RESUMO
INTRODUCTION: The Quebec Government Policy of Prevention in Health incited several regional Public health departments (PHD) to initiate health impact assessment (HIA) as a way to strengthen collaboration with municipal decision makers and improve their projects of urban planning projects. This article presents the main HIA implementation issues encountered in the last two years and the solutions applied or envisaged. METHOD: The documentation of the issues is based on the observations of HIA experts drawn from working sessions with practitioners from different regional PHDs and from the activities of a community of practice. RESULTS: Five issues have been identified : appropriation of the HIA process and new skills, support and collaboration of municipal partners, intersectoral work, access to expertise and evidence as well as HIA funding. DISCUSSION: A common implementation framework offering different tools, a scientific support and a vibrant community of practice will help to develop skills of practitioners and capacities of their respective organizations. These solid foundations will increase the credibility and relevance of HIA for municipal partners. CONCLUSION: An in-depth evaluation will be carried out at the end of the experiment to examine the relevance, feasibility and acceptability of HIA and to better understand the conditions necessary for a successful integration of this practice in various contexts. It will make it possible to assess whether the services and instrumentation made available to practitioners are useful or how they can be improved.
Assuntos
Planejamento de Cidades , Avaliação do Impacto na Saúde , Política de Saúde , Humanos , Saúde Pública , Quebeque , Projetos de PesquisaRESUMO
Many countries have introduced health impact assessment (HIA) at the national, regional, or local levels. In France and in Québec, there is increasing interest in using HIA to inform decision-makers and influence policies, programs, and projects. This paper aims to compare HIA implementation models in two regions: Nouvelle-Aquitaine (France) and Montérégie (Québec, Canada) using a case study methodology. The objective is to gain a better understanding of the similarities and differences in the approaches used to achieve the operationalization of HIA. The methodological approach involves four steps: (1) design of an analytical framework based on the literature; (2) exchanges within the research team and review of documents concerning the two implementation strategies under study; (3) development of the case studies based on the proposed framework; and (4) cross-comparison analysis of the case studies. The findings show that the two regions share certain similarities, including the strong commitment and political will of the public health organizations involved and a well-established culture of engaging in intersectoral action with municipal partners. Differences mainly concern their different approaches to implementing HIAs in accordance with the regional policies and the organizational and administrative contexts in place. This study identifies potential avenues for supporting the practice of HIA at the municipal level.
Assuntos
Avaliação do Impacto na Saúde , Saúde Pública , Canadá , França , Política de Saúde , Humanos , QuebequeRESUMO
Le présent article fait état du modèle de soutien à la prise de décision appliqué à l'évaluation d'impact sur la santé (EIS) en Montérégie, au Canada. Pour répondre à la volonté de soutenir l'élaboration de politiques et projets municipaux favorables à la santé et fondés sur les données probantes, la Direction de santé publique a mis en Åuvre une démarche d'EIS dont les fondements pratiques s'inspirent des expériences internationales en matière d'EIS et dont les assises théoriques reposent sur le partage et le courtage de connaissances. L'expérience montérégienne démontre que la stratégie de courtage de connaissances appliquées à l'EIS encourage un partage respectueux des responsabilités et rôles de chacune des parties prenantes et favorise l'utilisation des connaissances de santé publique dans la prise de décision municipale. Le courtage des connaissances permet de prendre en compte les enjeux locaux dans les analyses d'impact et dans les recommandations aux décideurs. En conclusion, il s'avère que l'implication des décideurs municipaux à la recherche de solutions favorables à la santé permet d'inscrire les données probantes à l'intérieur des processus décisionnels et d'observer leur utilisation à plusieurs niveaux. L'évaluation des premières expériences d'EIS révèle en effet que les connaissances partagées répondent à des besoins immédiats engendrant leur utilisation directe, contribuent à des changements de perception et de pratique à plus large échelle et font de la santé une valeur reconnue par les décideurs publics et promue auprès de leurs citoyens pour accroître l'acceptabilité des initiatives municipales.
Assuntos
Avaliação do Impacto na Saúde/métodos , Saúde Pública , Humanos , Modelos Teóricos , Política Pública , QuebequeRESUMO
CONTEXT: This article presents the main results from a large-scale analytical systematic review on knowledge exchange interventions at the organizational and policymaking levels. The review integrated two broad traditions, one roughly focused on the use of social science research results and the other focused on policymaking and lobbying processes. METHODS: Data collection was done using systematic snowball sampling. First, we used prospective snowballing to identify all documents citing any of a set of thirty-three seminal papers. This process identified 4,102 documents, 102 of which were retained for in-depth analysis. The bibliographies of these 102 documents were merged and used to identify retrospectively all articles cited five times or more and all books cited seven times or more. All together, 205 documents were analyzed. To develop an integrated model, the data were synthesized using an analytical approach. FINDINGS: This article developed integrated conceptualizations of the forms of collective knowledge exchange systems, the nature of the knowledge exchanged, and the definition of collective-level use. This literature synthesis is organized around three dimensions of context: level of polarization (politics), cost-sharing equilibrium (economics), and institutionalized structures of communication (social structuring). CONCLUSIONS: The model developed here suggests that research is unlikely to provide context-independent evidence for the intrinsic efficacy of knowledge exchange strategies. To design a knowledge exchange intervention to maximize knowledge use, a detailed analysis of the context could use the kind of framework developed here.
