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一项旨在减少健康方面社会不平等的干预研究项目(AAPRISS):方法与验证

[An intervention research program (AAPRISS) to reduce social inequalities in health: methods and validation].

作者信息

Villeval Mélanie, Bidault Elsa, Gaborit Emilie, Grosclaude Pascale, Haschar-Noé Nadine, Lang Thierry

机构信息

UMR 1027 INSERM - Université Toulouse III.

出版信息

Can J Public Health. 2015 Oct 3;106(6):e434-41. doi: 10.17269/cjph.106.4955.

Abstract

OBJECTIVE

The AAPRISS intervention-research program (Apprendre et Agir Pour Réduire les Inégalités Sociales de Santé) aims to change prevention projects to improve the extent to which they take health inequalities into account. The goal is to assess a project's feasibility and its acceptability, from the viewpoint of the sponsors of the project in question, and to present its tools and potentially-transferable elements.

PARTICIPANTS

Five cancer-prevention projects focused on nutrition have been included in the AAPRISS program: two projects conducted in school, one community-health project conducted in a disadvantaged neighbourhood and two hospital therapeutic-education programes. For each one, a workgroup was created bringing together the project sponsors and their team as well as researchers from various disciplines.

LOCATION

The study involves projects currently underway in the Midi- Pyrénées region of France.

INTERVENTION

AAPRISS is based on the exchange of knowledge among project sponsors and researchers and the co-construction of the analysis, reorientations and the assessment of the prevention projects included in the program. The validation of the program and its feasibility from the project sponsors' point of view is based on a questionnaire and presentations carried out during a symposium that took place in May 2014 in Toulouse.

RESULTS

Twelve key program functions have been described. They have been shown to be feasible and acceptable and concrete project modifications towards a better consideration of social inequalities of health (SIH) have been realized in most of the projects. Co-construction among the stakeholders raises many issues and difficulties that could have been overcome by the establishment of a relationship of trust between project sponsors and researchers.

CONCLUSION

The complexity of the determinants leading to SIH calls for programs that revisit existing projects rather than a new intervention aimed at reducing them.

摘要

目的

AAPRISS干预研究项目(Apprendre et Agir Pour Réduire les Inégalités Sociales de Santé,意为“学习与行动以减少健康方面的社会不平等”)旨在改变预防项目,以提高其对健康不平等问题的考虑程度。目标是从相关项目赞助方的角度评估一个项目的可行性和可接受性,并展示其工具和可能可转移的要素。

参与者

AAPRISS项目纳入了五个关注营养的癌症预防项目:两个在学校开展的项目、一个在贫困社区开展的社区健康项目以及两个医院治疗教育项目。对于每个项目,都成立了一个工作组,成员包括项目赞助方及其团队以及来自不同学科的研究人员。

地点

该研究涉及法国南部-比利牛斯地区目前正在进行的项目。

干预措施

AAPRISS基于项目赞助方与研究人员之间的知识交流以及对该项目中所包含的预防项目的分析、重新定位和评估的共同构建。从项目赞助方的角度对该项目及其可行性进行验证,是基于一份问卷以及在2014年5月于图卢兹举行的一次研讨会上所做的报告。

结果

已描述了该项目的十二个关键功能。这些功能已被证明是可行且可接受的,并且大多数项目都针对更好地考虑健康方面的社会不平等(SIH)进行了具体的项目修改。利益相关者之间的共同构建引发了许多问题和困难,而通过在项目赞助方和研究人员之间建立信任关系,这些问题和困难本可以得到克服。

结论

导致健康方面社会不平等的决定因素的复杂性要求有重新审视现有项目的项目,而不是旨在减少这些不平等的新干预措施。

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