Developing evaluation capacities in integrated care projects: Lessons from a scientific support mission implemented in Belgium.

The capacity of self-assessment, to learn from experience, to make information-based decisions, and to adapt over time are essential drivers of success for any project aiming at healthcare system change. Yet, many of those projects are managed by healthcare providers' teams with little evaluation capacity. In this article, we describe the support mission delivered by an interdisciplinary scientific team to 12 integrated care pilot projects in Belgium, mobilizing a set of tools and methods: a dashboard gathering population health indicators, a significant event reporting method, an annual report, and the development of a sustainable "learning community." The article provides a reflexive return on the design and implementation of such interventions aimed at building organizational evaluation capacity. Some lessons were drawn from our experience, in comparison with the broader evaluation literature: The provided support should be adapted to the various needs and contexts of the beneficiary organizations, and it has to foster experience-based learning and requires all stakeholders to adopt a learning posture. A long-time, secure perspective should be provided for organizations, and the availability of data and other resources is an essential precondition for successful work.

From therapeutic patient education principles to educative attitude: the perceptions of health care professionals - a pragmatic approach for defining competencies and resources.

Educative attitude is an essential, if implicit, aspect of training to acquire competency in therapeutic patient education (TPE). With multiple (or nonexistent) definitions in the literature, however, the concept needs clarification. The primary aim of this study was to analyze the representations and transformations experienced by health care professionals in the course of TPE training in order to characterize educative attitude. We conducted an exploratory qualitative study using several narrative research-based tools with participants of two TPE continuing education courses. We then performed an inductive thematic analysis. Thirty-three people participated in the study; the majority were women (n=29), nurses (n=17) working in a hospital setting (n=28). Seven categories of statements were identified: time-related ("the right moment, how much time it takes"), the benefits of TPE (to health care professionals' personal well-being), emotions and feelings (quality of exchanges, sharing), the professional nature of TPE (educational competencies required), the holistic, interdisciplinary approach (complexity of the person and value of teamwork), the educational nature of the care relationship (education an integral part of care) and the ethical dimension (introspection essential). The first three components appear fairly innovative, at least in formulation. The study's originality rests primarily in its choice of participants - highly motivated novices who expressed themselves in a completely nontheoretical way. Health models see attitude as critical for adopting a behavior. Best TPE practices should encourage personal work on this, opening professionals to the social, experiential and emotional aspects of managing chronic illness.

Obese subjects involvement in a population-based survey: the use of information and communication technologies (ICT) to avoid stigmatization.

BACKGROUND: Epidemiological and health promotion studies in obese subjects are hampered by the difficulty of obtaining a representative sample from the community. The enrollment process can be at high risk of stigmatization. The purpose of this study is to describe an original information and communication technologies (ICT) strategy to get around these ethical and methodological difficulties. METHODS: A multimedia campaign of communication was organized on the topic of overweight and quality of life (QoL). A specific website was developed to collect via a questionnaire QoL data as well as information related to patient's needs and health perception from participants. To promote the website, multiple information supports were largely diffused. Primary care professionals were solicited to enhance the enrollment. The campaign started with a press conference covered by the main television channels. RESULTS: The ICT-based approach allowed the participation of 4,155 subjects homogeneously distributed with respect to body mass index, age, gender and socioeconomic level. A high percentage of subjects fully completed the web-based questionnaire. The press conference allowed reaching a quarter of the total sample within 5 days. CONCLUSIONS: Overweight remains a major public health problem. This survey showed that a holistic approach supported by ICT is a promising way to recruit obese subjects without stigmatizing the disorder.