Health mediation intervention at the base of a social housing complex in Seine-Saint-Denis, France: a mixed-methods, realistic evaluation protocol.

Abstract

Health mediation, similar to health navigation in the United States or Canada, is known by various terms worldwide. In France, health mediation has historically been implemented by civil society organizations to support hard-to-reach populations. Health mediation is increasingly considered by health authorities as a valuable tool for health promotion to reduce health inequalities. However, systematic evaluations of its effects are scarce, making it difficult for decision-makers to generalize health mediation as a health policy. Our study aims to bridge this gap, by framing a research protocol to evaluate a health mediation intervention. The intervention consists of setting up a biweekly mobile booth using an 'outreach' approach at the base of a social housing complex in 12 neighborhoods of Seine-Saint-Denis with marked indicators of social deprivation. We chose a realistic evaluation approach and a mixed-methods methodology, which is the best fit for assessing complex interventions such as the one we aim to assess. Realistic evaluation is a relatively new approach, and sharing studies based on this type of epistemological and methodological approach is required. This study aims to contribute to the reflection on and the production of standard tools to ensure that the use of this evaluation approach is improved.