The Influence of Educational Determinants on Children's Health: A Scoping Review of Reviews.

Objectives: Education is one of the most important social determinants shaping the development and wellbeing of children. The purpose of this review of reviews is to inform policymakers, practitioners and public health stakeholder involved in developing child-friendly policies outside of the healthcare system. Methods: We carried out a scoping review of reviews. It included 32 reviews. Results: We identified four main categories of educational determinants in relation to children's health: 1) the organization and structure of educational activities, 2) the interpersonal relations in the educational facilities and structures, 3) the spatial environment of educational facilities and structures, 4) social inequalities in the educational facilities and structures. This last category highlighted the capacity of education system to act on inequalities derived from the way social structures are organized. Conclusion: We suggest a conceptual framework for action which distinguishes structural determinant (gender, race, social class, etc.) and structuring determinant (public policy, systems of governance, organization of cultures/values consideration). Finally, we discuss on how these social structures and structuring determinants influence the intermediary educational determinants collated in the review.

[Can health impact assessment be conducted on the political platforms of presidential election candidates?] / L'évaluation d'impact sur la santé peut-elle être appliquée aux programmes de candidats à l'élection présidentielle ?

Health impact assessment (HIA) is defined as a method by which a policy, program or project may be judged as to its potential effects on the health of a population in order to mitigate negative impacts and strengthen the positive ones. During the 2017 French presidential elections, health promotion actors decided to conduct an HIA on the political platforms of the five main candidates. The assessment of each political platform was conducted by 7 evaluators and reviewed by 35 health promotion experts. Then, a comparative analysis of the platforms was led on 3 specific topics. This HIA was conducted in accordance with the international standards of practice. Within all of the 5 political platforms, the proposals related to Environmental and energy policy, and to Agricultural policy were the ones with widely positive impacts on the determinants of health. Concerning all of the other policy proposals, their respective impacts and affected populations broadly change from one platform to another. Due to its political object, this HIA had to deal with methodological challenges such as platform instability, uncertainty over the genuine implementation of measures as well as the importance of the underlying platform values. Nonetheless, such an implementation of the HIA process on the political platforms of candidates running for an important position is interesting because it represents an opportunity to look at the platforms with fresh eyes and enriches the advocacy to take public health into account in the policy making processes and tries to operationalize the concept of health in all policies.

Population health intervention research: the place of theories.

BACKGROUND: An international workshop on population health intervention research (PHIR) was organized to foster exchanges between experts from different disciplines and different fields. This paper aims to summarize the discussions around some of the issues addressed: (1) the place of theories in PHIR, (2) why theories can be useful, and (3) how to choose and use the most relevant of them in evaluating PHIR. METHODS: The workshop included formal presentations by participants and moderated discussions. An oral synthesis was produced by a rapporteur to validate, through an expert consensus, the key points of the discussion and the recommendations. All discussions were recorded and have been fully transcribed. RESULTS: The following recommendations were generated through a consensus in the workshop discussions: (i) The evaluation of interventions, like their development, could be improved through better use of theory. (ii) The referenced theory and framework must be clarified. (iii) An intervention theory should be developed by a partnership of researchers and practitioners. (iv) More use of social theory is recommended. (v) Frameworks and a common language are helpful in selecting and communicating a theory. (vi) Better reporting of interventions and theories is needed. CONCLUSION: Theory-driven interventions and evaluations are key in PHIR as they facilitate the understanding of mechanisms of change. There are many challenges in developing the most appropriate theories for interventions and evaluations. With the wealth of information now being generated, this subject is of increasing importance at many levels, including for public health policy. It is, therefore, timely to consider how to build on the experiences of many different disciplines to enable the development of better theories and facilitate evidence-based decisions.

[Proportionate universalism: Towards "real equality" of prevention in France]. / Universalisme proportionné : vers une « égalité réelle ¼ de la prévention en France.

Although their design may feature a considerable amount of universalism, prevention strategies often produce results that are socially and/or spatially differentiated. This differentiation process can induce social or territorial gradients of access to and/or effectiveness of prevention and, in turn, worsen health inequalities. This process also accentuates the gap between the principles of certain public policies and their practical implementation, raising the question of the real benefit of these policies for beneficiaries. Although Sir Marmot considers proportionate universalism to be a strategy to tackle health inequalities, the practical modalities of implementation of this principle have been rarely described in the literature until very recently. This pragmatic paper therefore presents a causal analysis of differentiation processes, underlines the need for self-reflexive prevention strategies, and investigates practical implications of proportionate universalism.

[Health promotion at last? Trends in French health education over the past decade]. / La promotion de la santé, enfin? L'evolution du champ de l'education pour la santé au cours des dix dernières années.

Major legislative, structural and organizational changes have had a significant impact on public health in France over the past decade. This paper examines the effects of these changes in terms of the development of health education over the same period. Six significant trends were identified: the development of research in health education, the emphasis on health education as a strategy for reducing health and social inequalities, the emergence of health education as a field of intervention, the emergence of therapeutic patient education, the unprecedented economic difficulties of health education associations, and the changing perception of health education among public health authorities. The embeddedness of health education in health promotion remains vital since it provides the basis for developing the full potential of health education as part of a cross-sector approach, in combination with a range of other strategies aimed at broadening the scope of intervention.

[Attitudes of professionals towards prevention practices and guidelines]. / Attitudes des acteurs vis-à-vis des recommandations de prévention.

The prevention of alcohol abuse among adolescents is a political priority. Local prevention practitioners have campaigned extensively in schools and the public arena. Scientific guidelines aimed at improving the efficiency of alcohol abuse prevention have also been widely promoted. In order to identify the role and place of scientific guidelines in practitioner practices, a qualitative study was conducted in 21 local organizations involved in the prevention of alcohol abuse among adolescents throughout the Brittany region of France. This study shows that the guidelines have been largely ignored by prevention practitioners. The production and dissemination of guidelines explains why they are difficult to locate and have remained relatively inaccessible to lay professionals.

[Opinion of the National Federation of Education and Health Promotion on report "New approaches to public health prevention"]. / Opinion de la Fédération nationale de l'éducation et la promotion de la santé sur le Rapport « Nouvelles approches de la prévention en santé publique ¼

In 2009, the Center for Strategic Analysis initiated a study, entitled Neurosciences and Public Policies, to assess the use of neurosciences in prevention policy. Subsequently, a report highlighted the inefficiency of the "traditional" prevention programs and the potential contribution of neurosciences to defining a new prevention approach. For the French National Federation for Health Education and Promotion, health promotion cannot be limited to a "counter-manipulation" of consumers confronted with marketing strategies from the food and tobacco industries. Promoting health helps people increase control over the determinants of their health, by means of educational empowering strategies.