Publications

Background: The number of people living with type 2 diabetes (T2D) is increasing worldwide. The prevalence rate of this disease is generally higher in the migrant population compared to the general population. However significant inequalities in the prevalence of T2D are notable between and within migrant populations. Among them, migrants from sub-Saharan Africa, South America and South Asia are more affected than those of European origin. The act of eating and the corporality play an essential role in the development of this disease. Dietary and body norms systems favorable to the prevention and control of type 2 go against what is vital for most of these people, exposing them to conflicts of norms that are difficult to reconcile. 

Objectif: to identify factors that may influence the acceptance or rejection of dietary and body norm systems favorable to the prevention and control of T2D by Sub-Saharan Africa migrants living with T2D. 

Materials and methods: Scoping review according to the steps described by Arksey and O’Malley (2005) will be conducted. An electronic search of studies from 2011 to 2022, published English, Italian, French or in Portuguese will be conducted in eight databases (CINAHL, Cochrane library, Embase, Google Scholar, PsycInfo, PubMed, Scopus, and Web of Sciences). The grey literature including publication in Open Grey database and Website of non-governmental organizations working on migrant from Sub-Saharan Africa will be searched. All articles related to body norms, dietary behaviors, or determinants of body behaviors and dietary of migrants from Sub-Saharan Africa and those related to factors that influence acceptance or rejection of dietary and body norms systems favorable to the prevention and control of T2D among the migrants from Sub-Saharan Africa living with T2D or at risk to develop this disease will be included. This scoping review will be reported following the Standard Protocol Items: Recommendations for interventional Trials (SPIRIT) and Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. 

Results: The results will focus on factors influencing the acceptance or rejection of dietary and body norms systems favorable to the prevention and control of T2D among the migrants from Sub-Saharan Africa living with T2D or at risk to develop it.

The COVID-19 pandemic highlighted the impact of social inequalities in health (SIH). Various studies have shown significant inequalities in mortality and morbidity associated with COVID-19 and the influence of social determinants of health. The objective of this qualitative case study was to analyze the consideration of SIH in the design of two key COVID-19 prevention and control interventions in France: testing and contact tracing. Interviews were conducted with 36 key informants involved in the design of the intervention and/or the government response to the pandemic as well as relevant documents (n = 15) were reviewed. We applied data triangulation and a hybrid deductive and inductive analysis to analyze the data. Findings revealed the divergent understandings and perspectives about SIH, as well as the challenges associated with consideration for these at the beginning stages of the pandemic. Despite a shared concern for SIH between the participants, an epidemiological frame of reference dominated the design of the intervention. It resulted in a model in which consideration for SIH appeared as a complement, with a clinical goal of the intervention: breaking the chain of COVID-19 transmission. Although the COVID-19 health crisis highlighted the importance of SIH, it did not appear to be an opportunity to further their consideration in response efforts. This article provides original insights into consideration for SIH in the design of testing and contact-tracing interventions based upon a qualitative investigation.

Digital technology offers several opportunities to improve access to professional expertise in primary care, and the offer of various “virtual” services has exploded in the past few years. The aim of this study was to evaluate the implementation of a direct-to-consumer on-line pharmacy consultation service (Ask Your Pharmacist – AYP) to a universal phone consultation service led by the universal public health system in Quebec (811 Info-Santé), through a direct bridge. Semi-structured interviews were conducted with clinician users of the service, and stakeholders involved in this pilot project funded by the Ministry of Economy (n = 22); documents were also analyzed, and content of the question was asked through the AYP service. Adoption of the service was low, and it suggests a poor alignment between the need and the service as implemented. Further research should investigate the mechanisms for an appropriate integration of digital services for primary care universal consultation services.

Background

Children in Afghanistan live in dangerous areas, and have been exposed to traumatic events and chaotic education. Progress has been made on access to education for girls who were the most affected by traditional attitudes against engagement in education.

Objectives

The objectives were to evaluate the mental health of Afghan children living in regions of conflict and the association of mental health with school attendance for girls and boys.

Method

The study included 2707 school aged children in eight regions of Afghanistan (16 provinces) residing in households recruited through a multi-stage stratified cluster sampling strategy in 2017. The level of terrorist threat was evaluated by the intensity of terrorist attacks recorded that year in each province. Child mental health was assessed with the parental report Strengths and Difficulties Questionnaire (SDQ) along with information on school attendance, sociodemographic characteristics and geographic location.

Results

A total of 52.75% of children had scores above threshold for the SDQ total difficulties score, 39.19% for emotional difficulties, 51.98% for conduct challenges, and 15.37% for hyperactivity/inattention. Peer relationship problems were high (82.86%) and 12.38% reported that these problems impacted daily life. The level of terrorist threat was associated with SDQ total difficulties (Adjusted Odds Ratio [AOR] = 4.08, P < 0.0001), with youth in regions with high levels of terrorist threat more likely to have problems than youth in regions with low or medium levels of danger, independent of region and ethnicity. School attendance was negatively associated with emotional symptoms (AOR = 0.65, P < 0.0001) and mental health difficulties with impairment (AOR = 0.67, P = 0.007), but positively associated with peer relationships difficulties (AOR = 1.96, P > 0.0001). Conduct (AOR = 1.66, P < .0001) and SDQ total difficulties (AOR = 1.22, P = 0.019) were higher among boys. Overall, gender did not modify the relationship between school attendance and child mental health.

Conclusion

Attending school is essential for children’s mental health, across gender, and should be supported as a priority in Afghanistan despite the return of the Taliban.

Case formulation is used in clinical training to weave together theoretical perspectives and support a shared plan of action. Although a cornerstone of clinical practice, critical social theorists have highlighted the risks of depoliticizing political struggles and of reifying and fixing subjects when using psychopathology and case formulation to address situations of injustice. In the field of violent radicalization, this risk is increased by the extreme affects evoked by terror in practitioners and in societies. This article explores the challenges of training clinicians in the field of violent radicalization. It does so by analyzing a Community of Practice (CoP) that was developed to support practitioners involved in this domain of practice in Quebec, Canada. Four focus groups with CoP participants and participant observation of nine CoP meetings were conducted. Thematic and narrative analyses were used to explore the training potential of the CoP and to identify the discursive processes and group dynamics associated with this modality. Results indicate that the diversity of professional perspectives and social positionalities in the group plays a central role in helping participants become aware of their biases and in developing more complex understandings of cases and of their social embedding. Results also suggest that the collective holding of risk is key to preserve practitioners’ investment in patients involved with violent radicalization. The sensitive issue of partnership between health and social services and security agencies is also addressed. Results suggest that CoPs with strong leadership allow for experiential training to enhance clinical and critical thinking.

Background: Wanting to offer culturally sensitive services to a diverse population, rehabilitation counsellors employed by a workers’ compensation board (WCB) in a Canadian province asked the researchers to provide them with support to develop their intercultural competencies. A collaborative research design was suggested as a potential way to make full use of experiential knowledge. This article presents an action research approach in which study participants were also active in the development of new knowledge and sought to become key players in organizational change. Objective: The objective of this article is to present the steps involved in the co-construction of an intercultural communication support tool and to describe the mechanisms and structure put in place to develop the tool. Methodology: A working group (WG), a steering committee (SC) and a validation group (VG) were created, and each met on a regular basis over approximately 18 months. Several methodological approaches and data collection tools were used: participant observation charts, diaries, an “intercultural situation” workshops. Results: A total of 28 people participated in the project, in addition to the three researchers. The study showed the importance of integrating three dimensions—the individual, collective, and organizational—into the definition of intercultural competence. It soon became evident in our study that a self-reflection process grounded in a collective learning approach was the core component of the entire process of developing intercultural competencies. This finding went well beyond the production of any materials (practical guides, checklists, and supporting documents) that resulted from this process.

Given the increasing value placed on research among social work practitioners, and that field education is primarily responsible for the integration of social work values, knowledge, and practice, it is essential that research skills be incorporated into BSW and MSW field practica. In 2020, a team of faculty co-investigators and students explored the integration of research activities into Canadian BSW and MSW field practica through the review of online field education materials of all accredited programs. We make the argument that not only is it essential for professional social workers to receive training in practice research, but also that there is much room for us to integrate such research into field education. We begin with a review of the literature regarding social work student attitudes toward research, widely known to be hesitant and even hostile, before discussing the limited international literature (English and French) on the experience of integrating research into field education. After describing our methods, we then present our findings in terms of BSW and MSW programs at Canada’s anglophone and francophone universities. We conclude with a discussion of the implications in terms of ways to increase the role of research in field practica.

Accumulation of diverse mutations across the structural and nonstructural genes is leading to rapid evolution of SARS-CoV-2, altering its pathogenicity. We performed whole genome sequencing of 239 SARS-CoV-2 RNA samples collected from both adult and pediatric patients across eastern India (West Bengal), during the second pandemic wave in India (April–May 2021). In addition to several common spike mutations within the Delta variant, a unique constellation of eight co-appearing non-Spike mutations was identified, which revealed a high degree of positive mutual correlation. Our results also demonstrated the dynamics of SARS-CoV-2 variants among unvaccinated pediatric patients. 41.4% of our studied Delta strains harbored this signature set of eight co-appearing non-Spike mutations and phylogenetically out-clustered other Delta sub-lineages like 21J, 21A, or 21I. This is the first report from eastern India that portrayed a landscape of co-appearing mutations in the non-Spike proteins, which might have led to the evolution of a distinct Delta subcluster. Accumulation of such mutations in SARS-CoV-2 may lead to the emergence of “vaccine-evading variants.” Hence, monitoring of such non-Spike mutations will be significant in the formulation of any future vaccines against those SARS-CoV-2 variants that might evade the current vaccine-induced immunity, among both the pediatric and adult populations.

This study documents immigrant men’s use of Quebec healthcare and social services. It begins by sketching a portrait of the physical health and psychological well-being of these men. It then looks at their use (or non-use) of these services and explores both the barriers they encounter while trying to access services and factors facilitating their use of services. Finally, it examines the expectations and perceptions immigrant men have of these services. Transversally, the impact of the COVID-19 pandemic and confinement measures on the various sub-themes was specifically examined, since all of the data was collected in the context of the pandemic.

Extract

In the fight against infectious diseases, social inequalities in health (SIH) are generally forgotten. Mali, already weakened by security and political unrest, has not been spared by the COVID-19 pandemic. Although the country was unprepared, the authorities were quick to implement public health measures, including a SARS-CoV-2 testing programme. This study aimed to understand if and how social inequalities in health were addressed in the design and planning for the national COVID-19 testing policy in Mali. A qualitative survey was conducted between March and April 2021 in Bamako, the capital of Mali. A total of 26 interviews were conducted with key government actors and national and international partners. A document review of national reports and policy documents complemented this data collection. The results demonstrated that the concept of SIH was unclear to the participants and was not a priority. The authorities focused on a symptom-based testing strategy that was publicly available. Participants also mentioned some efforts to reduce inequalities across geographical territories. The reflection and consideration of SIH within COVID-19 interventions was difficult given the governance approach to response efforts. The urgency of the situation, the perceptions of COVID-19 and the country’s pre-existing fragility were factors limiting this reflection. Over time, little action has been taken to adapt to the specific needs of certain groups in the Malian population. This study (re)highlights the need to consider SIH in the planning stages of a public health intervention, to adapt its implementation and to limit the negative impact on SIH.

ABSTRACT

The association of ideologically motivated violence with mental health disorders raises spe-cific challenges for security agencies and clinical services. The aim of this paper is todescribe the clientele of a specialized intervention program based in Montreal, Quebec, interms of type of violent ideology and clinical presentation. We conducted a retrospectivechart review of 156 individuals referred for violent extremism who received clinical servicesbetween 2016 and 2021. Univariate statistics were used to present a description of clientsociodemographic and clinical characteristics. Roughly a third of clients referred for violentextremism presented non-ideologically based violence (32.6%), followed by 31.4% affiliatedwith far-right extremist ideology and over a quarter (25.6%) holding extremist views on gen-der. Over a third of these individuals had a stress-related (35.7%) and/or mood and anxietydisorder (36.9%), followed by 28% with an autism spectrum disorder diagnosis. The majorityhad some previous contact with mental health services. A significant number of clients dis-playing extremist discourses and/or actions needed psychiatric services but often failed toreceive them because of the reluctance of clinicians to work with individuals perceived ashigh risk; in addition, individuals may be reluctant to engage in services perceived to bepart of a socio-political system they reject. Specialized services are important as a means toprovide mental health care to this group and also to develop knowledge and best practicesfor working with this clientele and provide consultation to mainstream mental health serviceproviders.

KEYWORDS

Violent extremism; clinicalservices; mental health care;specialized intervention

Abstract

Purpose

To elicit stakeholder perspectives on the findings from our scoping review on youth participation in mental health policymaking, we conducted a global consultation with young people and adults directly involved in mental health policymaking.

Method

Forty-four stakeholders from 16 countries, including 15 young people, 9 policymakers and 20 facilitators of youth participation, took part in individual interviews and/or focus groups. They were asked about how the review findings contrasted with their own experiences in mental health policymaking. The transcribed data were thematically analyzed.

Results

All participants viewed lived experience as valuable in identifying policy gaps. Youth pointed out that children and youth with disabilities, diverse sexual orientations, and/or gender identities were often excluded, and spoke about feelings of being an “accessory”, illustrating a lack of power-sharing in a tokenized policymaking process. Adult participants’ accounts highlighted the challenges inherent in policymaking such as the need for political knowledge and institutional time constraints. A range of cultural, socio-economic, and political barriers to youth participation, that were often context-specific, were identified.

Conclusions

The diverse perspectives of stakeholders extended the review results. Based on our findings, we recommend that adults and institutions: (1) recognize lived experience as expertise in shaping mental health policies; (2) include diverse groups; (3) reduce tokenistic relationships through the creation of safer spaces, adult feedback, co-production, and social accountability; and (4) adopt an intersectional approach to address cultural, socio-economic, and political barriers to participation. Methodologically, our work demonstrates why stakeholder consultations are an essential component of scoping reviews.

Introduction : Au Burkina Faso, le manque d’études sur les itinéraires thérapeutiques en santé mentale limite la compréhension des obstacles associés au recours aux soins. Comme dans plusieurs pays d’Afrique subsaharienne, cette situation se traduit par une difficulté des systèmes de santé à adapter l’offre de soins disponible à la réalité des personnes souffrant de troubles mentaux.
But de l’étude : Dans cette étude, des observations participantes ont été faites ; sept groupes de discussion et 25 entretiens individuels ont ainsi été organisés afin d’explorer les représentations sociales et l’utilisation des soins existants en santé mentale. Différents acteurs ont été interrogés : patients, soignants, accompagnants et informateurs clés.
Résultats : Une analyse thématique a révélé la présence de trois systèmes de soins dans la ville de Bobo-Dioulasso : 1) les soins psychiatriques associés à une fonction diagnostique et à la prise en charge de pathologies graves ou déclenchées par des causes « naturelles », 2) les soins traditionnels perçus comme ayant une fonction de guérison pour les pathologies « surnaturelles », mais associés à un risque d’escroquerie, et 3) les soins informels prodigués par la famille identifiés comme représentant le pilier des itinéraires thérapeutiques.
Conclusions : Cette étude révèle qu’à travers la diversité des ressources consultées, l’entourage direct représente le principal pourvoyeur de soins et que les contraintes financières constituent l’obstacle principal aux recours aux soins. Ce constat nous amène à formuler des recommandations relatives à l’élaboration d’éventuelles politiques publiques à l’échelle nationale ainsi qu’à l’organisation des services de santé dans la ville de Bobo-Dioulasso.

Le projet de recherche-action à l’origine de ce bilan est né d’une collaboration entre le Regroupement pour la Valorisation de la Paternité (RVP) et l’Institut universitaire SHERPA. Il a pour objectif de sensibiliser et d’outiller les organismes communautaires (organismes de soutien à la famille et organismes d’accueil des immigrants) à l’adaptation de leurs services afin de mieux rejoindre et de mieux répondre aux besoins des pères issus de l’immigration.
Ce bilan présente une synthèse des principaux résultats obtenus dans le cadre de ce projet qui a été mené dans le Grand Montréal entre octobre 2020 et avril 2022.

We sought to determine the association between SES and glycemic control in children with type 1 diabetes (T1D) followed at the Montreal Children’s Hospital (MCH), and whether insulin pump use, processes of care and depression modified the association. Using MCH’s Pediatric Diabetes Database, we conducted a retrospective cohort study of children ages 0 to 18 years diagnosed with T1D for at least a year with a visit between November 2019 and October 2020. Our outcome was mean glycated hemoglobin (HbA1c) in the following year. Our main exposure was socioeconomic status (SES; least deprived, moderately deprived, most deprived) measured by the Material and Social Deprivation Index. We used multivariable linear regression to determine the association between SES and HbA1c, adjusting for age, sex, diabetes duration, insulin pump use and processes of care. Interaction terms for insulin pump, processes of care and depression were included. A total of 306 children were identified. Children in the most deprived quintiles had higher mean HbA1c compared to those in the least deprived quintiles (p<0.01). HbA1c in the most deprived quintiles was 0.5% higher compared to the least deprived quintiles (95% confidence interval, 0.14 to 0.86). Effect modification by insulin pump, processes of care and depression was not significant. Consistent with previous findings, lower SES was associated with higher HbA1c. Our results are important for further research to understand contributing factors to these disparities.

La pandémie de maladie à coronavirus 2019 (COVID-19) a exacerbé les inégalités sociales dans les aspects ethniques, raciaux et socio-économiques, avec d’importantes conséquences nocives pour les enfants. En s’appuyant sur les leçons tirées des initiatives communautaires, le présent commentaire propose une réflexion sur les défis de l’équité, de la diversité et de l’inclusion qui sont intégrés dans les campagnes de vaccination des enfants dans un contexte d’urgence. Nous sommes d’avis que la mise en place de pratiques équitables et inclusives liées à la vaccination des enfants des communautés marginalisées est un défi à multiples facettes. Au-delà des bonnes intentions (vouloir protéger les enfants), les risques et les avantages associés à la mise en évidence de la diversité dans chaque intervention doivent être soigneusement examinés, surtout en ce qui concerne une procédure contestée ou polarisée, comme la vaccination avec un nouveau type de vaccin. Souvent, une approche unique réfute et perpétue les inégalités structurelles. Dans d’autres cas, la mise en évidence de la diversité et des inégalités peut par inadvertance accroître la stigmatisation et la discrimination, et nuire davantage ou infantiliser les collectivités ciblées. En offrant des perspectives multiples, une approche transdisciplinaire peut appuyer la prise de décision dans un contexte de crise.

Mots-clés : santé et médecine des adolescents, services de santé communautaires, santé des minorités, équité et inclusion

Keywords: Quality Lessons Learned (QLLs); Quebec; Hospitals’ Resilience; COVID-19 pandemic project

Background

Refugees, asylum seekers, and migrants without status experience precarious living and working conditions which disproportionately expose them to COVID-19. In the two most populous Canadian provinces (Quebec and Ontario), to reduce the vulnerability factors experienced by the most marginalized migrants, the public and community sectors engage in joint coordination efforts called intersectoral collaboration. This collaboration ensures holistic care provisioning, inclusive of psychosocial support, assistance to address food security, as well as educational and employment assistance. This research project explores how community and public sectors collaborated on intersectoral initiatives during the COVID-19 pandemic to support refugees, asylum seekers, and migrants without status in cities of Montreal, Sherbrooke, and Toronto, and generates lessons for a sustainable response to the heterogeneous needs of these migrants.

Methods

This theory-informed participatory research is co-created with socio-culturally diverse research partners (refugees, asylum seekers and migrants without status, employees of community organizations, and employees of public organizations). We will utilize Mirzoev and Kane’s framework on health systems’ responsiveness to guide the 4-phases of a qualitative multiple case study (a case being an intersectoral initiative). These phases will include, 1) building an inventory of intersectoral initiatives developed during the pandemic, 2) organizing a deliberative workshop with representatives of the study population, community and public sectors respondents to select and validate the intersectoral initiatives, 3) interviews (n = 80) with community and public sector frontline workers and managers, municipal/regional/provincial policymakers and employees of philanthropic foundations 4) focus groups (n = 80) with refugees, asylum seekers, and migrants without status. Qualitative data will be analyzed using thematic analysis. The findings will be used to develop discussion forums to spur cross-learning among service providers.

Discussion

This research will highlight the experiences of community and public organizations in their ability to offer responsive services for refugees, asylum seekers, and migrants without status in the context of a pandemic. We will draw lessons learnt from the promising practices developed in the context of COVID-19, to improve services beyond times of crisis. Lastly, we will reflect upon our participatory approach – particularly in relation to the engagement of refugees and asylum seekers in the governance of our research.

Introduction

UNICEF estimates that there are as many as 100 million street-involved youth (SIY) globally. Marginalized conditions put SIY at higher risk of HIV and adverse outcomes once HIV-positive. The objective of this analysis was to describe barriers and facilitators of accessing HIV prevention, testing, and treatment services as Phase I of an implementation study evaluating the use of peer navigators to increase access to HIV services.

Methods

Semi-structured interviews, focus group discussions (FGD), and theatre testing were conducted with individuals who identify as SIY, health care providers, and community stakeholders living in Canada (Toronto, Montreal, London) and Kenya (Eldoret, Huruma, Kitale). Data were analyzed using a directed content approach, guided by the socio-ecological model (SEM).

Results

Across the six sites were 195 participants: 64 SIY, 42 healthcare providers, and 97 community-based stakeholders. Barriers were identified at the societal (e.g. intersectional stigma and discrimination), public policy (e.g., inadequate access to basic needs, legal documentation, lack of health insurance, and limited community-based funding), institutional (e.g. lack of inclusive education and training, inadequate HIV educational outreach, and restrictive service provision), interpersonal (e.g., ineffective communication from healthcare providers), and intrapersonal levels (e.g. lack of trust and associated fear, low perception for healthcare, and lack of self-esteem). These contributed to limited HIV services utilization among SIY. Conversely, numerous facilitators were also identified at the public policy (e.g. affordable HIV services and treatment), institutional (e.g. available and accessible HIV prevention tools, HIV education and awareness programs, and holistic models of care), interpersonal level (e.g., systems navigation support, peer support, and personal relationships), and intrapersonal levels (e.g. self-efficacy) as positively supporting SIY access to HIV services.

Conclusion

Intersectional stigma was a critical barrier in all sites, and policies and programs that foster welcoming environments for youth from diverse backgrounds and living circumstances may be better able to respond to the HIV service needs of this high risk population. Social support and navigation services were reported to facilitate access to HIV services in all sites.

L’implantation de réseaux de services intégrés jeunesse (RSIJ) au Québec et ailleurs dans le monde témoigne de la volonté des décideurs de répondre de façon efficace aux problématiques de santé globale des jeunes de 12 à 25 ans. Cette évaluation a eu pour objectif d’analyser le contexte de mise en œuvre et l’efficacité de ce modèle. Les questions d’évaluation s’articulaient autour des facilitateurs et des obstacles à la mise en œuvre d’un RSIJ; son efficacité (sur le plan de l’amélioration de l’état de santé et du bienêtre des jeunes et de leur trajectoire) et de son efficience (coûts-avantages, coûts-efficacité; coûts-utilité). L’évaluation s’intéressait également aux variations éventuelles de la mise en œuvre et de l’efficacité dans le cas où les services sont offerts à des jeunes de la diversité ethnoculturelle. Cinq réseaux de services intégrés à l’international ont été étudiés (headspace, Australie; Youth One-Stop Shop, Nouvelle-Zélande; Jigsaw, Irlande; Foundry, Canada; Prépsy, France). La revue de la littérature systématique a permis, entre autres, d’identifier neuf (9) composantes clés dans la mise en œuvre et la prestation des services dans les RSIJ qui ont été validées en consultation avec les jeunes et des intervenants.

This is the protocol for a Campbell systematic review. The main objective of this project is to gather, critically appraise, and synthesize evidence about the appropriateness and utility of tools used to assess the risk of violent radicalization.

Summary

Objectives: The aim of this issue of the journal is to study the way in which “making a family” influences access to rights and the integration of migrant families in Europe (France, Germany), North America (Quebec) and Djibouti, from Yemen, Syria, Tunisia, Mozambique or Brazil. Similarly, and reciprocally, he is interested in the impact of law on family experiences in a migratory context.

Methodology: The ethnographic observation approach, through the cross-referenced collection of life stories and the reconstruction of the life contexts of these migrants (while respecting their words and their anonymity) makes it possible to discover, sometimes in a counter-intuitive way, the effects of the policies on their lives.

Results: It often happens that within the same migrant family the legal status of its members is different, and therefore their rights to be regularised or not. As a result, these families – and more broadly, entire groups of migrants – have to carry out important work in terms of information for access to residence rights, work, access to schooling for their children, health, nationality, etc. Nothing is guaranteed a priori. Nothing is guaranteed a priori.

Conclusion: We can imagine how much migration will continue in the face of climate change and political unrest throughout history. It is likely that a policy evaluation approach, or lack thereof, by those affected, will be increasingly necessary in the future.

Contribution: This thematic issue of the journal Enfances Familles Générations highlights, from a historical and comparative approach, the impact of the legitimacy of being part of the national community to which these men and women have migrated (Destremau, 2022).

The health context surrounding the COVID-19 pandemic has led to significant individual and social upheaval, which has also affected traditional teaching methods. Art therapy training was not spared, notably at the Université du Québec en Abitibi-Témiscamingue (UQAT). UQAT adopts an experiential teaching approach that engages students in a process that promotes the optimal acquisition of the skills inherent to the ethical exercise of the profession, allowing them to take the position of art therapist, in contact with their peers, while emotionally integrating the learning achieved. As the pandemic context forced a rapid shift to distance learning, the authors wanted to put into perspective the potential effects of virtual art therapy teaching on the development of female art therapy students’ sense of self-efficacy (SSE). To do this, they base their reflection on the results of surveys conducted among students and graduates as part of the evaluation of the master’s program in art therapy. Since experiential distance learning implies limitations in terms of emotional experience and actual contact with peers, it is justified to question the effects that these changes will have on trainees’ SSE.

Abstract

L’implantation de réseaux de services intégrés jeunesse (RSIJ) au Québec et ailleurs dans le monde témoigne de la volonté des décideurs de répondre de façon efficace aux problématiques de santé globale des jeunes de 12 à 25 ans. Cette évaluation a eu pour objectif d’analyser le contexte de mise en œuvre et l’efficacité de ce modèle. Les questions d’évaluation s’articulaient autour des facilitateurs et des obstacles à la mise en œuvre d’un RSIJ; son efficacité (sur le plan de l’amélioration de l’état de santé et du bienêtre des jeunes et de leur trajectoire) et de son efficience (coûts-avantages, coûts-efficacité; coûts-utilité). L’évaluation s’intéressait également aux variations éventuelles de la mise en œuvre et de l’efficacité dans le cas où les services sont offerts à des jeunes de la diversité ethnoculturelle. Cinq réseaux de services intégrés à l’international ont été étudiés (headspace, Australie; Youth One-Stop Shop, Nouvelle-Zélande; Jigsaw, Irlande; Foundry, Canada; Prépsy, France). La revue de la littérature systématique a permis, entre autres, d’identifier neuf (9) composantes clés dans la mise en œuvre et la prestation des services dans les RSIJ qui ont été validées en consultation avec les jeunes et des intervenants.

Low enrolment in micro-health insurance (MHI) schemes is a recurring issue affecting the viability of such schemes. Beyond the efforts addressing low subscription and retention in these schemes, little is known on how social representations are related to micro-health insurance schemes enrolment and retention. This scoping review aimed at exploring the role of social representations in shaping enrollment and retention in MHI in sub-Saharan Africa. We reviewed qualitative, quantitative and mixed methods studies conducted between 2004 and 2019 in sub-Saharan Africa. We limited our search to peer-reviewed and grey literature in English and French reporting on social representations of MHI. We defined social representations as conventions, cultural and religious beliefs, local rules and norms, local solidarity practices, political landscape and social cohesion. We applied the framework developed by Arksey and O’Malley and modified by Levac et al. to identify and extract data from relevant studies. We extracted information from a total of 78 studies written in English (60%) and in French (40%) of which 56% were conducted in West Africa. More than half of all studies explored either cultural and religious beliefs (56%) or social conventions (55%) whereas only 37% focused on social cohesion (37%). Only six papers (8%) touched upon all six categories of social representation considered in this study whereas 25% of the papers studied more than three categories. We found that all the studied social representations influence enrollment and retention in MHI schemes. Our findings highlight the paucity of evidence on social representations in relation to MHI schemes. This initial attempt to compile evidence on social representations invites more research on the role those social representations play on the viability of MHI schemes. Our findings call for program design and implementation strategies to consider and adjust to local social representations in order to enhance scheme attractiveness.