Epidaure Market-Effectiveness and transferability of a school-based intervention to improve healthy and sustainable food choices by schoolchildren: Protocol of a randomized controlled trial and qualitative study.

CONTEXT: At least 40% of cancers are linked to environmental or behavioral factors, and dietary behavior appears to be a major lever. Epidaure Market is a prevention initiative developed using a method for co-constructing health promotion initiatives and prevention programs that stratifies evidence from the scientific literature and combines it with experiential knowledge (DEVA, TPB, BCT). It promotes a sustainable diet (i.e., healthy, ecological and ethical nutrition) among 5th and 4th grade students during the crucial period of adolescence, when these behaviors are often far from the recommendations. METHOD: The protocol implemented was carried out in 72 middle school classes in the Montpellier and Dijon academies. The intervention included teaching sessions and a virtual supermarket game, integrated into the school curriculum and delivered by science teachers. Effectiveness is tested in a cluster randomized controlled trial with 3 evaluation times (pre- and post-intervention and 1 follow-up). The study also includes an implementation assessment, with process analysis and implementation elements, as well as a transferability assessment based on key functions (FIC model and Astaire grid). EXPECTED OUTCOMES: The study is still underway within the school. The primary expected outcome is a positive influence on the motives underlying food choices to move towards a sustainable diet. Secondary expectations involve changes in variables such as self-efficacy and perceived social norms, as well as an increase in knowledge about healthy eating. We also expect the qualitative approaches to provide information on the deployment process in the new territories. DISCUSSION: The study aims not only to demonstrate the effectiveness of Epidaure Market, but also to identify the optimal conditions for its nationwide implementation in France's middle schools. Ultimately, the initiative aims to help reduce the incidence of cancer by promoting healthier eating habits among teenagers.

[A caregiver-person with schizophrenia partnership to improve oral health education] / Un partenariat patients schizophrènes-soignants pour conduire un programme d'éducation en santé orale.

INTRODUCTION: Poor oral health in persons with schizophrenia is a major public health issue affecting 600,000 people in France. The aim of this article was to present the different stages in the development of a specific oral health educational program for persons with schizophrenia. It takes into account experimental knowledge of these persons and presents the results of the feasibility study. PATIENTS AND METHOD: The focus group method was applied to a group of health professionals and users to highlight an exploratory corpus in order to develop an oral health educational program. An expert group including persons with schizophrenia among others validated the fields and tools of this program. A feasibility study was then conducted in a control group of 7 persons with schizophrenia. RESULTS: Altogether, 26 persons participated in this feasibility study. The main fields investigated by the expert group aimed to promote personal responsibility for one's health, to improve access to the healthcare system and to promote the global management of health. The feasibility study showed the ability of this program to change persons with schizophrenia representations and knowledge of this health problem. Most educational tools were considered relevant. CONCLUSION: An oral health educational program was built as part of a caregiver-persons with schizophrenia partnership and showed its feasibility. A multicentric randomized trial is currently ongoing to assess the efficacy of this program with a high level of proof.

Development of a new questionnaire to assess the links between children's self-regulation of eating and related parental feeding practices.

Young children have an innate ability to self-regulate food intake, driven primarily by hunger and satiety cues, but this ability tends to decrease during early childhood. The study aimed to first examine the development and initial validation of a self-report questionnaire suitable for French samples that assess two dimensions of children's self-regulation of eating (eating in the absence of hunger, poor eating compensation abilities) and potential related parental feeding practices. The second aim was to assess the links between children's self-regulation of eating and parental feeding practices as well as the links between children's self-regulation and children's body mass index. An initial 28-item questionnaire was developed. It included items related to the child's eating in the absence of hunger and eating compensation, which were selected mainly from interviews conducted with 45 mothers, and items related to parental feeding practices selected from existing tools. This questionnaire was then completed by 793 parents. A 21-item questionnaire was validated using a confirmatory factor analysis that showed satisfying fit indices. The structural equation modeling indicated that the use of food as reward was positively associated with eating in the absence of hunger, whereas parental awareness of children's cues was negatively associated with both children's eating in the absence of hunger and poor eating compensation ability. Interestingly, positive associations between eating in the absence of hunger and child's BMI, and between poor eating compensation ability and child's BMI were reported. The current study offered an initial validation of a new questionnaire that combines parental feeding practices and constructs involved in children's self-regulation of eating. Further studies are needed to disentangle these links and their directionality as well as the associations with children's body mass index.

A Therapeutic Educational Program in Oral Health for Persons with Schizophrenia: A Qualitative Feasibility Study.

OBJECTIVE: The aim of this study was to test the feasibility of a therapeutic educational program in oral health (TEPOH) for persons with schizophrenia (PWS). DESIGN: In a qualitative study, we explored the representation of oral health before and after a TEPOH. Clinical Setting: PWS are at greater risk of decayed and missing teeth and periodontal diseases. In a previous publication, we described the different steps in building a TEPOH by taking into account the experiences of PWS concerning oral health quality of life. This TEPOH aimed at promoting a global health approach. Participants: Voluntary PWS and their caregivers were recruited during face-to-face interviews at "Les Boisseaux" (a psychiatric outpatient centre) in Auxerre (France) and were included in the study between November and December 2016. Intervention: We explored the experiences of participants and their perceptions of oral health before and after the TEPOH with focus group meetings. RESULTS: Four females and three males participated in the study, and the mean age was 29.4 ± 5. Before the TEPOH, the PWS produced 28 ideas about oral health perception and 37 after the TEPOH. After the TEPOH, elements relating to the determinants of oral health (smoking and poor diet) emerged. CONCLUSIONS: These results show an evolution in oral health representation, and after some adjustments to the TEPOH, the second step will be to test this program in a large sample to generate a high level of evidence of the impact of TEPOH in the long term.

The Relationship between Junior and Senior Nurses. Analysis of a Case of Intergenerational Discrimination Using the RepMut Tool / Las relaciones entre enfermeras junior y senior. Análisis de un caso de discriminación intergeneracional utilizando la herramienta RepMut

This research aims to show that the implementation of intergenerational salience at a social level can affect the work context, particularly in hospitals. Participants were 50 voluntary nurses (25 juniors, 25 seniors) working in French hospitals. RepMut Methodology, based on the theories of social categorization and self-categorization, highlights the mutual representations of group relations and allows measurement of the biases of perception and evaluation. The results support the idea that junior/senior self-categorization plays an important role in structuring work relations. Both groups express in-group homogeneity, but also contrast and values consistent with their social group membership. We discuss the benefit of differentiating the levels of analysis in order to acquire an understanding of diversity and its associated effects.

Esta investigación considera el impacto social de las diferencias intergeneracionales en contexto laboral hospitalario. Participaron voluntariamente 50 enfermeros(as) de hospitales públicos franceses (25 junior, 25 senior). La metodología RepMut, basada en las teorías de la categorización social y de la autocategorización, permite evidenciar las representaciones mutuas de las relaciones intergrupales y una fácil medición de sesgos perceptivos y evaluativos. Los resultados muestran que la autocategorización Junior/Senior juega un papel importante en la estructuración de las relaciones laborales. Los participantes expresan un efecto de homogeneidad pro-endogrupo, acentuando el contraste y los valores coherentes con su endogrupo. La discusión aborda la ventaja de diferenciar entre niveles de análisis para adquirir una comprensión de la diversidad y sus efectos asociados.

Study protocol: a cluster randomized controlled trial to assess the effectiveness of a therapeutic educational program in oral health for persons with schizophrenia.

BACKGROUND: Schizophrenia is a severe mental disorder that affects 1 % of the world's population, including 600,000 people in France. Persons with schizophrenia (PWS) have excess mortality (their life expectancy is reduced by 20 %) and excess morbidity. In addition, such persons may have a large number of missing or decayed teeth. Dental caries and periodontal measurement indexes are often twice as high as the level found in the general population. Poor oral health can also affect quality of life and oral health is inseparable from general health. The management of oral health problems needs a multidisciplinary approach. According to the World Health Organization, the aim of therapeutic education (TE) is to help patients take care of themselves and to improve empowerment and recovery. In this educational approach, it is important to take into account the patient's personal experience. Though rarely investigated, the personal experience of PWS in oral health quality of life (OHRQoL) must be used to build a therapeutic educational programme in oral health (TEPOH) in a multidisciplinary approach, and the effectiveness of this program must be evaluated. METHODS/DESIGN: We report the protocol of a randomized controlled cluster study. This study will be conducted in twelve hospitals in France. We hypothesized that a decrease of 20 % in the proportion of patients with CPI ≥ 3 would establish the effectiveness of TEPOH. Therefore, 12 hospitals will be randomly allocated to either TEPOH or no TEPOH. Altogether, they will have to recruit 230 PWS, who will be randomly allocated with a ratio of 1:1 to one of two conditions: control without intervention versus the group benefitting from TEPOH. DISCUSSION: If successful, the study will generate methodologically sound results that provide knowledge on the effectiveness of a TEP in oral health for PWS. The results can be used to promote OHRQoL in a global health approach and develop appropriate strategies to encourage and facilitate financial support for healthcare, the multidisciplinary treatment of dental disorders, and the development of training in oral and mental health for caregivers. Trial registration Clinical Trials Gov NCT02512367. Date registered 19 July, 2015.