Girl-boy differences in perceptions of health determinants and cancer: a more systemic view of girls as young as 6 years.

Introduction: To model and analyze the differences between girls' and boys' conceptions of the determinants of health and cancer, as expressed and perceived by children and adolescents. Method: A multicentric qualitative study was conducted in five schools (ages 6-11 years), four middle schools (ages 11-15 years), and three high schools (ages 15-18 years). A multi-phase protocol (phase 1 uses the e.Photoexpression© and phase 2 uses the Photonarration) enables children and teenagers to express themselves through photography and storytelling. Results: A total of 4,174 qualitative productions were produced by 1,068 children, of which 47% were girls and 53% were boys, all in the ages of 6-18 years. From the results of the productions, it can be noticed that children mentioned and were aware of 30 determinants of health and cancer. The three determinants most mentioned were "Consumption of psychotropic drugs", "Diet", and "Harmful environment". Among these 30 determinants, some were mentioned to a greater or lesser extent by girls and boys. These significant gender differences are present for 20 determinants of health and cancer. These differences evolve with age: (1) In elementary school (ages 6-11), girls gave significantly more importance (p < 0.05) to 11 determinants, while boys attached significantly more importance (p < 0.05) to 2 determinants. (2) In middle school (ages 11-16), girls gave significantly (p < 0.05) more importance to 12 determinants, while boys gave significantly (p < 0.05) more importance to one determinant. (3) In high school (ages 15-18 years), girls gave significantly (p < 0.05) more importance to 13 determinants. There was no significant difference (p < 0.05) in favor of boys for high school students. Girls also have a more systemic view of health determinants than boys. The increase in the number of determinants cited by girls is significant (p = 0.017) between the ages of 6-11 and 15-18 years. This gap widens with age (+1.45 determinants) for girls and (+0.68 determinants) for boys between elementary school and high school. Conclusion: The determinants identified as predominantly female or male, as well as age-related specificities, constitute a resource for effective preventive action, as close as possible to the needs and particularities of a population. This mapping of people's conceptions could provide a decision-making aid in defining the strategic orientations of prevention policies.

Modelling the determinants of health and cancers as perceived by children: using imagery as a mediator of expression and narration.

OBJECTIVES: To model and analyse conceptions of determinants of health and cancer that are expressed and perceived by school children aged 6-11 based on a multiphase qualitative protocol. METHODOLOGY: This is a multicentric, qualitative study of human and social sciences conducted among school children aged 6-11 years old. Two different tools were used, e.Photoexpression and Photonarration, in four French schools. This innovative and exploratory method addresses global health during the first phase (e.Photoexpression) and the theme of cancer during the second phase (Photonarration). The children express themselves through photography and narration. RESULTS: 1498 qualitative productions were made by 381 children aged 6-11 years old. The analysis of these productions of expression and narration through images allowed modelling of determinants of health and cancer as perceived by children through 7 fields and 28 categories. The conceptions of determinants of health and child cancer refer to rationalities that are centred on individual determinants (76%), minimise environmental determinants (20%) and conceal the parameters of access to healthcare and social services (3%). DISCUSSION: These findings provide new data to the international literature on children's perceptions of determinants of health and cancer. These research findings, which can be applied to interventions and current practices, will enable prevention workers to act more effectively, closer to children's perceptions and needs.

Global Health Determinants Perceived and Expressed by Children and Adolescents Between 6 and 17 Years: A Systematic Review of Qualitative Studies.

Aim: To identify the determinants of global health in the literature as perceived and expressed by children and adolescents in order to adapt prevention actions to this young audience. To also question the pertinence of a qualitative approach when interviewing children. Method:Systematic review of the literature from PubMed, Google Scholar, CINAHL, PsycINFO databases. The studies selected used qualitative methods alone for investigating the views of health determinants in children and adolescents. Results:185 articles were read to reach a final selection of 13 articles on global health, excluding studies with children who were ill, studies using quantitative, mixed, or retrospective methodologies, and those dealing exclusively with themes of health. Collecting information from children and adolescents showed the pertinence and effectiveness of qualitative methods. It also appears necessary to explore new paths: improving and adapting the tools and methodological supports used and combining them to enrich repositories. Conclusion:The small amount of qualitative data available with the views of children and adolescents on health determinants requires that new studies with better adapted collection methodologies be set up. To increase pertinence and effectiveness among a young audience, it is necessary, considering the methodologies identified during this literature review, to turn toward a multi-phase method that combines these methods. A methodology in several phases allows each one to use a different approach with young people and to obtain richer and more varied information. A corpus of images appeared as a powerful tool for collection: it facilitates children's capacity for oral expression and places the researcher in a position of listening.