Making sense of what exactly public health does: a typology of public health interventions.

SETTING: Montréal. INTERVENTION: The lack of common knowledge about what public health does is a hindrance to its recognition and capacity to act. Montréal's regional public health department set an explicit goal to clarify and better communicate its specific contributions when it developed its 2016-2021 action plan. This article briefly describes the efforts made to classify public health practice, introduces a typology of public health interventions and discusses its application and benefits. OUTCOMES: The typology that was developed defines 29 types of interventions grouped into four categories: direct action targeting the population; advocacy (persuading partners to take action); support (helping partners take action); collaboration (taking action with partners). The analysis of Montreal's most recent action plan, completely drafted in terms of the typology, provides an insightful characterization of public health practice. Globally, four out of five interventions target partners (indirect), with more than half falling within the support category. Other indirect interventions are divided almost equally between advocacy and collaboration. Following a rigorous planning process and enforcing the use of the typology also had a significant structuring effect on the organization and its teams and enabled greater synergy with partners from other sectors. IMPLICATIONS: Very few people are familiar with everything public health does, sometimes not even the responsible political decision-makers. This situation poses a threat to the survival of its prevention mission. The typology of public health interventions is an innovative tool that can be used to better inform the public and decision-makers.

[Accompaniment to improve public health professional practice]. / L'accompagnement pour améliorer les pratiques professionnelles en santé publique.

Accompaniment (professional support) is increasingly used to support improvement of public health practices. In the field of education, the term accompaniment is at the heart of a structured teaching approach. In public health, the term is commonly used, but has not been clearly defined, which means that proposals are often not sufficient to support real changes in practice. The present article proposes a reflection on accompaniment in the field of public health inspired by progress in the education sector. The actions of managing, guiding and supporting are derived from the action of accompaniment and are illustrated by the example of the Health Promotion Laboratory of the Montréal Public Health Department. Accompaniment requires knowledge that is acquired with practice, hence the importance of strategically targeting a project which could benefit from such an approach and supporting the development of professional skills. The improvement of public health professional practices and public health management, necessary for adaptation of the health system, is dependent on development of an expertise in accompaniment of the processes of change.