Burnout among direct support workers of adults with autism spectrum disorder and intellectual disability.

BACKGROUND: Direct support workers (DSWs) accompany adults with autism spectrum disorder (ASD) and intellectual disability (ID) in residential care homes. Such DSWs, without specialised ASD training, are exposed to chronic stress linked to supporting ASD-ID clients and must adjust by coping strategies adapted to the needs of the residents. Nevertheless, difficulties adjusting constitute a burnout risk for DSWs, characterised by high levels of emotional exhaustion, depersonalisation and loss of a sense of personal accomplishment. We aimed to describe the burnout of DSWs who support adults with ASD-ID and to identify personal variables (experience and specialised training for ASD) and transactional variables (perceived stress and coping strategies) that could predict and mediate burnout. METHOD: In total, 125 DSWs accompanying ASD-ID adults on a daily basis were included. Each participant answered four questionnaires measuring burnout, sociodemographic and professional variables, coping strategies and perceived stress. RESULTS: Five per cent of DSWs were in a state of burnout. Eighteen, six and fifty-nine per cent showed high average scores of emotional exhaustion, depersonalisation and loss of a sense of personal accomplishment, respectively. Being older, specialised training in ASD, stress perceived as a challenge and problem-focused coping strategies were associated with low levels of depersonalisation and loss of a sense of personal accomplishment. CONCLUSIONS: Understanding the burnout process of ASD-ID DSWs may require the assessment of the organisational characteristics linked to the quality of life of the DSWs and the recognition of their specific needs when facing difficulties. The necessary ASD-focused training and support depends on an appraisal that would be individualised to adult ASD-ID DSWs.

Study protocol for a pragmatic cluster randomized controlled trial to improve dietary diversity and physical fitness among older people who live at home (the "ALAPAGE study").

BACKGROUND: Diet and physical activity are key components of healthy aging. Current interventions that promote healthy eating and physical activity among the elderly have limitations and evidence of French interventions' effectiveness is lacking. We aim to assess (i) the effectiveness of a combined diet/physical activity intervention (the "ALAPAGE" program) on older peoples' eating behaviors, physical activity and fitness levels, quality of life, and feelings of loneliness; (ii) the intervention's process and (iii) its cost effectiveness. METHODS: We performed a pragmatic cluster randomized controlled trial with two parallel arms (2:1 ratio) among people ≥60 years old who live at home in southeastern France. A cluster consists of 10 people participating in a "workshop" (i.e., a collective intervention conducted at a local organization). We aim to include 45 workshops randomized into two groups: the intervention group (including 30 workshops) in the ALAPAGE program; and the waiting-list control group (including 15 workshops). Participants (expected total sample size: 450) will be recruited through both local organizations' usual practices and an innovative active recruitment strategy that targets hard-to-reach people. We developed the ALAPAGE program based on existing workshops, combining a participatory and a theory-based approach. It includes a 7-week period with weekly collective sessions supported by a dietician and/or an adapted physical activity professional, followed by a 12-week period of post-session activities without professional supervision. Primary outcomes are dietary diversity (calculated using two 24-hour diet recalls and one Food Frequency Questionnaire) and lower-limb muscle strength (assessed by the 30-second chair stand test from the Senior Fitness Test battery). Secondary outcomes include consumption frequencies of main food groups and water/hot drinks, other physical fitness measures, overall level of physical activity, quality of life, and feelings of loneliness. Outcomes are assessed before the intervention, at 6 weeks and 3 months later. The process evaluation assesses the fidelity, dose, and reach of the intervention as its causal mechanisms (quantitative and qualitative data). DISCUSSION: This study aims to improve healthy aging while limiting social inequalities. We developed and evaluated the ALAPAGE program in partnership with major healthy aging organizations, providing a unique opportunity to expand its reach. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05140330 , December 1, 2021. PROTOCOL VERSION: Version 3.0 (November 5, 2021).

Action Control of Colorectal Cancer Screening Participation with fecal immunochemical test (FIT).

BACKGROUND: Most of the individuals concerned by colorectal cancer screening recognize the importance of screening participation. However, the screening rates for this cancer remain low in most countries, including France. Based on the action control framework, the present study aimed to (i) explore the distribution of intentions-behavior profiles toward colorectal cancer screening and (ii) to determine to what extent the profiles could be differentiated on theory of planned behavior (TPB) (i.e., attitudes, subjective norms, perceived behavioral control [PBC]) and self-regulation variables (i.e., action planning, coping planning). METHOD: A total of 149 participants from the general French population (M = 60 years, SD = 7.04) completed a questionnaire measuring TPB and self-regulation variables. Subsequent screening behavior was determined from medical records. Participants were notably categorized as non-intenders, unsuccessful intenders, or successful intenders. Data were analyzed using discriminant function analysis and analyses of covariance. RESULTS: Main findings revealed that 71% of the intenders were unsuccessful intenders. TPB and self-regulation variables were significantly correlated with the discriminant function (rs ≥ .40). Successful and unsuccessful intenders reported significantly higher levels of subjective norms, PBC, and coping planning than non-intenders (ps < .01). Successful intenders reported a significantly higher level of coping planning than unsuccessful intenders (p < .01). CONCLUSIONS: Further research appears necessary to empirically test to what extent interventions targeting subjective norms, PBC, and coping planning could enhance the proportion of successful intenders toward colorectal cancer screening.

The importance of using ordinal scores for patient classification based on health-related quality of life trajectories.

Changes in health-related quality of life (HRQoL) over time are not necessarily homogeneous within a population of interest. Our study aim was twofold: to determine homogeneous patient subpopulations distinguished by HRQoL trajectories, and to identify the particular patient profile associated with each subpopulation. To classify patients according to HRQoL dimension scores, we compared mixtures of linear mixed models (LMMs) classically applied to scores defined by the EORTC procedure, and mixtures of random effect cumulative models (CMs) applied to scores treated as ordinal variables. A simulation study showed that the mixture of LMMs overestimated the number of subpopulations and was less able to correctly classify patients than the mixture of CMs. Considering HRQoL scores as ordinal rather than continuous variables is relevant when classifying patients. The mixture of CMs for ordinal scores is able to identify homogeneous subpopulations and their associated trajectories. The application focused on changes over time in HRQoL data (collected using the EORTC QLQ-C30 questionnaire) from 132 breast cancer patients from the Moral study. Once the classification is obtained only from HRQoL scores, class membership was then explained through a logistic regression model, given a large panel of variables collected at baseline. Analysis of data revealed that deterioration over time of role functioning and insomnia was closely related to patient anxiety: anxiety at baseline is a prognostic factor for a poor level and/or a deterioration over time of HRQoL. For functional dimensions, large tumor size and high education level were associated with worse HRQoL scores.

Characteristics and impact of theory of planned behavior interventions on smoking behavior: A systematic review of the literature.

Theoretical frameworks such as the theory of planned behavior (TPB) can be applied to design and evaluate smoking behavior interventions. The present systematic review aimed to: (i) determine the characteristics of TPB-based interventions and their reported impact on smoking behavior and TPB variables, (ii) evaluate the level of methodological quality in the included studies, and (iii) assess the quality of the theoretical implementation. Studies were eligible for inclusion if the intervention targeted smoking behavior, was explicitly based on the TPB, and if smoking behavior or intention was measured at least at post-intervention. Relevant articles were identified through searches on databases and internet search engines, responses to messages sent on thematic forums, consultation of prominent authors, and manual searches on key websites and key TPB-publications. Seventeen studies met the inclusion criteria. A majority of studies (65%) targeted the student population (i.e., elementary school, high school, university). Interventions minimally included the provision of health messages. The proportion of studies that reported a significant impact on smoking behavior, intention, attitude, subjective norm, or PBC ranged between 42% and 50%. Regarding methodological quality, unclear or high risks of bias were notably found regarding the selection of participants, data collection methods, withdrawal and drop-outs, and blinding. Regarding theoretical implementation, the reciprocal link between intervention techniques and TPB variables targeted remain unclear for a majority of studies. To better inform tobacco prevention and TPB research, future studies should more systematically use rigorous methods when designing, implementing, and reporting TPB-based interventions.

Représentations du dépistage organisé du cancer colorectal : le point de vue des médecins généralistes.

OBJECTIVES: Various studies have shown that general practitioners (GPs) have a strong influence on adherence to organized screening for colorectal cancer. Faced with very low screening rates (29.8%), this study aims to apprehend the context of screening, the representations of GPs and the context of the arrival of new screening test in how to consider medical practice. METHODS: On the basis of a qualitative methodology, semi-structured interviews were conducted with 17 general practitioners in 2014-2015. A thematic content analysis was then performed. RESULTS: The doctors interviewed said that they discussed colorectal cancer screening quickly at the end of the consultation, along with other screening tests (mammography), due to lack of time and management of several reasons for consultation. GPs had very little information about the new test, so they had no specific expectations for the new test. The analysis revealed an inconsistency between the role that GPs feel they should play with patients in prevention and screening and the reality of their practice that leaves them little time to devote to it. CONCLUSIONS: A lack of information regarding the arrival of the new test and the difficulties associated with the organization of care has an impact on the representations of screening management. Setting up a consultation dedicated to prevention could be a prospect of improvement.

The "great live and move challenge": a program to promote physical activity among children aged 7-11 years. Design and implementation of a cluster-randomized controlled trial.

BACKGROUND: Recent population-based surveys have reported that large majorities of children in France, Europe and in the US are not complying with international physical activity (PA) guidelines. There is, therefore, a need to find programs that will improve children's PA habits from an early age. Theory-based interventions that include school, family, and community involvement have the potential to generate a considerable increase in the PA level of children. The theory of planned behavior (TPB) is one of the most widely tested models of the factors influencing health-related behaviors. The Great Live and Move Challenge (GLMC) is an extended TPB-based intervention designed to promote PA in French primary school children aged 7-11 years. The objective of this paper is to describe the protocol of a randomized controlled trial to evaluate the effectiveness of the GLMC on the PA level of children. METHODS: This is a two-year cluster-randomized controlled trial comparing an intervention group to a control group, randomized into clusters (community of communes) and stratified by department (Hérault, Gard, Aude) and residential environment (urban, rural). The goal is to recruit 4000 children. The GLMC involves children and their parents, and multiple local grassroots partners, such as school teachers, municipal officials and policy stakeholders. The intervention will be delivered over 3.5 months per year for a two-year period. Pre- and post-intervention, children and parents will be asked to fulfill a questionnaire concerning current PA level, TPB variables (i.e., intentions, attitudes, subjective norms, perceived behavioral control) and other psychosocial variables (e.g., perceptions of activity opportunities). A subsample of 400 children will be proposed to wear an accelerometer (i.e., the Actigraph GT3X+). The primary hypothesis is that the GLMC intervention will increase the proportion of children achieving the World Health Organization's recommended 60 min of moderate to vigorous PA per day by 15%. DISCUSSION: This study will evaluate the effectiveness of a multilevel, theory-based PA program and potentially provide valuable information for schools and public health officers looking for innovative PA programs. TRIAL REGISTRATION: ISRCTN:61116221 , 19/06/2018.

Coping strategies of parents of children with autism spectrum disorder: a systematic review.

To deal with stress, parents of children with ASD use coping strategies that help to tackle the challenging situations of raising their child. This systematic review examines parental coping strategy's questionnaires, factors which influence these coping strategies, interactions between these strategies and perceived stress and their impact on parental quality of life. According to PRISMA guidelines, an electronic search was conducted on Medline, PsycInfo and Eric: 156 articles were identified and 11 studies were selected. Many types of self-reported questionnaires were used to assess parental coping strategies. Studies highlighted that parents of a child with ASD used more avoidance strategies and less social support-seeking strategies than those of typical children. Furthermore, problem-focused coping protects parental stress and quality of life, that on the contrary, emotion-focused coping is a risk factor for alteration. Our systematic review illustrates the need to adapt psychoeducational interventions for parents of children with ASD.

Quality of life, fatigue and changes therein as predictors of return to work during breast cancer treatment.

PURPOSE: To our knowledge, only one study has assessed Quality of Life (QOL) as a predictor of return to work (RTW) during breast cancer treatment and one has evaluated multidimensional cancer-related fatigue (CRF) as a determinant of RTW. However, no study has assessed the impact of changes in these variables on RTW. The objective of this study was to evaluate QOL, multidimensional CRF and changes in these variables as determinants of RTW during breast cancer treatment. METHODS: We performed a longitudinal study of 68 patients with a mean age of 46.97 years (SD = 6.92), who were employed at the time of diagnosis. Women were assessed at the beginning of adjuvant treatments (T0) and followed up with by telephone at three (T1) and 6 months later (T2), using questionnaires (QLQ-C30; MFI-20). RESULTS: Global QOL, OR = 1.12 [1.01-1.25], sleep disturbance, OR = 1.04 [1.002-1.08], fatigue (QLQ-C30), OR = 0.93 [0.88-0.99], nausea-vomiting, OR = 0.84 [0.73-0.97], reduced motivation, OR = 1.49 [1.05-2.11] and general fatigue, OR = 0.79 [0.63-0.99] at T0 were associated with RTW at T1. At T2 global QOL, OR = 1.09 [1.01-1.17], cognitive functioning, OR = 1.10 [1.03-1.17], general fatigue, OR = 1.82 [1.04-3.17] and mental fatigue, OR = 0.29 [0.11-0.81] were associated with RTW. Furthermore, changes in mental fatigue were associated with RTW at T2, OR = 0.02 [0.001-0.29]. CONCLUSIONS: Quality of life, fatigue and their changes in them, especially cognitive functioning and mental fatigue, can play an important role in predicting the RTW of women with breast cancer. This confirms the importance of multidisciplinary care for cancer and the emergence of a theoretical psychological model of RTW.

[Representations of colorectal cancer screening: the GPs point of view] / Représentations du dépistage organisé du cancer colorectal : le point de vue des médecins généralistes.

OBJECTIVES: Various studies have shown that general practitioners (GPs) have a strong influence on adherence to organized screening for colorectal cancer. Faced with very low screening rates (29.8%), this study aims to apprehend the context of screening, the representations of GPs and the context of the arrival of new screening test in how to consider medical practice. METHODS: On the basis of a qualitative methodology, semi-structured interviews were conducted with 17 general practitioners in 2014-2015. A thematic content analysis was then performed. RESULTS: The doctors interviewed said that they discussed colorectal cancer screening quickly at the end of the consultation, along with other screening tests (mammography), due to lack of time and management of several reasons for consultation. GPs had very little information about the new test, so they had no specific expectations for the new test. The analysis revealed an inconsistency between the role that GPs feel they should play with patients in prevention and screening and the reality of their practice that leaves them little time to devote to it. CONCLUSIONS: A lack of information regarding the arrival of the new test and the difficulties associated with the organization of care has an impact on the representations of screening management. Setting up a consultation dedicated to prevention could be a prospect of improvement.

Fasting and weight-loss restrictive diet practices among 2,700 cancer survivors: results from the NutriNet-Santé cohort.

Nutrition is often used by cancer survivors as a lever to take charge of their own health. However, some dietary behaviors are not currently recommended for patients without medical supervision. Our study aimed at evaluating weight-loss restrictive diets and fasting practices among cancer survivors of the NutriNet-Santé cohort, as well as related socio-demographic and lifestyle factors. In October 2016, 2,741 cancer survivors had completed a specific questionnaire about their practices. Fasting and non-fasting patients (respectively dieting and non-dieting) were compared using logistic regression models. Analyses were weighted according to the age, gender, and cancer location distribution of French cancer cases. 13.8% had already practiced weight-loss restrictive diet as their diagnosis. They were more likely to be women, professionally active, overweight/obese, to use dietary supplements and to have breast cancer (all p < 0.05). 6.0% had already fasted, 3.5% as their diagnosis. They were more likely to be younger, with higher educational level, higher incomes, professionally active, to have a healthy weight, and to use dietary supplements (all p < 0.05). Fasting was associated with the opinion that such practice could improve cancer prognosis (p < 0.0001). Patients who received nutritional information from health care professionals were less likely to practice fasting or weight-loss restrictive diet (0.42[0.27-0.66], p < 0.0001 and 0.49[0.38-0.64], p < 0.0001 respectively). Our study provided original results suggesting that weight-loss restrictive diets are widely practiced by cancer survivors. Fasting was less common in our study though non negligible. Sources of nutritional information received as cancer diagnosis seemed to be a key determinant of these practices.

Preventing tobacco in vocational high schools: study protocol for a randomized controlled trial of P2P, a peer to peer and theory planned behavior-based program.

BACKGROUND: In France, the issue of youth smoking remains a major challenge for public health. School failure, socio-economic and socio-cultural backgrounds influence the initiation and maintenance of smoking behavior in adolescents. Vocational students are at particularly high risk of using psychoactive substances, including tobacco. One of the most important factors is the environment, whether family, friends or peers. Therefore, peer education has a positive potential to change smoking behavior of adolescents. It has also been demonstrated that the Theory of Planned Behavior (TPB) has yielded the best prediction of intentions and behavior, in several health domains, including on tobacco. However, it is usually confined to the measurement of processes by which interventions change behavior, rather than to the development of these interventions. The objective of this paper is to describe the protocol for a randomized controlled trial of a peer intervention based on the TPB on a highly exposed young population. METHODS/DESIGNS: This is a cluster randomized controlled trial comparing an intervention group to a control group, randomized into clusters (professional schools and classes) and stratified in three departments (Hérault, Aude and Gard) in the Languedoc-Roussillon region. The primary issue is the prevalence of daily smoking at 24 months, defined by a daily tobacco use of at least 1 cigarette, validated by CO levels in exhaled air. The primary hypothesis is that intervention will lead to decrease the daily smoking prevalence of 10% between the intervention group and the control group during a 2-year follow-up. DISCUSSION: The results from this trial will provide evidence on the effectiveness of an innovative peer-to-peer intervention based on the TPB. TRIAL REGISTRATION: ISRCTN: 37336035 , Retrospectively registered 11/12/2015.

Impact and Moderating Variables of an Intervention Promoting Physical Activity Among Children: Results From a Pilot Study.

This pilot study pursued three objectives: to assess the effect of a 1-month multilevel intervention on the PA of children, to assess the impact of the intervention on the theory of planned behavior (TPB) variables, and to evaluate the extent to which the impact of the intervention on PA and TPB variables varied according to personal (i.e., gender and age) and situational (i.e., class and school) moderating variables. Children were aged 7 to 11 years ( n = 306). Analyses revealed a significant increase of PA practice and TPB variables ( ps < .001). Age (i.e., being a younger child) was associated with a higher increase on attitude and perceived control ( ps < .01). The class or the school levels explained a meaningful variance in the evolution of PA or TPB variables (intraclass correlation coefficients > .10). The present study reports the interest and feasibility of a multilevel intervention to increase PA and TPB variables in children.

Subjective Lexical Characteristics: Comparing Ratings of Members of the Target Population and Doctors for Words Stemming from a Medical Context.

The present study investigated the subjective lexical characteristics of words stemming from a medical context by comparing estimations of the target population (age range = 46-89) and of doctors. A total of 58 members of the target population and 22 oncologists completed measures of subjective frequency and emotional valence for words previously collected in interviews of announcement of cancer diagnosis. The members of the target population also completed tests of word definitions, without and within context. As expected, most of the words were rated less familiar, more negative and as generating more intense emotions to the target population than to the doctors. Moreover, only a few words were correctly defined by the target population. Adding a context helped the participants to define most of the words correctly. Importantly, we identified words that were rated familiar by the patients although they did not know their exact meaning. Overall, these results highlight the importance of taking into account the subjective lexical characteristics of words used in specific contexts.

Promoting Physical Activity among Children: The "Great Live and Move Challenge" / Promouvoir l'activité physique des enfants : Le « Grand Défi Vivez Bougez ¼.

Objective: The "Great Live and Move Challenge" (GLMC) is an intervention designed to promote physical activity (PA) in schools and the community among 6- to 11-year-old schoolchildren and their families.Method: This project, implemented in the Montpellier and Pays Coeur d'Hérault regions since 2013, encourages children to quantify their daily PA level by illustrating each 15 minutes of exercise by an "energy cube". Based on collaboration between pilots, teachers and policymakers, this project is implemented over a 6-week period in schools, municipalities and recreation centres. "Great Challenge" events are organized to promote PA. The GLMC is also a theory-based intervention based on the tenets of the planned behaviour theory.Results: Since the 2014-2015 edition, 2,243 children have taken part in the GLMC and have accumulated 391,102 "energy cubes". In addition, more than 30 "Great Challenge" events have been organized. Since its launch during the 2012-2013 school year, the numbers of children who have taken part in the GLMC have been multiplied by 5.58. The mean number of daily "energy cubes" accumulated by children has increased from 4.04 in the first year to 6.22 in 2014-2015.Conclusion: The "energy cube" can provide a measure of the commitment of children and their surrounding community in a comprehensive approach to PA promotion.

Dyadic effects of coping strategies on emotional state and quality of life in prostate cancer patients and their spouses.

BACKGROUND: During cancer, coping strategies adopted by patients with prostate cancer and their spouses have an effect on their own emotional state and quality of life (QoL). However, the effects of coping strategies used by a member of a couple on the well-being of the other member are unknown. The aim of this study is to examine the dyadic effects of coping strategies on the emotional state and QoL of couples dealing with cancer. METHODS: Ninety-nine couples completed various self-questionnaires to assess psychological and physical QoL, anxiety, depressive symptoms, and coping strategies at the beginning, middle, and end of primary treatment. RESULTS: Results obtained with the actor-partner interdependence model showed that coping strategies used by patients or spouses play a key role not only in their own well-being but also in their partners'. Indeed, when patients use problem-focused coping or social support-seeking, they, as well as their spouses, experience fewer anxiety and depressive symptoms. Conversely, patients or spouses who use emotion-focused coping experience higher levels of anxiety and depressive symptoms. Finally, and it is a surprising result, when spouses seek social support, patients feel greater anxiety. CONCLUSIONS: These findings suggest that both patients and spouses should be included in psychosocial programs, which develop and reinforce their ability to cope with cancer. Couples may benefit from membership in support groups allowing them to share their experiences.

Effect of a peer-led prevention program (P2P) on smoking in vocational high school students: Results from a two-school-year cluster-randomized trial.

AIMS: The aim of this work was to measure the impact of P2P (i.e. peer-to-peer), a peer-led smoking prevention intervention, on daily smoking prevalence of adolescents over 2 school years. DESIGN: A cluster-randomized controlled trial was performed over a 16-month follow-up (trial status: closed to follow-up). P2P was implemented 1-3 and 13-15 months after baseline. Assessments took place at baseline and 4, 10 and 16 months after baseline. The research team, assessors and adolescents were blinded to the study-arm assignment only at baseline. SETTING: Fifteen vocational high schools in France were randomized into two clusters, using a 1:1 allocation ratio per French department (n intervention = 7, n control = 8). PARTICIPANTS: Participants comprised a sample of 2010 students in year 11 (i.e. 15-16 years) in vocational high schools. A total of 437 students could not be assessed at baseline (absent or left school), yielding a total sample of 1573 students (n intervention = 749, n control = 824). INTERVENTION AND COMPARATOR: The P2P programme trained voluntary students to become peer educators and design smoking prevention actions for their schoolmates in the intervention group (n = 945 students), compared with a passive control group (n = 1065 students). MEASUREMENTS: The primary outcome was change from baseline in the prevalence of self-reported daily smoking (i.e. at least one cigarette per day) at 16 months. FINDINGS: The 'time × group' interaction indicated that, compared with the control group, the intervention group had statistically significantly fewer daily smokers after 16 months [odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.20, 0.53]. Similarly, compared with the control group, the intervention group had statistically significantly fewer daily smokers after 4 months (OR = 0.50, 95% CI = 0.30, 0.82) and 10 months (OR = 0.60, 95% CI = 0.37, 0.98). No adverse events of P2P2 were reported. CONCLUSIONS: A cluster-randomized trial found evidence that the peer-led P2P (peer-to-peer) smoking prevention intervention reduced the uptake of daily smoking among high school students in France over 16 months.

Epidaure Market-Effectiveness and transferability of a school-based intervention to improve healthy and sustainable food choices by schoolchildren: Protocol of a randomized controlled trial and qualitative study.

CONTEXT: At least 40% of cancers are linked to environmental or behavioral factors, and dietary behavior appears to be a major lever. Epidaure Market is a prevention initiative developed using a method for co-constructing health promotion initiatives and prevention programs that stratifies evidence from the scientific literature and combines it with experiential knowledge (DEVA, TPB, BCT). It promotes a sustainable diet (i.e., healthy, ecological and ethical nutrition) among 5th and 4th grade students during the crucial period of adolescence, when these behaviors are often far from the recommendations. METHOD: The protocol implemented was carried out in 72 middle school classes in the Montpellier and Dijon academies. The intervention included teaching sessions and a virtual supermarket game, integrated into the school curriculum and delivered by science teachers. Effectiveness is tested in a cluster randomized controlled trial with 3 evaluation times (pre- and post-intervention and 1 follow-up). The study also includes an implementation assessment, with process analysis and implementation elements, as well as a transferability assessment based on key functions (FIC model and Astaire grid). EXPECTED OUTCOMES: The study is still underway within the school. The primary expected outcome is a positive influence on the motives underlying food choices to move towards a sustainable diet. Secondary expectations involve changes in variables such as self-efficacy and perceived social norms, as well as an increase in knowledge about healthy eating. We also expect the qualitative approaches to provide information on the deployment process in the new territories. DISCUSSION: The study aims not only to demonstrate the effectiveness of Epidaure Market, but also to identify the optimal conditions for its nationwide implementation in France's middle schools. Ultimately, the initiative aims to help reduce the incidence of cancer by promoting healthier eating habits among teenagers.

Are psychosocial factors associated with quality of life in patients with haematological cancer? A critical review of the literature.

BACKGROUND: Haematological cancers differ from other cancers mainly with regard to treatment strategies: surgery is used for diagnostic purposes but rarely for treatment, whereas chemotherapy is of central importance and, in some cases, cures patients. This article reviews studies that examine the relationships between psychosocial factors and quality of life (QoL) in haematological cancer patients. METHODS: A review of the literature was conducted from the databases 'PsycInfo', 'Medline' and 'Science Direct' using the keywords 'lymphoma', 'leukaemia', 'myeloma', 'quality of life', 'psychosocial factors', 'coping', 'social support', 'personality', 'anxiety,' 'depression', 'locus of control' and 'alexithymia'. RESULTS: Fourteen studies were analysed. One study found positive relationships between sense of coherence and health-related QoL, whereas another showed a positive link between self-esteem and QoL. Another study suggested that a high external health locus of control was related to a better QoL. Fighting spirit had a positive impact on QoL for two studies, and helplessness-hopelessness was positively related to emotional distress in one study. Two studies indicated the relationships between emotional distress and QoL. Satisfaction with information about disease determined emotional distress in another study. Social support, general health perceptions, global meaning or spirituality were found to improve QoL in four other reports. CONCLUSION: Literature about the relationships between psychosocial factors and QoL is lacking. Sense of coherence, self-esteem and health locus of control, coping strategies, social support, global meaning or emotional distress are associated with QoL. Results concerning coping and social support should be interpreted with caution because of level II evidence in studies.