Centre de Recherche de l'Hôpital Charles-Le Moyne (CR-CLM), Direction de Santé Publique de Montérégie, 1255, rue Beauregard, Longueuil, Québec, Canada J4K 2M3.
Department of Family Medicine, McGill University, Montreal, Canada.
Health Promot Int. 2017 Feb 1;32(1):167-176. doi: 10.1093/heapro/dav080.
To explore an example of a reflexive intervention with health professionals working in tobacco control (TC). This study reports the perceived intervention effects regarding: (i) participants' understanding of reflexivity and personal learning and (ii) conditions needed in order to integrate reflexivity into professional and organizational practices. This is a qualitative study using an interpretative evaluation framework to assess the perceived effects of a reflexive intervention in Montréal, Québec. Semi-structured qualitative interviews (n = 8) gathered data. Data analysis began deductively, guided by the broad categories found in research questions. Sub-categories to populate these broad categories captured the inhibitors and facilitators through an inductive thematic analysis. Our study reveals that, following the intervention, most participants had a generally good understanding of reflexivity and described concrete learning in association with the intervention. Main facilitators and inhibitors to conducting a reflexive workshop pertained to the organizational context as well as to the professional and individual characteristics of the participants. Some participants implemented sustainable changes as a result of the intervention, such as creating a tool, reviewing work plans and developing new mechanisms to integrate the voice of their clientele in the planning process. The need and interest for dialogue among health professionals about how TC intervention activities may inadvertently contribute to social inequalities in smoking is apparent. While there appears to be potential for reflexive practice, the integration of reflexivity into practice is reliant upon the organizational context (financial and time constraints, culture, support, and climate) and the reflexivity concept itself (intangibility, complexity and fuzziness).
探讨一个卫生专业人员参与烟草控制（TC）的反思性干预的例子。本研究报告了关于以下方面的干预效果感知：（i）参与者对反思性和个人学习的理解；（ii）将反思性纳入专业和组织实践所需的条件。这是一项使用解释性评估框架的定性研究，以评估在魁北克省蒙特利尔进行的反思性干预的感知效果。采用半结构化定性访谈（n=8）收集数据。数据分析始于演绎法，以研究问题中发现的广泛类别为指导。通过归纳主题分析，填充这些广泛类别的子类别捕捉到了抑制剂和促进剂。我们的研究表明，干预后，大多数参与者对反思性有了一般的理解，并描述了与干预相关的具体学习。进行反思性研讨会的主要促进因素和抑制剂与组织背景以及参与者的专业和个人特征有关。一些参与者由于干预而实施了可持续的变革，例如创建工具、审查工作计划以及开发新机制，以将客户的意见纳入规划过程中。卫生专业人员之间需要就 TC 干预活动如何可能无意中导致吸烟方面的社会不平等进行对话，这一点显而易见。虽然反思实践似乎有潜力，但将反思性纳入实践依赖于组织背景（财务和时间限制、文化、支持和氛围）和反思性概念本身（无形性、复杂性和模糊性）。
