Collaborative research and knowledge translation on road crashes in Burkina Faso: the police perspective 18 months on.

In this commentary, we present a follow-up of two articles published in 2017 and 2018 about road traffic crashes, which is an important public health issue in Africa and Burkina Faso. The first article reported on a research project, conducted in partnership with local actors involved in road safety, carried out in Ouagadougou in 2015. Its aim was to test the effectiveness, acceptability, and capacity of a surveillance system to assess the number of road traffic crashes and their consequences on the health of crash victims. Several knowledge translation activities were carried out to maximize its impact and were reported in the 2018 article published in HRPS: monthly reports presenting the research data, large-format printed maps distributed to the city's police stations, and a deliberative workshop held at the end of the research project. The present commentary presents our efforts to deepen our understanding of the impacts of the knowledge translation strategy, based on follow-up interviews, 18 months after the workshop, with the heads of the road traffic crash units in Ouagadougou police stations (n = 5). Several benefits were reported by respondents. Their involvement in the process prompted them to broaden their knowledge of other ways of dealing with the issue of road crashes. This led them, sometimes with their colleagues, to intervene differently: more rapid response at collision sites, increased surveillance of dangerous intersections, user awareness-raising on the importance of the highway code, etc. However, sustaining these actions over the longer term has proven difficult. Several lessons were derived from this experience, regarding the importance of producing useful and locally applicable research data, of ensuring the acceptability of the technologies used for data collection, of using collaborative approaches in research and knowledge translation, of ensuring the visibility of actions undertaken by actors in the field, and of involving decision-makers in the research process to maximize its impacts.

Partnership between patients, nurse leaders and researchers: Outcomes of a web-based KT strategy for hospital discharge planning and care transitions in oncology.

A research project brought together patient partners, nurse leaders from six clinical settings in Quebec and researchers to develop and test a web technology, the Forum for Knowledge Exchange (FKE), in order to improve discharge planning practices and oncological care transitions. The project led to the creation of a FKE accessible to the oncology sector of the Francophonie. It revealed an innovative strategy of knowledge transfer (KT) based on the FKE and was fed by collaborative work among partners, where the patient partners played a vital role. The results highlighted the importance, for health research, of giving a voice to patient partners in close collaboration with clinicians and researchers so that clinical practices are better adapted to the actual needs of patients and of their relatives.

Experiences and decisions that motivate women at increased risk of breast cancer to participate in an experimental screening program.

Although the discovery of mutations on BRCA1 and BRCA2 genes associated with high breast cancer risk has given rise to screening and surveillance initiatives, there is little documentation on why high-risk women choose to enter screening programs. The objective of this qualitative study was to develop a detailed understanding of the experiences and decisions that motivate women with increased risk of hereditary breast cancer to participate in the multicentered Quebec experimental breast screening program. Our study involved 21 participants who were either BRCA carriers or at risk and untested. These women were interviewed while participating in the screening program. Our study demonstrates that intensive screening programs may provide valuable reassurance for women with increased familial risk of hereditary breast cancer, who count on early detection and rapid response from professionals if and when a problem arises. Health professionals must take these and others concerns into account to ensure their interventions are most consistent with women's needs.

[The oncology care pathway and its transitions, an exploratory literature review]. / La trajectoire de soins oncologiques et ses transitions, revue exploratoire de la littérature.

A literature review was undertaken to describe the experience of people with cancer with regard to the different transitions of their care pathway. It enables all these transitions to be identified, documented and mapped out. The aim is to improve the quality of the care provided to this vulnerable population, all along the pathway.

[A partnership to favour patient self-determination in oncology]. / Un accompagnement partenarial pour favoriser l'autodétermination des patients en cancérologie.

Today's patients wish to establish a dialogue with the health professional and aspire to become partners in their care. A dedicated tool can help patients with cancer create such a partnership. Cooperative research to improve transitions in cancer care focused on this question.

[Comment on the perception of risk and its relationship to advancements in health knowledge]. / Comment l'analyse profane du risque peut-elle contribuer à l'avancement des savoirs en santé?

Since World War II, industrialized Western societies have been making significant public investments that have yielded spectacular improvements in the health status of their populations. Yet despite such considerable strides, it is nonetheless evident that lay peoples are expressing both more scepticism than in the past and greater mistrust toward medical science and biomedicine, even as they show increasing concern about health risks. In this article we intend to discuss some of the broader opportunities that the analysis of lay risk perceptions offers for appreciating the concerns of lay peoples about health-related issues as well as to provide new insights in population health.

When is knowledge ripe for primary care? An exploratory study on the meaning of evidence.

The objectives of this study were to explore the meaning of scientific evidence as it is understood by primary care physicians. Individual interviews were conducted with actors chosen for their roles in the production and use of knowledge: 22 family physicians, 13 specialist physicians, and 6 researchers. Two situations served as points of reference for these discussions: screening for genetic breast cancer and treatment of hypertension. The results suggest that there may be a misunderstanding between the producers of knowledge and primary care practitioners with respect to what constitutes "evidence"--knowledge ready for integration into the clinical practice of primary care. These potential differences go beyond the issues of how information is disseminated. Rather, many of the questions raised by family physicians concern how knowledge is developed. In the interests of fostering better dissemination of new knowledge and encouraging its adoption, new links should be created between knowledge "producers" and potential users.

Social context, the struggle with uncertainty, and subjective risk as meaning-rich constructs for explaining HBP noncompliance.

OBJECTIVE: To identify the reasons for which people fail to take blood-pressure-lowering medication regularly, a qualitative study was conducted. METHODS: Interviews lasting approximately 90 min were conducted with 27 patients (15 women, 12 men) aged 40-70. The verbatim of the 27 interviews was first read and divided into segments with explanatory value. This was followed by the production of a final text in vignette form for all interviews. An integrative, analytical phase consisted of identifying trends, significant central themes, regularities, and divergences in the vignettes. RESULTS: Analysis revealed the explanatory power that 3 broad groups of subjective meanings could hold for given medication noncompliance scenarios. These scenarios are expressing the role of: (1) stress and living conditions in the occasional skipping or deferral of medication-taking; (2) doubt as the motivating factor for transitory, irregular medication use; (3) subjective risk as the motivating factor for persistent irregular use. CONCLUSION: Life and social contexts, doubt and risk subsume extremely meaning-rich constructs that can help identify dilemmas facing people about medication-taking. PRACTICE IMPLICATIONS: By discussing these dimensions with their patients, health professionals will be better able to understand patient medication behaviors that sometimes run counter to their recommendations.

Expérience de fréquentation des lieux publics par des personnes âgées ayant subi un TCC en présence d'un accompagnateur-citoyen: projet pilote.

This pilot project aims to test and see the relevance of the direct observation method to collect data on the barriers and facilitators to attending public places by seniors with TBI. The study is based on the conceptual framework VADA WHO which focuses on the development of friendly built and technological environments for seniors. Three elderly people participated in the study, recruited from an ongoing project, The Citizen Intervention in Community Living (APIC), in the presence of their personalized attendant. The study shows the feasibility of the method in terms of its acceptability and resources mobilized. It shows its relevance to access additional data that would have been difficult to obtain using others methods (e.g., semi-structured interview), such as the identification of the strategies used by the participants to address the obstacles encountered (avoidance, travel planning, use of physical and preventative support of the personalized attendant).

[Partnership and renewal of a educational paradigm in nursing sciences]. / Partenariat et renouvellement du paradigme éducatif en sciences infirmières.

The Program of Interdisciplinary Family Surgical Procedures (PIFSP), is oriented towards the development of partnerships between families and nurses in order to respond to the specific needs of families with children suffering from health problems. It was implemented by the accumulation of information and expertise respective of the other and in regards to their relevance. A retrospective qualitative study on apprenticeships conducted with parents and nurses during a proposal by PIFSP shows at what point parents' and nurses' educational conduits are linked to faith, thought patterns, perception and behaviour, which corresponds to a specific conception of educational medical procedures in nursing science. This is part of the paradigm structure in educational and nursing science.

[Parents' satisfaction at the birth of a handicapped child following a family intervention]. / Satisfaction de parents à la naissance d'un enfant ayant une déficience lors d'une intervention familiale.

The aim of this study is to estimate parents' satisfaction following a surgical procedure on their child. This includes support as well as additional information and documentation for the individual parent (cognitive and emotional), conjugal, parental and other family members. The majority of parents are satisfied with the treatment program, realizing that the treatment enables them to adapt to their new situation, that is, as parents of a newborn child suffering from health problems. This support allows them to recognize and talk about their own fears and emotions as well as those of their partner, to be reassured when facing their child's treatment, and to better understand the available resources. The results of the study show that there are significant differences in regards to the sex of the parent, the diagnosis of the child and the level of income. Mothers of children inflicted with Down's syndrome are more emotionally satisfied with the treatment than fathers, and lower income families are more satisfied with the treatment as well as with the sub-system of family health-care than middle and upper-income families. Parents of children with a labial and/or palatine cleft are more satisfied with the treatment in regards to the family plan than parents of children with Down's syndrome. These results raise several questions that, with more profound deliberation on the adequacy of early medical procedures with regards to the parents of children with health problems, shall not be overlooked. Let us highlight the heuristic qualities of this evaluative approach which possess the same relevance as the questionnaires developed in order to assess the families' satisfaction. After modifications, these questionnaires could eventually be used on different clientele as well.

Patterns of health services utilization by recent immigrants.

This study was undertaken to analyze how the way young, recently immigrated, families utilize health services evolves over time. Twenty families participated in the study. They all included at least one child of preschool age, had immigrated less than 8 years previously, and had used primary healthcare services since their arrival. A triphasic pattern of utilization was observed, consisting of contact with one or more health services, selection of specific services from those available, and consolidation of choices. Families relied upon a variety of information sources in each of these phases. The primary attributes upon which the families based their evaluation, selection, and adoption of health services were geographical and temporal accessibility, interpersonal and technical quality of services, and language spoken by health professionals and staff. Perception of health services' attributes is influenced by the families' sociocultural referents and preemigration experience. Results indicate that utilization of primary healthcare services progressively changes over time, evolving from the ad hoc use of walk-in services to the adoption of regular sources of care.