A postpartum intervention for vaccination promotion by midwives using motivational interviews reduces mothers' vaccine hesitancy, south-eastern France, 2021 to 2022: a randomised controlled trial.

BackgroundDespite childhood vaccine mandates imposed in 2018 in France, parental vaccine hesitancy (VH) remains frequent. Interventions in Quebec, Canada, applying motivational interviewing (MI) techniques have successfully reduced parents' VH for childhood immunisations.AimTo determine whether MI intervention for mothers in maternity wards in the days after birth in France could significantly reduce VH, increase intentions to vaccinate (VI) their child at 2 months and reduce VH social inequalities.MethodsWe conducted a parallel-arm multicentre randomised controlled trial from November 2021 to April 2022 to compare impacts of MI performed by MI-trained midwives (intervention) vs a vaccination leaflet (control). We included 733 mothers from two maternity hospitals in south-eastern France, randomly assigned either arm. The validated Parents Attitudes about Childhood Vaccines questionnaire was used before and after MI or leaflet to assess mothers' VH (13 items, 0-100 score) and VI (1 item, 1-10 score). Difference-in-difference (D-I-D) models were used to estimate net impact of MI vs leaflet for the entire sample and stratified by VH and education level.ResultsMotivational interview intervention reduced mothers' VH score by 33% (p < 0.0001) and increased VI by 8% (p < 0.0001); the effect was largest for the highest initial VH levels. D-I-D analyses estimated net VH decrease at 5.8/100 points (p = 0.007) and net VI increase at 0.6/10 points (p = 0.005). Net VH decrease was highest for high initial VH levels and low education levels.ConclusionsOur results show positive effects of MI intervention, and means of its implementation should be investigated in France.

Rôle d'un centre ressources en prévention, promotion et éducation pour la santé dans le cadre d'une crise sanitaire.

The COVID-19 pandemic outbreak has had massive consequences on health care systems. At the same time, the health crisis caused an overabundance of information. Access to accurate and verified information became crucial to professionals and the population to understand the epidemic and the prevention measures. In this context, the Regional health education committee of Provence-Alpes-Côte d'Azur (CRES), health promotion and education resources center, played its role as a health public actor by getting involved in a transfer of knowledge through the creation of 3 tools: a newsletter, an audio recording collection and a training program. It also transformed its regular activities by using digital solutions.This article describes the necessary adaptation to an unprecedented situation by creating new activities and adjusting usual ones to a complex context. It also shows how these activities were relevant and met the need of the professionals.The evaluation results prove that the provided tools were pertinent: the need of the professionals to access clear and scientifically proven information was satisfied. The CRES acted as an essential participant from the beginning of the crisis by making access to information easier.New needs related to the epidemic are nowadays spotted and are today's new concrete perspectives for the CRES activities.

[COMETE: a tool to develop psychosocial competences in patient education]. / COMETE : un outil pour développer les compétences psychosociales en éducation thérapeutique du patient.

This article presents a detailed description of the development and use of the COMETE tool. The COMETE tool is designed to help medical teams identify, develop or evaluate psychosocial skills in patient education and counselling. This tool, designed in the form of a briefcase, proposes methodological activities and cards that assess psychosocial skills during a shared educational assessment, group meetings or during an individual evaluation. This tool is part of a support approach for medical teams caring for patients with chronic diseases.

Therapeutic education unit for heart failure: setting-up and difficulties. Initial evaluation of the I-CARE programme.

BACKGROUND: Education programmes are required in chronic diseases. The insuffisance cardiaque : éducation thérapeutique (I-CARE) programme was developed in France to promote the setting-up of therapeutic education units for chronic heart failure. AIM: To evaluate the setting-up of such units, assessing the influence of training on the creation and organization of the unit, the problems encountered and the contribution of the dedicated educational tools. METHODS: We submitted a questionnaire to the first 136 trained centres. The questionnaire was divided into two sections: one section dealing with educational practices and the other with the advantages and disadvantages of the tools provided. RESULTS: The participation rate reached 69.1%. Seventy-four centres (78.7%) declared themselves to be active in therapeutic education. Unit educational activities determined an educational diagnosis (89.2% of the centres) and provided education by means of collective workshops (73.0%) or one-to-one teaching sessions (75.7%). A complete education programme for a patient consisted of a median of four sessions (25th-75th percentile, 2-5 sessions) and lasted for a median of 6 h (25th-75th percentile, 4-10 h). The education team was multidisciplinary and usually included a nurse (93.2%), a dietician (78.4%), a cardiologist (71.6%) and a physiotherapist (40.5%). Heart failure educational tools were used only in part in most centres (89.2%). All advantages and disadvantages were recorded. CONCLUSION: This first evaluation of the setting-up of therapeutic education units in the I-CARE programme has yielded promising results, despite expected difficulties. The effects of therapeutic education on the behaviour of heart failure patients remain to be determined.