[From Amiens to Quebec: the first milestones of an on-going adventure]. / D'Amiens à Québec: les jalons d'une aventure à poursuivre.

The first two international conferences on local and regional health programmes held in Amiens and Quebec have paved the road for a new public health paradigm. The conferences have served to share experiences from the field to re-think practice and create bridges between health promotion, prevention, care and integration at both the action and decision levels, and amongst diverse actors from the field. The challenges have been put forth, in Amiens in 2001 and in Quebec three years later. The next step is to pursue and enrich these exchanges at the international level reinforcing the Francophone position by capitalising on approaches and tools, and mobilising new partners. The next rendezvous for this on-going adventure is set for the third conference.

[Integrating prevention and promotion in health systems: four realities, diverse similarities]. / L'intégration de la prévention et de la promotion dans les systèmes de santé: quatre réalités, plusiers similitudes.

The Forum Dialogue on national health systems which took place as a satellite meeting of the 2nd International Conference on Local and Regional Health Programmes compared four countries (Brazil, France, Switzerland and Canada) sustain "conditions to integrate prevention and promotion in health systems". Despite the diversity of the four systems presented, several similarities regarding difficulties faced and achievements obtained in the integration process have been extracted, which has allowed highlighting three perspectives of action. It is suggested that prevention and promotion can be integrated into health systems by mobilising the population and health professionals towards prevention, but with the condition that the promotion and prevention sector increase its credibility by developing practices of quality, organisation, discourse, and prevention practices adjusted to the health care context. Finally, exchange between the countries on this subject is the way forward to nourish the thinking and support each other to obtain this desired integration.

Factors in creating sustainable intersectoral community mobilization for prevention of heart and lung disease.

This paper describes factors facilitating and working against successful community mobilization in the implementation of an integrated prevention programme for cardiovascular disease and lung cancer in four community settings in Québec, Canada. Implementation evaluation data from several sources showed that over the 3-year period, mobilization was partly achieved in all four communities, although the degree of success varied. The data support those of previous studies showing that several factors are key to effective intersectoral community mobilization: (i) involvement of concerned and influential community members with a commitment to shared goals and a visible community focus; (ii) formation of multi-organization systems among appropriate organizations, recognizing their strengths, resources and competencies, and preserving both their autonomy and interdependence with an appreciation of divergent perspectives; (iii) development of decision-making mechanisms through the setting up of formal structural arrangements to facilitate decisions with clear leadership; (iv) clear definition of objectives, tasks, roles and responsibilities; and (v) official support and legitimization from participating agencies, government authorities, and organizations with adequate resources devoted to partnership building. This study also replicated a number of barriers to the creation of sustainable intersectoral community mobilization, notably the potentially destructive role of power conflicts among the key institutional partners.