Penser la coordination de la prévention à l’échelle territoriale : une approche qualitative exploratoire.

Introduction: In the context of the localization of health policies in France, prevention has historically been relegated to the background. The need to improve the coordination of preventive efforts at the regional level is frequently emphasized, particularly since the emergence of structures with prevention mandates, such as the Health Territorial and Professional Communities (HTPC). This study aims to describe and characterize the regional organization of prevention, and to discuss various models of cooperation proposed by actors in a pilot region.

Method: The pilot area studied is that of the Sud Yvelines CPTS. A series of focus groups was conducted, involving professional, community, and institutional actors from the region. Participants were invited, in small groups, to design an "ideal" cooperation framework for implementing prevention initiatives, selecting and discussing the approaches they considered most appropriate.

Results: The regional organization of prevention appears relatively complex, involving a wide range of actors and diverse relationships among them. The cooperation models proposed by professionals show significant heterogeneity. Health professionals tend to favor coordination through mutual adjustment, while community actors prefer more formalized coordination, such as direct supervision.

Discussion: The regional coordination of prevention is part of a broader process of localizing public health. Primary care actors are now formally mandated to take part in the implementation of regional prevention efforts.