclines decision makers toward universal moral principles. Managerial implications are discussed, stressing how a rediscovery of decision makers’ intuitive moral judgments could be relevant in the reflective thinking practice of managers’ ethical reasoning, thus saving them from rational insensitivity to ethical dilemmas

Developing software beyond customer needs and plans: An exploratory study of its forms and individual-level drivers

Excessive software development is the tendency to develop new software above and beyond the requirements of the market and/or planned specifications. It is a widespread phenomenon involving both risks and flexibility advantages. As it represents a challenging dilemma for software developers, it is important to study its human origins. Drawing on the tripartite model of individual attitudes, this study investigates the influence of developers’s cognitive (intuitive and rational thinking styles), affective (emotional attachment) and behavioural (reliance on past experiences) traits on two forms of excess, beyond needs and beyond plans. Using survey data on 307 software developers, this study shows that different manifestations of excess are associated with distinct traits of software developers. Emotional attachment drives beyond needs excess. A positive (negative) association is found between relying on past experiences and beyond needs excess (beyond plans excess). An intuitive cognitive style fosters the inclusion of extra features in the new product scope, whereas a rational style might lead to developing one-size-fits-all software that targets the needs of a broad user base. These findings contribute to research on the development of digital new products and production technologies by offering a comprehensive yet fine-grained picture of excessive software development’s nature and drivers

Sustainable consumption in organic food buying behavior: The case of quinoa

Using an enhanced version of the theory of reasoned action (TRA), this study investigates the antecedents of organic quinoa-based food buying intention. In addition to attitude toward this behavioral intention, the proposed model examines the influence that ecological welfare, political values, and consumer-perceived corporate social responsibility (CSR) of the point of sale exert on consumer willingness to purchase organic quinoa-based food. Structural Equation Modeling (SEM) was used to analyze the data collected through an intercept survey conducted at specialized organic stores on a convenience sample of 158 individuals in Italy. Although ecological welfare and a retailer’s CSR image positively influence consumer attitude toward buying organic quinoa-based food, political values negatively affect this attitude. Furthermore, consumer attitude is found to be a crucial predictor of behavioral intention. At the theoretical level, the results are useful for demonstrating that other variables, in addition to those used in the traditional TRA, can further explain consumers’ organic food buying intention. Additionally, the findings might be useful for both quinoa producers and retailers in creating and executing their marketing and communication strategies. In addition to contributing to the stream of literature that investigates possible variables that might increase the predictive power of the TRA, this study sheds some light on organic food purchasing consumer behavior

Solving the luxury fashion and sustainable development “oxymoron”: A cross-cultural analysis of green luxury consumption enablers and disablers

Green luxury is a promising stream in the environmental marketing and sustainable development literature. Yet, scholars are still investigating why green consumers show a positive attitude toward ethical consumption but then act inconsistently by preferring conventional products due to price or quality criteria, especially in the luxury sector. Building on Heider's balance theory, this study investigates the underlying mechanisms of green luxury consumption focusing on how consumers' psychological imbalance fosters their attitude–behavior gap. The authors used partial least squares structural equation modeling to assess the green enablers and disablers predicting consumers' purchase intention. Multigroup analysis is performed on a cross-cultural sample of 792 luxury consumers belonging to collectivistic (China) and individualistic (Italy) cultures. Moderation analysis shows how consumers' self-enhancement and self-transcendence impact the relationships between green enablers, disablers, and attitudes toward green luxury. An importance-performance map analysis is conducted to identify which aspects are most important in explaining consumers' intentions to purchase green luxury products

Social media strategies to protect brand image and corporate reputation in the digital era: a digital investigation of the Eni vs. Report case

Over the last decade digital technologies have significantly affected branding strategies and corporate reputation monitoring. Due to the diffusion of digital platforms, stakeholders and consumers have become more engaged in marketing strategies. Specifically, the “consumer decision journey” has represented a new paradigmatic shift in recent marketing literature. The advent of social networking sites has indeed caused an increase of digital touch points, which foster the connection between brand strategists and consumers. Hence, nowadays consumers may directly express their opinions about companies’ practices and products using the Internet. Because of this emerging phenomenon, modern marketing strategies are progressively focusing on preserving corporate reputations in the digital environment. In order to better understand how monitoring corporate reputations and responding to consumers to avoid the rise of negative brand perceptions, this explorative paper analyses the digital response strategy implemented by Eni, the largest Italian oil and gas company. The case explored consists of a digital investigation on Twitter, aimed at investigating how Eni’s digital counterattack strategies affected consumers’ perceptions after accusations moved by Report, a popular Italian journalism TV programme. The conclusions suggest that real-time digital counterattack strategies on social networking sites represent effective strategies to preserve corporate reputations as perceived by customers

Analyzing the main types of co-created experiences

espanolProposito La presente investigacion se propone analizar en profundidad como las marcas pueden estar de acuerdo con la co-creacion de las experiencias de los consumidores. En particular, el objetivo de la investigacion es aclarar cuales son los principales tipos de experiencias co-creadas que los consumidores pueden experimentar debido a su participacion en las comunidades de marcas de redes sociales. Diseno/metodologia/enfoque Para hacerlo, en primer lugar, se han identificado los factores que influyen en la co-creacion de las experiencias de los miembros de las comunidades de marcas. En particular, el punto de partida de esta investigacion esta representado por el papel de otros consumidores y de la marca en la co-creacion de experiencias. Con el fin de identificar los principales tipos de experiencias co-creadas, se ha utilizado una investigacion digital como el principal metodo de analisis. Dibujamos nuestra investigacion digital en el paradigma de Metodos Digitales. Hallazgos Se identificaron y conceptualizaron cuatro tipos principales de experiencias co-creadas. Originalidad/valor Los resultados enfatizan la importancia de que los estrategas de marca involucren a los miembros de las comunidades de marcas de medios sociales para estimular la co-creacion de experiencias. Especificamente, surgio como la interaccion simultanea de otros miembros de la comunidad y la marca puede afectar la co-creacion. EnglishPurpose – This paper presents an in-depth investigation on how brands may concur to the co-creation of consumers' experiences. In particular, the purpose of this paper is to clarify the main types of co-created experiences that consumers may encounter as a result of social media brand communities. Design/methodology/approach – To identify the main types of co-created experiences, a digital investigation has been used as the main method of analysis. The authors draw their digital investigation on the digital methods paradigm. Findings – Four principal types of co-created experiences have been identified and conceptualized, namely, brand's products' individual usage experiences, auto-celebrative experiences, brand's products' communal usage experiences and collective celebration experiences. Originality/value – Results stress the importance for brand strategists to involve members of social media brand communities to stimulate co-creation experiences. Specifically, it emerges that the simultaneous interaction among members of the community and the brand may directly affect co-creation experiences

Mega‐influencers and brand dynamics: Shaping attitudes toward leading and challenger brands through electronic word of mouth

The aim of this paper is to explore how mega-influencers' electronic word of mouth (eWOM) messages on social media influence consumers' brand attitudes in duopolistic markets. Through three experimental studies, we observe that when mega-influencers send positive (vs. negative) eWOM messages about a leading brand, followers form positive (vs. negative) brand attitudes, but these effects fail to occur when influencers back challenger brands. The findings are consistent across three duopolistic market rivals (Apple vs. Samsung; UPS vs. FedEx; Nike vs. Adidas), three social media platforms (Facebook, Instagram, and X), and four mega-influencers (Marques Brownlee, Gary Vaynerchuk, Kanye West, and Kylie Jenner). Findings indicate that mega-influencers have more persuasive power when recommending or criticizing leading brands rather than challenger brands, irrespective of their follower base. The findings contribute to the marketing literature by showing that in duopolistic market contexts, mega-influencers' e-WOM has varied effects on followers' brand attitudes, depending on brand status in the market

Finding the extraordinary and creating the unexpected: Gnome and Genius combined in an entrepreneurial ethical heuristic

Purpose – This paper aims to present an integrated framework for ethical decision making in uncertain conditions, such as those of entrepreneurship. The model aims to build an exceptional ethical heuristic employable by entrepreneurs. Design/methodology/approach – The theoretical framework is anchored to Aquinas’ theory of practical reason virtue, specifically its minor virtue gnome, and the Kantian faculty of genius or to better say its modus operandi. Thanks to the composition of these prima facie distant ontologies it is possible to build a ‘ready-to-use’ heuristic. Findings – The paper through a philosophical discussion offers a ready-to-use heuristic that may help entrepreneurs and businesspersons when ‘navigating’ uncertain and troubled situations. In such situations, firstly it is important to recognize the ‘exceptionality’ of the situation, disregarding where necessary the ordinary criteria of judgment (an act directed by gnome). Secondly, a creative reconstruction of available knowledge able to re-shape the ‘rules of the game’ is needed (an act directed by PR but with connotations drawn from genius). Research limitations/implications – The paper provides only a theoretical conceptualization of the heuristic model. However, the result is a ready-to-use heuristic rule for entrepreneurs, who work in uncertain and unclear conditions. Empirical validation of the framework can represent an opportunity for future research to test the operative impact of such an exceptional ethical heuristic. Originality/value – Little attention has been dedicated to ethical decision making in the entrepreneurial setting built on a virtue ethics approach. This paper’s proposed model may represent an innovative alternative to strictly rational models for ethical decision making