Enabling the transferability of complex interventions: exploring the combination of an intervention's key functions and implementation.

OBJECTIVES: Several public health interventions are not described, not evaluated and not transferred. The objective was to assess the feasibility and acceptability of using a description model making a distinction between interventions' transferable elements, and those that are more context-specific, to make their evaluation and transferability easier. METHODS: The theoretical distinction between an intervention function and its form in a specific context has been empirically explored. A community-based intervention (named "Ciné-Ma-Santé") has been described, using a "key function/implementation/context" model. This process has been co-constructed through qualitative research and knowledge exchange process between project leaders and researchers from different disciplines. RESULTS: The use of the model proves feasible and useful for both project leaders and researchers. Nine key functions were described, as well as their implementation and the features of the intervention context. CONCLUSIONS: Rendering explicit key functions of public health interventions could constitute a useful step to their evaluation and transfer. It enables the formulation of hypotheses regarding the potentially standardizable elements of interventions, and elements that can be modified while maintaining the integrity of the intervention.

A health equity impact assessment umbrella program (AAPRISS) to tackle social inequalities in health: program description.

BACKGROUND: The failure to simultaneously address two objectives (increasing the average health of the population and reducing health inequalities) may have led to what has been observed in France so far: an overall decrease in mortality and increase in inequality. OBJECTIVE: The Apprendre et Agir pour Réduire les Inégalités Sociales de Santé (AAPRISS) methodology is to analyze and modify interventions that are already underway in terms of their potential impact on health inequalities. It relies on partnership between researchers and actors in the health field, as well as policy makers. In this paper, we describe the program and discuss its feasibility and acceptability. METHODS: This program is not a single intervention, but a process aiming at assessing and reshaping existing health programs, therefore acting as a kind of meta-intervention. The program develops scientific and methodological support stemming from co-construction methods aimed at increasing equity within the programs. Stakeholders from prevention policy-making and the health care system, as well as researchers, collaborate in defining interventions, monitoring their progress, and choosing indicators, methods and evaluation procedures. The target population is mainly the population of the greater Toulouse area. The steps of the process are described: (1) establishment of AAPRISS governance and partnerships; (2) inclusion of projects; and (3) the projects' process. DISCUSSION: Many partners have rallied around this program, which has been shown to be feasible and acceptable by partners and health actors. A major challenge is understanding each partner's expectations in terms of temporality of interventions, expected outcomes, assessment methods and indicators. Analyzing the projects has been quite feasible, and some modifications have been implemented in them in order to take inequalities in health into account.

[Interdisciplinarity in action: "trap-words" in interdisciplinary research]. / L'interdisciplinarité en action: les "mots-pièges" d'une recherche interdisciplinaire.

CONTEXT: Interdisciplinary work is essential to understand and address Social Inequalities in Health (SIH), but involves a number of practical difficulties. The AAPRISS programme, comprises project leaders and researchers from various disciplines in order to co-construct the reorientation of prevention projects, in order to more effectively reduce SIH. Certain challenges emerged during this project concerning the interdisciplinary work, especially misunderstanding of certain terms with different meanings according to various disciplines, within the same discipline, or even between British and US English. The objective is to identify these "trap-words" in order to create a glossary clearly explaining the various meanings, rather than rigidly defining a unique correct definition. METHODS: The words leading to misunderstandings were identified and several definitions were provided by participating researchers and literature searches. RESULTS: Five sets of words were defined: "politique, programme, projet et intervention"; "impact"; "ressortissant, public cible, population cible, bénéficiaire, et communauté"; "inégalités sociales de santé, disparités et iniquités"; and "protocole". DISCUSSION: Issues raised by the construction of this glossary, designed to support co-construction between researchers from different disciplines, allow reflection on the richness and difficulties of interdisciplinary research.