Soutien à la recherche et concours Lauréat.e.s Concours publications 2019-2020 / Winners Publications competition
Découvrez les lauréat.e.s du concours de soutien à la production d'ouvrage scientifique 2019-2020. Winners of the 2019-2020 support for scientific production.
Belaid, Loubna (McGill University) et al.
“I can now sit down and discuss with my husband about our family issues”: Narratives of change experienced by participants in a home visit program to improve maternal health in Northern Nigeria
Une publication soutenue par le RRSPQ (central).
This paper describes the findings of the qualitative evaluation of perceived impact of the home visits. Using the most significant change technique, we collected stories of change in their lives attributed to the program among pregnant women, their spouses, and home visitors. We use the CASCADA behavior change model of intermediate outcomes from Conscious knowledge, through Attitudes, Subjective norms, intention to Change, Agency, Discussion, to Action (behavior change) to assess the stories. The stories of the visited pregnant women and their spouses reflected increases in conscious knowledge (for example about danger signs, and about adverse consequences of domestic violence and heavy work during pregnancy), and changes in intermediate outcomes, as well as actions, such as seeking help for danger signs and increased communication between spouses. The home visitors reported feeling more confident to advise pregnant women and to respond to the financial needs of their families. They also gained social recognition in their communities. The stories highlighted impacts of the home visits on the lives of participants and program workers, that go well beyond the specific aims of the program. They support the relevance of the CASCADA model for understanding the way in which the program changed behaviors.
Doyle, Carla (McGill University) et al.
Une publication soutenue par le RRSPQ (central).
We used latent class analysis to classify HIV-negative and -positive MSM based on prevention use and multinomial logistic regression to identify determinants of class membership. Participants were from the Montreal site of Engage, a Canadian cohort of MSM recruited by respondent driven sampling. We showed condoms are still widely used by Montreal MSM and affirmed that distinct groups of MSM using antiretroviral-based prevention have emerged. Between 84-93% of HIV-positive MSM had undetectable viral loads, suggesting treatment as prevention is a key strategy practiced. We also saw the rise of PrEP-sorting as a strategy used by HIV-positive MSM. We found PrEP itself to be a main strategy practiced by a small group of HIV-negative MSM. The overall level of PrEP use is likely too low to appreciably impact HIV transmission, so actions to increase PrEP-use in Montreal MSM are needed. We found PrEP-users had higher levels of education, which should be considered when planning the future delivery of PrEP and the reach of educational/promotional materials. The possible barriers to its access (e.g. the co-payment or forms of stigma) should be assessed. Also, reaching those unaware of their HIV-status for testing remains a priority, as it is extremely important for all HIV-positive MSM to be engaged in care.
Lanièce-Delaunay, Charlotte (McGill University) et al.
Une publication soutenue par le RRSPQ (central).
En utilisant les données d’enquêtes réalisées en 2005, 2009 et 2018 parmi les HARSAH vivant à Montréal, nous avons estimé la séroprévalence du VHC et ses tendances temporelles dans l’ensemble de la population et stratifiée par statut VIH, antécédents de consommation de drogues injectables, et groupe d’âge. Afin d’obtenir des estimés de séroprévalence comparables dans le temps, nous avons standardisé les échantillons de 2005 et de 2009 sur celui de 2018, déterminé selon les répondants (respondent-driven sampling). Par la suite, nous avons regroupé les données des trois échantillons afin d’identifier les facteurs sociaux, comportementaux et biologiques associés avec l’exposition au VHC au sein de cette population. Pour cela, nous avons utilisé un modèle de régression de Poisson modifié pour générer des ratios de prévalence. Nos résultats révèlent que la prévalence du VHC est stable parmi les HARSAH vivant à Montréal sur la période étudiée, autour de 8%. Nous avons toutefois observé des tendances divergentes en fonction de l’âge, avec une diminution de la séroprévalence chez les moins de 30 ans, et une augmentation chez les plus de 45 ans. Si les antécédents de consommation de drogues injectables sont fortement associés à l’exposition au virus, cela n’est pas le cas pour les comportements sexuels étudiés.
Mac-Seing, Muriel (ESPUM, UdeM) et al.
Une publication soutenue par les axes Politiques publiques et santé des population et Santé mondiale
Introduction : la revue systématique décrit les raisons conceptuelles et méthodologiques pour lesquelles elle est entreprise. Méthodologies : toutes les étapes de sélection, d’éligibilité et d’inclusion et d’extraction de 33 études à partir de 5454 citations, issues de neuf bases de données, ainsi que les outils utilisés pour évaluer la qualité des devis des études incluses. Résultats et Discussion : 33 études incluses et mises en place dans 19 pays en Afrique subsaharienne; la plupart des services SSR touchent les services de santé maternelle et surtout les femmes en âge de procréer; trois grandes populations en Afrique subsaharienne sont exclues (les jeunes, les PVVIH et les PH) et discussion des raisons potentielles; le manque de rigueur dans les devis quasi-expérimentaux adoptés dans les études; les limites de l’approche PICO pour répondre à des questions complexes en santé mondiale; et les implications futures pour la recherche et la mise en place de politiques publiques.
Rouleau, Geneviève (ULaval) et al.
Une publication soutenue par l'axe TIC & Santé
This viewpoint paper is an opportunity to make explicit the tacit knowledge that come from our personal experience in having codeveloped an innovative theory-informed virtual patient (VP) simulation to improve healthcare communication, supported by literature. Motivational interviewing (Miller & Rollnick, 2012) is the theory that informed the fine content of the intervention. It is a person-centered and collaborative communication style to elicit people’s own motivation and their commitment to change. The specific objectives of the paper are to describe: 1) The whole codevelopment processes and assumptions of a VP simulation; 2) its content and features; 3) the challenges encountered and the strategies used to overcome them. We used a collaborative and creative approach to codevelop the VP simulation, divided in two main processes: planning the codevelopment and designing the content, sequence and format of the intervention. The simulation is composed of a prebriefing, the simulated scenario (nurse-patient consultation), including patient’s electronic file, glossary as well as quizzes and feedbacks to promote learners’ active and transformative learning. Writing the whole scenario was the most challenging process because no guidance was available on how to create and translate pre-programmed interpersonal interactions between virtual nurse and patient based on the proficiency use of motivational interviewing. Communication remains a complex professional behaviour to address, especially in asynchronous interactions. Teamwork between two nurse-researchers and one project manager from the VP simulation team was the most important success element.
Sarmiento, Ivàn (McGill University) et al.
Une publication soutenue par les axes Éthique et Inégalités sociales de santé et équité.
Background: Cultural practices have an important role in shaping maternal health care, but their impact on health outcomes remains a matter of discussion. Fuzzy cognitive mapping (FCM) is a tool with relative cultural neutrality to represent indigenos knowledge systems around health issues. FCM contributes to incorporate local knowledge into evidence-based discussion of action. Methods: FCM uses graphs to represent factors causing or protecting around a helath issue. We describe the mapping sessions and context of participating traditional midwives. Then, we describe in detail the analysis procedure: thematic synthesis of factors, transitive closure to measure net influence of factors, and maps combination. Results: Traditional midwives described their definition of maternal health. The final maps show key risk (e.g. not following traditional self-care practices or gender violence) and protective (e.g. male support and care from traditional midwives) factors. Discussion: Evidence about the factors identified by traditional midwives is scarse and inconclusive. In spite of this, traditional perspcetives shape health practices among communities. Therefore, additional dialogue is needed to design cultyurally relevant actions. A main limitations of FCM is that it describes assumptions of causality but cannot confirm these assumptions. We discuss additional stengths and limitations of FCM. Conclusions: Results from FCM can inform future research on maternal health, for exaple, as prior knowledge for quantitative modeling or identifying key issues for qualitative inquiery.
