Université Laval, Québec, Canada.
Direction de santé publique de la Montérégie, Longueuil, Québec, Canada.
Health Promot Int. 2019 Dec 1;34(6):e71-e83. doi: 10.1093/heapro/day047.
While numerous tools are available to better incorporate equity into population health actions, they are limited mainly by their lack of adaptation to professional practices and organizational realities. A study was conducted in Québec to identify and understand, from the perspective of future users, conditions that would facilitate use of a tool (Reflex-ISS) targeted at supporting collaborative action to improve consideration of social inequalities in health (SIH) within population health actions. Concept mapping and focus groups were implemented as complementary methods for investigating the conditions. Significant results that emerged were strong participant interest in the tool and the need for resources to better take SIH into account. The conditions for use that were identified referred to the tool itself (user-friendliness and literacy) and to resources for appropriating the tool, competency development, as well as the role and responsibilities of organizations and policies in promoting use of the tool in daily activities and more fundamentally in acting against SIH in general. Models for organizational innovation give an idea of the dimensions that need to be considered to strengthen the integration of equity into organizations and to support the changes in practice that result from using the tool. They provide a reminder that a health equity tool cannot be the cornerstone of an organizational strategy to fight against SIH; rather, it must be incorporated as part of a systemic strategy of professional and organizational development.
虽然有许多工具可用于更好地将公平性纳入人口健康行动中,但它们主要受到缺乏对专业实践和组织现实的适应性的限制。在魁北克进行了一项研究,从未来用户的角度出发,确定并理解有利于使用工具(Reflex-ISS)的条件,该工具旨在支持改善人口健康行动中对社会不平等(SIH)的考虑的协作行动。概念映射和焦点小组被用作互补的方法来调查条件。出现的重要结果是参与者对该工具非常感兴趣,并且需要资源来更好地考虑 SIH。确定的使用条件涉及工具本身(易用性和可读性)以及工具的资源,包括能力发展,以及组织和政策在促进工具在日常活动中的使用以及更根本地在总体上反对 SIH 方面的作用和责任。组织创新模型提供了一些思路,需要考虑这些维度来加强组织内部的公平性,并支持使用该工具带来的实践变化。它们提醒人们,健康公平工具不能成为与 SIH 作斗争的组织战略的基石;相反,它必须作为专业和组织发展的系统战略的一部分来纳入。