Sante Publique最新文献

{"title":"Mesurer l’hétérogénéité territoriale de l’accessibilité aux soins : aller au-delà de l’APL.","authors":"Arnaud Chéron, F Maunoury, Anthony Terriau","doi":"10.3917/spub.262.0189","DOIUrl":"10.3917/spub.262.0189","url":null,"abstract":"<p><strong>Introduction: </strong>Access to primary health care is a major public health issue in France. The Localized Potential Accessibility (LPA) indicator, considered the benchmark indicator for identifying underserved areas, provides an indirect measure of the imbalance between health care supply and demand. The aim of this study is to propose a complementary indicator, based on general practitioners&amp;#8217; acceptance of new patients, in order to better characterize territorial inequalities in access to primary care.</p><p><strong>Methods: </strong>We use original data collected from online medical appointment-booking platforms, covering nearly 12,000 general practitioners and more than two-thirds of the French population. At the municipal level, we compute the Proportion of general practitioners accepting New Patients (PNP), using a methodology comparable to that employed for the LPA.</p><p><strong>Results: </strong>Territorial disparities appear more pronounced when measured using the PNP than when measured using the LPA. Across the different measures of dispersion considered, territorial heterogeneity is two to three times higher with the PNP. Substantial discrepancies are observed between the two indicators: for 8.61% of municipalities (15.35% of the population), the LPA underestimates difficulties in accessing primary care, whereas for 11.19% of municipalities (22.28% of the population), it overestimates them relative to the PNP.</p><p><strong>Conclusion: </strong>The PNP constitutes a direct and concise indicator of the imbalance between health care supply and demand. Complementary to the LPA, it enables a more refined identification of underserved areas and improves the targeting of public policies aimed at reducing territorial inequalities in access to primary care. These findings support broader collection and systematic use of the PNP as a central criterion for analyzing supply&amp;#8211;demand imbalances and as a tool to guide public policy targeting.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 2","pages":"189-202"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inégalités socio-territoriales de vaccination contre la grippe : accessibilité des soins, revenus et santé des individus âgés.","authors":"Raphaël Dhuot","doi":"10.3917/spub.262.0103","DOIUrl":"10.3917/spub.262.0103","url":null,"abstract":"<p><strong>Introduction: </strong>In France, influenza vaccination (IV) coverage among individuals aged 65 and over remains below public health targets. Clarifying the structural factors influencing IV can help inform prevention campaigns.</p><p><strong>Methods: </strong>This study uses aggregated departmental-level public data. Variations in IV coverage among individuals aged 65 years and older between 2016 and 2022 were estimated using multiple linear regression models. Changes in median income, poverty rate, health and physical activity indicators, and general practitioner availability across territories were included as explanatory variables. Individual and time fixed effects were incorporated to control for unobserved heterogeneity. Heteroskedasticity-robust standard errors were computed using White's method.</p><p><strong>Results: </strong>A one percentage-point increase in their poverty rate was associated with a 1.06% decrease in IV coverage among individuals aged 65 and over (p&amp;lt;0.001). An increase of 1 per 10,000 emergency visits for influenza-like illness was associated with a 0.004% increase in IV coverage in the following season (p&amp;lt;0.001). One additional general practitioner consultation per person per year was associated with a 1.56% increase in IV coverage among those aged 65 and over (p&amp;lt;0.01). The effect of primary care accessibility declined as median income among the 65+ population increased (p&amp;lt;0.001) and as their health status improved (p&amp;lt;0.01) Conclusions: A socio-territorial approach to the determinants of IV among older adults can help inform the scale and targeting of public health policies and, to a lesser extent, clarify the mechanisms underlying IV uptake more broadly.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 2","pages":"103-118"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L’Emploi Accompagné : un levier d’inclusion professionnelle et de santé mentale publique.","authors":"Marie-Gaëlle Marec","doi":"10.3917/spub.hs1.2026.0201","DOIUrl":"https://doi.org/10.3917/spub.hs1.2026.0201","url":null,"abstract":"<p><strong>Introduction: </strong>Supported Employment, based on the Individual Placement and Support (IPS) model, is increasingly implemented in France to promote the professional inclusion of people with mental health disabilities. This study examines its effects on employment outcomes and certain dimensions of mental health, as well as its implementation modalities.</p><p><strong>Methods: </strong>The study is based on a mixed-methods approach combining quantitative and qualitative analyses at three levels: organizations (N&amp;#160;=&amp;#160;27), employment specialists (N&amp;#160;=&amp;#160;71), and service users (N&amp;#160;=&amp;#160;1,027, including N&amp;#160;=&amp;#160;67 followed longitudinally over one year). Qualitative data were collected through 27 group interviews and telephone interviews conducted as part of the longitudinal follow-up.</p><p><strong>Results: </strong>An employment rate of 51% and a 6-month job retention rate of 62% were observed. Mental well-being increased among individuals who gained employment, while some dimensions of recovery progressed independently of employment status. Organizations showed a high level of fidelity to the IPS model, and employment specialists reported high levels of competency associated with employment outcomes.</p><p><strong>Discussion: </strong>These findings suggest that Supported Employment is not limited to facilitating access to employment but may also contribute to broader recovery processes. They highlight the role of employment specialists and the importance of cooperation between mental health, social, and employment sectors.</p><p><strong>Conclusion: </strong>Supported Employment promotes professional inclusion and supports recovery trajectories in mental health. It constitutes a lever for improving public mental health.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 HS1","pages":"201-211"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Évaluation d’une intervention de courtage de connaissances à l’Agence régionale de santé Île-de-France.","authors":"Amandine Fillol, Lola Traverson, Tony Zitti, Gwendal Bars, Nils Minssieux, Aurélie Hot, Christian Dagenais, Valéry Ridde","doi":"10.3917/spub.261.0015","DOIUrl":"10.3917/spub.261.0015","url":null,"abstract":"<p><p>Introduction&amp;#160;: Reducing social health inequalities requires bridging the gap between knowledge and its implementation. Knowledge brokering facilitates exchanges between researchers and practitioners but remains underexplored in the French public health system. Methods&amp;#160;: This study evaluates a knowledge brokering intervention within the &amp;#206;le-de-France Regional Health Agency (ARS). The intervention aimed to strengthen staff capacities through knowledge translation activities, including training sessions and thematic groups. A qualitative evaluation was conducted based on participant observations and 16 semi-structured interviews. Data were analyzed both inductively and deductively using a coding framework focused on effectiveness, implementation, and influencing factors. Results&amp;#160;: The intervention was well received, supported by strong institutional leadership and motivated stakeholders. However, participation remained limited due to time constraints, a lack of clarity regarding the role of brokers, and difficulties integrating the intervention into existing mechanisms. While thematic groups and the MOOC helped strengthen staff knowledge and skills, their impact on decision-making was modest, and dissemination across the different departments of the Regional Health Agency was limited. Discussion&amp;#160;: The evaluation prompted adjustments in the intervention and highlighted the need to redefine the knowledge brokering function to better fit this context&amp;#8212;for example, by establishing brokering as a dedicated unit.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 1","pages":"15-34"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urgences dentaires : la médecine générale en première ligne ?","authors":"Constance Ambroise, Gilles Amador","doi":"10.3917/spub.262.0161","DOIUrl":"10.3917/spub.262.0161","url":null,"abstract":"<p><strong>Introduction: </strong>In many countries, patients with dental pain often consult general practitioners (GPs), even though such care is usually inadequate. This study aimed to estimate the frequency of dental emergency consultations in general practice and to describe GPs&amp;#8217; behavior and patients&amp;#8217; care pathways.</p><p><strong>Method: </strong>A cross-sectional observational survey was conducted using self-administered questionnaires distributed via professional bodies and social media.</p><p><strong>Results: </strong>A total of 342 GPs participated, 68% of whom reported receiving at least one dental pain or dental infection consultation each week. These consultations were significantly less frequent in departments with a high density of dentists (p&amp;lt;0.001). Across all regions, over 90% of GPs frequently or very frequently heard patients explain that their dentist&amp;#8217;s next available appointment was too far away or that the dentist themselves had advised them to seek medical consultation before the dental visit. Only one third of GPs felt confident managing these consultations, and 95% reported prescribing antibiotics often or systematically. Finally, 77% redirected patients to a dentist.</p><p><strong>Discussion: </strong>Although GPs are less frequently consulted in areas with a higher density of dentists, our findings also highlight a delegation of dental emergency care to primary care physicians. This suggests that recourse to GPs does not depend solely on territorial distribution but reflects a more complex dynamic involving professionals&amp;#8217; accessibility and availability, as well as patients&amp;#8217; perceptions.</p><p><strong>Conclusion: </strong>Strengthening GPs&amp;#8217; training in oral health could improve both their confidence and the appropriateness of management. However, a sustainable response requires simultaneous action on both the supply and demand sides of care: by supporting greater involvement of dentists in non-scheduled care, improving their territorial distribution and integration into coordinated care structures, and encouraging patients to make greater use of preventive consultations.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 2","pages":"161-173"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying neurocognitive disorders in older adults: The role and perceptions of primary care professionals","authors":"Aurélie Barbe, Isabelle Aubin-Auger","doi":"10.3917/spub.263.0247","DOIUrl":"10.3917/spub.263.0247","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to understand the role and experiences of primary care professionals in identifying neurocognitive disorders in older adults. Identifying barriers, enablers, and their expectations will help consider avenues for improvement.</p><p><strong>Methods: </strong>Using a descriptive and exploratory qualitative approach, two focus group interviews were conducted with 10 primary care professionals of various backgrounds, all members of a Territorial Professional Health Community. Thematic analysis of the collected verbatim transcripts revealed themes and sub-themes relevant to the research question.</p><p><strong>Results: </strong>All professionals acknowledged their ability to recognize early signs and to gather complaints from the patient or their relatives. However, this did not always lead to a diagnostic process. Among the noted barriers were lack of knowledge, constraints specific to their practice, and patient refusal. Interprofessional collaboration emerged as essential. Collective practice appeared to be limited by communication difficulties and ethical concerns. Participants expected better information sharing and more effective partnership.</p><p><strong>Conclusion: </strong>Identifying neurocognitive disorders in primary care is complex and should be viewed as a collective challenge. The role of each professional must be acknowledged, and interprofessional collaboration should be strengthened through smoother and more effective communication. This complementary approach, involving other professionals alongside the general practitioner, opens new perspectives, including the implementation of geriatric advanced practice nursing roles and the development of coordination tools and systems.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 3","pages":"247-257"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacists’ perceptions and acceptability of HIV self-testing in private pharmacies in Bamako, Mali: A mixed-methods study","authors":"Samuel Kaboré Delwendé, Juliette Tranchot-Diallo, Alicia Christiana Koné, Dragoss Ouedraogo, Thérèse Kagoné, Abdoul Salam Ouedraogo, Ramata Traoré-Ouédraogo","doi":"10.3917/spub.263.0227","DOIUrl":"10.3917/spub.263.0227","url":null,"abstract":"<p><strong>Introduction: </strong>HIV self-testing can expand access to screening, particularly among populations with limited connection to health services. In Mali, the role of private pharmacies remains understudied. This study examines pharmacists&amp;#8217; perceptions and client acceptability to inform the integration of HIV self-testing into private pharmacy settings.</p><p><strong>Method: </strong>This mixed-methods study was conducted in Bamako between February 7 and 28, 2022. Twelve pharmacists participated in semi-structured interviews, and 501 pharmacy clients completed a structured questionnaire. Qualitative data were analyzed using NVivo 14, while quantitative data were analyzed using SPSS and R. Multivariable logistic regression was used to identify factors associated with acceptability (defined as willingness to pay for an HIV self-test).</p><p><strong>Results: </strong>The mean age of participants was 31.6 years, and 67.1% were male. Most respondents did not know their HIV status (76.7%) and had never heard of HIV self-testing (91.6%).Overall, 62.1% of clients reported willingness to pay for an HIV self-test. In multivariable analysis, acceptability was independently associated with urban residence (aOR = 2.15; 95% CI: 1.28&amp;#8211;3.61), university education (aOR = 3.28; 95% CI: 1.68&amp;#8211;6.40), civil servant/student status (aOR = 2.52; 95% CI: 1.34&amp;#8211;4.74), knowledge of one&amp;#8217;s HIV status (aOR = 2.91; 95% CI: 1.18&amp;#8211;7.18), prior awareness of HIVST (aOR = 4.22; 95% CI: 2.38&amp;#8211;7.48), participation in HIV awareness sessions (aOR = 2.68; 95% CI: 1.42&amp;#8211;5.06), recent HIV testing (aOR = 2.95; 95% CI: 1.55&amp;#8211;5.61), and preference for both oral and blood-based tests (aOR = 1.85; 95% CI: 1.02&amp;#8211;3.35) (all p &amp;lt; 0.05). Age, sex, perceived HIV risk, and knowledge of partner&amp;#8217;s HIV status were not significantly associated with acceptability after adjustment. The mean acceptable price for an HIV self-test was 2,134 FCFA (~3.5 USD). Pharmacists perceived HIV self-testing as a confidential strategy that could facilitate early diagnosis, while highlighting challenges related to cost, availability, and limited public awareness.</p><p><strong>Discussion: </strong>Private pharmacies appear to be a relevant entry point for scaling up HIV self-testing in Mali. A phased implementation strategy including capacity building, targeted communication, and clear regulatory guidance is needed.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 3","pages":"227-236"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health insurance representatives’ visits to general practitioners: A qualitative study using semi-structured interviews within a proton pump inhibitor deprescribing trial","authors":"Florian Hurteau, Océane Paneccasio, Jérôme Nguyen-Soenen, Rosalie Rousseau, Jean-Pascal Fournier","doi":"10.3917/spub.263.0087","DOIUrl":"10.3917/spub.263.0087","url":null,"abstract":"<p><strong>Introduction: </strong>In the DeprescrIPP-DAM trial, health insurance representatives (HIRs) conducted visits to general practitioners (GPs) to raise awareness on the need to deprescribe proton pump inhibitors (PPIs) and to present strategies for engaging in the deprescribing process. This study aimed to explore HIRs&amp;#8217; interactions and experiences during these interventions.</p><p><strong>Methods: </strong>A qualitative study was conducted using semi-structured interviews with 12 voluntary HIRs. Data were analyzed using a grounded theory approach.</p><p><strong>Results: </strong>HIRs demonstrated the ability to balance the objectives of medical control and support for healthcare professionals. They adapted their approach by drawing on their internal resources and training to communicate effectively with GPs while maintaining relationships of trust. In the DeprescrIPP-DAM trial, innovative training and flexibility of the intervention were identified as key factors for effectiveness. However, the professional identity of the HIRs may have posed challenges in the context of tensions between GPs and the national health insurance system at the time of the trial. HIRs also identified several barriers to deprescribing, including the role of other medical specialties, GPs&amp;#8217; workload, and patient resistance.</p><p><strong>Conclusion: </strong>More flexible training approaches, greater involvement of other medical specialists, and the implementation of regular audits with individualized feedback to GPs could enhance future HIR-led PPI deprescribing interventions.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 3","pages":"87-99"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commitment, communication and empowerment: Lessons from a national survey on quality of life at work in maternal and child health services in France","authors":"Charles Eury, Julie Picard-Bodard, Thomas Saïas","doi":"10.3917/spub.263.0237","DOIUrl":"10.3917/spub.263.0237","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this article is to update the measurement of work-related quality of life and working conditions (WRQoL) among France&amp;#8217;s Protection maternelle et infantile (Maternal and Child Health Services) professionals, and to identify the key influencing factors and challenges associated with this WRQoL.</p><p><strong>Method: </strong>A national online survey was conducted between March and April 2025 among Maternal and Child Health Services professionals (n = 960). WRQoL was assessed using the WRQoL-2 scale. A confirmatory factor analysis was carried out, followed by an examination of individual and regional variables.</p><p><strong>Results: </strong>The overall WRQoL-2 score was 3.17 &amp;#177; 0.65. Among Maternal and Child Health Services professionals, 77% consider their working hours compatible with their personal lives and 69% feel that &amp;#8220;things are going well at work,&amp;#8221; but only 41% report being satisfied with material conditions, 33% feel they have the necessary resources, and 31% say they are proud to be part of and would recommend their organization. Only 17% consider institutional communication to be adequate, and 11% say they are involved in the decisions taken by the organization. Length of service is negatively associated with WRQoL (p &amp;lt; 0.001). Significant unfavorable discrepancies are observed in the overseas territories, particularly regarding working conditions.</p><p><strong>Discussion: </strong>Overall, WRQoL appears to be at an average and stable level compared to 2019, with significant weaknesses in perceived control at work, engagement and communication. Organizational actions are a priority: scope for action and participation, mechanisms for exchange (peer review/practice analysis), improvement of material conditions, and targeted support for the regions facing the greatest difficulties.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 3","pages":"237-246"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Évaluation médico-économique du programme ALAPAGE : une intervention combinant alimentation et activité physique pour améliorer la diversité alimentaire et la force musculaire des membres inférieurs chez les personnes âgées vivant à domicile.","authors":"Bérengère Davin-Casalena, Chloé Cogordan, Anne-Fleur Jacquemot, Lisa Fressard, Sarah Danthony, Agnès Vinet, Christophe Dubois, Nicole Darmon, Pierre Verger, Au Nom du Groupe d'étude Alapage","doi":"10.3917/spub.262.0141","DOIUrl":"10.3917/spub.262.0141","url":null,"abstract":"<p><strong>Introduction: </strong>Health authorities increasingly emphasize the essential role of physical activity (PA) and nutrition as key determinants of healthy aging. In this context, preventive measures are being implemented at the local level to promote the adoption of health-enhancing behaviors.</p><p><strong>Methods: </strong>The ALAPAGE program aimed to improve dietary diversity and physical capacity in community-dwelling adults aged 60 years and older. It was evaluated through an intervention research study of the same name, with a control arm (n = 122 participants, across 12 groups) and an intervention arm (n = 257 participants, across 26 groups). The program was co-developed between 2019 and 2021, based on existing prevention workshops. The intervention research was conducted between 2022 and 2024, in collaboration with organizations that typically run such workshops (retirement funds and mutual insurance federations), within 26 community centers (e.g., neighborhood centers in direct contact with older adults). Participants in the intervention arm attended 8 ALAPAGE sessions alongside the scientific evaluation, while those in the control arm participated in 4 scientific evaluation sessions and 2 social activities unrelated to the program theme (a convivial snack and a zero-waste workshop). After the study, the control group also attended 7 ALAPAGE sessions. This article presents the medical-economic evaluation of the program, which measures both its effectiveness and its cost.</p><p><strong>Results: </strong>An improvement in dietary diversity scores was observed, all other factors being equal: Scores were higher at the three-month follow-up after the study, with no significant difference between the control and intervention arms. The effectiveness of the ALAPAGE program was demonstrated by a significant improvement in physical capacity in the intervention arm compared to the control arm. The total estimated cost for implementing the program and its evaluation was €6,072 for the intervention arm versus €4,169 for the control arm.</p><p><strong>Discussion: </strong>The ALAPAGE program proved effective in improving physical activity (significant improvement in physical capacity in the intervention arm) and showed promising results in enhancing dietary diversity (similar improvement in both arms), although the cost was 45% higher than that of the control arm.</p><p><strong>Conclusion: </strong>These findings may help inform public policy decisions when selecting interventions to encourage older adults to take care of their health through nutrition and physical activity, despite a significantly higher cost.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 2","pages":"141-152"},"PeriodicalIF":0.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}