Sante Publique最新文献

{"title":"Équité et politiques publiques en santé mentale : évaluation normative à partir de l’outil EquiFrame.","authors":"Morgane Gabet, Alexie Kim, Arthur Cailhol, Lara Gautier, Muriel Mac-Seing","doi":"10.3917/spub.hs1.2026.0109","DOIUrl":"https://doi.org/10.3917/spub.hs1.2026.0109","url":null,"abstract":"<p><strong>Introduction: </strong>In a context marked by heightened activity in mental health public policy and increasing challenges for public systems&amp;#8212;particularly regarding inequities in access to and quality of services&amp;#8212;it becomes essential to evaluate these policies through the lens of health equity. The pilot study presented explores the following question: (How) is equity considered in mental health public policies?</p><p><strong>Method: </strong>Drawing on the EquiFrame framework (2011), which enables a systematic analysis of public policies based on 21 concepts of equity, and using three contrasting Qu&amp;#233;bec policies as case studies, the analysis focuses on: 1) the equity concepts addressed (and their level of quality), 2) the equitydeserving groups mentioned, and 3) the alignment between equity concepts and the equity-seeking groups identified in these policies.</p><p><strong>Results: </strong>The results show stronger coverage of equity concepts in the strategic-level policy compared to operational-level ones. However, the quality of these concepts&amp;#8212;defined by the presence of planned actions or evaluations&amp;#8212;remains weak, as does the explicit consideration of equity-deserving groups. This raises questions about the actual political will behind equity-related discourse.</p><p><strong>Discussion: </strong>Policies tend to frame mental health interventions as universal, without accounting for the varying capacities of different groups to benefit from them. Yet, such disparities are particularly salient among individuals living with mental health conditions, who often experience multiple intersecting vulnerabilities.</p><p><strong>Conclusion: </strong>Integrating a health equity perspective into policy evaluation is crucial to ensure that mental health policies do not reproduce&amp;#8212;or worsen&amp;#8212;existing inequities.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 HS1","pages":"109-122"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867601","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’engagement des soignants dans un exercice coordonné : entre influence sur la qualité de vie et des conditions de travail et risque d’épuisement professionnel.","authors":"Alice Rochette, Charlotte de Fontgalland, Jean-Marie Ozanne, L Roy","doi":"10.3917/spub.hs1.2026.0153","DOIUrl":"https://doi.org/10.3917/spub.hs1.2026.0153","url":null,"abstract":"<p><strong>Introduction: </strong>In response to healthcare desertification in the Centre-Val de Loire region, healthcare professionals have increasingly engaged in coordinated models of practice. While this involvement represents progress in healthcare organization, it may also lead to an unintended consequence: professional burnout. The objective of this study is to identify the influence of coordinated practice on the mental health, quality of life, and quality of working conditions of healthcare professionals involved in such models.</p><p><strong>Methods: </strong>Twenty interviews were conducted with healthcare professionals from different specialties and with varying levels of involvement in coordinated practice.</p><p><strong>Results: </strong>Coordinated practice transforms professional practices and representations, while also acting as a framework for learning and mutual recognition. However, it generates a significant mental workload, relational tensions, and a form of exhaustion associated with overcommitment.</p><p><strong>Discussion: </strong>The findings of this study highlight changes in both practices and professional identities among healthcare providers engaged in coordinated practice. While this collective mechanism appears to be a driver for professional recognition and improved quality of working life, it also raises challenges related to burnout, collective expectations, and internal power dynamics.</p><p><strong>Conclusions: </strong>Coordinated practice represents a lever for improving quality of working life, strengthening the sense of usefulness, and fostering peer recognition. It provides a space for cooperation, skills enhancement, and collective support. Nevertheless, it may also be a source of tension, emotional fatigue, or even professional burnout when implicit expectations, social pressure, or unequal levels of involvement are not adequately balanced.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 HS1","pages":"153-164"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867628","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":"Dengue prevention in Wassakara: knowledge, attitude, and practices survey, Yopougon-Est, Ivory Coast, 2025","authors":"Ama Kounangui Marie Noelle Ano, Daniel Kouadio Ekra, Maky Diallo, Aristide Goueu Doua, Isaac Tiembré Issaka","doi":"10.3917/spub.263.0039","DOIUrl":"10.3917/spub.263.0039","url":null,"abstract":"<p><strong>Introduction: </strong>Dengue is an infectious disease transmitted by mosquitoes that is rapidly spreading in West Africa, particularly in C&amp;#244;te d&amp;#8217;Ivoire. Despite the efforts of health institutions, the disease remains underdiagnosed and difficult to control, particularly in urban and peri-urban areas such as Abidjan. This study focused on Wassakara, a disadvantaged neighborhood in the Yopougon district of Abidjan, to assess adults&amp;#8217; knowledge, attitudes, and practices (KAP) regarding dengue prevention.</p><p><strong>Method: </strong>A cross-sectional survey was conducted among 316 randomly selected adults. A structured questionnaire was used to collect sociodemographic data and assess KAP levels. Statistical analyses included chi-squared tests and logistic regressions to identify influencing factors.</p><p><strong>Results: </strong>While the majority of participants (94.3%) were aware of the existence of dengue, specific knowledge regarding its transmission, symptoms, and prevention was insufficient: only 7.6% achieved a satisfactory level of knowledge, and barely 2.8% regularly adopted protective practices. Participation in sanitation campaigns remained low. Factors positively associated with high scores included age, educational level, household size, and community engagement.</p><p><strong>Conclusion: </strong>The study concludes that there is a need to intensify targeted health education initiatives, train community health workers, and provide appropriate resources. A multisectoral and participatory strategy is essential to strengthen community resilience.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 3","pages":"39-57"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117577","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":"Contribution and feasibility of general practitioners-community pharmacists practice groups in France: Insights from participating general practitioners","authors":"Florent Macé, Sophie Logerot, Christine Peyron","doi":"10.3917/spub.263.0117","DOIUrl":"10.3917/spub.263.0117","url":null,"abstract":"<p><strong>Introduction: </strong>General practitioners and community pharmacists practice groups (GPMPs) have demonstrated their relevance in several European countries (Belgium, the Netherlands, Switzerland) and represent a potential avenue for the French primary care system. This study aims to examine the contribution and feasibility of this practice among a panel of French general practitioners (GPs).</p><p><strong>Methods: </strong>Based on a nationwide experiment conducted between 2019 and 2020, an evaluation was carried out among participating GPs using questionnaires administered at different stages of the experiment. These questionnaires collected feedback on expectations, satisfaction, and perceived future prospects related to this practice.</p><p><strong>Results: </strong>Although few sessions were conducted, the experimental GPMP model demonstrated its contribution to participants&amp;#8217; practice (changes in prescribing behavior, acquisition of new knowledge, impact on professional practice), as well as a high level of adherence (satisfaction and willingness to recommend the practice to colleagues).</p><p><strong>Conclusions: </strong>Given their potential interest for policies aimed at improving quality of care, GPMPs could benefit from measures facilitating their wider implementation in France. This is particularly relevant in light of the appeal of group practice for younger generations of GPs and the recognition of such practices within existing structural frameworks (Interprofessional Conventional Agreements, Continuing Professional Development).</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 3","pages":"117-163"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117469","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":"Déprescription et santé durable : enseignements d’une journée interdisciplinaire.","authors":"Matthias Brunn, Étienne Nouguez, Eva Stahl, Max Cocard, Fabrice Berna, Céline Bouglé, Sylvain Bouquet, Frédéric Bounoure, Delphine Cabelguenne, Patrick Castel, Pierre Chirac, Odessa Dariel, Anneliese Depoux, Laura Duprat, Emmanuel Gigon, Jean-Pascal Fournier, Charlotte Halpern, Jean-François Huon, Sophie Kelley, Agnès Laforest-Bruneaux, Hervé Leneel, Pierre Le Quinio, Charlotte Masia, Maeva Musso, Zeynep Or, Maurice-Pierre Planel, Raoul Santucci, Nicolas Senn, Jean-Pierre Thierry, Claire Traon","doi":"10.3917/spub.262.0153","DOIUrl":"10.3917/spub.262.0153","url":null,"abstract":"<p><p>Deprescribing, defined as the supervised reduction or discontinuation of inappropriate medications with the aim of improving quality of care, has become a major public health issue. Long guided primarily by clinical and economic considerations, deprescribing now increasingly incorporates an environmental dimension, particularly with regard to the ecological footprint of the pharmaceutical life cycle. This article presents a synthesis of key insights from an interdisciplinary workshop held at Sciences Po in December 2024, which brought together researchers, clinicians, institutional representatives, and health system stakeholders. The discussions highlighted that France remains a country with high levels of medication consumption, exposing patients to substantial risks of iatrogenesis while generating significant environmental impacts. Speakers emphasized the existence of structured international deprescribing initiatives, whose implementation in France would require adaptation to the specific features of the national health system. Despite institutional efforts led by the French National Health Insurance, the National Authority for Health, the National Agency for the Safety of Medicines and Health Products Safety, and regional observatories, several obstacles persist, including the lack of consolidated data, deeply rooted prescribing cultures, organizational constraints, and ambivalent patient expectations. Key levers for action were identified, such as greater recognition of medication review activities, the development of decision-support tools acceptable to health care professionals, the strengthening of territorially based multiprofessional dynamics, and the active involvement of patients. The case of psychotropic medications particularly illustrates the complexity of deprescribing practices. Beyond existing approaches, the discussions point to the need for a structured national strategy to embed deprescribing within a sustainable health framework, articulating quality of care, equity, and ecological transition.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 2","pages":"153-159"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989808","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":"Le déploiement du dispositif Sentinelle dans le monde agricole et rural : une approche collaborative et communautaire.","authors":"Pierrine Aly, Raphaëlle Desrousseaux, Emilie Diop-Perrot, Mélanie Coquelin, Pierre Grandgenèvre","doi":"10.3917/spub.hs1.2026.0219","DOIUrl":"https://doi.org/10.3917/spub.hs1.2026.0219","url":null,"abstract":"<p><p>The mental health of the French agricultural population represents a major public health concern, characterized by an increased vulnerability to suicide due to demanding working conditions, social isolation, economic pressures, and limited access to healthcare in rural areas. In this context, the deployment of the Farm Sentinel Model emerges as a relevant approach to suicide prevention, grounded in a community-based and collaborative framework. Led by the Mutualit&amp;#233; Sociale Agricole (MSA), in collaboration with the Groupement d&amp;#8217;&amp;#201;tudes et de Pr&amp;#233;vention du Suicide (GEPS), the Farm Sentinel Model aims to promote early identification and referral of individuals at risk of suicide through a network of sentinels drawn from, or closely connected to, the agricultural community. Embedded within a national program for prevention and support of agricultural beneficiaries in situations of distress, the model builds on the MSA&amp;#8217;s strong territorial presence, its elected representatives, local MSA professionals, and its mutualist values. Sentinel training, developed by the GEPS and tailored to agricultural realities, constitutes a core component of the Farm Sentinel Model. A recent innovation involves the development of agricultural facilitators&amp;#8212;non-clinical co-facilitators trained to enhance program ownership within rural communities through a peer-to-peer approach. As of December 31, 2024, more than 8,000 sentinels were active across rural areas in France. Despite persistent challenges, this collaborative and community-based model appears promising for reducing social and territorial inequalities in mental health and strengthening suicide prevention in agricultural settings.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 HS1","pages":"219-223"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866141","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":"Santé mentale en prévention spécialisée : la « transprofessionnalité » des relations entre psychologues et éducateurs.","authors":"Pape Momar Niang","doi":"10.3917/spub.hs1.2026.0139","DOIUrl":"https://doi.org/10.3917/spub.hs1.2026.0139","url":null,"abstract":"<p><strong>Introduction: </strong>This paper aims to analyze the pilot program for street psychologists in specialized prevention launched in 2018 in the Nord and Pas-de-Calais departments in France. The goal is to highlight the challenges and dimensions of this new cross-disciplinary and innovative approach.</p><p><strong>Method: </strong>The methodology is based on action research conducted in 2024 with seven street psychologists, as well as with young people receiving support and other professionals, as part of a qualitative study.</p><p><strong>Result: </strong>The results demonstrate that by internalizing the issue of mental health, specialized prevention is developing a new practice of &amp;#8220;reaching out&amp;#8221; by psychologists trained throughout their education to &amp;#8220;let things come.&amp;#8221; This new methodological challenge of coordinating &amp;#8220;outside the walls&amp;#8221; and &amp;#8220;inside the walls&amp;#8221; enables the deconstruction of negative perceptions of psychology in priority neighborhoods and involves both professional realignments between educators and psychologists centered on &amp;#8220;transprofessionalism&amp;#8221; and the optimization of care delivery methods.</p><p><strong>Conclusion: </strong>The arrival of street psychologists enables the sector to offer psycho-socio-educational services, establishing it as a major player in mental health policies. Nevertheless, while the effects on young people are clearly observable, the gains are fragile insofar as the precarious nature of the positions may jeopardize promising results.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 HS1","pages":"139-152"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867416","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":"Co-créer une intervention sur la littératie en santé mentale des enfants : feuille de route.","authors":"Ilaria Montagni, Garance Mazoyer, Consortium Child-Mhl","doi":"10.3917/spub.hs1.2026.0031","DOIUrl":"https://doi.org/10.3917/spub.hs1.2026.0031","url":null,"abstract":"<p><strong>Introduction: </strong>The prevention of mental disorders and the promotion of children&amp;#8217;s psychological well-being are key public mental health priorities. In this context, the cocreation of school-based mental health literacy interventions emerges as a key lever for successful implementation. However, there are currently no established recommendations for developing this type of intervention with positive outcomes. The aim of this study was to propose a roadmap based on the description of the cocreation steps of a French school-based intervention.</p><p><strong>Methods: </strong>A heterogeneous working group, including children aged 9&amp;#8211;11, developed a multi-tool intervention based on the theoretical framework of the Child-Focused Mental Health Literacy Model. Multiple methodologies (questionnaires, literature review, semi-structured interviews, pedagogical sheets) were used to guide the development of the intervention.</p><p><strong>Results: </strong>The cocreation process (2024&amp;#8211;2025) combined a mental health survey of 254 children with a review of existing interventions. The data were synthesized into pedagogical sheets, validated by professionals, parents, and teachers, and subsequently used to develop educational tools. A sequence of six weekly sessions was designed and tested with children, whose feedback informed content adjustments and confirmed the relevance of the intervention.</p><p><strong>Discussion: </strong>We described the cocreation process of a school-based intervention combining researchers&amp;#8217; scientific knowledge with stakeholders&amp;#8217; expertise. This approach brought together academic rigor and diverse empirical contributions and provided a practical roadmap for developing interventions in real-world settings. Children&amp;#8217;s involvement was essential to adapt the content to their level of understanding and to incorporate their perspectives, taking into account their sensitivity and vulnerability regarding this complex topic.</p><p><strong>Conclusions: </strong>Cocreation appears to be an essential condition for the development of effective school-based mental health literacy interventions for children. The proposed roadmap aims to guide the different stages of the process for professionals wishing to engage in this still underexplored field of intervention.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 HS1","pages":"31-42"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867578","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":"Les enjeux socio-économiques de l’IA en santé.","authors":"Carine Milcent","doi":"10.3917/spub.261.0007","DOIUrl":"https://doi.org/10.3917/spub.261.0007","url":null,"abstract":"","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 1","pages":"7-10"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671100","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":"Les situations de vulnérabilité liées à la santé : un angle mort du progrès. À propos de l’avis 148 du Comité consultatif national d’éthique.","authors":"Régis Aubry, Anne Caron-Déglise, Jean-François Delfraissy","doi":"10.3917/spub.261.0011","DOIUrl":"https://doi.org/10.3917/spub.261.0011","url":null,"abstract":"<p><p>Based on a recent advisory opinion issued by the French National Consultative Ethics Committee (Comit&amp;#233; consultatif national d&amp;#8217;&amp;#233;thique&amp;#160;; CCNE) on this subject [1], the authors draw readers&amp;#8217; attention to a phenomenon correlated with advances in healthcare&amp;#160;: situations of health-related vulnerability. They first define this concept, then explore the ethical issues it raises, and finally consider ways in which our healthcare system and society can support these developments, which they themselves help bring about.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 1","pages":"11-14"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671118","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}