De la recherche en collaboration à la recherche communautaire. Un guide méthodologique (From collaborative research to community-based research. A methodological toolkit)

Paris, ANRS/Coalition Plus (coll. Sciences sociales et sida)Intitulé " De la recherche en collaboration à la recherche communautaire. Un guide méthodologique " et édité dans la collection " Sciences sociales et sida " de l'ANRS, cet ouvrage alimente de manière inédite le partage d'expériences et la réflexion sur la fabrication de la recherche dans ses aspects les plus concrets. Guide méthodologique innovant de par son ancrage dans le domaine de la recherche communautaire - recherche guidée par les besoins des communautés, répondant à des problématiques de terrain et effectuée dans l'action, avec les principes de participation et de collaboration communautaires -, il constitue un précieux outil pour tous ceux qui s'engagent dans des recherches en collaboration et éveillera l'intérêt de ceux qui ne s'y sont pas encore essayés, qu'ils soient chercheurs, cliniciens ou acteurs de terrain

PAPRICA : un dispositif de formation participatif et collaboratif au service de la santé publique

International audienceCette contribution a pour objectif de présenter l’évaluation du pilote d’un dispositif de formation médicale continue (PAPRICA) à destination des médecins généralistes, visant à faire évoluer leurs représentations et leurs attitudes vis-à-vis de la vaccination contre les infections par les virus du papillome humain (VPH). Ce dispositif est un module d’apprentissage collaboratif, devant permettre le développement - à travers les interactions des participants et leur décentration - d'un conflit sociocognitif aboutissant à une transformation de leurs représentations professionnelles vis-à-vis de la vaccination contre les VPH. Les postulats conceptuels, ainsi que les caractéristiques de ce module d’apprentissage collaboratif (population cible, matériel, déroulement, modalités d’évaluation) sont ici détaillés

Factors associated with HIV voluntary disclosure of people living with HIV to their steady sexual partner in the Democratic Republic of the Congo: results from a community-based participatory research

Introduction: HIV disclosure to a steady sexual partner (SSP) is important both in preventing HIV transmission and improving the quality of life of people living with HIV (PLHIV). “Its determinants have been poorly investigated in the Democratic Republic of the Congo.” The study objective was to determine factors independently associated with voluntary disclosure to one's SSP in PLHIV receiving services from a Congolese community-based organization (CBO). Methods: a community-based participatory research was performed and 300 PLHIV were interviewed by members of the CBO, using a standardized questionnaire. A multivariate logistic regression was used to determine the variables independently associated with disclosure. Results: in this sample, 79 of the 127 participants (62%) included in the analysis declared having voluntarily disclosed their serostatus to their SSP. Declaring to be in a relationship (Odds Ratio (95% Confidence Interval): 4.2 (1.4-12.6)), having tested for HIV because of symptoms (2.5 (1.0-6.4)), having taken the test on one's own initiative (3.2 (1.3-8.0)), having felt sympathy and indifference from people when disclosing (6.0 (1.4-26.9) and 5.0 (1.1-22.8), respectively) as well as having a higher score of the "regular discussion about daily life with HIV" index (1.7 (1.1-2.5)) were significantly associated with disclosure to one's SSP. Conclusion: several individual and contextual factors were associated with voluntary disclosure to SSP in this study, highlighting the complex nature of the disclosure process. Interventions encouraging disclosure should be designed "so as to adapt to one's personal life with HIV as well as psychosocial environment"

Analysing breast cancer survivors' acceptance profiles for using an electronic pillbox connected to a smartphone application using Seintinelles, a French community-based research tool.

peer reviewedIntroduction: Up to 50% of breast cancer (BC) survivors discontinue their adjuvant endocrine therapy (AET) before the recommended 5 years, raising the issue of medication non-adherence. eHealth technologies have the potential to support patients to enhance their medication adherence and may offer an effective way to complement the healthcare. In order for eHealth technologies to be successfully implemented into the healthcare system, end-users need to be willing and accepting to use these eHealth technologies. Aim: This study aims to evaluate the current usability of eHealth technologiesin and to identify differences in BC SURVIVORS BC survivors accepting a medication adherence enhancing eHealth technology to support their AET to BC survivors that do not accept such a medication adherence enhancing eHealth technology. Methods: This study was conducted in 2020 including volunteering BC survivors belonging to the Seintinelles Association. Eligible participants were women, diagnosed with BC within the last 10 years, and been exposed to, an AET. Univariable and multivariable logistic regression analyses were performed to investigate medication adherence enhancing eHealth technology acceptance profiles among BC survivors. The dependent variable was defined as acceptance of an electronic pillbox connected to a smartphone application (hereafter: medication adherence enhancing eHealth technology). Results: Overall, 23% of the participants already use a connected device or health application on a regular basis. The mean age of the participants was 52.7 (SD 10.4) years. In total, 67% of 1268 BC survivors who participated in the survey declared that they would accept a medication adherence enhancing eHealth technology to improve their AET. BC survivors accepting a medication adherence enhancing eHealth technology for their AET, are younger (OR = 0.97, 95% CI [0.95; 0.98]), do take medication for other diseases (OR = 0.31, 95% CI [0.13; 0.68]), already use a medication adherence enhancing eHealth technology or technique (OR = 1.74, 95% CI [1.06; 2.94]) and are willing to possess or currently possess one or more connected devices or health applications (OR = 2.89, 95% CI [2.01; 4.19]). Conclusion: Understanding acceptance profiles of BC survivors is fundamental for conceiving an effective eHealth technology enhancing AET among BC survivors. Hence, such profiling will foster the development of personalized medication adherence enhancing eHealth technology

a planned ancillary analysis of the coVAPid cohort

Funding: This study was supported in part by a grant from the French government through the «Programme Investissement d’Avenir» (I-SITE ULNE) managed by the Agence Nationale de la Recherche (coVAPid project). The funders of the study had no role in the study design, data collection, analysis, or interpreta tion, writing of the report, or decision to submit for publication.BACKGROUND: Patients with SARS-CoV-2 infection are at higher risk for ventilator-associated pneumonia (VAP). No study has evaluated the relationship between VAP and mortality in this population, or compared this relationship between SARS-CoV-2 patients and other populations. The main objective of our study was to determine the relationship between VAP and mortality in SARS-CoV-2 patients. METHODS: Planned ancillary analysis of a multicenter retrospective European cohort. VAP was diagnosed using clinical, radiological and quantitative microbiological criteria. Univariable and multivariable marginal Cox's regression models, with cause-specific hazard for duration of mechanical ventilation and ICU stay, were used to compare outcomes between study groups. Extubation, and ICU discharge alive were considered as events of interest, and mortality as competing event. FINDINGS: Of 1576 included patients, 568 were SARS-CoV-2 pneumonia, 482 influenza pneumonia, and 526 no evidence of viral infection at ICU admission. VAP was associated with significantly higher risk for 28-day mortality in SARS-CoV-2 (adjusted HR 1.70 (95% CI 1.16-2.47), p = 0.006), and influenza groups (1.75 (1.03-3.02), p = 0.045), but not in the no viral infection group (1.07 (0.64-1.78), p = 0.79). VAP was associated with significantly longer duration of mechanical ventilation in the SARS-CoV-2 group, but not in the influenza or no viral infection groups. VAP was associated with significantly longer duration of ICU stay in the 3 study groups. No significant difference was found in heterogeneity of outcomes related to VAP between the 3 groups, suggesting that the impact of VAP on mortality was not different between study groups. INTERPRETATION: VAP was associated with significantly increased 28-day mortality rate in SARS-CoV-2 patients. However, SARS-CoV-2 pneumonia, as compared to influenza pneumonia or no viral infection, did not significantly modify the relationship between VAP and 28-day mortality. CLINICAL TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov, number NCT04359693.publishersversionpublishe

Interventions en santé publique et questions éthiques

International audienc

Interventions en santé publique et questions éthiques

International audienc

Discussing HIV Status: Is It Easier After 10 Years of Antiretroviral Treatment? The ANRS CO8 APROCO-COPILOTE Cohort

International audienc

Two years after cancer diagnosis, which couples become closer

International audienc

Prevention and Management of Lyme Disease : on Complexity and the Need to Take into Consideration Various Psycho-social factors

Objectif : Cet article vise à proposer une analyse psychosociale de la littérature scientifique relative aux actions de prévention et de prise en charge de la maladie de Lyme. Méthodes : Nous avons mené une revue de la littérature existante autour de la maladie de Lyme, en particulier autour de sa prévention et prise en charge, à la fois dans la perspective des médecins et des patients. Résultats : Trente et un documents ont été retenus pour analyse. La littérature montre que l’acceptabilité des mesures préventives, qui résulte être relative-ment faible, doit être associée à la nature comportementale, et non médicale, de ces interventions. Par ailleurs, la prise en charge de la maladie de Lyme est caractérisée par une condition d’incertitude, en particulier vis-à-vis de la forme chronique et du traitement à adopter, qui provoque des conséquences importantes sur la qualité de vie du patient. C’est pourquoi la reconnaissance du savoir profane autour de la forme chronique de la maladie est fortement revendiquée par les patients, en particulier par la recherche d’une condition d’engagement et participation active vis-à-vis des médecins. Dans ce contexte, la construction d’une relation solide entre soignant et patient s’avère essentielle. Conclusions : L’invisibilité de la majorité des symptômes, l’expérience subjective du patient ainsi que les représentations sociales autour de la maladie de Lyme montrent l’apport nécessaire de l’approche psychosociale, afin de mieux comprendre le vécu de cette condition d’incertitude et, plus en général, de cette maladie.Objective: This paper aims to present a psychosocial analysis on the scientific literature concerning Lyme disease prevention and care. Methods: We performed a literature review on Lyme disease, especially on pre-vention and care, both through physicians and patients’ perspective. Results: A total of 31 documents were included in our literature review. Literature shows that the acceptability of preventive measures, which is rela-tively poor, has to be associated with the behavioral nature, and not medical one, of these interventions. Moreover, the Lyme disease care is characterized by a condition of uncertainty —especially because of the controversy about the existence of the chronical form and the treatment to adopt— provoking important consequences on patient’s quality of life. That is why the acknowledgment of profane knowledge’s legitimacy is strongly demanded by patients, especially through the research of an empowered condition in the relation with the physicians. In this sense, the construction of a solid relation between caregiver and patient seems to be essential. Conclusions: The invisibility of most symptoms, the patient’s subjective experience and the social representations about Lyme disease show the need and the contribution of a psychosocial approach, in order to better understand the life experience of this uncertain condition and, more in general, of this disease