Comment promouvoir la participation dans les projets de promotion de la santé ? Les facteurs clés selon les professionnels

Abstract

IntroductionThe participation of the stakeholders concerned by health promotion interventions targeting health determinants is a founding principle of integral importance. Notwithstanding the potential benefits of these approaches, their implementation is still quite limited and field practices are highly varied, if not totally heterogeneous. Such limitations can be considered in conjunction with the poorly defined outlines of participation, which can lead to variable interpretations of what it entails, and also to the different contextual factors potentially affecting its implementation. This study therefore aims: (1) to identify the various perceptions and experiences of participation, and (2) to identify the factors impacting the implementation of participation in support and development of health promotion. MethodologyAll in all, 34 professionals participated in this qualitative research, in which triangulation was associated with analysis of the written productions collected during creativity workshops (Cube activity) and semi-structured interviews and observations. All participants gave their informed consent to participate, and the data were anonymized and remained accessible to one and all. The data were subjected to content analysis (Bardin, 2003) focusing on types of factors contributing to the implementation (or non-implementation) the of participation. ResultsData analysis led to the emergence of 7 categories of factors: stakeholder characteristics, the individual characteristics of professionals and decision-makers, relations between professionals among themselves and with stakeholders, the methods and form of the approach implemented, the local organization and its missions, and the national context. DiscussionThe representations and experiences of participatory approaches among health promoters are very heterogeneous. Implementation depends largely on how stakeholder characteristics are taken into account, on the ability of professionals to adapt to them, on the development of favorable interpersonal relationships through reflexive work on posture, and on the use of relevant and scientifically validated methods. ConclusionsTo strengthen the openness and motivation of field professionals to undertake participatory actions, awareness-raising and training in specific skills seems relevant, the objective being to enable them to anticipate risks and to make the most of whatever opportunities appear.