How to Evaluate Health in All Policies at the Local Level: Methodological Insights Within Municipalities From the WHO French Healthy Cities Network.

BACKGROUND: This article proposes a method for analysing the degree of maturity of Health in All Policies (HiAP) among World Health Organization-French Healthy Cities Network (WHO-FHCN) as part of the GoveRnance for Equity, EnviroNment and Health in the City (GREENH-City) project. We focused on the creation or enhancement of health-promoting environments, and more specifically, public green spaces. METHODS: We conducted a cross-sectional quantitative study guided by the evaluative framework of the HiAP maturity level developed by Storm et al mixed with a qualitative interpretation. A self-administered questionnaire was sent to elected officials and health department officers in the 85 member cities of the WHO-FHCN in 2017. Subsequently 58 cities were included in the analysis, which was based on a multiple correspondence analysis (MCA) and a hierarchical ascending classification (HAC). RESULTS: Thirty-two criteria among a total of 100 were identified and were used to organize the cities into 8 groups which was then reduced to three profiles among the cities: a less advanced HiAP profile, an established HiAP profile and an advanced HiAP profile. This process allows us to identify 4 dimensions that make it possible to evaluate the level of maturity of cities in the HiAP process, namely: (1) the consideration of social inequalities in health and/or health issues in the policies/actions of the sector studied, (2) occasional intersectoral collaboration, ie, one-off initiatives between the health department and others sectors, (3) the existence of joint projects, ie, common projects between two or more sectors, (4) the existence of intersectoral bodies, in this case on the theme of urban green spaces including an intersectoral committee and/or working groups. CONCLUSION: Four dimensions which allow to the measurement of the degree of progress in implementing health-all-policies are proposed. With a view to integrating knowledge into public action, this study carried out under real conditions offers a realistic method to evaluate HiAP.

[Links between mental disorders and the use of disability allowances and services in France] / Liens entre troubles psychiques et recours aux dispositifs du champ du handicap en France.

INTRODUCTION: The French social system offers many kinds of allowances and support (in work, everyday life and social life fields) to persons with disabilities. People with severe mental disorders are often considered as having less access than other disabled persons to the various forms of compensation offered by the national solidarity system. Purpose of research : Our objective was to study, for people with diverse kinds of mental disorders, those who are frequent users of support devoted to disability. METHODS: By proceeding to an ascending hierarchical classification from the data of the Disability and Health National survey of 2008-2009 and by studying the characteristics of these groups with regards to the available resources of the disability field we wished to clarify the determinants of recourse. RESULTS: Two groups who very frequently have both various kinds of mental disorders (including mental retardation) and physical disorders have a very high rate of using solidarity support linked to disability. A third group, whose recourse to the field of the disability system is less high without being negligible includes people with different medical and social profiles, having signs of social difficulties and physical troubles which may precede or follow their mental problems instead of belonging to a same complex pattern. CONCLUSIONS: This self-reported data survey inevitably comprises approximate data as regards to diagnoses and impairments, but no other survey brings such diversified information and it usefully highlights that people with mental disorders should not be considered has having only mental disorders as long as they use the French disability system.

Practices and representations of health education among primary school teachers.

AIMS: School is one of the key settings for health education (HE). The objectives of this study are to assess primary school teachers' self-reported teaching practices in HE and to describe their representation concerning their role in HE. METHODS: A quantitative study was conducted on a sample of primary school teachers (n = 626) in two French regions in order to analyze their practices and representations in HE. A hierarchical clustering dendogram was performed on questions exploring representations of HE. Multiple linear regression analysis helped explain the motivation and self-perceived competency score. RESULTS: Three quarters of the teachers declare they work in HE. Only one third of them declare they work in a comprehensive HE perspective. The HE approach is often considered in terms of specific unique curriculum intervention. Two thirds of the teachers say they work alone in HE, the other third associate other partners and choose mainly school health services. Parents are rarely (12%) involved in HE initiatives. It is essentially the practice of HE, teacher training and teachers' representation of HE that condition their motivation to develop HE. CONCLUSIONS: Teachers can take different approaches to HE. Teachers' representation of HE plays an important role in the development of HE activities: some teachers consider that HE is the mission of the health professionals and the parents. Our expectations of teacher involvement should be realistic, should take into account the representations of their role, the difficulties they encounter, and should be sustained by specific training.