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Laberge M, Brundisini FK, Zomahoun HTV, Sawadogo J, Massougbodji J, Gogovor A, David G, Légaré F. Knowledge exchange sessions on primary health care research findings in public libraries: A qualitative study with citizens in Quebec. PLoS One 2023; 18:e0289153. [PMID: 37490456 PMCID: PMC10368291 DOI: 10.1371/journal.pone.0289153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 07/12/2023] [Indexed: 07/27/2023] Open
Abstract
Little is known about knowledge transfer with the public. We explored how citizens, physicians, and communication specialists understand knowledge transfer in public spaces such as libraries. The initial study aimed at evaluating the scaling up of a program on disseminating research findings on potentially inappropriate medication. Twenty-two citizen workshops were offered by 16 physicians and facilitated by 6 communication specialists to 322 citizens in libraries during spring 2019. We did secondary analysis using the recorded workshop discussions to explore the type of knowledge participants used. Participants described four kinds of knowledge: biomedical, sociocultural beliefs, value-based reasoning, and institutional knowledge. Biomedical knowledge included scientific evidence, research methods, clinical guidelines, and access to research outcomes. Participants discussed beliefs in scientific progress, innovative clinical practices, and doctors' behaviours. Participants discussed values related to reliability, transparency, respect for patient autonomy and participation in decision-making. All categories of participants used these four kinds of knowledge. However, their descriptions varied particularly for biomedical knowledge which was described by physician-speakers and communication specialists-facilitators as scientific evidence, epidemiological and clinical practice guidelines, and pathophysiological theories. Communication specialists-facilitators also described scientific journalistic sources and scientific journalistic reports as proxies of scientific evidence. Citizens described biomedical knowledge in terms of knowledge to make informed decisions. These findings offer insights for future scientific knowledge exchange interventions with the public.
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Affiliation(s)
- Maude Laberge
- Faculty of Medicine, Department of Social and Preventive Medicine, Université Laval, Quebec, Canada
- VITAM Centre de Recherche sur la Santé Durable, CIUSSS de la Capitale Nationale, Québec, Canada
- Centre de Recherche du CHU de Québec-Université Laval, Université Laval, Québec, Canada
- Quebec SPOR-SUPPORT Unit, Quebec, Canada
| | - Francesca Katherine Brundisini
- Faculty of Medicine, Department of Social and Preventive Medicine, Université Laval, Quebec, Canada
- VITAM Centre de Recherche sur la Santé Durable, CIUSSS de la Capitale Nationale, Québec, Canada
- Quebec SPOR-SUPPORT Unit, Quebec, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Quebec, Canada
| | - Hervé Tchala Vignon Zomahoun
- VITAM Centre de Recherche sur la Santé Durable, CIUSSS de la Capitale Nationale, Québec, Canada
- Quebec SPOR-SUPPORT Unit, Quebec, Canada
- Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, Canada
| | - Jasmine Sawadogo
- First Nations of Quebec and Labrador Health and Social Services Commission, Quebec, Canada
| | - José Massougbodji
- Quebec SPOR-SUPPORT Unit, Quebec, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Quebec, Canada
- Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, Canada
| | - Amédé Gogovor
- VITAM Centre de Recherche sur la Santé Durable, CIUSSS de la Capitale Nationale, Québec, Canada
- Quebec SPOR-SUPPORT Unit, Quebec, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Quebec, Canada
| | - Geneviève David
- Centre d'excellence sur le Partenariat avec les Patients et le Public, Centre de Recherche du CHUM, Québec, Canada
- École Nationale d'administration Publique, Québec, Canada
| | - France Légaré
- VITAM Centre de Recherche sur la Santé Durable, CIUSSS de la Capitale Nationale, Québec, Canada
- Centre de Recherche du CHU de Québec-Université Laval, Université Laval, Québec, Canada
- Quebec SPOR-SUPPORT Unit, Quebec, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Quebec, Canada
- Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, Canada
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Ashcroft R, Menear M, Silveira J, Dahrouge S, Emode M, Booton J, McKenzie K. Inequities in the delivery of mental health care: a grounded theory study of the policy context of primary care. Int J Equity Health 2021; 20:144. [PMID: 34147097 PMCID: PMC8214779 DOI: 10.1186/s12939-021-01492-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/08/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Strengthening capacity for mental health in primary care improves health outcomes by providing timely access to coordinated and integrated mental health care. The successful integration of mental health in primary care is highly dependent on the foundation of the surrounding policy context. In Ontario, Canada, policy reforms in the early 2000's led to the implementation of a new interprofessional team-model of primary care called Family Health Teams. It is unclear the extent to which the policy context in Ontario influenced the integration of mental health care in Family Health Teams emerging from this period of policy reform. The research question guiding this study was: what were key features of Ontario's policy context that influenced FHTs capacity to provide mental health services for mood and anxiety disorders? METHODS A qualitative study informed by constructivist grounded theory. Individual interviews were conducted with executive directors, family physicians, nurse practitioners, nurses, and the range of professionals who provide mental health services in interprofessional primary care teams; community mental health providers; and provincial policy and decision makers. We used an inductive approach to data analysis. The electronic data management programme NVivo11 helped organise the data analysis process. RESULTS We conducted 96 interviews with 82 participants. With respect to the contextual factors considered to be important features of Ontario's policy context that influenced primary care teams' capacity to provide mental health services, we identified four key themes: i) lack of strategic direction for mental health, ii) inadequate resourcing for mental health care, iii) rivalry and envy, and, iv) variations across primary care models. CONCLUSIONS As the first point of contact for individuals experiencing mental health difficulties, primary care plays an important role in addressing population mental health care needs. In Ontario, the successful integration of mental health in primary care has been hindered by the lack of strategic direction, and inconsistent resourcing for mental health care. Achieving health equity may be stunted by the structural variations for mental health care across Family Health Teams and across primary care models in Ontario.
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Affiliation(s)
- Rachelle Ashcroft
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario, M5S 1V4, Canada.
| | - Matthew Menear
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, Quebec, Canada
| | - Jose Silveira
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Simone Dahrouge
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Monica Emode
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Jocelyn Booton
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario, M5S 1V4, Canada
| | - Kwame McKenzie
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Wellesley Institute, Toronto, Ontario, Canada
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Stakeholder Coalitions and Priorities Around the Policy Goals of a Nation-Wide Mental Health Care Reform. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 48:639-653. [PMID: 33386528 DOI: 10.1007/s10488-020-01100-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2020] [Indexed: 10/22/2022]
Abstract
The difficulty of implementing mental healthcare reforms owes much to the influence of stakeholders. So far, the endorsement of mental health policy reforms by stakeholder coalitions has received little attention. This study describes stakeholder coalitions formed around common mental health policy goals and highlights their central goals and oppositions. Data were collected on the policy priorities of 469 stakeholders (policymakers, service managers, clinicians, and user representatives) involved in the Belgian mental healthcare reform. Four coalitions of stakeholders endorsing different mental health policy goals were identified using a hierarchical cluster analysis on stakeholders' policy priorities. A belief network analysis was performed to identify the central and peripheral policy goals within coalitions. Coalitions brought together stakeholders with similar professional functions. Disagreements were observed between service managers and policymakers around policy goals. The two coalitions composed of policymakers supported a comprehensive approach that combines the different goals and also supported the shortening of hospital stays, whereas the two coalitions composed of service managers emphasised the personal recovery of users and continuity of care. Regardless of the coalitions' differing policy priorities, strengthening community care was a central goal while patient-centred goals were peripheral. The competing policy positions of the coalitions identified may explain the slow and inconsistent pace of the Belgian mental healthcare reform. Strengthening community care may be an essential part of reaching consensus across coalitions. Finally, special care must be taken to ensure that patient-centred policy goals, such as social integration, are not set aside in favour of other goals.
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