Environment and child well-being: A scoping review of reviews to guide policies.

Background: Acting on social determinants is the most effective, efficient, and fairest strategy to improve population health and health equity. Because of their vulnerability and dependence, children are particularly exposed to the deleterious effects of their living environment. Taking these issues into account in the development of public policies and identifying levers for action are crucial. The objective of this scoping review of reviews is to identify the main environmental determinants on children's health and development, and their mechanisms of effect, to be addressed by public policies. Methods: We conducted a scoping review of reviews in accordance with the method developed by Arksey and O'Malley, and Levac and colleagues' methodology advancement and the PRISMA guideline. Inclusion criteria were identified with the PICos (population-phenomena of interest-context-study design) framework. We used the PubMed database and conducted a thematic analyze. Results: Forty-seven articles were selected. Their analysis allowed us to identify five categories of interdependent environmental determinants of child health: i) urban design ii) contaminants, iii) parenting environment, iv) social conditions, v) climate change. Together and in a systemic way, they act on the health of the child. Conclusion: The review carried out allows us to propose a pragmatic framework for clarifying the effects of the physical, social, and economic environment on children's health and wellbeing.

Exploring the Determinants of Polypharmacy Prescribing and Dispensing Behaviors in Primary Care for the Elderly-Qualitative Study.

Polypharmacy is particularly prevalent in the elderly. The interest in this issue is growing, and many interventions exist to improve the appropriate use of polypharmacy for older people. However, evidence of their effectiveness is still limited. Thus, the aim of this study, based on a qualitative approach, was to identify the key elements perceived to influence the prescribing and dispensing of appropriate polypharmacy to older people in primary care. Semistructured interviews were conducted with general practitioners and community pharmacists practicing in the region of Nouvelle-Aquitaine (France). Pre-existing topic guides based on the 12 TDF domains have been adapted and used. Data were analyzed using the framework method and content analysis. A focus group of healthcare professionals was conducted, and behavior change techniques (BCTs) were used to select the intervention components. Seventeen interviews were convened. A wide range of determinants were identified as barriers and/or facilitators. Nine domains were selected as key domains to target for intervention. Five intervention components (behavior change techniques-BCTs) to include in an intervention were finally selected. The results of this study will serve as a starting point for the design of a theory-based intervention targeting healthcare professionals to improve appropriate prescribing and dispensing of polypharmacy for older people in primary care.

Knowledge, Attitudes, Beliefs, and Practices Regarding Dengue in La Réunion Island, France.

Since 2017, La Réunion island has been facing a major epidemic of dengue. Despite actions carried out by the anti-vector control department, public authorities have failed to contain this epidemic. As individual involvement is key to success in vector control, we carried out a mixed-methods study on population knowledge, attitudes, beliefs, and practices (KABP) regarding dengue infection risk in La Réunion. The study combined quantitative data collected through a questionnaire administered to a representative sample of 622 people to assess the use of protective measures and the perception of severity and risk of dengue, and a sample of 336 people to assess the level of knowledge and concern about dengue, as well as qualitative data collected through semi-structured interviews among 11 individuals who had previously completed the questionnaire. The study results show that 63% of the surveyed population had a good level of knowledge associated with age, education, and socio-professional category variables-78% considered dengue to be a serious threat, and concern was estimated at 6/10, while 71% were likely to use protective measures. The interviews revealed contradictory behaviors in the implementation of recommended actions, in conflict with personal beliefs regarding respect of human body and nature. The study also revealed a loss of confidence in public authorities.

A Comparative Analysis of Health Impact Assessment Implementation Models in the Regions of Montérégie (Québec, Canada) and Nouvelle-Aquitaine (France).

Many countries have introduced health impact assessment (HIA) at the national, regional, or local levels. In France and in Québec, there is increasing interest in using HIA to inform decision-makers and influence policies, programs, and projects. This paper aims to compare HIA implementation models in two regions: Nouvelle-Aquitaine (France) and Montérégie (Québec, Canada) using a case study methodology. The objective is to gain a better understanding of the similarities and differences in the approaches used to achieve the operationalization of HIA. The methodological approach involves four steps: (1) design of an analytical framework based on the literature; (2) exchanges within the research team and review of documents concerning the two implementation strategies under study; (3) development of the case studies based on the proposed framework; and (4) cross-comparison analysis of the case studies. The findings show that the two regions share certain similarities, including the strong commitment and political will of the public health organizations involved and a well-established culture of engaging in intersectoral action with municipal partners. Differences mainly concern their different approaches to implementing HIAs in accordance with the regional policies and the organizational and administrative contexts in place. This study identifies potential avenues for supporting the practice of HIA at the municipal level.