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Today, physical activity is one of the most effective preventive and health-promoting factors for people with diabetes. Understanding the issues involved and how to implement it will help you to support patients in maintaining this practice., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Social prescribing offers a practical mechanism by which public health and health care systems can work together toward a future in which well-being is prioritized, health equity is addressed and people and communities thrive. The articles in this second part of the Health Promotion and Chronic Disease Prevention in Canada special issue on social prescribing explore how social prescribing in Canada supports action on two frameworks important to public health and health care communities: the Ottawa Charter for Health Promotion, which emphasizes building healthy public policy, creating supportive environments, strengthening community action, developing personal skills and reorienting health services, and the Quintuple Aim for health care improvement, which focusses on improved population health, health equity, patient experience, care team well-being and reduced costs.

Introduction: Older adults with higher needs are ideal candidates for social prescribing interventions, given the complex and intersectoral nature of their needs. This article describes findings from a developmental evaluation of 19 social prescribing programs for older adults at risk of frailty., Methods: An evaluation of the programs was conducted from 2020 to 2023. We used data from three components of the evaluation: (1) initial evaluation data collected in 2020 and 2021; (2) program profiles developed in 2022; and (3) co-creation sessions conducted in 2023., Results: From startup until March 2023, the programs served a total of 2544 older adults. The community connectors identified factors at the individual, interpersonal, institutional, community and policy levels that contributed to the successful implementation and delivery of their programs (e.g. physician champions, communities of practice, strong pre-existing relationships with the health care system), as well as challenges (e.g. limited capacity of family physicians, lack of community resources). There was strong agreement among community connectors that successful social prescribing programs should include the following core elements: (1) making connections to needed community resources; (2) co-creation of a wellness plan with long-term clients or clients who require intensive supports; (3) ongoing follow-up and check-ins for clients with wellness plans; and (4) an assessment and triaging process for the prioritization of clients., Conclusion: To leverage the full potential of social prescribing interventions, it is essential that programs engage with a range of health and social care providers, that community connectors are skilled and well supported, and that adequate investments are made in the nonprofit and voluntary sector., Competing Interests: Laura Kadowaki, Bobbi Symes and Kahir Lalji are employed by United Way British Columbia. Grace Park is a contracted regional medical director for community health services in Fraser Health. Wynona Giannasi, Jennifer Hystad and Elayne McIvor are independent consultants from the Howegroup who were contracted to conduct the evaluation of the social prescribing programs.

Introduction: Integrated youth services (IYS) presents a unique opportunity to adopt social prescribing (SP) strategies within the IYS service model by developing and leveraging a highly connected multidisciplinary network of clinical and community-based service providers to tackle health inequities and enhance service access and outcomes for youth. This paper outlines a case study of Youth Wellness Hubs Ontario (YWHO), Canada, a collective of youth-serving organizations integrated and networked, and operating as a learning health system implementing SP services. The main study objective was to document how YWHO hubs engage in social prescribing through service provision., Methods: We adopted an embedded case study approach. Data were collected from youth (n = 6361) aged between 12 and 25 years who were seeking services at a YWHO hub. Descriptive analyses, including frequencies across categories, were generated from service data, including reason for visit, needs addressed and service provided., Results: A comparative analysis of services requested and provided found that youth across visits to YWHO hubs were engaging with multiple services and service providers, with a wide range of health, mental health and social support needs being addressed., Conclusion: YWHO implements SP services that aim to improve mental health resilience by supporting the vocational, educational and socialization needs of young people accessing IYS through YWHO hubs., Competing Interests: The authors declare there are no conflicts of interest.

At the intersection of health promotion and health data sharing, a normative paradigm is emerging: solidarity. This principle became evident with the European Commission's proposal for the European Health Data Space in 2022, approved by the European Parliament in 2024, and Switzerland's DigiSanté project. This article examines health data spaces beyond traditional legal considerations, exploring the implications of increased reliance on solidarity. Highlighting public and private actors, it analyzes the use of health data for research, health surveillance, and profit. The article emphasizes the need for robust frameworks to balance data use for the common good and mitigate the risks of repression and exploitation., Competing Interests: L’auteure n’a déclaré aucun conflit d’intérêts en relation avec cet article.

Hobbes' Leviathan symbolizes state sovereignty. In public health, this concept now extends to the prevention and promotion of health and the fight against non-communicable diseases (NCDs). This article explores the evolution towards an i-Leviathan, utilizing health data for more effective health surveillance. Precision public health, grounded in a personalized law approach, relies on the collection, availability, and use of these health data. This article analyzes the legal challenges of this precision, such as stigmatization, discrimination, and repression. It addresses the balance between public interests and individual freedoms, outlining state measures to monitor, control, and discipline healthy individuals., Competing Interests: L’auteure n’a déclaré aucun conflit d’intérêts en relation avec cet article.

Competing Interests: Intérêts concurrents:: Matt Bowes, Robert Strang et Dirk Huyer participent à la collaboration dans leur province entre les systèmes d’investigations médicolégales et de santé publique. Aucun autre intérêt concurrent n’a été déclaré.

Smoking cessation appears to be the response that provides the best cost/benefit ratio among cardiovascular prevention actions. However, hospitalization precisely offers a strategic opportunity to initiate smoking cessation. This work evaluates the assistance in smoking cessation of patients treated by coronary angioplasty at the University Hospital of Liege over the last 6 years. It aims to provide food for thought regarding optimal management of smoking. Analysis of data showed a withdrawal rate of 55 % at year one. Strengthening motivation (with motivational interviewing and conversational hypnosis), the use of nicotine replacement and participation in cardiac rehabilitation have been identified as factors in consolidating abstinence. This work attests to the relevance and necessity of the intervention of a tobacco specialist in hospitalization and outpatient settings to ensure follow-up and improve the success rate of smoking cessation.

The Paris 2024 Olympic Games promise not only world-class sporting competition, but also a legacy of sustainable sport that extends far beyond the stadiums. At the heart of this legacy are the Healthy Sports Houses, innovative projects designed to promote an active lifestyle and improve public health in the long term., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

The importance of physical activity in preventing diseases and maintaining physical and mental health in humans is undeniable. An active lifestyle plays a significant role in the primary, secondary, and tertiary prevention of chronic diseases. Despite abundant evidence in the literature and recommendations from the World Health Organization (WHO) on physical activity, the global population remains insufficiently active. It is therefore essential to promote physical activity and educate individuals in order to create an environment conducive to the sustainable adoption of an active lifestyle and the maintenance of health. In Belgium, initiatives such as «Sport-Health» programmes are emerging to overcome barriers to autonomous physical activity by offering tailored programmes for individuals with chronic diseases or those wishing to age healthily. With this perspective, the «Citizen, in motion for my health» project offers physical activity sessions while improving the physical literacy of participants to promote their autonomy.

The Lalonde report, published in 1974 by the Canadian Minister of National Health and Welfare, broke ground for public health in Canada by acknowledging that the determinants of health are much broader than health care services. Fifty years later, this special issue of Health Promotion and Chronic Disease Prevention in Canada charts a clear path towards addressing upstream determinants of health through an emerging intervention called "social prescribing." Social prescribing connects patients with community resources tailored to their individual priorities, fostering a paradigm shift from a deficitbased to a strengths-based approach in health promotion. Part 1 of this issue covers the rapid growth and diverse applications of social prescribing across Canada, with targeted initiatives for various populations and interventions ranging from nature and arts to physical activity and social connectivity. Contributions from a wide range of partners, including researchers, health professionals and community members, explore the adaptability of social prescribing for different groups, underscore the role of community and lived experiences in research, and call for more studies on social prescribing's effectiveness and outcomes. Highlighted case studies demonstrate tangible benefits in health equity and access to social services. This issue not only reflects the current scope and impact of social prescribing in Canada but also sets the stage for its future development and integration into broader health practices., Competing Interests: KM, KGC, and SA were Guest Editors for this issue of the HPCDP Journal, but removed themselves from the editorial decision-making associated with this manuscript.

The Black-Focused Social Prescribing (BFSP) project is a unique initiative by the Alliance for Healthier Communities that intertwines Afrocentric principles with social prescribing. Going beyond conventional social prescribing models, BFSP addresses specific health needs within Black communities. It is rooted in the Alliance Black Health Strategy, advocates for Black health, and is guided by Afrocentric principles. The evaluation framework prioritizes client voices, ensuring cultural safety and, by taking time for trust-building, underscores the importance of an inclusive approach. BFSP holds the potential to foster community trust and engagement, and enhance health outcomes in the Black community., Competing Interests: The authors declare they have no conflicts of interest.

Introduction: Social prescribing is defined as "a means for trusted individuals in clinical and community settings to identify that a person has nonmedical, health-related social needs and to subsequently connect them to nonclinical supports and services within the community by co-producing a social prescription-a nonmedical prescription, to improve health and well-being and to strengthen community connections." Globally, there is growing interest in social prescribing as a holistic approach to health and well-being, with almost 30 countries involved in the social prescribing movement. In Canada, great strides are being made in social prescribing research, policy and practice, with all of this work being supported by the Canadian Institute for Social Prescribing., Competing Interests: The authors have no conflicts of interest to declare.

Introduction: There is growing interest in food prescriptions, which leverage health care settings to provide patients access to healthy foods through vouchers or food boxes. In this commentary, we draw on our experiences and interest in food prescribing to provide a summary of the current evidence on this intervention model and critically assess its limitations and opportunities., Rationale: Food insecurity is an important determinant of health and is associated with compromised dietary adequacy, higher rates of chronic diseases, and higher health service utilization and costs. Aligning with recent discourse on social prescribing and "food is medicine" approaches, food prescribing can empower health care providers to link patients with supports to improve food access and limit barriers to healthy diets. Food prescribing has been shown to improve fruit and vegetable intake and household food insecurity, although impacts on health outcomes are inconclusive. Research on food prescribing in the Canadian context is limited and there is a need to establish evidence of effectiveness and best practices., Conclusion: As food prescribing continues to gain traction in Canada, there is a need to assess the effectiveness, cost-efficiency, limitations and potential paternalism of this intervention model. Further, it is necessary to assess how food prescribing fits into broader social welfare systems that aim to address the underlying determinants of food insecurity., Competing Interests: The authors declare no conflicts of interest.

In France, clinical preventive practices are still underdeveloped and formalized, notably due to a lack of guidelines, despite the fact that a proactive and systematic prevention and health promotion strategy involving all healthcare professionals seems essential. The P3C program aims to encourage preventive clinical practices among healthcare professionals, and thus contribute to the emergence of a common culture of prevention., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

MAISONS SPORT-SANTÉ TO PROMOTE PHYSICAL ACTIVITY. Maisons sport-santé are an organizational innovation proposed by the government in 2019. Responding to the concept of a "one-stop shop", these 500 or so structures with no legal status of their own have a highly variable composition, ranging from sports associations to health services, local authorities and private companies, or even digital platforms. Their vocation is to help any citizen who feels the need to be supported in taking charge through physical activity, whether for primary, secondary or tertiary prevention of chronic diseases, or because of a loss of autonomy, with or without a medical prescription. Welcomed and supervised by an adapted physical activity or sport-health professional, users are given a fitness and motivational assessment, before being referred to a structure offering physical activity (sports club, gym, individual coach). If necessary, they are offered "bridge" sessions for initial reconditioning. The cost of this program is still largely borne by the participants themselves, as the financing of the maisons sport-santé relies largely on public subsidies, which are still insufficient to ensure their sustainability. French health insurance coverage of physical activity programs on medical prescription could considerably help the operation of maisons sport-santé, but this, hoped for by 2024, is no longer envisaged for the time being. These funding difficulties threaten the survival of a highly promising concept., Competing Interests: L’auteure déclare n’avoir aucun lien d’intérêts.

Introduction: Health literacy is a major public health issue. It directly influences the health-related decisions that individuals make. Improved health literacy is also directly correlated with better health. On the basis of this correlation, health literacy has ostensibly taken on the function of improving and maintaining good health. However, there is no evidence that health literacy, and hence the decisions it generates, are aimed at improving health., Purpose of the Research: The aim of our study is to describe, using data collected via the Health Literacy Questionnaire (HLQ), the framework underpinning the health literacy in those surveyed. This allows us to verify whether or not this framework is aligned with the objective of promoting or maintaining health., Results: Health literacy is not governed by the objective of improving health., Conclusions: Health literacy is not necessarily cultivated in a bid to improve personal health. Health-related decision-making (as a product of health literacy) is governed, at least in part, by other forces than that of the desire to improve health. We need to move beyond the model that reduces health literacy, and therefore health decision-making, to a purely rational and individual process aimed exclusively at promoting or maintaining personal health.

At the last congress of the Association Dentaire Française (ADF) (French Dental Association), the minister of health and prevention, François Braun, stressed the importance he attached to oral health prevention. He also emphasized his desire to roll out and extend prevention campaigns, targeting young people in particular. With this in mind, we are working to lay the political foundations for the mass, free distribution of single-use toothbrushes with fluoride toothpaste in schools. This oral health promotion campaign would aim to debunk any myths or misinformation spread by manufacturers and to encourage a profound cultural change in the way children and their parents learn about oral hygiene. The "cavity-score," which is still under development, could help to reinforce the idea, both among the general public and among healthcare professionals, that oral health is not isolated from the rest of the body, and that this health issue cannot be dealt with in isolation, but in conjunction with all healthcare professionals.

The perception of obesity and the ideal body image has evolved over time, largely due to social norms that are not always guided by scientific knowledge. The use of social media for health promotion is an emerging area of investigation. Preliminary research suggests that they have the potential to both serve as a platform for combating the stigma of obesity and promoting positive body image. But there is also evidence that supports the contrary. In particular, the dissemination of digitally altered images that convey ideals of the slim female form can be detrimental to physical and psychological health. Further research is needed to determine how best to use social networks and media as a health promotion tool., Competing Interests: Les auteures n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Introduction: The participation of the stakeholders concerned by health promotion interventions targeting health determinants is a founding principle of integral importance. Notwithstanding the potential benefits of these approaches, their implementation is still quite limited and field practices are highly varied, if not totally heterogeneous. Such limitations can be considered in conjunction with the poorly defined outlines of participation, which can lead to variable interpretations of what it entails, and also to the different contextual factors potentially affecting its implementation. This study therefore aims: (1) to identify the various perceptions and experiences of participation, and (2) to identify the factors impacting the implementation of participation in support and development of health promotion., Methodology: All in all, 34 professionals participated in this qualitative research, in which triangulation was associated with analysis of the written productions collected during creativity workshops (Cube activity) and semi-structured interviews and observations. All participants gave their informed consent to participate, and the data were anonymized and remained accessible to one and all. The data were subjected to content analysis (Bardin, 2003) focusing on types of factors contributing to the implementation (or non-implementation) the of participation., Results: Data analysis led to the emergence of 7 categories of factors: stakeholder characteristics, the individual characteristics of professionals and decision-makers, relations between professionals among themselves and with stakeholders, the methods and form of the approach implemented, the local organization and its missions, and the national context., Discussion: The representations and experiences of participatory approaches among health promoters are very heterogeneous. Implementation depends largely on how stakeholder characteristics are taken into account, on the ability of professionals to adapt to them, on the development of favorable interpersonal relationships through reflexive work on posture, and on the use of relevant and scientifically validated methods., Conclusions: To strengthen the openness and motivation of field professionals to undertake participatory actions, awareness-raising and training in specific skills seems relevant, the objective being to enable them to anticipate risks and to make the most of whatever opportunities appear., Competing Interests: Déclaration de liens d'intérêts Les auteurs déclarent ne pas avoir de liens d'intérêts., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Competing Interests: Intérêts concurrents: Azza Eissa, Aisha Lofters et Onye Nnorom sont membres de l’Association des médecins noirs de l’Ontario. Nancy Akor est infirmière autorisée au centre de santé communautaire TAIBU. Cheryl Prescod est la directrice générale du centre de santé communautaire Black Creek. Aucun autre intérêt concurrent n’a été déclaré.

Introduction: Early childhood caries is a public health concern, and the considerable burden exhibited by Indigenous children highlights the oral health inequities across populations in Canada. Barriers include lack of access to oral health care and lack of culturally appropriate oral health promotion. The purpose of this study was to determine where and how First Nations and Métis parents, caregivers and community members learn about caring for young children's oral health, and what ideas and suggestions they have on how to disseminate information and promote early childhood oral health (ECOH) in Indigenous communities., Methods: Sharing circles and focus groups engaged eight groups of purposively sampled participants (n = 59) in four communities in Manitoba. A grounded theory approach guided thematic analysis of audiorecorded and transcribed data., Results: Participants said that they learned about oral health from parents, caregivers and friends, primary care providers, prenatal programs, schools and online. Some used traditional medicines. Participants recommended sharing culturally appropriate information through community and prenatal programs and workshops; schools and day care centres; posters, mailed pamphlets and phone communication (calls and text messages) to parents and caregivers, and via social media. Distributing enticing and interactive oral hygiene products that appeal to children was recommended as a way to encourage good oral hygiene., Conclusion: Evidence-based oral health information and resources tailored to First Nations and Métis communities could, if strategically provided, reach more families and shift the current trajectory for ECOH., Competing Interests: The authors have no conflicts of interest to declare.

Depression is the most common and prevalent mental disorder today, affecting an estimated 1 in 4 Canadians at some point in their lifetime. Physical activity is recommended as a primary treatment for mild to moderate depression and a secondary treatment for moderate to severe depression. Despite this, specific guidelines are still lacking on how to best promote physical activity in this population. Accordingly, this policy brief provides evidence-based recommendations for primary care providers and allied health professionals to promote lifelong physical activity in individuals with depression. Recommendations include asking for permission to discuss physical activity with the individual; framing physical activity as something that they have control over in order to feel better; clarifying that incorporating even a few more minutes of weekly physical activity is better than nothing and that mild forms are enough to achieve mental health benefits; and providing choices of activities to try and accompanying them on their first few sessions. Moreover, this article highlights the importance of promoting physical activity enjoyment for this population, which can be done by guiding the individual to slowly build up the frequency, duration and intensity of activity; encouraging them to be self-compassionate toward physical activity; suggesting they engage in outdoor activity, listen to music, and/or participate with a buddy or group; and incorporate self-monitoring or journalling to solidify the link between physical activity and improved mood. Practitioners are encouraged to use these evidence-informed recommendations-especially maximizing choices, enhancing physical activity enjoyment and emphasizing personal preferences-to help individuals with depression move, recover and flourish. These recommendations may also be used to tailor future interventions and inform policy guidelines to reduce depression rates in Canada., Competing Interests: The authors declare no conflicts of interest.

Prevention is at the heart of the government's national health strategy. The health service is the centrepiece of this policy. Since autumn 2018, this has allowed health students to develop and implemente prevention actions in their regions. Nursing students were some of the first to commit to this., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Background: A high level of physical fitness is associated with cardiovascular health in adolescents. We describe change in physical fitness levels assessed at two time points over 3 years., Methods: The study presents a longitudinal design, with the first phase data collection at 8 years and the second phase carried out at 11 years. A total of 516 children (254 boys) aged to 7.7±0.4 years (in 2010) and 10.9±0.4 years (in 2010) and 10.9 ± 0.4 years (in 2013) participated to the study. Cardiorespiratory fitness, muscular strength, speed, and agility were assessed in this study. For each physical fitness test, determination of the situation (in terms of percentiles) of each child in 2010 and then in 2013 compared to national standards. The 2010 and 2013 percentiles are then compared using the Wilcoxon signed rank test., Results: Muscular strength, agility and cardiorespiratory fitness decrease in both sex (p<0.01). A significant decrease was also found for all physical fitness components in normal weight children (p<0.05). For normal weight children in 2010 who became overweight or obese in 2013, there was a significant decrease in scores of cardiorespiratory fitness and agility tests (p<0.05). For overweight children in 2010 becoming from to normal weight status in 2013, only the agility test decreased significantly (p<0.05). Children being overweight or obese in 2010 and remaining in 2013, had a significant decrease in their physical fitness levels (p<0.05)., Conclusions: Our results indicate that the physical fitness of French youth decrease between childhood and early adolescence. Developing and introducing a health promotion curriculum in the French schools is suggested to improve health and physical fitness., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

As the benefits of physical activity (PA) in oncology field continue to be demonstrated, multiple structures (sports clubs, associations…) develop PA programs and activities to offer cancer patients survivors the opportunity to continue adapted physical activity. Promoted in the 2014-2019 cancer plan as complementary supportive care, the practice of physical activity is legitimized by the 2016 Health Act of the Ministry of Social Affairs and Health, including the amendment 'prescription health sport', by giving it a legislative framework. In this context of development of new PA offers for cancer patients, it seems necessary to determine and evaluate the structures on their capacities to supervise physical activities for this population with specific needs. This article presents the methodological development and validation process of a tool used to characterize the different structures offering physical activity programs for people who have had cancer, and seeks to define the quality criteria that a structure should meet in the current state of knowledge. Ten of these criteria were selected according to a qualitative methodology and the final tool therefore facilitates the identification of quality programs in post-cancer PA, and could be used systematically by both users and professionals as part of the post-cancer care pathway, as well as by the sport-health platforms themselves in the current dynamics of their deployment throughout the national territory., (Copyright © 2020 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Introduction: The rise in sedentary behaviour, coupled with the decline in overall mental health among Canadian children and youth in recent decades, demonstrates a clear need for applied research that focusses on developing and evaluating cross-disciplinary interventions. Outdoor spaces provide opportunities for physical activity and social connectedness, making them an ideal setting to address these critical health concerns among children and youth., Methods: We conducted a rapid review of peer-reviewed (n = 3096) and grey literature (n = 7) to identify physical activity and/or social connectedness outdoor space interventions targeted at children and youth (19 years and under) in Australia and New Zealand, Canada, Europe and the United States. We determined if interventions were effective by analyzing their research design, confidence intervals and reported limitations, and then conducted a narrative synthesis of the effective interventions., Results: We found 104 unique studies, of which 70 (67%) were determined to be effective. Overall, 55 interventions targeted physical activity outcomes, 10 targeted social connectedness outcomes and 5 targeted both. Play (n = 47) and contact with nature (n = 25) were dominant themes across interventions, with most taking place in a school or park. We report on the identifying features, limitations and implications of these interventions., Conclusion: The incorporation of natural and play-focussed elements into outdoor spaces may be effective ways to improve physical activity and social connectedness. There is a considerable need for more Canadian-specific research. Novel methods, such as incorporating smartphone technology into the design and evaluation of these interventions, warrant consideration., Competing Interests: The authors have no conflicts of interest.

Background: Many programs which aim to reduce tobacco consumption in young people are carried out in the school environment, addressing a "captive audience" and monitoring the actions over a period of several years. The approaches identified as promising involve putting in place a tobacco prevention program throughout the entire school years incorporated in the school program. Several studies showed that early initiation to psychoactive substances is a strong predictor of addiction. Considering the above points, an intervention trial on tobacco prevention covering the four years of secondary school (±11-15 years old) was implemented in the Essonne area, in France., Method: This study was based on a cluster randomized trial comparing three groups: two intervention groups and a control group. The present paper describes the school children (1st year in six secondary schools) included in the trial. It studies the national representativity of this population, the comparability between the control and intervention groups and the items link to tobacco initiation., Results: When considering tobacco behavior in 2014, the included population was representative of the school children in 1st year of secondary school in France with 11.5% of tobacco initiation and 2.5% of regular smokers. The groups were comparable except for four items (family and friends smoking, only child, sensitive urban areas). With this knowledge on factors linked to smoking behaviors this population can be included in the trial analysis., Conclusion: The study of the included population will help to perform the trial analysis and authorize the transferability of the trial results if positive., (Copyright © 2019 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

Background.: The Lifestyle Redesign® (LR) aims to support health, functioning, and quality of life of older adults through the development of healthy and meaningful routines. However, evidence concerning the effectiveness and cost-effectiveness of this intervention is scattered., Purpose.: This study aimed to synthetize the clinical effects and cost-effectiveness of the LR as well as to verify the applicability of the results in a community-based setting in Quebec., Method.: A systematic review of the literature was conducted, followed by a focus group with four occupational therapists., Findings.: Considered as cost-effective (under $50,000 in quality-adjusted life-years), the LR offers benefits for both mental and physical health. According to occupational therapists, the LR is clearly relevant for their practice but involves some challenges., Implications.: The LR is an occupational therapy intervention with promising clinical effects and cost-effectiveness for older adults living in the community.

Schools are considered as one of the most effective vectors for education on sexually transmitted diseases among young people. We report here the results of a study of HIV infection as presented in school textbooks in Ivory Coast, conducted in June 2018 as part of the development of a communication strategy to increase demand for HIV infection testing, especially among young people. Surprisingly, even though the textbooks studied were published between 2007 and 2017, almost all of them stated that HIV infection leads to death, with no mention of the existence of treatments that make it possible to live in good health. Some textbooks even stated that no treatment is available. These findings highlight one cause - perhaps major - for the reluctance of young people to get tested. The misrepresentation of HIV infection, reinforced by education, hampers incentive campaigns for HIV testing, for which the best argument is that awareness of a positive HIV status makes it possible to benefit from treatment. The present study included textbooks from the French educational program, used throughout French-speaking Africa, and from the Ivory Coast program. It would be interesting to conduct a similar study in other French-speaking and English-speaking African countries. Adapting the presentation of HIV in school textbooks to reflect the current situation in the fight against HIV infection should be a priority., Competing Interests: The authors have no conflicts of interest to declare

Prevention is everyone's concern. Whether decisions are made on a collective or individual level, they can all help to improve health. Choosing prevention interventions which are proven to be effective and intervening early are two essential elements for an ambitious policy. Particular attention must be paid to behaviour which is known to be harmful for health and on which it is possible to act: diet, smoking and alcohol., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

The health service scheme seeks to promote prevention, health education and wellbeing across the country. Involving future caregivers in a cross-disciplinary approach, it offers exciting prospects for addressing today's public health challenges., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Objective: The goal of this review is to present online social support interventions described in recent scientific literature, in order to (i) guide organizations wishing to develop such an intervention or to improve an existing program, and (ii) to identify future research directions and recommendations for practitioners., Methods and Results: 59 peer-reviewed articles presenting online social support interventions (2006-2016) were analyzed by using a thematic grid focusing on theoretical perspectives on social support, the online platforms used and their functionalities, the process of intervention development and evaluation, the modalities of participation and the facilitation methods, the documented impacts of interventions, and finally future research directions and recommendations for practitioners. A narrative methodology was used to identify challenges in intervention development and implementation, in order to provide guidance to organizations who want to develop or improve their online social support services., Conclusions: Several research directions and recommendations for the development of online social support interventions are suggested, including the need to develop theoretical models of online social support and enrich traditional models of social support, the need to understand the benefits associated with different levels of participation, the importance of needs assessment in the development of interventions, and the contribution of qualitative methods to the evaluation of interventions.

In Canada, it is challenging to find examples of positive population mental health interventions that meet scientific standards of evidence. It is even more difficult to identify effective interventions that address health equity. The discrepancy between standards of evidence in the health sciences, and the evidence that can be gleaned from social experiments, is not new. Efforts to reconcile these differences show a general tendency toward controlled interventions in public health. However, it is possible to extract findings from quasi-experimental interventions that meet scientific standards while also showing promise of positive impacts on mental health equity. This article describes work undertaken in 2015 to begin to address this evidence gap., Competing Interests: The authors have no conflicts of interest to disclose.

Aim: By means of a personalized consultation with a professional, the Consultations Jeunes Consommateurs (CJC) provide the opportunity to young people and their family to take stock of the consumption level and a potential addiction. A mass-media promotion campaign of this service was released twice in 2015. This article aims to evaluate the impact of this campaign on the visibility of the CJC among adolescents' parents and on the access to CJC., Methods: Three sources were used: 1/ a study with three independent phases (before the campaign, after the first release, after the second one) by phone with 500, 500 and 531 parents and adolescents in order to evaluate the impact on the CJC visibility among the targets, 2/ the request data from the help line and web service (Drogues Info Service), connected to the campaign, to observe the evolution of profiles and numbers, 3/ a study of the CJC, gathering information from 3747 consultations, to compare profiles of consultants who came thanks to the campaign or not., Results: Before the campaign, 15.98% of parents had already heard of the CJC. After the releases, this part was unchanged among parents non-exposed to the campaign and greater than 60% among exposed parents. The other sources showed a greater implication of parents and a diversification of consultations' reasons., Conclusion: The campaign offered an increase in awareness of the service among parents (the target audience). Secondary analyses suggest that the campaign has made the use of CJCs easier for parents, but also for cocaine users.

Introduction: Health inequalities is a complex issue and may appear to be unrelated to the reality of field workers. This article describes Lor'IS, a support grid for project leaders designed to enable them to review their actions based on criteria contributing to reduction of social and geographical inequalities in health., Methods: This tool was based on a review of the literature and assessment of the needs of field workers. It was created by a multidisciplinary working party and was tested and improved by the future users., Results: Lor'IS justifies the role of all institutional or associative field workers to fight against inequalities in health. This readily accessible tool is designed to facilitate the setting-up of health promotion projects, that are known to contribute to reduction of these inequalities, based on a set of 51 items., Discussion: This approach must be extended to professionals in the fields of health care, housing, employment, rural environment, who constitute essential links in reduction of inequalities, but who are currently not involved in this challenge. Lastly, advocacy actions must be conducted to ensure that health inequality issues are integrated into all public policies.

Although actions to reduce social inequalities in health cannot be considered the exclusive responsibility of public health actors, they should at least make sure their interventions account for these inequalities. However, the actors involved in these interventions have few tools to support them in this process. Therefore, building on a study conducted in France, we have adapted, tested, and developed in Quebec a tool intended to help actors take into account social inequalities in health. The article presents the approach that led to the adaptation of the tool to the Quebec context, to describe the tool, and then to discuss some issues for inclusion in professional practices. A participatory and constructive process between researchers, managers and practitioners led to a useful and useable tool. It is composed of five aspects of intervention (planning, implementation, evaluation, sustainability, and empowerment) and 44 items for discussion presented as questions. A user guide, a glossary, and some practical examples accompany the tool. It follows a reflexive and constructive process wherein a third party facilitator can assist actors involved in an intervention to analyze how they take social inequalities in health into account. This assessment can help generate collective recommendations for improvements, which can be monitored over time, to improve consideration of equity in public health interventions. The article concludes on some issues related to its integration into professional practices.

Introduction: ParticipACTION is a Canadian physical activity communications and social marketing organization relaunched in 2007. This study assesses the capacity of Canadian organizations to adopt, implement, and promote physical activity initiatives. The four objectives were to compare findings from baseline (2008) and follow-up (2013) with respect to: (1) awareness of ParticipACTION; (2) organizational capacity to adopt, implement and promote physical activity initiatives; (3) potential differences in capacity based on organizational size, sector, and mandate; and (4) assess perceptions of ParticipACTION five years after relaunch., Methods: In this cross-sectional study, representatives from local, provincial/territorial, and national organizations completed an online survey assessing capacity to adopt, implement, and promote physical activity. Descriptive statistics and one-way analyses of variance were conducted to examine the objectives., Results: Response rate for opening an email survey invitation and consenting to participate was 40.6% (685/1688) and 540 surveys were completed. Awareness of ParticipACTION increased from 54.6% at baseline to 93.9% at follow-up (Objective 1). Findings at both baseline and follow-up reflected good organizational capacity to adopt, implement and promote physical activity (Objective 2) although some varied by organizational sector and mandate (Objective 3). Most respondents reported that ParticipACTION provided positive leadership (65.3%), but there was less agreement regarding ParticipACTION's facilitation of infrastructure (44.0%) or organizational will/motivation (47.1%)(Objective 4)., Conclusion: Canadian organizations continue to report having good capacity to adopt, implement, and promote physical activity. There was no discernible change in capacity indicators five years after ParticipACTION's relaunch although its broader contribution to the physical activity sector was endorsed., Competing Interests: GF, TB, SD, AEL, RER, MST and JS serve on the ParticipACTION Research Advisory Group.

ParticipACTION is the Canadian physical activity communications and social marketing organization first launched in the fall of 1971 and then ceased operations in 2001. ParticipACTION was relaunched in 2007. Framed as a public health natural experiment, evidence was collected from a population-based survey of knowledge, awareness, understanding of physical activity, and physical activity levels among Canadians (individual level), and key informant surveys and interviews examining capacity, readiness and advocacy for physical activity promotion among physical activity organizations (organizational level). The purpose of this paper is to first provide an overview of some of the major initiatives undertaken by the 'new' ParticipACTION that may have contributed to any changes at these individual or organizational levels. Second, the paper sets the stage for the three empirical papers in this special series reporting follow-up results., Competing Interests: GF, MST and JCS serve on the ParticipACTION Research Advisory Group.

The impact of climate change on the health of individuals raises fears of significant long-term effects. Certain repercussions are already evident. Health professionals, particularly those working with vulnerable people, play a key role in health promotion and taking into account the challenges posed by hot weather. They need to be better trained in order to promote behaviours more favourable to health., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Context: The objective of this study was to identify collaborative processes involved in a physical activity health promotion project in companies, conducted through a participatory approach in a cross-sectoral partnership, and to estimate the preliminary effects in terms of employee health., Methods: Action research was conducted in an industrial company comprising 240 employees over a 2-year period. This research was based on 4 criteria: description of the actors' network, the opportunities and constraints of the project, the implementation of physical activities, the participation of employees in the various activities, the impacts observed (after 3 months of activities) on physical parameters and quality of life., Results: Six work groups selected two activities : muscle-development exercise and Taïchi. We evaluated muscle strengthening activity. The participation rate in the activity was 16%. A higher age, female gender and being a manager or employee rather than a worker were significantly associated with participation. A tendency towards increased physical and mental scores of SF12 was observed. We identified two major barriers: logistic and communicational., Conclusion: The participatory approach, based on a cross-sectoral partnership, is the determining element of the project's success in a context of local opportunities. Two factors were identified to perpetuate this dynamic and improve the system: rationalization of the structuring of the service and greater resources, particularly financial resources.

Objective: To adapt the supply of services to the needs of the community, a local health authority has developed a consultative model in health and social services. This approach, based on shared governance and various health promotion strategies, identifies targets, develops actions, and measures the effects of these actions. This study evaluates the implementation of this consultative model from three dimensions : describe (1) implementation of the model, (2) how user experience was taken into account to prioritize and draw up action plans, (3) favourable and unfavourable implementation conditions., Methods: A qualitative methodology based on four data sources was used (i.e. individual interviews, focus groups, observations, analysis of reports). Content analysis was conducted on the individual interviews and focus groups. The observations and analysis of reports contributed to enhance the evaluation process., Results: Valorisation of experienced-based knowledge, citizen participation, shared leadership, support from institutions or stakeholders, and the dynamism of discussion tables were favourable to implementation. Time, language, cumbersome procedures, staff instability, the recent reform of the Quebec network and inherent elements of discussion tables were unfavourable conditions., Conclusion: The model allows actions adapted to health and social needs of a local population and increases the sense of belonging to a community. Further efforts are required to preserve the relevance, flexibility, and dynamism of this model in a context of restructuring of the Quebec health and social services network.

Introduction: HANS KAI is a unique health promotion intervention to improve participants' health by focussing on interrelated chronic disease prevention behaviours through peer support and strengthening of social support networks. The study objective was to determine the effectiveness of HANS KAI in an urban Canadian setting., Methods: We used a mixed methods intervention research design that involved multiple sites from November 2010 to April 2015. Data was obtained from participant surveys as well as in-person interviews at zero, 6, 12 and 24 months. Participants met in groups at least once a month during the research period, to self-monitor health indicators, prepare and share a healthy snack, participate in a physical activity, set a healthy lifestyle goal (optional) and socialize., Results: There were statistically significant mental health improvements from pre- to post-program, and 66% of the participants described specific behaviour changes as a result of HANS KAI participation. Additional positive health impacts included peer support; acquiring specific health knowledge; inspiration, motivation or accountability; the empowering effect of monitoring one's own health indicators; overcoming social isolation and knowing how to better access services., Conclusion: The need to identify innovative ways to address chronic disease prevention and management has been the driver for implementing and evaluating HANS KAI. While further research will be required to validate the present findings, it appears that HANS KAI may be an effective approach to create environments that empower community members to support each other while promoting healthy lifestyle choices and detecting early changes in health status., Competing Interests: The authors have no conflicts of interest.

Introduction: The main aim of this study is to evaluate the effectiveness of preventive actions regarding influenza in the studied populations. The secondary objective is to analyze and understand the mechanisms which bring about a behavioural change regarding influenza vaccination., Methods: The interventional and prospective study was undertaken in the form of an anonymous questionnaire about influenza vaccination coverage and about the reasons for vaccinating or not vaccinating. The studied populations were patients followed for cystic fibrosis (n=67) in the Dunkerque cystic fibrosis treatment centre and their health care workers (n=117), before (April 2014) and after (April 2015) an information campaign and primary prevention actions (vaccination in the workplace with expanded time slots) in collaboration with the department of occupational medicine., Results: In 2015, the vaccination coverage rate of health care workers rose to 65.63%, that is to say 2.38 times more than in 2014 (27.55%). This difference is significant (χ 2 [1]=29.17, P<0.0001). However, no significant difference between 2014 and 2015 was observed among patients (children and adults) (χ 2 [1]=0.24, NS) whose vaccination coverage was already optimal before the study., Conclusions: Raising awareness among health care workers about vaccination against influenza increases the coverage rate and decreases outbreaks of virus infection in the care services and among patients at risk. Three main levers were identified: the necessity of providing information on influenza vaccination to health care workers, the ease of vaccination access and the attitude towards vaccination of supervisory staff (health executives/doctors)., (Copyright © 2017 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Recreation and sport settings (RSS) typically promote health in the form of physical activity, but the healthfulness of their food environment is often neglected. We explored stakeholder perspectives on barriers to healthy food provision in RSS through telephone interviews with ten representatives from RSS across Nova Scotia. Three key barriers were identified: 1) cultural norms associated with food in RSS and the broader environment, 2) the persisting notion of personal choice and responsibility, and 3) financial implications of healthy food provision. These barriers challenge healthy food provision in RSS and require multi-faceted strategies to overcome social norms that undermine health behaviours., Competing Interests: The authors had no conflicts of interest to report.

Playing video games has been associated with several negative effects in children. However, serious games, which are video games designed for a primary purpose other than pure entertainment, should not be neglected by pediatricians. In the field of public health, some serious games are a means to decrease drug consumption and improve sexual health behavior in adolescents. In schools, serious games can be used to change students' perception of the disease of one of their classmates, or to train students on basic life support. Serious games are also used with patients: they can distract them from a painful procedure, increase their compliance to treatments, or participate in their rehabilitation. Finally, serious games allow healthcare professionals to train on the management of various medical situations without risk. For every field of application, this review presents the rationale of the use of video games, followed by concrete examples of video games and the results of their scientific evaluation., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Introduction: Many North American cities have a built environment that provides access to energy-dense food and little opportunity for active living. Urban agriculture contributes to a positive environment involving food plant cultivation that includes processing, storing, distributing and composting. It is a means to increase local food production and thereby improve community health. The purpose of this study was to understand how participating in urban agriculture can help to empower young adults and build capacity for growing food in the city., Methods: This was a qualitative study of seven participants (five Indigenous and two non-Indigenous) between the ages of 19 and 29 years, engaged as interns in an urban agriculture project known as "askîy" in Saskatoon, Saskatchewan, Canada in 2015. We used a case-study design and qualitative analysis to describe the participants' experience based on the sustainable livelihoods framework., Results: A collaborative approach had a great effect on the interns' experiences, notably the connections formed as they planned, planted, tended, harvested and sold the produce. Some of the interns changed their grocery shopping habits and began purchasing more vegetables and questioning where and how the vegetables were produced. All interns were eager to continue gardening next season, and some were planning to take their knowledge and skills back to their home reserves., Conclusion: Urban agriculture programs build capacity by providing skills beyond growing food. Such programs can increase local food production and improve food literacy skills, social relationships, physical activity and pride in community settings., Competing Interests: The authors have no conflicts of interest to declare.