Software to assist with programme planning: two community-based cases.
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Community Health Services↗
Biomedical subjects
Louise Potvin
Publications and source records attributed to Louise Potvin.
A theoretical and empirical analysis of context: neighbourhoods, smoking and youth.
Numerous studies are currently addressing the issue of contextual effects on health and disease outcomes. The majority of these studies fall short of providing a theoretical basis with which to explain what context is and how it affects individual disease outcomes. We propose a theoretical model, entitled collective lifestyles, which brings together three concepts from practice theory: social structure, social practices and agency. We do so in an attempt to move away from both behavioural and structural-functionalist explanations of the differential distribution of disease outcomes among areas by including a contextualisation of health behaviours that considers their meaning. We test the framework using the empirical example of smoking and pre-adolescents in 32 communities across Québec, Canada. Social structure is operationalised as characteristics and resources; characteristics are the socio-economic aggregate characteristics of individuals culled from the 1996 Canadian Census, and resources are what regulates and transforms smoking practices. Information about social practices was collected in focus groups with pre-adolescents from four of the participating communities. Using zero-order and partial correlations we find that a portrait of communities emerges. Where there is a high proportion of more socio-economically advantaged people, resources tend to be more smoking discouraging, with the opposite being true for disadvantaged communities. Upon analysis of the focus group material, however, we find that the social practices in communities do not necessarily reflect the "objectified" measures of social structure. We suggest that a different conceptualisation of accessibility and lifestyle in contextual studies may enable us to improve our grasp on how differential rates of disease come about in local areas.
Adolescent↗
Youth smoking initiation: disentangling context from composition.
This paper examines the relative contributions of compositional and contextual effects on the one hand, and behavioural and material factors on the other, to help explain smoking initiation. We present results from a cross-sectional, multi-level analysis linking data from pre-adolescents, their households and their neighbourhoods across Quebec, Canada. Results show a significant geographical area variation in youth smoking initiation. The variation is explained not only by individual characteristics (parents' smoking status, parents" education and pre-adolescents' age), but also by aspects of the social structure at the neighbourhood level. When both the individual level and territory level predictors are entered in the model, only 2.66% of the between-territory variance in smoking initiation remain unexplained.
Adolescent↗
[Theories emerging from daily clinical practice of community occupational therapists].
Occupational therapists working in the community have adapted their knowledge to the distinct characteristics and expectations of the various settings. To do so, they have had to reflect on the professional nature of their interventions, while intervening. This simultaneous process has yielded specific knowledge that is solidly anchored in current clinical reality. A survey on occupational therapy in the Centres locaux de services communautaires in Québec (CLSC) highlighted three theories developed by occupational therapists in their daily clinical practice. The first relates mostly to referral processing while the other two address the occupational therapist's role within the treatment team. This paper briefly presents the survey's results, then focuses mainly on the three emergent theories and underlines some elements congruent with the reference theories in occupational therapy. The author then proposes avenues for reflection to help foster balance between the constraints inherent to the community health care system and occupational therapy professional values.
Community Health Services↗
Making youth tobacco control programs more ecological: organizational and professional profiles.
PURPOSE: To identify the organizational and professional correlates of the integration of the ecological approach in Canadian public health organizations' tobacco control programs for youth. DESIGN: Cross-sectional survey. SETTING: Canadian public health organizations. SUBJECTS: One hundred and ten tobacco control programs implemented in 90 organizations. The response rate for the organizations was 87%. MEASURES: Descriptions of programs were obtained by telephone interviews. An analytical procedure was applied to the program data to identify intervention settings, targets and strategies for each program. Using this information, a summary score of the integration of the ecological approach was estimated for each program. Organizational and professional variables were assessed by self-administered questionnaires to managers and professionals involved in these programs. RESULTS: The level of integration of the ecological approach in programs was related to organizational (frequency of contacts and collaborations with external partners, team composition) and extraorganizational factors (size of the city in which the public health unit is located). Cognitive attributes of the practitioners (knowledge and beliefs) also emerged as significant predictors. Finally, positive associations were observed between practitioners' personal characteristics (educational achievement, working status in health promotion [full vs. part-time], previous experience, gender, and disciplinary/professional background) and cognitive predictors. CONCLUSIONS: Organizational environment and staff preparation play a critical role in the adoption of the ecological approach in tobacco control programs.
Access to Information↗
Family process and parent's leisure time physical activity.
OBJECTIVE: To examine relations between family environment and parent's leisure-time physical activity conceived as a system of interdependent variables (LTPA-specific variables) including family rules, support, and exercise activity. METHODS: Family environment was described using site of residence and a family typology. Two-way MANCOVA on the LTPA-specific scores were conducted for 533 male and 603 female parents from a community sample. RESULTS: Main effects for family type, site of residence, and a significant family type by site of residence interaction were found. There were gender-specific patterns of LTPA-specific scores. CONCLUSION: Different families may have different mechanisms of influence on physical activity habits.
Adult↗
[Social inequalities in health. A partnership of research and education].
The Chair on Health Inequality is one of the 12 Chairs created by the CHSRF. Resulting from a partnership between l'Université de Montréal, together with the Direction de la santé publique of the Régie régionale de la santé et des services sociaux Montréal-centre, the Chair will create a research program that will document and assess the role of public health programs based on social development in urban districts, in reducing social health inequality. This research infrastructure will support two training programs: 1) a post-doctoral training program that will introduce newly minted social science PhDs to collaborative research in public health; and 2) a professional doctorate program for public health professionals. The decision-makers and policy-makers targeted by the Chair's knowledge diffusion program are Directors of public health organizations.
Canada↗
[Evaluation of the viability and validity of an instrument to measure community activation].
OBJECTIVE: This study examines psychometric properties of a community activation assessment scale used for the evaluation of the Quebec project within the Federal Provincial Heart Health Initiative. The scale is composed of three sub scales, one for each of the intervention target risk factors. METHODS: Data were collected by telephone interviews conducted with 199 key informants from the 24 communities of the project. Reliability was studied using Cronbach's alpha coefficients and intraclass correlations. Validity was explored with factor analysis techniques. RESULTS: Subscales' internal consistency were very good, ranging from 0.71 to 0.83, but intraclass correlations between informants from the same communities were low. Factor analyses indicated a unidimensional structure for each scale. INTERPRETATION: These results show that the scale seems to provide reasonable assessments of the opinion of key informants regarding activation in their community. However, ranking communities based on the aggregated scores from local key informants may lead to classification problems.
Cardiovascular Diseases↗