The "Besançon smoke-free" programme. Concepts, measures and evaluation.

Three years ago the city of Besançon, France, launched a city-wide, multi-level and multi-disciplinary smoking prevention programme with the ambitious goal of reducing the number of smokers by 50%. This paper describes the philosophy and methodology behind the programme while reporting on its mid-term progress.

[A cooperative program for the prevention of domestic accidents in children at the department of the Doubs. II. Educative aspects and evaluation]. / Programme coopératif de prévention des accidents domestiques de l'enfant dans le département du Doubs. II. Aspects éducatifs et évaluation.

Effective prevention of domestic accidents in children includes regimental and/or legislative action, information for parents and education of the children. The latter two strategies have been applied in the deparment of the Doubs in a cooperative health promotion program. Preschool and kindergarten structures were chosen and the pedagogical project involved acquainting the children with the idea of danger by use of a kit prepared by the "Comité Français d'Education pour la Santé" (French Committee for health education). This study was set up in two stages: "experimental" in 2 schools (1983-1984) and "operational" in 40 schools (1984-1985). In order to evaluate it, the population was divided into a control group and an experimental group. A total of 5,720 tests were carried out among 520 children. 494 parents and 82 teachers answered the questionnaires sent to them. The teachers were generally very positive about the effectiveness of education about dangers and the teaching activities which could be employed: discovery of environment, awareness of body, a.s.o. The changes in attitude were real and enduring among children. The parents changed their behavior significantly concerning the storing of poisonous products (medicines and household cleaning products), which allows to feel that this program can be effective in terms of risk reduction.

[Cooperative program for domestic accidents of children in the department of Doubs. Epidemiological aspects]. / Programme coopératif de prévention des accidents domestiques de l'enfant dans le département du Doubs. I. Aspects épidémiologiques.

This work presents the results of a survey carried out among 818 families in the department of the Doubs. Each family had a child between one and 6 years of age. Its aim was to come as close as possible to exploring morbidity in accidents by questioning parents about the accidents which took place a month before the investigation, and to study the influence of certain psychosocial factors on this pathology, for example the attitude of parents confronted with risks. The annual accident morbidity rate was 1,056 accidents per 1,000 children. In other words, each child has, on the average, one accident per year. Even though no significant difference between town and country has been noted, serious accidents occurred more frequently in rural areas. This may be explained by the way dangerous products are stored (medicines, household cleaning and agricultural products), looser parental surveillance (predominance at games outside home), as well as the fact that children are more often in the kitchen when they are indoors, which is potentially the most dangerous room. Classical notions of disturbing events occurring prior to the accident (divorce, moving, a.s.o.) and children who are "repeat offenders" have also been noticed. The examination of parental attitude in dealing with the possibility of accidents (instructive, lax or repressive) did not allow us to demonstrate in any significant way the influence of these attitudes on accidental morbidity. On the other hand the so-called "instructive" parents are the ones who best put away the poisonous products. There is therefore, an encouraging connection between attitude and behavior.