Guichard Anne, Hébert Catherine, Nour Kareen, Lafontaine Ginette, Tardieu Émilie, Ridde Valery
Sante Publique. 2018 May-Jun;30(1 Suppl):121-130. doi: 10.3917/spub.184.0121.
Although actions to reduce social inequalities in health cannot be considered the exclusive responsibility of public health actors, they should at least make sure their interventions account for these inequalities. However, the actors involved in these interventions have few tools to support them in this process. Therefore, building on a study conducted in France, we have adapted, tested, and developed in Quebec a tool intended to help actors take into account social inequalities in health. The article presents the approach that led to the adaptation of the tool to the Quebec context, to describe the tool, and then to discuss some issues for inclusion in professional practices. A participatory and constructive process between researchers, managers and practitioners led to a useful and useable tool. It is composed of five aspects of intervention (planning, implementation, evaluation, sustainability, and empowerment) and 44 items for discussion presented as questions. A user guide, a glossary, and some practical examples accompany the tool. It follows a reflexive and constructive process wherein a third party facilitator can assist actors involved in an intervention to analyze how they take social inequalities in health into account. This assessment can help generate collective recommendations for improvements, which can be monitored over time, to improve consideration of equity in public health interventions. The article concludes on some issues related to its integration into professional practices.
虽然减少健康方面社会不平等的行动不能被视为公共卫生行为者的专属责任,但他们至少应确保其干预措施考虑到这些不平等。然而,参与这些干预措施的行为者在这一过程中几乎没有什么工具来支持他们。因此,基于在法国进行的一项研究,我们在魁北克对一个旨在帮助行为者考虑健康方面社会不平等的工具进行了调整、测试和开发。本文介绍了使该工具适应魁北克背景的方法,描述了该工具,然后讨论了一些应纳入专业实践的问题。研究人员、管理人员和从业者之间的参与性和建设性过程产生了一个有用且可用的工具。它由干预的五个方面(规划、实施、评估、可持续性和赋权)以及作为问题呈现的44个讨论项目组成。该工具配有用户指南、词汇表和一些实际示例。它遵循一个反思性和建设性的过程,其中第三方促进者可以协助参与干预的行为者分析他们如何考虑健康方面的社会不平等。这种评估有助于产生可随时间监测的集体改进建议,以改善公共卫生干预措施中对公平性的考虑。本文最后讨论了与将其纳入专业实践相关的一些问题。