Sante Publique最新文献

Introduction: Pakistan has the second highest prevalence of hepatitis C globally. The Musafir study, set up in 2018 in a Parisian suburb to understand the representations of hepatitis and HIV within the Urdu-speaking, male, migrant community living there, provided an opportunity to think about culturally acceptable health promotion interventions. These included awareness campaigns on hepatitis—which did not cover the question of HIV, considered taboo—, held in a mosque.

Purpose of the research: The aim of this article is to describe the implementation of awareness and testing campaigns within a Pakistani religious and cultural association.

Method: A partnership with a Pakistani association that runs a place of worship enabled awareness and testing campaigns for hepatitis and HIV to be carried out, thanks to the involvement of the association’s managers and the imam.

Results: Between February and June 2023, 113 people were tested during the five campaigns that were carried out. The population screened consisted almost exclusively of Urdu-speaking men. Anti-HCV antibodies were found in six people, three of whom had already recovered, and two people tested positive for HBV. No cases of HIV were detected.

Conclusions: The prevalence of hepatitis C found was 5.3 percent, in line with the prevalence in Pakistan. This experiment highlighted the feasibility conditions of a partnership with a faith-based organization and offers ideas for developing this type of initiative in France.

Objective: Biomedical innovation plays an important role in health care pathways and public debates. Nevertheless, existing measures of health literacy take little account of medical research. In this article, we explore the relationship between health literacy and attitudes toward medical research, from clinical trials to more general attitudes toward science.

Methods: We analyze the results of two self-administered questionnaires conducted on samples of the French adult population in 2020 and 2021 (N=2003 and N=2022). A series of twelve questions assessed health literacy (HLS19-Q12-EN) and ten questions addressed attitudes to clinical trials, medical research, and science in general. The analyses characterize the population’s perception of medical research issues and its association with health literacy.

Results: There is a significant association between health literacy and perception of research. A low level of literacy is associated with lower knowledge of clinical trials and a more negative attitude toward them, less confidence in science and its contributions to society.

Conclusions: Given the continuity between care and research, health literacy is likely to be a relevant measure for characterizing disparity in attitudes toward clinical trials and improving access to innovation.

Introduction: The health needs of the population are changing and the health care system must adapt to meet them. In France, the need for prevention is significant and recognized. Yet the shift toward prevention is struggling to take hold in primary care, and prevention indicators remain low.

Purpose of the research: This article presents the developments and challenges involved in integrating prevention into primary care. It is based on three leading French reports on the subject.

Results: Prevention and health promotion initiatives are described as poorly organized, being based on individual and opportunistic initiatives. In particular, this is due to the difficulty of integrating a collective, long-term dimension into preventive clinical practices, even though most preventive situations require a coordinated, repeated approach that is integrated intothe care offered. At the same time, the primary care system is being structured around coordinated practice. These organizational changes are opportunities to integrate prevention into the practices of primary care professionals.

Conclusions: A great deal depends on successfully integrating prevention into the structuring and organizational evolution of the primary care system. The convergence of the operationalization of the preventive shift and the organizational transformation of the primary care system is potentially synergistic for the integration of prevention. But this development is not self-evident and must be accompanied by precise, up-to-date, and contextualized knowledge of the factors influencing the practice of prevention.

Objective of the study: To estimate the prevalence of four STIs in women of reproductive age in the Kara region.

Methods: A cross-sectional study was conducted in March 2022. Data were collected using a standardized questionnaire. Screening for HIV and syphilis was performed using the SD-BIOLINE HIV/Syphilis Duo® rapid tests. The GeneXpert PCR technique was used to test for Chlamydia trachomatis and Neisseria gonorrhoeae. The prevalences of STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, and HIV) were reported with 95% confidence intervals.

Results: A total of 300 women with a median age of 32 years (interquartile range 24–39) were included. Of these, 25.7% had consulted a gynecologist in the last twelve months. The prevalence of Chlamydia trachomatis was 4.3% (95% CI [2.4–7.5]); Neisseria gonorrhoeae 3.3% [95% CI: 1.7–6.2], Treponema pallidum 0.3% [95% CI: 0.02–2.1] and HIV 3.7% [95% CI: 1.9–6.7]. Three cases of co-infection with Neisseria gonorrhoeae and Chlamydia trachomatis were reported; no cases of co-infection with HIV and bacterial STIs were reported.

Conclusion: This study confirms the women’s limited access to gynecological consultations, the low circulation of syphilis, and the presence of Neisseria gonorrhoeae and Chlamydia trachomatis in women of reproductive age in the Kara region. An STI surveillance system is needed to improve STI management among this population.

Introduction: Many Knowledge Translation (KT) networks have been set up to support the improvement of research-based practices. However despite the deployment of KT networks, there is little empirical data on how they work. The Réseau national d’expertise en trouble du spectre de l’autisme (RNETSA) is the result of a ministerial initiative.

Objective and method: Its mission is to promote the evolution of autism practices and services in the education, early childhood, and health and social services sectors. The purpose of this article is to analyze the governance structure and KT strategy of the RNETSA in terms of its legitimacy. The study was based on a case study design combining a literature review and interviews.

Results: The results highlight the key components of 1) the governance structure (e.g., identification of a common need, formalization of bodies, allocation of resources) and 2) the KT strategy (e.g., knowledge dissemination, collaborations, increasing participation in activities). The discussion addresses a number of building blocks that could help strengthen the network’s legitimacy with a view to bringing it closer to its purpose.

Conclusions: RNETSA has demonstrated a strong capacity to ensure its legitimacy in the autism KT ecosystem. The potential to influence public policy in the field of autism is also a key feature of RNETSA. To improve knowledge of RNETSA’s legitimacy, an evaluation of the effects of its KT activities would be necessary.

Introduction: Travelers have poorer health than the general population due to more precarious living conditions. In France, there are no epidemiological studies on Travelers, accentuating their invisibility in public health policy and planning. Discrimination against them, their distrust of the state and institutions, and their non-prioritization of health were the reasons for a participatory research project on Travelers’ health status. This research was carried out collaboratively by researchers, decision-makers, associations, and volunteer Travelers in Nouvelle-Aquitaine.

Purpose of research: In this article we aim to share the challenges and benefits of the co-construction of this research.

Results: The approach allowed the specific and sometimes divergent expectations of the stakeholders to be expressed and taken into consideration. It required a period of mutual acculturation, which resulted in a high level of participation in the study (74 percent), the acquisition of knowledge and skills, and the identification of points of contention. This participatory approach led to a better appropriation of the study and a greater awareness of health issues among the respondents, particularly thanks to the co-construction of the questionnaire and the communication tools.

Conclusions: This approach highlights the need to involve stakeholders in the governance of the research project from the very beginning. The approach was all the more crucial as it involved socially excluded people, and aims to avoid the possibility of excluding them further in the production of knowledge that concerns them.

Introduction: The Probashi project has produced four short autobiographical films on the life experiences in France of Bangladeshi nationals living in the Île-de-France region and the barriers they face to healthcare access.

Purpose of research: The development of this creative research project raises questions about issues of involvement and how participants are generated, in the context of methodological reflections on participatory research.

Results: The material and subjective availability of the participants determines involvement and production in the different stages of the filmed research, from data collection to the reporting of the results.

Conclusions: The conditions that ensure the involvement of participants, in particular those that are socially vulnerable, must be factored into the participatory research arrangements themselves.

Participatory research can help improve addiction services. However, the superficial involvement of people with experiential knowledge runs the risk of reproducing social inequity rather than strengthening their empowerment. This article aims to present a critical analysis, co-constructed through a dialogue between people with academic and experiential knowledge, of different types of participation and collaboration undertaken over a number of years, while also examining issues raised by the professionalization or formalization of the role of people with experiential expertise in participatory research in the field of addiction. The results of this analysis have led to a co-constructed critical assessment that deals with the following themes: 1) a description of the collaborative process over time and the diverse ways in which people with experiential knowledge have been involved; 2) conceptual considerations with respect to the terms used and the identities linked to them; 3) aspects that have facilitated collaboration; 4) obstacles and challenges that were encountered. This dialogue between academic and experiential knowledge highlights the need to review institutional rules so as to better recognize the status of people with experiential knowledge involved in research. Recognition of skills related to eligibility for research positions should not be limited to academic qualifications. Experiential knowledge should be integrated into hiring processes as a recognized type of expertise.