Benefits and challenges of a community-based programme for women living with HIV in Mali

Gundo-So is a community-based programme developed by and for women living with HIV (WLHIV) in Mali through the ARCAD-Santé-PLUS association. It provides support, co-constructed with WLHIV, to develop strategies on whether or not to disclose their status. The aim of the ANRS-12373 research is to evaluate the impact of this programme in the short and medium term. As part of this research, semi-structured interviews were conducted with participants (14). These interviews were analysed thematically. Three themes are presented here: positive feedback from the programme, which enabled them to be listened to and supported them both psychologically and financially. The impact of the programme on the participants' social network is also described, in terms of the links made with peers met during the programme. Finally, a new perspective on issues such as disease management, which improved through the contribution of knowledge, and also through the development of psychosocial resources. The programme enabled participants to acquire psychosocial skills, the ability to effectively self-manage their condition, and strategies on whether or not to disclose their HIV status. Participants' empowerment and social support in relation to the disease were developed through the programme, particularly through the links created with other women living with HIV.

Defining an enabling environment for those with chronic disease: an integrative review

BACKGROUND

Health policies are currently being implemented to cope with the 37% of those affected by chronic disease and 63% of deaths worldwide. Among the proposals, there is accelerating support for greater autonomy for patients, which incorporates several concepts, including empowerment. To achieve this, develop an environment to increase an individual's capacity for action seems to be a fundamental step. The aim of this study is to characterize an enabling environment for patients in the context of chronic disease management.

METHODS

An integrative review design was applied. Medline, CINAHL, and Web of Science databases were searched to identify relevant literature published between 2009 and 2019. Overall, the review process was guided by the PRISMA 2020 checklist. The Mixed Methods Appraisal Tool for quality evaluation was used.

RESULTS

A total of 40 articles were analyzed, divided into 18 quantitative studies, 11 qualitative studies, two mixed studies, seven expert opinions, one theory and one conference report. The following characteristics defining an enabling environment were taken from the literature relating to those with a chronic condition: Needs assessment-adaptation of responses, supporting "take care", involvement in support, knowledge improvement, engagement with professionals, use of information and communication technologies, and organization of care. Beyond that, the interactions highlighted between these seven categories characterize an enabling environment.

CONCLUSION

This review specifies the essential elements of an enabling environment for patients with chronic conditions. It encompasses the partnership between the healthcare professional, such as the advanced practice nurse, and the individual for whom interventions and care strategies must be devised.

The Development of a "Neighborhood in Solidarity" in Switzerland

This article presents a case study based on the "Neighborhood in Solidarity" (NS) methodology to illustrate its application in a locality of 8,000 inhabitants in Switzerland. This specific project is proposed to exemplify the global aim of the NS methodology. That aim is to increase the integration of elderly persons in societies in order to improve their quality of life. The case study demonstrates the enhancement of the capacity of the older people to remain actively engaged in their neighborhood. The article focuses on the creation of an autonomous community of empowered older people who can resolve their own problems after a 5-year project. The construction of the local community is presented throughout the six steps of the methodology: (1) preliminary analysis, (2) diagnostic, (3) construction, (4) project design, (5) project implementation, and (6) empowerment and with three degrees of involvement (community, participative, and integrative involvement). Performance and output indicators, quality indicators, and social determinants of health assess the development of the local project. The impacts of the projects which are illustrated in this specific example motivated this publication to inspire practitioners from other countries.

[The Citizen Committee as a co-management strategy in participatory research in the field of mental health in Quebec]

The theme of users' rights has become a central issue in contemporary debate on mental health. Drawing from the experiences of "Comitê Cidadão" (Citizen Committee), consisting of users and family members in an international research alliance between Brazil and Canada, an attempt is made to discuss the effects of the experience of co-management of the so-called Autonomous Medication Administration (GAM - Gestão Autônoma da Medicação) participatory research project on these individuals. By means of a detailed description of the background of the Committee and interviews and analysis of the voice transcriptions of its members, the problems raised by the relation of dialogue between scientific knowledge and users' knowledge are examined in a methodological approach of participatory research. As a result of the research, it was established that the experience of the Citizens Committee in co-management of health research can be propitious to the increase in the degree of autonomy, greater empowerment and the exercise of leadership and citizenship, with the consequent emergence of subjects with rights.

Internet use and the logics of personal empowerment in health

OBJECTIVES

The development of personal involvement and responsibility has become a strategic issue in health policy. The main goal of this study is to confirm the coexistence of three logics of personal empowerment through health information found on the Internet.

METHODS

A theoretical framework was applied to analyze personal empowerment from the user's perspective. A well-established Canadian Web site that offers information on personal health was used as a case study. A close-ended questionnaire was completed online by 2275 visitors and members of the Web site.

RESULTS

The findings confirm that the development of feelings of competence and control through Internet use is structured around three different logics. This implies three types of aptitudes that are fostered when the Internet is used to seek health information: doing what is prescribed (the professional logic), making choices based on personal judgment (the consumer logic), and mutual assistance (the community logic).

CONCLUSIONS

A recurring issue in three logics is the balance of roles and responsibilities required between the individual and the health provider.