ANPIS is an association established in 2000 which includes 40 sports club associations spread over most of the national territory and which progressively, starting from the first half of the 1990s, established themselves as a tool for social promotion and fight against marginality, adopted in various areas of psychosocial disadvantage. The sports clubs were first created starting from the activity of operators and users of public services and social cooperatives in the mental health sector, to then also be constituted by those who faced the problems of disadvantaged youth and drug addiction.

Tuscany is the origin place of such a social action prospect, so that it’s the first organisation which created a regional coordination, which includes today 27 registered sports clubs. The contacts that these sports clubs have managed to establish, as well as the exchanges between the involved operators and other colleagues from others national locations, have had the capacity to stimulate the creation of many others projects endowed with the same intentionality.

The multiplier engine of such a project can be recognized in a precise theoretical and practical perspective about the meaning of keywords like "prevention" and "health promotion". We consider the aforementioned key words essentially coincident, or better, for more effectiveness, we consider the problem of prevention merging and transforming in that of health promotion, that becomes operationally methods of construction of active minorities, and that means participatory citizenship.

The objective of prevention is essentially a modification of the conditions (material, ecological, social, cultural and psychological) that influence and contribute to determine personal biographies and  destinies, that are also relevant to determine collective biographies,  that is on the social history of real groups. The question  arises about the method through which to produce such a modification.    

This problem must be faced considering some of the most significant risk and protection factors, for and from pathological and psychosocial discomfort events, as reported by a vast international literature:

1. Multicentric researches by the World Health Organization shows that social support is one of the main positive predictive factors of the course of schizophrenia. Since social support is a function of the social network of people, this fact highlights the necessity to build the social bond as one of the mainstay of the caring.
2. Social support is, however, considered one of the factors of prevention of psychosocial distress; it is generally placed as a central concept for the production of health from disciplines such as community psychology and social psychiatry.
3. The social stigma related to mental disease, as well as to various forms of deviance, constitutes a risk and chronicity factor: on the one hand, it removes subjects in need from care organizations - which produces a delay between the occurrence of pathological configurations and possible therapeutic interventions; on the other, it feeds the vicious circles of marginalization.
4. Unemployment is seen as result of both pathological situations and  "social deviance" - and, it should be emphasized, from the accompanying stigma - as from a factor of exclusion.

Considering what has been described so far, the action of sports clubs is based on the following perspectives:

• The organizational choice, the associations, constitutes a natural form of aggregation between people according to shared objectives. That is, it is configured as a culturally established method of producing social bond, which over the years has shown its capacity to product spaces of sharing and support among the members involved. It should also be emphasized that the proposed association system is aimed at the whole citizenship, that is to say not constituting separate spaces between "normality" and "disease"; this factor is one of the preconditions for any social reintegration.
• The stigma is the attribution of (dis) value that accompanies the unfolding of a prejudice. The prejudice, however, in itself does not constitute a deformation of the knowledge process, but simply and basically the way of the real approach, in the sense of foreknowledge (common sense) that is built up in people with reference to a certain portion of reality, within certain structural conditions. From this point of view, the reality of prejudice is a dimension that unites the community (in the context of a substantial non-interaction with mental illness as a reality that continues to be separate), the operators of services (within a 'professional interaction with its users, which is declined in separate environments of the clinic and protected contexts) and family members (in the context of an interaction that unfolds progressively, in the absence of alternative possibilities, in the alternation between domestic walls and places care / assistance). The sports clubs have constituted and constitute a common space, "intermediate" between the places of care and those of "normality", which, directly involving the community (both in its individual and institutional dimensions) and configuring a specific structuring of the interaction between " normality "and" disease ", has allowed and allows:

- at important levels of citizenship, to interact directly and concretely with the dimensions of suffering and psychosocial distress, allowing the re-evaluation of prejudices and related value attributions (stigmatization). This clearly did not mean eliminating the suffering / disease, nor the difficulties / disabilities of the people cared by the services, but it certainly helped to reformulate the attributions of danger, stupidity, unpredictability, and unsociable, which are often associated with mental illness or other forms of discomfort. Reformulation that is not the replacement of a negative prejudice with a positive one, but verifies - case by case and moment by moment - the balance between suffering / illness / need for support and assistance and health / possibility of interaction and exchange;

- to family shares, to interact with the sick relative in situations that involve the latter in specific social activities to which he also contributes to varying degrees and therefore to reformulate their expectations beyond the dimensions of daily assistance and containment; - to the operators themselves, to think again not about the levels of suffering / pathology experienced by users, but certainly about the shares of health that they can express, thus allowing them to reformulate their expectations about the patient, and in a more specific sense, the therapist projects.

• If the pathogenic value of unemployment is widened to all those situations and roles characterized by social unproductiveness, or rather by a non-contribution to the overall social sense and therefore by civil death, sports clubs have constituted and constitute means through which disadvantaged people (often completely excluded from the economic-productive circuit) have been able to participate directly in sports, social, ecological-environmental, cultural activities and thus recover their own social significance. Often these activities have been inscribed in a third sector project, by sports clubs. These activities have constituted the way through which sports clubs have established themselves as associations capable of obtaining financing from public bodies for public utility activities.

Then, in the strict sense,  the sports clubs have allowed  to procure micro-income and / or temporary income for their members. Finally, at times, these projects became part of the constitution of real type B cooperatives and therefore in the construction of stable works.

To these aspects, it should finally be added that the sports clubs, in their construction of non-competitive sporting opportunities, play a dual role: on the one hand, specifically for disadvantaged members, they allow the rediscovery of body size and its care (with all returns direct in terms of prevention of physical health); on the other hand, in general, they contribute to the "sport for all" movement, recovering quotas of population that are excluded or not involved in competitive sports.

For all these reasons, the sports clubs have built themselves as a concrete way of promoting health and fighting against the processes of marginalization of various segments of the population at risk. This is the sense that, over the years, the sports clubs have acquired, having constituted in one time:  opportunities of planning in the field of care and taking charge of mental disease and other forms of distress and deviance, and common mode of promotion of active forms of citizenship. Moreover, the various national realities present different situations depending on the local structural situations, on the experience gained by the operators and by the members in general, on the relationship that has been established between health and social institutions / operators engaged in similar sports clubs experiences. The regional coordination, first, and Anpis, in a second moment, have been  the tools through which the sports clubs tried to share experiences and projects, to develop shared ways of action and common  know-how of organization.